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1

Haemorrhagic septicaemia vaccines  

Microsoft Academic Search

Haemorrhagic septicaemia (HS), an economically important disease of cattle and buffaloes, is caused by Pasteurella multocida (6:B). Vaccination against this disease is widely practised. Plain broth bacterins, or alum precipitated and aluminium hydroxide gel vaccines are administered twice a year since these vaccines offer an immunity of 4–6 months. Many countries use oil adjuvant vaccine (OAV), which gives both a

Rishendra Verma; T. N. Jaiswal

1998-01-01

2

Haemorrhagic septicaemia vaccines.  

PubMed

Haemorrhagic septicaemia (HS), an economically important disease of cattle and buffaloes, is caused by Pasteurella multocida (6:B). Vaccination against this disease is widely practised. Plain broth bacterins, or alum precipitated and aluminium hydroxide gel vaccines are administered twice a year since these vaccines offer an immunity of 4-6 months. Many countries use oil adjuvant vaccine (OAV), which gives both a higher degree and a longer duration of immunity up to 1 year. A double emulsion and multiple emulsion vaccine consisting of a thin viscosity have also been experimentally developed that gave an immunity parallel to OAV. Recently, a live vaccine developed from a fallow deer strain (B:3,4) has been used in Myanmar that offers an immunity for more than a year but is not free from constraints. The present review provides information on HS vaccines developed from time to time using whole bacteria or their components. The kinetics and isotype of antibody and cell-mediated immune responses have also been poorly understood so far, and hence information on their role in protection against HS is reviewed. PMID:9682378

Verma, R; Jaiswal, T N

1998-07-01

3

Selective breeding provides an approach to increase resistance of rainbow trout ( Onchorhynchus mykiss) to the diseases, enteric redmouth disease, rainbow trout fry syndrome, and viral haemorrhagic septicaemia  

Microsoft Academic Search

In this study, we reasoned that if we challenged rainbow trout with the causative agents of enteric redmouth disease (ERM), rainbow trout fry syndrome (RTFS), and viral haemorrhagic septicaemia (VHS), we would: 1) detect additive genetic variation for resistance to ERM, RTFS, and VHS; and 2) find that resistance of the trout to ERM and RTFS are favourably correlated genetically,

Mark Henryon; Peer Berg; Niels J. Olesen; Torben E. Kjær; Wilhelmina J. Slierendrecht; Alfred Jokumsen; Ivar Lund

2005-01-01

4

Prevention of experimental haemorrhagic septicaemia with a live vaccine  

Microsoft Academic Search

Pasteurella multocida serotype B:3,4 isolated from a fallow deer in England was used as a vaccine to prevent haemorrhagic septicaemia. The deer strain was less virulent for calves than typical serotype B:2 of haemorrhagic septicaemia strains. It elicited antibodies in cattle that protected mice against serotype B:2 infection. The live deer vaccine containing 2 X 10(7) viable organisms per dose

A Myint; GR Carter; TO Jones

1987-01-01

5

Observations on haemorrhagic septicaemia in Pakistan livestock.  

PubMed

Information based on field observations of Veterinary Officers in nine districts of Punjab, Pakistan showed 11% incidence, 9% mortality and 78% case fatality rates of haemorrhagic septicaemia in buffalo, whereas these values were 4%, 2.5% and 62% in cattle. Disease incidence was higher in 0-24-month-old animals and groups of less than 10 animals. The disease was seasonal, occurring only in rainy seasons of the year, and victims were only cattle and buffalo. The clinical course of the disease was generally 1-2 days. symptoms included high temperature, salivation, swelling of the throat and difficulty in breathing and could result in death. Successful treatment was reported if antibiotics were given at the initial stages of the disease. Various combinations of sulphur drugs and antibiotics were considered more effective. The results of the questionnaire survey suggest that a favourable response was obtained using clamoxyl LA, farmox 15%, vesulong, gentakel and chloramphenicol. Previous vaccination of livestock with the alum-precipitated formalinized broth culture of Pasteurella multocida vaccine (bacterin) was not considered to protect against field outbreaks. PMID:8779811

Sheikh, M A; Anzam, M; Shakoori, A R

1996-07-01

6

Trade practices are main factors involved in the transmission of viral haemorrhagic septicaemia.  

PubMed

Viral haemorrhagic septicaemia (VHS), caused by the novirhabdovirus viral haemorrhagic septicaemia virus (VHSV), causes significant economic problems to European rainbow trout, Oncorhynchus mykiss (Walbaum), production. The virus isolates can be divided into four distinct genotypes with additional subgroups. The main source of outbreaks in European rainbow trout farming is sublineage Ia isolates. Recently, this group of isolates has been further subdivided in to two subclades of which the Ia-2 consists of isolates occurring mainly in Continental Europe outside of Denmark. In this study, we sequenced the full-length G-gene sequences of 24 VHSV isolates that caused VHS outbreaks in Polish trout farms between 2005 and 2009. All these isolates were identified as genotype Ia-2; they divided however into two genetically distinct subgroups, that we name Pol I and Pol II. The Pol I isolates mainly caused outbreaks in the southern part of Poland, while Pol II isolates predominantly were sampled in the north of Poland, although it seems that they have been transmitted to other parts of the country. Molecular epidemiology was used for characterization of transmission pathways. This study shows that a main cause of virus transmission appears to be movement of fish. At least in Polish circumstances trading practices appear to have significant impact on spreading of VHSV infection. PMID:23020691

Reichert, M; Matras, M; Skall, H F; Olesen, N J; Kahns, S

2012-09-30

7

Reverse transcription loop-mediated isothermal amplification (RT-LAMP) for rapid detection of viral hemorrhagic septicaemia virus (VHS)  

Microsoft Academic Search

A one step reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay was developed for detection of viral hemorrhagic septicaemia virus (VHS). A set of six primers were designed, based on the G-protein sequence of the VHS virus serotypes (He, F1, 23.75, Klapmolle and Rindsholm). The assay was optimised to amplify VHS RNA by incubation at 63°C for only 1h, and required

H. Soliman; M. El-Matbouli

2006-01-01

8

Prevention of experimental haemorrhagic septicaemia with a live vaccine.  

PubMed

Pasteurella multocida serotype B:3,4 isolated from a fallow deer in England was used as a vaccine to prevent haemorrhagic septicaemia. The deer strain was less virulent for calves than typical serotype B:2 of haemorrhagic septicaemia strains. It elicited antibodies in cattle that protected mice against serotype B:2 infection. The live deer vaccine containing 2 X 10(7) viable organisms per dose was used to immunise calves. Six months after vaccination, five of six calves were protected against serotype B:2 challenge. Two calves challenged nine months after vaccination survived the same challenge. The live vaccine was more efficacious than an alum precipitated vaccine in protecting calves against B:2 challenge. PMID:3111071

Myint, A; Carter, G R; Jones, T O

1987-05-23

9

Immunity provided by haemorrhagic septicaemia-subunit vaccine in ruminants.  

PubMed

A subunit vaccine against haemorrhagic septicaemia (HS), the principal killer disease in ruminants, especially cattle and carabao, in the Philippines, has been developed. Using capsules of Pasteurella multocida Group B as an active component of the vaccine, it gave solid protection against challenge with live organism in mice. An active calf protection test showed that in 24 hours, animals vaccinated with plain saline died after challenge compared to those given the subunit vaccine which survive the challenge dose. Using 104 cattle from a farm, the field trial of the HS subunit vaccine showed that the antibody titre was high for up to 14 months. A high titer is an indication of protection. PMID:9554285

Maslog, F S

1998-01-01

10

Risks associated with commodity trade: transmission of viral haemorrhagic septicaemia virus (VHSV) to rainbow trout fry from VHSV-carrying tissue-homogenates.  

PubMed

Movements of commodity fish present a potential risk of transferring pathogens. Within a study to estimate the risk from imported rainbow trout Oncorhynchus mykiss carcases, fry were exposed to tissue homogenates from market size rainbow trout infected experimentally with viral haemorrhagic septicaemia (VHS) by waterborne exposure to VHS virus (VHSV, isolate of genotype Ia). Tissues were collected from fish that showed clinical signs and from recent mortalities. Homogenates of (i) internal organs, (ii) brain/gills and (iii) muscle tissue were prepared and added to tanks holding the fry. Virus transmission occurred from all tissues tested, causing high mortality of the fry. The results underline the potential risk of introduction of VHSV through the trade of fish products. PMID:21223535

Oidtmann, B; Joiner, C; Reese, R A; Stone, D; Dodge, M; Dixon, P

2011-01-12

11

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

USGS Publications Warehouse

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.

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

2013-01-01

12

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

13

Genotype-specific Taqman® assays for the detection and rapid characterisation of European strains of viral haemorrhagic septicaemia virus.  

PubMed

Viral haemorrhagic septicaemia virus (VHSV) is the agent of a disease that causes mortality events in marine and freshwater fish. It is one of the most important pathogens in European rainbow trout (Oncorhynchus mykiss) aquaculture. Four major genotypes of the virus are recognised reflecting different geographic and host ranges. Genotyping of VHS isolates is important for disease management enabling monitoring of disease spread into new geographical regions or susceptible species. This study sought to develop molecular tools for rapid and efficient classification of European VHSV genotypes. Specificity of genotype-specific real-time reverse transcription polymerase chain reaction (RT-qPCR) assays targeting the viral nucleoprotein (N) gene was tested using 66 viral isolates. All designed Taqman(®) RT-qPCR assays were genotype specific, displayed a high sensitivity and together constituted a diagnostic method for the rapid discrimination of European VHSV genotypes. Practical diagnostic applications of such assays demonstrated in this study include: (1) rapid genotype determination of isolates; and (2) identification of mixed-genotype isolates originating from pooled samples in areas where genotype distribution is known to overlap. However, the most important application will be supporting international VHSV surveillance programmes through the provision of a rapid specific and sensitive isolate characterisation method. PMID:23089575

Bland, Fiona; Snow, Michael; Garver, Kyle A; Matejusova, Iveta

2012-10-23

14

An outbreak of haemorrhagic septicaemia (septicaemic pasteurellosis) in cattle in Zimbabwe  

Microsoft Academic Search

An outbreak of haemorrhagic septicaemia caused byPasteurella multocida in beef cattle in Zimbabwe grazing effluent-irrigated pastures, is described. The outbreak occurred during the wet summer months and predisposing stress factors included excessive rainfall and unusual cold weather during the preceeding month. History, clinical features and post-mortem findings were consistent with reports of the disease from other countries, except that meningitis

N. D. Kock; F. W. G. Hill; K. Mohan

1992-01-01

15

Protection against haemorrhagic septicaemia induced by vaccination of buffalo calves with an improved oil adjuvant vaccine  

Microsoft Academic Search

An experimental oil adjuvant vaccine was developed against haemorrhagic septicaemia, a disease of cattle and buffalo caused by Pasteurella multocida serotype B and E. Mineral oil, Mercol 52, was used as adjuvant together with Span 85 and Tween 85 as emulsifiers. The vaccine was evaluated by single dose intramuscular immunisation of 1–2 year old buffalo calves. IgG and IgM class

Najmul H. Shah; Nasir H. Shah; Frits K. de Graaf

1997-01-01

16

Safety, efficacy and cross-protectivity of a live intranasal aerosol haemorrhagic septicaemia vaccine  

Microsoft Academic Search

The safety, efficacy and cross-protectivity of a live intranasal aerosol haemorrhagic septicaemia vaccine containing Pasteurella multocida serotype B:3,4 were tested in young cattle and buffaloes in Myanmar, where more than 1?5 million animals had been inoculated with this vaccine between 1989 and 1999. A recommended dose of 2 × 107 viable organisms was used for the efficacy test. The administration

A. Myint; H. H. Nyunt; T. O. Jones

2005-01-01

17

Protection against haemorrhagic septicaemia induced by vaccination of buffalo calves with an improved oil adjuvant vaccine.  

PubMed

An experimental oil adjuvant vaccine was developed against haemorrhagic septicaemia, a disease of cattle and buffalo caused by Pasteurella multocida serotype B and E. Mineral oil, Mercol 52, was used as adjuvant together with Span 85 and Tween 85 as emulsifiers. The vaccine was evaluated by single dose intramuscular immunisation of 1-2 year old buffalo calves. IgG and IgM class antibodies were determined by ELISA. The group of animals immunised with the experimental oil adjuvant vaccine showed a high titre of the IgG class of antibodies measured at 300 days post vaccination. To compare the protective efficacy of the vaccine with the commonly used broth bacterin, another group of buffalo calves was immunised by broth bacterin. This group showed a low level of IgG antibodies. Protection was assessed by challenge with 10(9) viable bacteria of P. multocida type B:2,5 administered subcutaneously, 250 days post vaccination. Animals vaccinated with the experimental oil adjuvant vaccine were fully protected. The other groups of animals, vaccinated with broth bacterin or used as control (non-vaccinated), developed symptoms of haemorrhagic septicaemia. A strong relationship between IgG but not IgM class antibody level and resistance to challenge was observed. The experiment demonstrated that the experimental oil adjuvant vaccine was superior to broth bacterin in providing protection against experimental haemorrhagic septicaemia in young buffalo calves beyond 250 days. PMID:9351202

Shah, N H; Shah, N H; de Graaf, F K

1997-10-15

18

An outbreak of haemorrhagic septicaemia (septicaemic pasteurellosis) in cattle in Zimbabwe.  

PubMed

An outbreak of haemorrhagic septicaemia caused by Pasteurella multocida in beef cattle in Zimbabwe grazing effluent-irrigated pastures, is described. The outbreak occurred during the wet summer months and predisposing stress factors included excessive rainfall and unusual cold weather during the preceding month. History, clinical features and post-mortem findings were consistent with reports of the disease from other countries, except that meningitis was also a constant feature. Morbidity approached 77% and mortality 5 per cent. Prophylactic treatment and vaccination with a killed bacterin together with a return of warmer and drier weather were probably important in halting the outbreak. PMID:1305340

Lane, E P; Kock, N D; Hill, F W; Mohan, K

1992-05-01

19

Phylogenetic analysis of viral haemorrhagic septicaemia virus (VHSV) isolates from France (1971-1999).  

PubMed

The nucleotide sequences of a specific region of the glycoprotein gene were compared among 63 strains of viral haemorrhagic septicaemia virus (VHSV) isolated from fish in France between 1971 and 1999. The analysis was performed on a region corresponding to amino acids 238 to 331 of the glycoprotein gene, also designated the V2 region and previously shown to accumulate most of the mutations. The sequences of many VHSV isolates were found to be identical or very conserved. An isolate, designated L59X, obtained from elver in the Loire estuary, depicted a higher degree of divergence compared to the other French isolates. The deduced amino-acid sequences were analysed together with the results of neutralisation tests performed using monoclonal antibody 168m4 specific to serotype 1. Non-neutralised VHSV strains had mutations in the region corresponding to the previously described 168m4 epitope. Phylogenetic analysis showed that all the VHSV isolates studied, except L59X, belong to genotype I, previously described as containing VHSV strains isolated from continental Europe. Most of the VHSV isolates studied were found to be genetically related to one of the previously described VHSV strains representative of the major serotypes. Isolate L59X, which was the only French marine strain studied, was found to belong to genotype II, previously shown to encompass the VHSV strains isolated from the British Isles coastal waters. Overall there was a good correlation between the geographical origin of the studied isolates and their genetic characteristics. PMID:12517003

Thiéry, R; de Boisséson, C; Jeffroy, J; Castric, J; de Kinkelin, P; Benmansour, A

2002-11-01

20

Safety, efficacy and cross-protectivity of a live intranasal aerosol haemorrhagic septicaemia vaccine.  

PubMed

The safety, efficacy and cross-protectivity of a live intranasal aerosol haemorrhagic septicaemia vaccine containing Pasteurella multocida serotype B:3,4 were tested in young cattle and buffaloes in Myanmar, where more than 1.5 million animals had been inoculated with this vaccine between 1989 and 1999. A recommended dose of 2 x 10(7) viable organisms was used for the efficacy test. The administration of 100 times the recommended dose to 50 cattle and 39 buffalo calves was innocuous. Seven months after they were vaccinated, three of three buffaloes were protected and 12 months after they were vaccinated, three of four buffaloes were protected against a subcutaneous challenge with serotype B:2 which killed three of three unvaccinated buffaloes. Twelve months after they were vaccinated, eight of eight cattle survived a serotype B:2 challenge, which killed four of four unvaccinated controls. The vaccinated cattle had developed serum antibodies detectable by the passive mouse protection test. Indirect haemagglutination tests on sera taken from cattle 10 days and five weeks after they were vaccinated showed high titres of antibodies. The serum of vaccinated cattle cross-protected passively immunised mice against infection with P. multocida serotypes E:2, F:3,4 and A:3,4. PMID:15675522

Myint, A; Jones, T O; Nyunt, H H

2005-01-01

21

The rainbow trout TLR9 gene and its role in the immune responses elicited by a plasmid encoding the glycoprotein G of the viral haemorrhagic septicaemia rhabdovirus (VHSV)  

Microsoft Academic Search

The aim of this work was to improve the knowledge about the factors contributing to the immunogenicity of the DNA vaccines based on the viral haemorrhagic septicaemia virus glycoprotein G gene, through identifying the rainbow trout Toll-like receptor 9 (Omtlr9) gene that curiously contains an insertion of an incomplete transposon at the 5?-end of the third intron. Concerning the role

M. Ortega-Villaizan; V. Chico; A. Falco; L. Perez; J. M. Coll; A. Estepa

2009-01-01

22

Inactivation of infectious salmon anaemia virus, viral haemorrhagic septicaemia virus and infectious pancreatic necrosis virus in water using UVC irradiation.  

PubMed

The UVC irradiation doses necessary for a 99.9% (3-log) inactivation of 3 different fish pathogenic viruses diluted in freshwater/seawater and wastewater from a fish processing plant were determined. The results showed that both infectious salmon anaemia virus (ISAV) and viral haemorrhagic septicaemia virus (VHSV) were very sensitive to UVC irradiation, showing a 3-log reduction of infectivity in freshwater of 33 +/- 3.5 and 7.9 +/- 1.5 J m(-2), respectively, while that of infectious pancreatic necrosis virus (IPNV) was substantially higher, 1188 +/- 57 J m(-2). Using ISAV as a model, a comparison of the effect of UVC irradiation on virus isolation versus reverse transcription polymerase chain reaction (RT-PCR) showed that considerably higher UVC doses, depending on the length of the amplified product, were necessary to abolish RT-PCR detection of viral RNA. PMID:11843135

Oye, A K; Rimstad, E

2001-12-20

23

Identification of immunogenic proteins associated with protection against haemorrhagic septicaemia after vaccination of calves with a live-attenuated aroA derivative of Pasteurella multocida B:2  

Microsoft Academic Search

Pasteurella multocida serotype B:2 is the causative agent of haemorrhagic septicaemia (HS), a fatal disease of cattle and buffaloes. As a step towards the identification of individual antigens that may protect against HS, proteins present in a sonicated cell extract (SCE) and outer-membrane protein (OMP) preparation of a wild-type P. multocida serotype B:2 were investigated by immunoblotting with sera from

Saeed Ataei; Richard Burchmore; J. Christopher Hodgson; Anna Finucane; Roger Parton; John G. Coote

2009-01-01

24

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

25

Prevalence of viral haemorrhagic septicaemia virus in Danish marine fishes and its occurrence in new host species.  

PubMed

In order to analyse the occurrence of viral haemorrhagic septicaemia virus (VHSV) in the marine waters around Denmark, staff from the Danish Institute for Food and Veterinary Research participated in 5 research cruises during 1998 to 2002 as a follow-up to 4 research cruises performed in 1996 to 1997. In total, 16,655 fish were examined virologically as 3569 samples. Forty fish species and 3 invertebrate species were represented. VHSV was isolated from 133 samples representing 8 species: herring Clupea harengus, sprat Sprattus sprattus, dab Limanda limanda, flounder Platichthys flesus, plaice Pleuronectes platessa, cod Gadus morhua, sand eel Ammodytes sp. and sand goby Pomatochistus minutus. Calculations showed that VHSV was more prevalent in the Baltic Sea in an area between Zealand and the island of Bornholm and the waters surrounding Bornholm than in the Kattegat, Skagerrak and along the North Sea coast of Denmark. This is the first report on the isolation of VHSV from dab, flounder and plaice and the first publication on VHSV from sand eel from Europe and sand goby. PMID:16231640

Skall, Helle Frank; Olesen, Niels Jørgen; Mellergaard, Stig

2005-09-01

26

Epidemiological aspects of viral haemorrhagic septicaemia virus genotype II isolated from Baltic herring, Clupea harengus membras L.  

PubMed

This study was carried out to clarify the role of wild fish, especially Baltic herring, Clupea harengus membras L., in the epidemiology of viral haemorrhagic septicaemia virus (VHSV) in brackish water in Finland. Baltic herring with no visible signs of disease were collected from the Archipelago Sea, the Gulf of Bothnia and the eastern Gulf of Finland. In total, 7580 herring were examined by virus isolation as 758 pooled samples and 3029 wild salmonid broodfish as pooled samples during 2004-2006. VHSV was isolated from 51 pooled herring samples in bluegill fibroblast-2 cells, but not in epithelioma papulosum cyprini cells. The majority of isolations were from the coastal archipelago and from fish caught during the spawning season. Based on glycoprotein (G) gene sequences, the virus was classified as a member of genotype II of VHSV. Pairwise comparisons of the G gene regions of herring isolates revealed that all the isolates were closely related, with 98.8-100% nucleotide homology. Phylogenetic analyses revealed that they were closely related to the strains isolated previously from herring and sprat, Sprattus sprattus (L.), in Gotland and to the VHSV isolates from European river lamprey, Lampetra fluviatilis (L.), in the rivers that flow into the Bothnian Bay. The infection in Baltic herring is likely to be independent of the VHSV Id epidemic in farmed rainbow trout, Oncorhynchus mykiss (Walbaum). PMID:21623835

Gadd, T; Jakava-Viljanen, M; Tapiovaara, H; Koski, P; Sihvonen, L

2011-05-29

27

Distribution of viral haemorrhagic septicaemia virus in wild fish species of the North Sea, north east Atlantic Ocean and Irish Sea.  

PubMed

A surveillance programme was initiated on the occurrence and distribution of viral haemorrhagic septicaemia virus (VHSV) in wild marine fish. Six research cruises were undertaken in an 18 mo period during 1997 and 1998, covering the North Sea, the Atlantic waters off the north and west coasts of Scotland and the Irish Sea. A total of 19,293 fish were sampled from 23 different species including cod, haddock, Norway pout, herring and sprat. Individual fish lengths were recorded and the fish were checked for lesions, haemorrhaging and other signs of disease. Pools of organ samples were taken for virus assay. The majority of fish sampled did not display clinical signs indicative of viral haemorrhagic septicaemia. A small number of cod were found with skin lesions and haddock with skin haemorrhaging. Of the 2081 organ and skin sample pools collected, 21 tested positive for VHSV by tissue culture and enzyme-linked immunosorbent assay. Seventeen of the isolates originated from Norway pout Trisopterus esmarkii, one from cod Gadus morhua (skin lesion), one from herring Clupea harengus, one from whiting Merlangius merlangus, and one from a previously unreported host species, poor cod Trisopterus minutus. PMID:11775798

King, J A; Snow, M; Smail, D A; Raynard, R S

2001-11-01

28

Protection, humoral and cell-mediated immune responses in calves immunized with multiple emulsion haemorrhagic septicaemia vaccine.  

PubMed

A multiple emulsion (ME), vaccine against Pasteurella multocida (P52) infection in cattle was prepared and the efficiency in terms of immunity to direct challenge, duration of this immunity for up to 1 year and the role of humoral and cell-mediated immune mechanisms were studied. ME vaccine was sterile, safe and was potent when tested in rabbits and calves. Nineteen calves were immunized with a single 4 ml dose of ME vaccine intramuscularly. Group of these calves were challenge infected with virulent P. multocida (P52) (10(-1) 18 h old broth culture) given by the subcutaneous route at 21 days, 3 months, 6 months, 9 months and 1 year. All the immunized calves withstood challenge infection and showed 100% protection. Humoral immune response was measured by indirect haemagglutination test (IHA) and enzyme-linked immunosorbant assay (ELISA). Statistically ELISA values were found to be superior to IHA values because of small coefficient of variance. A fall in mean antibody titres during 24 h, 48 h, post-challenge infection was recorded whereas a steady increase in the titre after 72 h up to 10 days was noticed. The prechallenge mean titre in animals correlated with survival of animals. Humoral antibodies were detected as early as 7 day post-immunization and persisted to 1 year after immunization. Leucocyte migration inhibition test showed > 20% migration inhibition during all pre- and post-challenge periods in animals suggesting an involvement of cell-mediated immune mechanism in protection. Our findings suggested that both humoral and cell-mediated immune responses contribute to protection in vaccinated animals. The results of these studies of ME vaccine showed that it can be successfully used for the effective control of haemorrhagic septicaemia. PMID:9286053

Verma, R; Jaiswal, T N

1997-08-01

29

In vitro viral haemorrhagic septicaemia virus replication in excised fins of rainbow trout: correlation with resistance to waterborne challenge and genetic variation.  

PubMed

In vitro viral haemorrhagic septicaemia virus replication in excised fin tissue (VREFT) was investigated as a possible criterion to predict the resistance of groups or individuals to viral haemorrhagic septicaemia virus (VHSV) in rainbow trout. Adipose and rayed fins were compared for VREFT response, and a statistically significant correlation was found. Correlation between VREFT and survival after waterborne viral challenge was estimated on a set of 27 groups of trout, and was highly significant (R = 0.72). A further experiment with fish individually tagged and challenged some time after fin clipping for determination of VREFT confirmed that the mean value of resistant (surviving) fish was significantly lower than the mean value of susceptible (dead) ones, but there was a wide variation within each of these groups. In particular, a large proportion of fish expected to be resistant based on VREFT values died all the same. Using clones, we showed that the correlation between VREFT and survival was dramatically high (R = 0.96). Genetic analyses of the data from the different groups available in the experiment consistently indicated a large amount of genetic determination of VREFT, an encouraging result for selection purposes. Though these results were obtained in experimentally controlled conditions not identical to those in the field, they shed new light on the analysis of defence mechanisms against the virus and on the possibility of performing indirect selection for resistance, using VREFT as the secondary character. PMID:11558726

Quillet, E; Dorson, M; Aubard, G; Torhy, C

2001-08-01

30

Neonatal septicaemia  

Microsoft Academic Search

A total of 410 proved cases of neonatal septicaemia from seven Finnish hospitals seen between 1976 and 1980 were reviewed. The annual incidence of neonatal septicaemia was 3 per 1000 births, and overall mortality was 23%. Onset was early in most patients. Symptoms of septicaemia occurred within the first 24 hours of life in 44% and within the first week

T Vesikari; M Janas; P Grönroos; N Tuppurainen; M Renlund; P Kero; M Koivisto; M Kunnas; K Heinonen; R Nyman

1985-01-01

31

Identification of immunogenic proteins associated with protection against haemorrhagic septicaemia after vaccination of calves with a live-attenuated aroA derivative of Pasteurella multocida B:2.  

PubMed

Pasteurella multocida serotype B:2 is the causative agent of haemorrhagic septicaemia (HS), a fatal disease of cattle and buffaloes. As a step towards the identification of individual antigens that may protect against HS, proteins present in a sonicated cell extract (SCE) and outer-membrane protein (OMP) preparation of a wild-type P. multocida serotype B:2 were investigated by immunoblotting with sera from calves which had been protected against challenge with a virulent strain of P. multocida B:2 by vaccination with a live-attenuated aroA derivative of the challenge strain. Five proteins in SCE, of approximately 50, 37, 30, 26 and 16 kDa, were recognised by the sera. In an OMP preparation, two bands, at 37 and 50 kDa, were recognised as strongly immunogenic. Mass spectrometry analysis of proteins corresponding in size to those detected by immunoblotting identified the 37 kDa band as OmpA, but the band at 50 kDa was not identified with certainty. A major 30 kDa OMP, identified as OmpH, was not strongly immunogenic. PMID:19243798

Ataei, Saeed; Burchmore, Richard; Christopher Hodgson, J; Finucane, Anna; Parton, Roger; Coote, John G

2009-02-24

32

Factors controlling the early stages of viral haemorrhagic septicaemia epizootics: Low exposure levels, virus amplification and fish-to-fish transmission  

USGS Publications Warehouse

Viral haemorrhagic septicaemia virus, Genogroup IVa (VHSV), was highly infectious to Pacific herring, Clupea pallasii (Valenciennes), even at exposure doses occurring below the threshold of sensitivity for a standard viral plaque assay; however, further progression of the disease to a population-level epizootic required viral amplification and effective fish-to-fish transmission. Among groups of herring injected with VHSV, the prevalence of infection was dose-dependent, ranging from 100%, 75% and 38% after exposure to 19, 0.7 and 0.07 plaque-forming units (PFU)/fish, respectively. Among Pacific herring exposed to waterborne VHSV (140PFUmL-1), the prevalence of infection, geometric mean viral tissue titre and cumulative mortality were greater among cohabitated herring than among cohorts that were held in individual aquaria, where fish-to-fish transmission was prevented. Fish-to-fish transmission among cohabitated herring probably occurred via exposure to shed virus which peaked at 680PFUmL-1; shed virus was not detected in the tank water from any isolated individuals. The results provide insights into mechanisms that initiate epizootic cascades in populations of wild herring and have implications for the design of VHSV surveys in wild fish populations. ?? Published 2011. This article is a US Government work and is in the public domain in the USA.

Hershberger, P. K.; Gregg, J. L.; Grady, C. A.; Hart, L. M.; Roon, S. R.; Winton, J. R.

2011-01-01

33

In vitro analysis of the factors contributing to the antiviral state induced by a plasmid encoding the viral haemorrhagic septicaemia virus glycoprotein G in transfected trout cells.  

PubMed

We have found out that transfection of the RTG-2 cell line with the viral haemorrhagic septicaemia virus (VHSV) glycoprotein G (G(VHSV))-coding plasmid induces an anti-VHSV state, similar to that induced by poly I:C. Taking the advantage of the constitutive expression of toll-like receptor 9 gene (tlr9) in RTG-2 cells, we have investigated whether this antiviral state was induced by the cytosine-phosphodiester-guanine (CpG) motifs present in the plasmid DNA, by the endogenous expression of G(VHSV) protein or by both elements. For that, we have analysed the expression profile of the rainbow trout tlr9 and several genes related to TLR9-mediated immune response in the absence or presence of a lysosomotropic drug that specifically blocks TLR9-CpG DNA interaction. The results suggested that the high levels of cell protection conferred by a plasmid encoding G(VHSV) gene are due to G(VHSV) rather than to the CpG motifs within plasmid DNA. Therefore, plasmid DNA might not play a key role in the immune response elicited by DNA vaccines or perhaps other receptors instead TLR9 could be implicated in CpG motifs recognition and signalling. In addition, since RTG-2 cells express tlr9 gene, this cell line could be a good tool for screening TLR9 agonists, such as the immunomodulatory oligonucleotides (IMOs), as fish DNA vaccine adjuvants. PMID:21095250

Ortega-Villaizan, M; Chico, V; Martinez-Lopez, A; Falco, A; Perez, L; Coll, J M; Estepa, A

2010-11-21

34

Susceptibility of whirling disease (WD) resistance and WD susceptible strains of rainbow trout Oncorhynchus mykiss to Tetracapsuloides bryosalmonae, Yersinia ruckeri and viral haemorrhagic septicaemia virus  

Microsoft Academic Search

The focus of this work was to examine the susceptibility of a German rainbow trout strain (H) along with a North American strain (TL, which is highly susceptible to whirling disease) to three pathogens: the myxozoan parasite Tetracapsuloides bryosalmonae, which causes proliferative kidney disease (PKD), the bacterium Yersinia ruckeri, which causes enteric red mouth disease (ERM) and VHS virus, which

M. El-Matbouli; M. Mattes; H. Soliman

2009-01-01

35

VHS Movies: Perturbations for Morphogenesis.  

ERIC Educational Resources Information Center

|This paper discusses the concept of a family system in terms of an interactive system of interrelated, interdependent parts and suggests that VHS movies can act as perturbations, i.e., change promoting agents, for certain dysfunctional family systems. Several distinct characteristics of a family system are defined with particular emphasis on…

Holmes, Danny L.

36

Efficacy of Oil Based Haemorrhagic Septicaemia Vaccine: A Field Trial  

Microsoft Academic Search

An oil adjuvanted vaccine prepared from Pasteurella multocida serotype 6:B was evaluated under field conditions for induction of immune response in cattle and buffaloes and its efficacy was compared with conventionally used Alum precipitated vaccine (APV). A total of 2703 cattle and buffaloes of various age groups (i.e., Adults, Heifers and Calves) were vaccinated with oil adjuvant vaccine (OAV). Alum

R. MUNEER; M. HUSSAIN; A. B. ZAHOOR

37

Evaluation of bovine antibody responses to haemorrhagic septicaemia vaccine.  

PubMed

ELISA and immunoblotting techniques were used to examine the humoral immune response to Pasteurella multocida, in bovine sera from Indonesia and Malaysia. Elevated levels of antibody to a crude lipopolysaccharide preparation were found in vaccinated animals. In addition to the response to lipopolysaccharide, antibodies from the vaccinated cattle strongly labelled five to six of the 40 protein bands in this organism. PMID:2508206

Johnson, R B; Dawkins, H J; Spencer, T L; Saharee, A A; Bahaman, A R; Ramdani; Patten, B E

1989-09-01

38

Intracerebral haemorrhage  

PubMed Central

Intracerebral haemorrhage is an important public health problem leading to high rates of death and disability in adults. Although the number of hospital admissions for intracerebral haemorrhage has increased worldwide in the past 10 years, mortality has not fallen. Results of clinical trials and observational studies suggest that coordinated primary and specialty care is associated with lower mortality than is typical community practice. Development of treatment goals for critical care, and new sequences of care and specialty practice can improve outcome after intracerebral haemorrhage. Specific treatment approaches include early diagnosis and haemostasis, aggressive management of blood pressure, open surgical and minimally invasive surgical techniques to remove clot, techniques to remove intraventricular blood, and management of intracranial pressure. These approaches improve clinical management of patients with intracerebral haemorrhage and promise to reduce mortality and increase functional survival.

Qureshi, Adnan I; Mendelow, A David; Hanley, Daniel F

2011-01-01

39

Pseudomonas septicaemia following tribal tatoo marks.  

PubMed

It is tradition in Northern Nigeria to make tribal tatoo marks on the face of a newborn, commonly on both sides of the angle of the mouth. A case of fatal septicaemia due to Pseudomonas aeruginosa following such tribal tatoo marks is reported. PMID:6506210

Mathur, D R; Sahoo, A

1984-09-01

40

Chromobacterium violaceum septicaemia from north India.  

PubMed

Though Chromobacterium violaceum is a common inhabitant of soil and water in tropical and sub-tropical regions, human infections are rare but when they do occur result in high mortality. Since the first case from Malaysia in 1927, about 150 cases have been reported in world literature. Till date 6 cases have been reported from southern and eastern parts of India. We report here a case of C. violaceum septicaemia, probably the first case from north India. The patient, a 6 and a half year old boy was admitted with high fever. The patient had anaemia, neutrophilic leucocytosis and bilateral chest infiltrates. Routine and bacteriological investigations were carried out to establish the aetiological diagnosis. C. violaceum was isolated in pure culture from blood and pus. The patient was successfully treated with ciprofloxacin and amikacin. This is probably the first documented case report of C. violaceum infection from north India and the only Indian case with septicaemia which survived. PMID:15654137

Ray, Pallab; Sharma, Jyoti; Marak, Rungmei S K; Singhi, S; Taneja, Neelam; Garg, Raj Kumar; Sharma, Meera

2004-12-01

41

Brain damage complicating septic shock: acute haemorrhagic leucoencephalitis as a complication of the generalised Shwartzman reaction.  

PubMed Central

The neuropathological findings in six patients who developed neurological signs after the onset of "septic shock" caused by Gram-negative septicaemia are described. The changes in the brains were characteristic of acute haemorrhagic leucoencephalitis, and there was evidence, particularly in the kidneys, of disseminated intravascular coagulation with tubular necrosis and, in some, appearances indistinguishable from membrano-proliferative glomerulonephritis. It is agreed that acute haemorrhagic leucoencephalitis is another manifestation of a generalised Shwartzman reaction, and it is suggested that activation of complement is the final common pathway that produces tissue damage in the brain and kidney. Images

Graham, D I; Behan, P O; More, I A

1979-01-01

42

Capnocytophaga canimorsus: infection, septicaemia, recovery and reconstruction.  

PubMed

A case is presented of a life-threatening septicaemia and associated peripheral necrosing microembolic phenomenon, resulting from a dog lick to an insignificant burn wound. The isolated bacterium was Capnocytophaga canimorsus, a slow-growing Gram-negative bacillus commonly found in dog saliva. Any clinician seeing patients with a history of dog bite/saliva contact and progressive illness should consider this bacterium as a possible offender and take special care to elicit an accurate history, specifically including questions regarding animal contact. PMID:18566152

Low, Stephanie Chiang-Mei; Greenwood, John Edward

2008-07-01

43

Viral haemorrhagic fevers of man.  

PubMed

This article reviews the current state of knowledge on the viral haemorrhagic fevers that infect man, namely smallpox, chikungunya fever, dengue fever, Rift Valley fever, yellow fever, Crimean haemorrhagic fever, Kyasanur Forest disease, Omsk haemorrhagic fever, Argentinian haemorrhagic fever (Junin virus), Bolivian haemorrhagic fever (Machupo virus), Lassa fever, haemorrhagic fever with renal syndrome, and Marburg and Ebola virus diseases. PMID:310725

Simpson, D I

1978-01-01

44

Viral haemorrhagic fevers of man*  

PubMed Central

This article reviews the current state of knowledge on the viral haemorrhagic fevers that infect man, namely smallpox, chikungunya fever, dengue fever, Rift Valley fever, yellow fever, Crimean haemorrhagic fever, Kyasanur Forest disease, Omsk haemorrhagic fever, Argentinian haemorrhagic fever (Junin virus), Bolivian haemorrhagic fever (Machupo virus), Lassa fever, haemorrhagic fever with renal syndrome, and Marburg and Ebola virus diseases.

Simpson, D. I. H.

1978-01-01

45

Massive obstetric haemorrhage  

Microsoft Academic Search

Massive obstetric haemorrhage is a major cause of maternal death and morbidity; abruptio placentae, placenta praevia and postpartum haemorrhage being the main causes. A delay in the correction of hypovolaemia, a delay in the diagnosis and treatment of defective coagulation and a delay in the surgical control of bleeding are the avoidable factors in most maternal deaths caused by haemorrhage.

John Bonnar

2000-01-01

46

Haemorrhagic pure motor stroke.  

PubMed

To describe the clinical characteristics of haemorrhagic pure motor stroke (PMS). Twelve patients with haemorrhagic PMS were identified. Haemorrhagic PMS accounted for 3.2% of all cases of pure motor hemiparesis (n = 380) and 3.3% of intracerebral haemorrhage (n = 364) entered in the database. When compared with PMS of ischaemic origin, patients with haemorrhagic PMS were more likely to be younger (62.2 vs. 75.2 years, P = 0.003) and to have headache (33% vs. 6.3%, P =0.007) and thalamus involvement (25% vs. 2.4%, P = 0.005). Limb weakness (100% vs. 74.1%; P = 0.03), involvement of the internal capsule (50% vs. 17.3%, P = 0.012) and symptom free at discharge (25% vs. 3.7%, P = 0.012) were significantly more frequent in patients with haemorrhagic PMS than in the remaining cases of haemorrhagic stroke, whereas nausea and vomiting (0% vs. 25.9%, P = 0.03), altered consciousness (0% vs. 42.9%, P = 0.001), sensory symptoms (8.3% vs. 46.9%, P =0.007) and ventricular haemorrhage (0% vs. 26.1%, P = 0.028) were significantly less frequent. Haemorrhagic PMS is a very infrequent stroke subtype. Headache at stroke onset may be useful sign for distinguishing haemorrhagic PMS from other causes of lacunar stroke. There are important differences between haemorrhagic PMS and the remaining intracerebral haemorrhages. PMID:17250733

Arboix, A; García-Eroles, L; Massons, J; Oliveres, M; Balcells, M

2007-02-01

47

Counting the Costs of Farmed Salmonids Diseases  

Microsoft Academic Search

This article describes the assumptions and calculations underlying best estimates of the direct and indirect costs of three salmonid diseases in the United Kingdom: infectious salmon anaemia (ISA), viral haemorrhagic septicaemia (VHS), and infectious haemorrhagic necrosis (IHN) using a standardized spreadsheet-based model. The data input for the model was derived from the literature and from a small survey specifically conducted

A. Fofana; C. Baulcomb

2012-01-01

48

Epizootic Haemorrhagic Disease  

Technology Transfer Automated Retrieval System (TEKTRAN)

Epizootic haemorrhagic disease (EHD) is an infectious non contagious viral disease transmitted by insects of the genus Culicoides which affects wild and domestic ruminants. The causative agent, the epizootic haemorrhagic disease virus (EHDV), belongs to the family Reoviridae, genus Orbivirus and sha...

49

Spontaneous orbital haemorrhage.  

PubMed Central

A 57-year-old housewife, with controlled hypertension, presented with acute right proptosis and visual loss with external ophthalmoplegia due to spontaneous orbital haemorrhage. Vision and ocular motility were returned to normal by the rapid surgical evacuation of the blood. Acute orbital haemorrhage is an ocular emergency requiring urgent treatment to prevent the usual previously reported outcome of permanent visual loss. Images

Brooks, A. M.; Finkelstein, E.

1984-01-01

50

Prevention of haemorrhagic septicaemia in buffaloes and cattle with a live vaccine.  

PubMed

Young cattle and buffaloes were vaccinated subcutaneously and intradermally with a live vaccine containing Pasteurella multocida serotype B:3,4. Twelve months after vaccination three of five young cattle in the subcutaneously vaccinated group and three of four in the intradermally vaccinated group were protected against serotype B:2 challenge. Eleven buffaloes vaccinated subcutaneously and two vaccinated intradermally survived the same challenge 13 months after vaccination. PMID:2502878

Myint, A; Carter, G R

1989-05-13

51

Preliminary field trails with a streptomycin-dependent vaccine against haemorrhagic septicaemia  

Microsoft Academic Search

In two trials, 68 cattle and buffalo calves, four to 10 months of age, were vaccinated with a vaccine containing a live streptomycin dependent mutant of Pasteurella multocida type B, isolated in Sri Lanka. Immunity was assessed using the passive protection test in mice with cattle and buffalo sera before and two or three weeks after vaccination. A single dose

MC De Alwis; GR Carter

1980-01-01

52

Prevention of haemorrhagic septicaemia in buffaloes and cattle with a live vaccine  

Microsoft Academic Search

Young cattle and buffaloes were vaccinated subcutaneously and intradermally with a live vaccine containing Pasteurella multocida serotype B:3,4. Twelve months after vaccination three of five young cattle in the subcutaneously vaccinated group and three of four in the intradermally vaccinated group were protected against serotype B:2 challenge. Eleven buffaloes vaccinated subcutaneously and two vaccinated intradermally survived the same challenge 13

A Myint; GR Carter

1989-01-01

53

Preliminary field trails with a streptomycin-dependent vaccine against haemorrhagic septicaemia.  

PubMed

In two trials, 68 cattle and buffalo calves, four to 10 months of age, were vaccinated with a vaccine containing a live streptomycin dependent mutant of Pasteurella multocida type B, isolated in Sri Lanka. Immunity was assessed using the passive protection test in mice with cattle and buffalo sera before and two or three weeks after vaccination. A single dose of vaccine conferred immunity in 66.6 to 83.3 per cent of cattle and 100 per cent of buffalo calves. A booster dose given three weeks later enhanced the immunity in cattle. There was no significant difference in the response, whether the vaccine was administered by the subcutaneous or intramuscular route. No adverse reactions were observed in any of the vaccinated animals. PMID:6776679

De Alwis, M C; Carter, G R

1980-05-24

54

Haemorrhagic septicaemia due to Pasteurella Multocida type B2 in Namibia  

Microsoft Academic Search

Two laboratory confirmed outbreaks of Pasteurella multocida Type B2 were diagnosed in cattle of different ages during 1994 and 1995. The first case (1994) occurred at the height of the austral winter (July 1994) in a group of about 150 weaner calves. The calves were assembled in a small camp for routine branding, annual castration and vaccination against lamsiekte (Clostridium

A. Voigts; Georginah Ngaisiue; Maryke M. Henton; O. J. B. Hübschle

1997-01-01

55

Natural history of adrenal haemorrhage in the newborn  

PubMed Central

5 cases of unilateral and 3 cases of bilateral haemorrhage are described. Only 1 infant died, from venous thromboses elsewhere. Apart from this case, all had an above average birthweight. Probable predisposing causes apart from large size were fetal hypoxia, septicaemia, thrombocytopenia, coagulation defect, and disseminated thromboembolic disease. The condition must be distinguished from renal vein thrombosis. In the acute stage pyelography shows depression of the kidney on the affected side, with flattening of the upper calyces. Calcification develops rapidly round the periphery of the mass, then slowly contracts into an area of the size and shape of the original gland. Treatment is with antibiotics and blood transfusion, with intravenous corticosteroids in severely shocked or bilateral cases. Adrenal insufficiency is rarely found on follow-up even in bilateral cases, but renal hypertension should be looked for. No single cause for the haemorrhage could be discovered, but the preponderance of haemorrhage into the right adrenal gland is probably due to anatomical differences between the venous drainage of the two sides. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5

Black, John; Williams, David Innes

1973-01-01

56

Herpes Simplex Virus Virion Host Shutoff (vhs) Activity Alters Periocular Disease in Mice  

PubMed Central

During lytic infection, the virion host shutoff (vhs) protein of herpes simplex virus (HSV) mediates the rapid degradation of RNA and shutoff of host protein synthesis. In mice, HSV type 1 (HSV-1) mutants lacking vhs activity are profoundly attenuated. HSV-2 has significantly higher vhs activity than HSV-1, eliciting a faster and more complete shutoff. To examine further the role of vhs activity in pathogenesis, we generated an intertypic recombinant virus (KOSV2) in which the vhs open reading frame of HSV-1 strain KOS was replaced with that of HSV-2 strain 333. KOSV2 and a marker-rescued virus, KOSV2R, were characterized in cell culture and tested in an in vivo mouse eye model of latency and pathogenesis. The RNA degradation kinetics of KOSV2 was identical to that of HSV-2 333, and both showed vhs activity significantly higher than that of KOS. This demonstrated that the fast vhs-mediated degradation phenotype of 333 had been conferred upon KOS. The growth of KOSV2 was comparable to that of KOS, 333, and KOSV2R in cell culture, murine corneas, and trigeminal ganglia and had a reactivation frequency similar to those of KOS and KOSV2R from explanted latently infected trigeminal ganglia. There was, however, significantly reduced blepharitis and viral replication within the periocular skin of KOSV2-infected mice compared to mice infected with either KOS or KOSV2R. Taken together, these data demonstrate that heightened vhs activity, in the context of HSV-1 infection, leads to increased viral clearance from the skin of mice and that the replication of virus in the skin is a determining factor for blepharitis. These data also suggest a role for vhs in modulating host responses to HSV infection.

Smith, Tracy J.; Ackland-Berglund, Cathleen E.; Leib, David A.

2000-01-01

57

Partial gastrectomy for haemorrhage  

PubMed Central

An analysis was made of the results of 566 partial gastrectomies for haemorrhage from gastroduodenal ulceration between 1953 and 1962 with regard to mortality, morbidity, and long-term follow up. With rigid criteria for selection of patients for surgery, the overall mortality rate for ulcerative gastroduodenal haemorrhage was 8·6%. The actual operative mortality rate more than doubles if an emergency operation is performed later than four days after the patient's admission with haemorrhage. Postoperative and later bleeding complications occurred in 5% of patients. Regardless of the length of ulcerative history, over 92% of patients have clinically satisfactory long-term results. Six per cent required further operation, after which, they too had clinically satisfactory results.

Cocks, J. R.; Desmond, A. M.; Swynnerton, B. F.; Tanner, N. C.

1972-01-01

58

Arenaviral haemorrhagic fevers.  

PubMed

Three arenaviruses--Lassa, Junin and Machupo--cause severe haemorrhagic disease in humans: Lassa fever, Argentine haemorrhagic fever and Bolivian haemorrhagic fever, respectively. These conditions are a source of considerable economic hardship in endemic areas and remain a worldwide concern for public-health officials. They are characterised by an insidious onset of influenza-like symptoms followed, in severe cases, by a generalised bleeding diathesis, encephalopathy and death. Central to studies of their pathogenesis is evidence for cellular dysfunction disproportionate to overt histopathology. Recent studies of patients with Lassa fever indicate that platelet and possibly endothelial-cell dysfunction play an important role in the bleeding tendency. The platelet defect appears to be mediated by an inhibitory factor in plasma; the nature of this is uncertain but it seems to be neither viral protein nor virus antibody. A similar inhibitor has since been demonstrated in patients with Argentine haemorrhagic fever. Plasma from patients with Lassa fever also profoundly modulates the amount of superoxide generated by normal neutrophils in response to the chemotactic peptide f-met-leu-phe, suggesting the inhibitor(s) has global effects on cellular function. These findings may have important implications for future therapeutic strategies. PMID:1777745

Cummins, D

1991-09-01

59

Zoonoses and haemorrhagic fever.  

PubMed

Virus zoonoses causing haemorrhagic fever have been recognized in three major families: Arenaviridae, Bunyaviridae and Filoviridae. All are negative-stranded RNA viruses, with genomes in two segments, three segments, or non-segmented, respectively. Acquisition of haemorrhagic fever in man generally requires close contact with a vertebrate vector species, usually rodents, for the arenaviruses and bunyaviruses. In the case of filoviruses, the vector is currently unknown, but these viruses may infect monkeys, and may contaminate cell cultures prepared from them. Both bunyavirus and arenavirus haemorrhagic fevers have arisen in humans following exposure to rodents, and in the case of Hantaan, a virus causing haemorrhagic fever with renal syndrome (HFRS), there have been numerous laboratory-acquired infections among animal care workers. As the technology to differentiate virus species has improved, it has become clear that there are numerous potentially hazardous viruses capable of causing HFRS or hantavirus pulmonary syndrome (HPS) within the feral rodent population. In many cases it would be desirable to introduce screening methods for such viruses before preparing cell cultures from these rodent or simian species that will be used to prepare biological products for human use. PMID:9737374

Mahy, B W

1998-01-01

60

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

61

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.

Feldmann, Heinz; Geisbert, Thomas W

2012-01-01

62

Ebola haemorrhagic fever.  

PubMed

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

2011-03-01

63

Further Haemorrhage after Admission to Hospital for Gastrointestinal Haemorrhage  

PubMed Central

During 1967 and 1968 817 episodes of acute alimentary tract haemorrhage were treated in Aberdeen hospitals. In 229 cases further haemorrhage occurred in hospital, with a mortality of 28·8%; the mortality among patients who did not have this complication was 7·8%. This was true of any kind of further haemorrhage. As judged by transfusion requirements and mortality the severity of the further haemorrhage was unaffected by its occurrence as haematemesis and melaena or as melaena only or by whether it took place before or after 48 hours from the time of admission. The occurrence of further haemorrhage did not appear to be affected by the sex or blood group of patients, by aspirin ingestion, or by a history of a previous haemorrhage. The effects of the occurrence of further haemorrhage, of the age being over 60 years, or of coincidental disease being present were of descending importance in regard to mortality. Among 151 patients with peptic ulcer and further haemorrhage half required urgent surgery and 20% died. Further haemorrhage is a dangerous condition and its occurrence should immediately signal the need for vigilance and for urgent consultation between physician and surgeon. Any delay in treatment entails increased mortality.

Jones, Peter F.; Johnston, Shirley J.; McEwan, Arthur B.; Kyle, James; Needham, Charles D.

1973-01-01

64

Clarithromycin-induced haemorrhagic colitis.  

PubMed

Haemorrhagic colitis by Klebsiella oxytoca has been described as an antibiotic-associated colitis, particularly with the use of ampicillin. Here we report a patient with haemorrhagic colitis caused by K oxytoca after the use of clarithromycin. A 67-year-old Japanese woman with diabetes presented with mucobloody diarrhoea and abdominal pain. Stool culture grew K oxytoca. Colonoscopy showed the appearance of haemorrhagic colitis. Further history taking revealed that she had received a course of oral clarithromycin for upper respiratory tract infection. She had recovered by conservative treatment. We should be careful about gastrointestinal symptoms in patients on clarithromycin, which can cause haemorrhagic colitis associated with K oxytoca. PMID:23964038

Miyauchi, Ryosuke; Kinoshita, Kensuke; Tokuda, Yasuharu

2013-08-20

65

Occult pulmonary haemorrhage in leukaemia.  

PubMed Central

Through gleeding into the lung parenchyma is responsible for morbidity and mortality in patients with leukaemia pulmonary haemorrhage is seldom diagnosed during life. We diagnosed occult pulmonary haemorrhage in five leukaemic patients with unexplained infiltrates on chest roetgenograms by examining alveolar macrophages retrieved by bronchopulmonary lavage. Macrophage haemosiderin content was greatly increased in the patients with pulmonary haemorrhage as compared to normal and thrombocytopenic control subjects. Haemoglobin and intact erythrocytes in alveolar macrophages were taken as evidence of recent haemorrhage. Intrapulmonary bleeding may occur often in patients with leukaemia, and bronchopulmonary lavage offers a safe approach to diagnosis and allows for concomitant identification of pulmonary infection. Images FIG. 1 FIG. 2

Golde, D W; Drew, W L; Klein, H Z; Finley, T N; Cline, M J

1975-01-01

66

[Neonatal subgaleal haemorrhage; a potential life-threatening extracranial haemorrhage  

Microsoft Academic Search

A female neonate delivered at term developed hypovolemic shock due to a subgaleal haemorrhage, i.e. extracranial bleeding between the galea aponeurotica and the cranial periosteum. The subgaleal haemorrhage was most likely the result of a traumatic vacuum extraction. The patient was treated with large volumes of fluids and blood products and received additional circulatory and respiratory support. The clinical features

J. Fuijkschot; T. A. J. Antonius; P. W. Meijers; S. L. A. G. Vrancken

2008-01-01

67

Intravitreal gas for submacular haemorrhage.  

PubMed

Submacular haemorrhage is an important cause for sudden visual loss needing immediate intervention. We report a case of submacular haemorrhage causing profound visual loss, which resolved after intravitreal injection of perfluoropropane (C3F8) gas followed by strict prone positioning. PMID:14750625

Mahesh, Gopalakrishnan; Giridhar, Anantharaman; Saikumar, Seshadri J; Elias, Anna

2003-12-01

68

Subaponeurotic haemorrhage in Malaysian neonates.  

PubMed

In a 30-month prospective study, between January 1987 and June 1989, 101 of 64,424 Malaysian neonates (1.6 per 1000 livebirths) born in the Maternity Hospital, Kuala Lumpur were found to have subaponeurotic haemorrhage shortly after delivery. The incidence was highest in neonates weighting 4000 gm or more. There was no significant difference in incidence of this condition in neonates of different ethnic origins. Hypoprothrombinemia was present in only 5/101 (5.0%) of the affected neonates. Sixty seven (66.3%) of the neonates with subaponeurotic haemorrhage had history of trial of vacuum extraction. The incidence of subaponeurotic haemorrhage was significantly higher in neonates delivered by vacuum extraction than by other modes of delivery in this hospital (41.4 per 1000 livebirths in neonates delivered by vacuum extraction versus 1.0 per 1000 livebirths in neonates delivered by other modes). Those neonates who developed subaponeurotic haemorrhage without trial of vacuum extraction had a history of either prolonged labour or difficult delivery. Thirty-three (32.7%) of the neonates with subaponeurotic haemorrhage developed anaemia which required blood transfusion and 3/33 (9.1%) were in shock. Fifty seven (56.4%) of the neonates with subaponeurotic haemorrhage developed hyperbilirubinemia due to the haemorrhage. Four (7.0%) of them had severe unconjugated hyperbilirubinemia which required exchange transfusion. The results of this study suggest that subaponeurotic haemorrhage in Malaysian neonates was commonly associated with vacuum extraction and was not a benign condition. PMID:2392696

Boo, N Y

1990-06-01

69

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

70

Postpartum haemorrhage: prevention  

PubMed Central

Introduction Loss of more than 500 mL of blood following childbirth is usually caused by failure of the uterus to contract fully after delivery of the placenta, and occurs in over 10% of deliveries, with a 1% mortality rate worldwide. Other causes of postpartum haemorrhage include retained placental tissue, lacerations to the genital tract, and coagulation disorders. Uterine atony is more likely in women who have had a general anaesthetic or oxytocin, an over-distended uterus, a prolonged or precipitous labour, or who are of high parity. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug interventions and of drug interventions to prevent primary postpartum haemorrhage? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 40 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: active management of the third stage of labour, carboprost injection, controlled cord traction, ergot compounds (ergometrine/methylergotamine), immediate breastfeeding, misoprostol (oral, rectal, sublingual, or vaginal), oxytocin, oxytocin plus ergometrine combinations, prostaglandin E2 compounds, and uterine massage.

2011-01-01

71

Six year trend of neonatal septicaemia in a large Malaysian maternity hospital.  

PubMed

A study carried out in the Maternity Hospital, Kuala Lumpur over a 6 year period from 1986 to 1991, showed that the annual rates of septicaemia ranged from 5.2 to 10.2/100 admissions. Septicaemia accounted for between 11.0 to 30.4% of all neonatal deaths. The case fatality ratios ranged from 23.0 to 52.2%, being highest in 1989 when basic facilities were compromised. Low birthweight neonates accounted for 55.5% of those with septicaemia. The most common causative organisms were Staphylococcus epidermidis and Staphylococcus aureus in 1986 and 1987, but from 1988 Klebsiella species became the most common. More than 50% of neonatal septicaemia occurred after the age of 2 days. The results of the study demonstrated the dynamism of infection control: when control measures introduced earlier were not sustained, outbreaks of nosocomial infection recurred or worsened. PMID:8148183

Boo, N Y; Chor, C Y

1994-02-01

72

Ampicillin 'Penbritin' in the Treatment of Acute Brucella Melitensis Septicaemia and Salmonella Typhi Urinary Carriers.  

National Technical Information Service (NTIS)

Seven patients with Brucella melitensis septicaemia were treated with various doses of ampicillin. Three patients were unable to complete the 21-day course of therapy due to a severe urticarial-like generalized rash accompanied by an increased clinical to...

Z. Farid S. Bassily M. S. Omar

1967-01-01

73

Massive post-partum haemorrhage  

Microsoft Academic Search

Death from haemorrhage occurs in 5.5 per million maternities in the UK. Sadly, this figure has not fallen since the 1985–1987 triennium and care remains sub-standard in 66% of cases. While various risk factors can be identified for post-partum haemorrhage, further improvements in care can only occur with dissemination of good practice and adoption of local protocols designed to deliver

S. Macphail; J. Fitzgerald

2001-01-01

74

Protection of cattle against experimental haemorrhagic septicaemia by the capsular antigens of Pasteurella multocida, types B and E.  

PubMed

Aluminum hydroxide adjuvant vaccines containing endotoxin-free capsular antigens of Pasteurella multocida, types B and E, were administered to cattle. Dose dependent serological responses were observed which were similar for both antigens. The immunised cattle were subjected to intravenous challenge by a virulent type E strain. All animals which received the highest vaccine dose survived and all unimmunised control animals died and a vaccine dose-response relationship was obtained. The results of passive mouse protection and indirect haemagglutination tests (type E) on the sera of immunised cattle corresponded with the degree of protection against challenge of the cattle. PMID:59379

Nagy, L K; Penn, C W

1976-05-01

75

Protection, humoral and cell-mediated immune responses in calves immunized with multiple emulsion haemorrhagic septicaemia vaccine  

Microsoft Academic Search

A multiple emulsion (ME), vaccine against Pasteurella multocida (P52) infection in cattle was prepared and the efficiency in terms of immunity to direct challenge, duration of this immunity for up to 1 year and the role of humoral and cell-mediated immune mechanisms were studied. ME vaccine was sterile, safe and was potent when tested in rabbits and calves. Nineteen calves

Rishendra Verma; T. N. Jaiswal

1997-01-01

76

Comparative analysis of the outer membrane protein profiles of isolates of the Pasteurella multocida (B:2) associated with haemorrhagic septicaemia.  

PubMed

Outer membrane proteins (OMP) of P. multocida (serotype B:2) field isolates (n = 6) and a vaccine strain (P-52) were extracted by a sarkosyl method and characterized using SDS-PAGE and immunoblotting. About 20 polypeptide bands were observed in the profile of the vaccine strain with MW ranging from 16 to 90 kDa and, based on band thickness and intensity of staining, three polypeptides of MW 31, 33 and 37 kDa were considered to be the major OMPs. The profiles of the field isolates showed minor differences when compared with that of the vaccine strain. The OMP of 33 kDa was only expressed by the vaccine strain. Four field isolates expressed an OMP of 39 kDa, which did not appear in the profiles of the remaining two field isolates and the P-52 strain. Similarly, an OMP of 25 kDa was exclusively seen in the profile of a single isolate. By immunoblotting studies, using anti-P. multocida (P-52) whole-cell hyperimmune serum raised in rabbits as well as buffalo immune sera, it became evident that the polypeptide of 37 kDa was the most antigenic OMP in the profiles of all the isolates, including the P-52 strain. Other polypeptides were either weakly antigenic or visible in the profile of only a few of the isolates. The study thus identified the major OMP of P. multocida (B:2) and suggested that this highly antigenic 37 kDa OMP has potential for further protective and immunodiagnostic studies. PMID:12416865

Tomer, P; Chaturvedi, G C; Minakshi; Malik, P; Monga, D P

2002-10-01

77

New Release: An Empirical Analysis of VHS\\/DVD Rental Success  

Microsoft Academic Search

This paper studies movie rental revenue in the home video industry. Using a cross-section of the top 100 films from 2001 as\\u000a a sample, domestic Video Home System (VHS) and Digital Versatile Disc (DVD) rental revenues are tested for responsiveness\\u000a to independent variables including: box office gross revenue, production budget, aggregate critic rating, Motion Picture Association\\u000a of America (MPAA) rating,

James J. Jozefowicz; Jason M. Kelley; Stephanie M. Brewer

2008-01-01

78

Complete genome sequence of virulence-enhancing Siphophage VHS1 from Vibrio harveyi.  

PubMed

Vibrio harveyi siphophage 1 (VHS1) is a tailed phage with an icosahedral head of approximately 66 nm in diameter and an unornamented, flexible tail of approximately 153 nm in length. When Vibrio harveyi 1114GL is lysogenized with VHS1, its virulence for the black tiger shrimp (Penaeus monodon) increases by more than 100 times, and this coincides with production of a toxin(s) associated with shrimp hemocyte agglutination. Curiously, the lysogen does not show increased virulence for the whiteleg shrimp (Penaeus [Litopenaeus] vannamei). Here we present and annotate the complete, circular genome of VHS1 (81,509 kbp; GenBank accession number JF713456). By software analysis, the genome contains 125 putative open reading frames (ORFs), all of which appear to be located on the same DNA strand, similar to the case for many other bacteriophages. Most of the putative ORFs show no significant homology to known sequences in GenBank. Notable exceptions are ORFs for a putative DNA polymerase and putative phage structural proteins, including a portal protein, a phage tail tape measure protein, and a phage head protein. The last protein was identified as a component of the species-specific toxin mixture described above as being associated with agglutination of hemocytes from P. monodon. PMID:22307287

Khemayan, Krit; Prachumwat, Anuphap; Sonthayanon, Burachai; Intaraprasong, Aungkul; Sriurairatana, Siriporn; Flegel, Timothy W

2012-02-03

79

Complete Genome Sequence of Virulence-Enhancing Siphophage VHS1 from Vibrio harveyi  

PubMed Central

Vibrio harveyi siphophage 1 (VHS1) is a tailed phage with an icosahedral head of approximately 66 nm in diameter and an unornamented, flexible tail of approximately 153 nm in length. When Vibrio harveyi 1114GL is lysogenized with VHS1, its virulence for the black tiger shrimp (Penaeus monodon) increases by more than 100 times, and this coincides with production of a toxin(s) associated with shrimp hemocyte agglutination. Curiously, the lysogen does not show increased virulence for the whiteleg shrimp (Penaeus [Litopenaeus] vannamei). Here we present and annotate the complete, circular genome of VHS1 (81,509 kbp; GenBank accession number JF713456). By software analysis, the genome contains 125 putative open reading frames (ORFs), all of which appear to be located on the same DNA strand, similar to the case for many other bacteriophages. Most of the putative ORFs show no significant homology to known sequences in GenBank. Notable exceptions are ORFs for a putative DNA polymerase and putative phage structural proteins, including a portal protein, a phage tail tape measure protein, and a phage head protein. The last protein was identified as a component of the species-specific toxin mixture described above as being associated with agglutination of hemocytes from P. monodon.

Khemayan, Krit; Prachumwat, Anuphap; Sonthayanon, Burachai; Intaraprasong, Aungkul; Sriurairatana, Siriporn

2012-01-01

80

Massive large-bowel haemorrhage.  

PubMed Central

Operative intervention for massive colonic haemorrhage is fortunately rarely necessary, but planned, low-risk segmental resections can only be performed if the bleeding site is known. This information can most frequently be obtained by using a combination of sigmoidoscopy, barium enema examination, and selective mesenteric angiography.

Roberts, P.; Thomas, P. A.

1981-01-01

81

Neuroradiological aspects of subdural haemorrhages  

Microsoft Academic Search

Aims: To review the neuroimaging of a series of infants and young children admitted to hospital with subdural haemorrhage (SDH).Methods: Neuroradiological investigations of 74 children under 2 years of age, from South Wales and southwest England, in whom an SDH or subdural effusion had been diagnosed between 1992 and 2001, were reviewed. Two paediatric neuroradiologists blinded to the original radiological

S Datta; N Stoodley; S Jayawant; S Renowden; A Kemp

2005-01-01

82

Dose response study of enrofloxacin against Riemerella anatipestifer septicaemia in Muscovy and Pekin ducklings.  

PubMed

The efficacy of enrofloxacin against Riemerella anatipestifer (formerly Pasteurella anatipestifer) septicaemia of Muscovy and Pekin ducklings was assessed in an artificial challenge model which reproduced typical duck riemerellosis with very high mortality. Mortality, clinical signs, gross lesions, microbiological clearance, feed intake and body weight gain were the efficacy criteria studied. A pulsing medication in drinking water for 4 h at 25, 50 or 100 ppm enrofloxacin on the first day, followed by 12.5, 25 or 50 ppm, respectively, on the following 4 days, provided clinical cure of R. anatipestifer septicaemia at all dosages tested. An optimum dosage of 50 ppm enrofloxacin, followed by 25 ppm was established. PMID:18483945

Turbahn, A; De Jackel, S C; Greuel, E; De Jong, A; Froyman, R; Kaleta, E F

1997-01-01

83

Generation of adenoviruses encoding the herpes simplex virus vhs gene: A novel strategy to generate adenoviruses expressing genes toxic to producer cells  

Microsoft Academic Search

Adenovirus vectors expressing suicide genes represent a promising approach for cancer gene therapy. We wanted to determine whether the virion host shutoff ( vhs ) gene of herpes simplex virus could be used as a suicide gene for gene therapy of glioblastomas. The vhs gene was cloned downstream of the glial fibrillary acidic protein promoter to direct tissue-specific expression, and

Gary M Glenn; Subhendra Chatterjee

2001-01-01

84

Aeromonas hydrophila septicaemia in a grey seal ( Halichoerus grypus) from the Baltic Sea: a case study  

Microsoft Academic Search

Aeromonas hydrophila septicaemia in a grey seal (Halichoerus grypus) from the Swedish part of the Baltic Sea is reported. The pathogen was isolated from both lung and spleen specimens. All of the A. hydrophila isolates produced haemolysin and Vero active cytotoxin. The aerolysin gene was found in all tested isolates as evidenced by the polymerase chain reaction (PCR) technique. Also,

Karel Krovacek; Kui Huang; Susanna Sternberg; Stefan B Svenson

1998-01-01

85

Rifampicin as an adjunct to vancomycin therapy in MRSA septicaemia in burns  

Microsoft Academic Search

Rifampicin has been successfully used as an adjunct to vancomycin therapy in several clinical conditions of MRSA infections such as endocarditis, ventriculoperitoneal shunts and septicaemia. However, very little information is available in the literature regarding its use in MRSA septiceamia in burns. The present prospective study was conducted to evaluate the efficacy of rifampicin as an adjunct therapy in burn

Raj Kumar Gang; Suhas C. Sanyal; Eiman Mokaddas; Abdul Reda Lari

1999-01-01

86

Neonatal Klebsiella Septicaemia in Ibadan: Implications for Neonatal Care in Developing Countries.  

ERIC Educational Resources Information Center

|The antecedent events, clinical features, prevalence, and complications of neonatal Klebsiella septicaemia in 73 infants admitted to a special care baby unit in Nigeria are retrospectively reviewed and compared with those of 72 infants who had no risk factors for sepsis admitted to the same unit during the same period. A nosocomial acquisition of…

Omokhodion, S. I.; And Others

1993-01-01

87

Dose response study of enrofloxacin against Riemerella anatipestifer septicaemia in Muscovy and Pekin ducklings  

Microsoft Academic Search

The efficacy of enrofloxacin against Riemerella anatipestifer (formerly Pasteurella anatipestifer) septicaemia of Muscovy and Pekin ducklings was assessed in an artificial challenge model which reproduced typical duck riemerellosis with very high mortality. Mortality, clinical signs, gross lesions, microbiological clearance, feed intake and body weight gain were the efficacy criteria studied. A pulsing medication in drinking water for 4 h at

A. Turbahn; Sonia Cortez De Jäckel; E. Greuel; A. De Jong; R. Froyman; E. F. Kaleta

1997-01-01

88

Community-acquired septicaemia in southern Viet Nam: the importance of multidrug-resistant Salmonella typhi  

Microsoft Academic Search

In a prospective study conducted between mid 1993 and 1994, 437 adults and children were admitted with community-acquired septicaemia to an infectious diseases hospital in southern Viet Nam. Gramnegative aerobes accounted for 90% of isolates and were predominantly Salmonella typhi (67%), Sal. paratyphi A (3%), Escherichia coli (10%), and Klebsiella spp. (5%). Other Salmonella spp. (1%), Pseudomonas aeruginosa (1%), Neisseria

Nguyen Thi Tuyet Hoa; To Song Diep; John Wain; Christopher M. Parry; Tran Tinh Hien; Michael D. Smith; Amanda L. Walsh; Nicholas J. White

1998-01-01

89

Fatal neonatal septicaemia and meningitis due to Haemophilus influenzae acquired from the mother  

Microsoft Academic Search

A fatal case of neonatal Haemophilus influenzae type b, septicaemia and meningitis is described. Although the mother was asymptomatic, maternal genital tract culture yielded H. influenzae which was indistinguishable from the strain found in the infant. Despite the rarity of this organism as a cause of neonatal sepsis, increased awareness is essential so that this important offending pathogen is not

B. Chattopadhyay

1984-01-01

90

Neuroradiological aspects of subdural haemorrhages  

PubMed Central

Aims: To review the neuroimaging of a series of infants and young children admitted to hospital with subdural haemorrhage (SDH). Methods: Neuroradiological investigations of 74 children under 2 years of age, from South Wales and southwest England, in whom an SDH or subdural effusion had been diagnosed between 1992 and 2001, were reviewed. Two paediatric neuroradiologists blinded to the original radiological report reviewed all the relevant images. Results: Neuroradiological review of images identified radiological features which were highly suggestive of non-accidental head injury (NAHI). Interhemispheric haemorrhages and SDHs in multiple sites or of different densities were almost exclusively seen in NAHI. MRI was more sensitive in identifying SDHs of different signal characteristics, posterior and middle cranial fossa bleeds, and parenchymal changes in the brain. CT scans, if performed with suboptimal protocols, were likely to miss small subdural bleeds. Conclusions: Guidelines for neuroimaging in suspected NAHI are recommended. A radiologist with experience in NAHI should report or review these scans. The initial investigation should be CT, but MRI will also be necessary in most cases. Head CT should be an integral part of the skeletal survey in all infants less than 6 months of age referred for child protection investigation, and in children less than 2 years where child abuse is suspected and there are neurological signs, retinal haemorrhages, or fractures.

Datta, S; Stoodley, N; Jayawant, S; Renowden, S; Kemp, A

2005-01-01

91

Spontaneous perinatal epidural haemorrhage in a newborn.  

PubMed

A full-term neonate, born by caesarean section, presents with focal seizures. EEG and cranial ultrasound are normal. MRI of the cerebrum shows an epidural haematoma. Perinatal intracranial haemorrhage in the full-term newborn is an important cause of morbidity and mortality. Most perinatal intracranial haemorrhages are located either subdural or intracerebral, rarely epidural. Epidural haemorrhage is usually a complication of assisted delivery, however it may also occur without forcipal or vacuum extraction, as demonstrated in this case. An epidural haemorrhage should be suspected on clinical findings, even in the absence of an assisted delivery. As cranial ultrasound sonography often misses epidural haemorrhage due to parietal location of the haemorrhage, the diagnosis needs either cerebral CT or MRI. PMID:22665463

Kroon, Elke; Bok, Levinus A; Halbertsma, Feico

2012-02-21

92

Disc haemorrhages, precursors of open angle glaucoma  

Microsoft Academic Search

In a long-term study of 1270 patients with at least one of the findings, open-angle glaucoma, disc haemorrhages or retinal vein occlusions, disc haemorrhages were witnessed in approximately 20% of the cases with open-angle glaucoma, and were a precursor of glaucomatous disc changes and associated visual field defects. Disc haemorrhages also preceded a rising intraocular pressure (IOP) in the destructive

Bo Sonnsjö; Yvonne Dokmo; Torsten Krakau

2002-01-01

93

[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

94

'Pseudocirrhosis' in hereditary haemorrhagic telangiectasia.  

PubMed Central

Telangiectasia-associated hepatic fibrosis (TAHF) in a 68-year-old woman with hereditary haemorrhagic telangiectasia (HHT) is described. The patient died of oat-cell carcinoma of the lung. In addition to the structural alterations which have been described previously in HHT, the liver exhibited focal midlobular hepatocytic necrosis and tumour metastases. The possibility that treatment of HHT was causally related to some of the hepatic abnormalities found in our patient and the differentiation of TAHF from true cirrhosis are discussed. Images

Cooney, T; Sweeney, E C; Coll, R; Greally, M

1977-01-01

95

Crimean–Congo haemorrhagic fever in Eurasia  

Microsoft Academic Search

Crimean–Congo haemorrhagic fever (CCHF) is a tick-borne infectious disease characterized by fever, malaise, headache, nausea, vomiting, diarrhoea, sore throat, muscle aches, haemorrhage and thrombocytopenia. It is a challenge for the population of endemic rural areas, and for healthcare workers, and carries a considerable mortality. The disease is widely distributed in Africa, Europe and Asia, and has become a serious threat

Hakan Leblebicioglu

2010-01-01

96

Intraperitoneal haemorrhage from anterior abdominal wall varices.  

PubMed Central

Patients with oesophageal varices frequently present with gastrointestinal haemorrhage but bleeding from varices at other sites is rare. We present a patient with hepatitis C-induced cirrhosis and partial portal vein occlusion who developed spontaneous haemorrhage from anterior abdominal wall varices into the rectus abdominus muscle and peritoneal cavity. Images Figure 1

Hunt, J. B.; Appleyard, M.; Thursz, M.; Carey, P. D.; Guillou, P. J.; Thomas, H. C.

1993-01-01

97

Significance of placental pathology in transplacental haemorrhage  

Microsoft Academic Search

Placentae were examined from 120 women whose pregnancy and delivery was normal, from 264 women whose pregnancy or delivery was complicated, and from 98 women who were Rh-negative without antibodies and 35 women Rh-negative with antibodies. The presence of Kline's haemorrhages, intervillous thrombi, infarcts, and retroplacental haemorrhages was positively correlated with the presence of foetal cells in the maternal circulation.

Banti Devi; R. F. Jennison; F. A. Langley

1968-01-01

98

Intracerebral haemorrhage after the neonatal period.  

PubMed Central

Intracerebral haemorrhage is rare in childhood. We have reviewed the last 10 years' experience, in our referral area, of parenchymatous intracerebral haemorrhage in children from 1 month to 16 years of age. There were 27 cases, five of which were intracerebellar and two predominantly intraventricular. The commonest aetiology was vascular malformation (10), followed by haemorrhage into tumour (four), and coagulopathies (five). Clinical features were non-specific, but altered consciousness, headache, vomiting, and focal signs were the most common. Focal signs were, however, rare in the patients with intracerebellar haemorrhage. There was an overall mortality of 54% (14 out of 27). Nine patients were handicapped on follow up, but none severely so. For the diagnosis of intracerebral haemorrhage a high level of clinical suspicion is needed with early use of computed tomography. Maintenance of homeostasis, relief of raised intracranial pressure, and evacuation of haematoma are the aims of management.

Livingston, J H; Brown, J K

1986-01-01

99

[Secondary right-sided diaphragmatic hernia following neonatal group B Streptococcal septicaemia in a preterm infant].  

PubMed

We report on a case of a secondary right-sided diaphragmatic hernia following group B streptococcal (GBS) septicaemia in a very low birth weight infant born at 30 weeks. After initial improvement, the diagnosis of a secondary right-sided diaphragmatic hernia was suspected with the persistent radiological pulmonary right-sided image on the chest x-ray and the clinical degradation. The diagnosis was confirmed by ultrasonography on day 43. The postoperative course was simple. Persistent respiratory distress in a neonate, after a GBS septicaemia associated with a right pulmonary opacity on the chest x-ray, should prompt a careful evaluation. A secondary right-sided diaphragmatic hernia should be considered. Treatment is surgery, the prognosis is good in the absence of pulmonary hypoplasia. PMID:17451917

Vedel-Werts, F; Desandes, R; Rouabah, M; Bach, P; de Miscault, G; Hascoët, J-M; Hamon, I

2007-04-23

100

Meningococcal septicaemia treated with combined plasmapheresis and leucapheresis or with blood exchange.  

PubMed Central

Mortality among patients suffering from meningococcal septicaemia has reached nearly 50% in parts of northern Norway despite intensive care. The activation of complement and blood cells by endotoxin is assumed to be the cause of most of the associated pathophysiological changes. Consequently, it would seem logical to remove such constituents either by combined plasmapheresis and leucapheresis or by blood exchange in patients with a fatal prognosis. Three patients were treated with plasmapheresis and leucapheresis and one with blood exchange. All recovered without sequelae, and no complications or serious problems caused by these procedures were observed. It is concluded that either combined leucapheresis and plasmapheresis or blood exchange is well tolerated and a valuable supplement to conventional intensive care in fulminant meningococcal septicaemia.

Bjorvatn, B; Bjertnaes, L; Fadnes, H O; Flaegstad, T; Gutteberg, T J; Kristiansen, B E; Pape, J; Rekvig, O P; Osterud, B; Aanderud, L

1984-01-01

101

The immunogenicity of viral haemorragic septicaemia rhabdovirus (VHSV) DNA vaccines can depend on plasmid regulatory sequences  

Microsoft Academic Search

A plasmid DNA encoding the viral hemorrhagic septicaemia virus (VHSV)-G glycoprotein under the control of 5? upstream sequences (enhancer\\/promoter sequence plus both non-coding 1st exon and 1st intron sequences) from carp ?-actin gene (pAE6-GVHSV) was compared to the vaccine plasmid usually described the gene expression is regulated by the human cytomegalovirus (CMV) immediate-early promoter (pMCV1.4-GVHSV). We observed that these two

V. Chico; M. Ortega-Villaizan; A. Falco; C. Tafalla; L. Perez; J. M. Coll; A. Estepa

2009-01-01

102

Terson's syndrome: subarachnoid haemorrhage presenting as sudden visual loss.  

PubMed

Subarachnoid haemorrhage is a condition that usually presents with headache and altered mental state. We report the case of a 50-year-old man with subarachnoid haemorrhage who presented with Terson's syndrome. This is a condition where there is retinal or vitreous haemorrhage secondary to subarachnoid or subdural haemorrhage. PMID:22862765

Moynihan, Gerard; Robinson, Kent

2012-08-01

103

[Endoscopic methods of treatment of variceal haemorrhages].  

PubMed

Haemorrhages from oesophagal varices are one of the most lifethreatening complications of the portal hypertension. Among various methods of treatment, endoscopic techniques are accepted and acknowledged as basic ones. The object of this paper is:--to present the variety of endoscopic procedures--to analyse the methodology and techniques of endoscopic procedures--to compare the effectiveness, safety and possible complications of different endoscopic techniques--to analyse the recommendations for treatment of acute variceal haemorrhages, primary and secondary prophylaxis. Endoscopic methods of haemostasis are essential in the treatment of acute variceal haemorrhages. Medical centres having at their disposal endoscopic methods of treating variceal haemorrhages can use the following techniques: EIS-endoscopic injection sklerotherapy--obliterating bleeding varices by injecting polidocanol or alcohol); rubber bands (EVL-Endoscopic Variceal Ligation); clipsing (closing varices with metal clipses). There are also different possibilities of combining methods mentionned above. In the primary prophylaxis of variceal haemorrhages, as the results of different studies are ambiguous, the endoscopic methods are used cautiously and for special indications only; pharmacological methods (non-selective b-blockers) have a leading role here. In the secondary prophylaxis of haemorrhages (in patients with history of previous variceal haemorrhages) endoscopic techniques have an acknowledged and leading role among other therapeutic methods. When comparing different endoscopic methods, crucial differences can be observed between their effectiveness, safety and technical possibilities of performing the procedures. PMID:17679386

Jaklewicz, Dariusz; Róza?ski, Waldemar; Wojtu?, Stanis?aw; Gil, Jerzy

2007-05-01

104

Cardiac bypass surgery with haemorrhagic endocrine sequelae.  

PubMed Central

Cardiac bypass surgery is associated with changes in haemostatis which can lead to bleeding. This report highlights two examples of such bleeding which led to unusual clinical presentations and endocrinological consequences: adrenal and pituitary haemorrhage. Images Figure 1 Figure 2

Khardori, R.; Bussing, R. C.; Burns, G. M.; Soler, N. G.

1987-01-01

105

A spontaneous suprachoroidal haemorrhage: a case report  

PubMed Central

Introduction We present a case of spontaneous suprachoroidal haemorrhage in a patient taking Warfarin. This is only the second case reported of a patient whose anticoagulation was within the therapeutic range. Case presentation An 84 year old white male with a history of end stage atrophic age related macular degeneration presented with angle closure glaucoma. The patient was taking warfarin and had a therapeutic International Normalized Ratio (INR). Ultrasound examination revealed a spontaneous suprachoroidal haemorrhage. Conclusion Anticoagulation is common in those with cardiovascular disease, which increases the risk of haemorrhagic complications. These patients are also more likely to suffer from age related macular degeneration. Suprachoroidal haemorrhage should be considered in such patients presenting with suspicious signs and a low threshold should be had for investigating for this condition in such circumstances. Early detection may reduce the morbidity.

2009-01-01

106

Disc haemorrhages, precursors of open angle glaucoma.  

PubMed

In a long-term study of 1270 patients with at least one of the findings, open-angle glaucoma, disc haemorrhages or retinal vein occlusions, disc haemorrhages were witnessed in approximately 20% of the cases with open-angle glaucoma, and were a precursor of glaucomatous disc changes and associated visual field defects. Disc haemorrhages also preceded a rising intraocular pressure (IOP) in the destructive process among open-angle glaucoma cases. Similar glaucomatous development appears among cases independent of IOP or detection of exfoliation syndrome. Retinal vein occlusions and disc haemorrhages behave similarly with respect to glaucoma. The large number of transgressions is an argument against dividing glaucoma into different types. These findings support a vascular genesis to open-angle glaucoma, presented in earlier epidemiological studies. PMID:11906810

Sonnsjö, Bo; Dokmo, Yvonne; Krakau, Torsten

2002-01-01

107

Complications and therapy after subarachnoid haemorrhage  

Microsoft Academic Search

Subarachnoid haemorrhage (SAH) is a subset of stroke with a poor prognosis, up to 40% of patients die. Besides the impact of the initial haemorrhage, several neurological and systemic complications contribute to a poor clinical outcome.\\u000a\\u000aThe first part of this thesis describes several complications after SAH. It is well known that SAH patients often have hyperglycaemia, and in chapter

S. M. Dorhout Mees

2012-01-01

108

Haemorrhagic smolt syndrome (HSS) in Norway: pathology and associated virus-like particles.  

PubMed

Atlantic salmon Salmo salar pre-smolt, smolt and post-smolt, with clinical signs of haemorrhagic smolt syndrome (HSS) have been found in several locations along the Norwegian coast (Rogaland to Troms). Affected fish had pale gills and bleeding at the fin bases, but seemed to be in good physical condition with no obvious weight loss. The internal organs and body cavity showed distinct bleedings. Petechiae were found on the gastrointestinal tract, swim bladder and peritoneum, visceral adipose tissue, heart and somatic musculature. The liver was bright yellow and sometimes mottled with petechiae and ecchymoses. Acitic fluid was found in the visceral cavity and fluid was also present in the pericardial cavity. Histological examination revealed haemorrhage in most organs. The glomeruli were degenerated and the renal tubules were filled with erythrocytes. The aims of this study were to describe the pathology and discover, if possible, the aetiology of the HSS. Tissues were collected for light and transmission electron microscopy (TEM), immunofluorescence (IFAT), reverse transcription (RT)-PCR diagnostics (screening for infectious salmon anaemia virus [ISAV], viral haemorrhagic septicaemia virus [VHSV], salmon pancreas disease virus [SPDV], sleeping disease virus [SDV] and infectious haematopoetic necrosis virus [IHNV]), and tissue homogenates (heart, liver, kidney and spleen) were sterile-filtered and inoculated into cell cultures. Homogenates made from several tissues were also injected intraperitoneally into salmon and rainbow trout Oncorhynchus mykiss. The diagnostic tests revealed no consistent findings of any pathogens, with the exception of TEM which showed 2 types of virus-like particles: Type I was 50 to 60 nm in diameter and Type II about 50 nm in diameter. These virus-like particles were found in salmon from all farms affected by HSS and screened by TEM. Several different cells, blood vessel endothelial cells, endocardial cells, heart myofibres, and leukocytes were associated with the 2 virus-like particles. The Type I particle seems to be an infectious pancreatic necrosis (IPN)-like virus, while (based on the number of target cells, particle morphology, budding and uptake into target cells) Type II particle could be a togavirus. PMID:12718466

Nylund, A; Plarre, H; Hodneland, K; Devold, M; Aspehaug, V; Aarseth, M; Koren, C; Watanabe, K

2003-03-17

109

Biochemical and structural characterization of the interaction of memapsin 2 (beta-secretase) cytosolic domain with the VHS domain of GGA proteins.  

PubMed

Memapsin 2 (beta-secretase) is a membrane-associated aspartic protease that initiates the hydrolysis of beta-amyloid precursor protein (APP) leading to the production of amyloid-beta and the onset of Alzheimer's disease (AD). Both memapsin 2 and APP are transported from the cell surface to endosomes where APP hydrolysis takes place. Thus, the intracellular transport mechanism of memapsin 2 is important for understanding the pathogenesis of AD. We have previously shown that the cytosolic domain of memapsin 2 contains an acid-cluster-dileucine (ACDL) motif that binds the VHS domain of GGA proteins (He et al. (2002) FEBS Lett. 524, 183-187). This mechanism is the presumed recognition step for the vesicular packaging of memapsin 2 for its transport to endosomes. The phosphorylation of a serine residue within the ACDL motif has been reported to regulate the recycling of memapsin 2 from early endosomes back to the cell surface. Here, we report a study on the memapsin 2/VHS domain interaction. Using isothermal titration calorimetry, the dissociation constant, K(d), values are 4.0 x 10(-4), 4.1 x 10(-4), and 3.1 x 10(-4) M for VHS domains from GGA1, GGA2, and GGA3, respectively. With the serine residue replaced by phosphoserine, the K(d) decreased about 10-, 4-, and 14-fold for the same three VHS domains. A crystal structure of the complex between memapsin 2 phosphoserine peptide and GGA1 VHS was solved at 2.6 A resolution. The side chain of the phosphoserine group does not interact with the VHS domain but forms an ionic interaction with the side chain of the C-terminal lysine of the ligand peptide. Energy calculation of the binding of native and phosphorylated peptides to VHS domains suggests that this intrapeptide ionic bond in solution may reduce the change in binding entropy and thus increase binding affinity. PMID:14567678

He, Xiangyuan; Zhu, Guangyu; Koelsch, Gerald; Rodgers, Karla K; Zhang, Xuejun C; Tang, Jordan

2003-10-28

110

Formalin dab for haemorrhagic radiation proctitis.  

PubMed Central

BACKGROUND: Haemorrhagic radiation proctitis frequently presents as a problem in management. We analysed the technique of formalin dab in its management. PATIENTS AND METHODS: Twenty patients presenting with haemorrhagic radiation proctitis and treated with formalin dab were prospectively analysed. RESULTS: Twelve patients ceased to bleed following one session of formnalin dab. Six patients needed more than one session to effect haemostasis. Two of three patients with torrential bleeding failed to respond to formalin dab and required surgical excision of the rectum. CONCLUSION: Formalin dab is a simple, effective and safe treatment modality in the management of chronic haemorrhagic radiation proctitis, and hence should be considered as the initial treatment modality for such a condition.

Ismail, M. A.; Qureshi, M. A.

2002-01-01

111

Haemophilia-associated Yersinia pseudotuberculosis serotype O:1 septicaemia: the role of iron.  

PubMed

Septicaemia and septic arthritis due to Yersinia pseudotuberculosis are rare diseases with high mortality rates. Reactive arthritis caused by Yersinia infection is a well-known complication but septic arthritis is found at a much lower frequency. It has already been established that there is a relationship between yersiniosis and iron but there are currently no data about yersiniosis and haematological disorders such as haemophilia. We report a case of septic arthritis due to Y. pseudotuberculosis as an early manifestation of Yersinia septicaemia in a patient with severe haemophilia A. The patient had no history of immunosuppression and presented with a repeat case of haemarthrosis with a fever of unknown origin. Furthermore, he suffered from acute-on-chronic renal failure and non-ST segment elevation myocardial infarction. Arthrocentesis and blood culture tested positive for Y. pseudotuberculosis. Iron deposits at localized sites in the synovium in patients with haemophilia have been described, and as Yersinia infections are common in patients with secondary iron overload, we felt that a review of the literature was in order. Severe Yersinia infection is often associated with iron overload, a condition that might occur as a side effect in the treatment of haemophilia. Iron overload, which plays an important role in the pathogenesis of haemophilic arthropathy, may have increased the virulence of Y. pseudotuberculosis in the present case. PMID:22184209

Mischnik, Alexander; Dahme, Tillman; Bekeredjian, Raffi; Zimmermann, Stefan

2012-01-01

112

Haemorrhagic strokes in pregnancy and puerperium.  

PubMed

There is an increased risk of strokes in pregnancy and puerperium. Intracranial haemorrhage is the rarer of the two stroke subtypes but carries a greater morbidity and mortality for both the mother and the child. This review highlights the causes of pregnancy-related intracranial haemorrhage and its management. The incidence varies from region to region with the highest being reported from China and Taiwan. Majority of these haemorrhages are secondary to hypertensive disorders of pregnancy with smaller proportions related to aneurysm and arteriovenous malformation rupture. A small but important contributor is cortical venous thrombosis which, although predominantly gives rise to ischaemic lesions, may lead to parenchymal haemorrhages as well. Presentation is usually with headaches or seizures, with or without focal deficits. Diagnosis requires brain imaging with computerized tomography or magnetic resonance imaging, and the necessity of investigation when this diagnosis is suspected supersedes the small risk of fetal malformation. Management follows the general management principles for intracranial haemorrhage management. Blood pressures need to be strictly monitored and medicines used for controlling them may differ slightly due to teratogenic effects. For preeclampsia, early but safe delivery is the best treatment. For cortical venous thrombosis, low-molecular-weight heparin is the preferred agent. Aneurysms and vascular malformations need to be definitively treated to prevent re-bleed and this can be achieved through surgical or endovascular procedures. The timing of surgery depends on neurosurgical considerations. However, the timing and mode of delivery are governed by obstetric factors. Risk of future haemorrhage depends on whether the underlying aetiology can be and has been definitively treated. PMID:22863273

Khan, Maria; Wasay, Mohammad

2012-08-01

113

Intraventricular haemorrhage and periventricular leucomalacia: ultrasound and autopsy correlation  

Microsoft Academic Search

The brains of 30 infants who died after at least one real time ultrasound scan were examined after fixation. The ultrasound diagnosis of either periventricular haemorrhage or periventricular leucomalacia was compared with the macroscopic and histological appearances. Each hemisphere was considered separately for both periventricular haemorrhage and periventricular leucomalacia. The accuracy of ultrasound diagnosis for periventricular haemorrhage was 88%, with

J Q Trounce; D Fagan; M I Levene

1986-01-01

114

Comparison of C-reactive protein and white blood cell count with differential in neonates at risk for septicaemia  

Microsoft Academic Search

We prospectively compared the diagnostic value of C-reactive protein (CRP) and white blood cell counts for detection of neonatal septicaemia. Sensitivity and specifity in receiver operating characteristics, and positive and negative predictive value of CRP and white blood cell count were compared in 195 critically ill preterm and term newborns clinically suspected of infection. Blood cultures were positive in 33

Christoph Berger; Judith Uehlinger; Daniela Ghelfi; N. Blau; Sergio Fanconi

1995-01-01

115

[Viral haemorrhagic fevers--evolution of the epidemic potential].  

PubMed

In this review modern data on dangerous and particularly dangerous viral haemorrhagic fevers caused by a group of viruses belonging to the families of phylo-, arena-, flavi-, bunya- and togaviruses are presented. Morbidity rates and epidemics caused by Marburg virus, Ebola fever virus, Lassa fever virus, Argentinian and Bolivian haemorrhagic fever viruses, dengue haemorrhagic fever virus, Crimean haemorrhagic fever virus, Hantaviruses are analyzed. Mechanisms of the evolution of the epidemic manifestation of these infections are considered. The importance of the development of tools and methods of diagnosis, rapid prevention and treatment of exotic haemorrhagic fevers is emphasized. PMID:11949268

Markin, V A; Markov, V I

116

The neuropathology of infant subdural haemorrhage  

Microsoft Academic Search

Subdural haemorrhage (SDH) in the infant has a different pattern from that seen in the older child and adult. It is usually a widespread, bilateral, thin film, unlike the thick, space-occupying and often unilateral clot seen in older children and adults after trauma. Whether both arise by the same mechanism is unknown, but it seems unlikely. Most SDH is said

Waney Squier; Julie Mack

2009-01-01

117

Primary cerebellar haemorrhage: complications, treatment and outcome.  

PubMed

Given its anatomical proximity to the brainstem and the ventricular system, cerebellar haemorrhage may lead to immediate life-threatening complications such as brainstem compression and hydrocephalus, or to herniation through the foramen magnum or the tentorium. This situation mandates fast diagnosis and precise emergency treatment strategies. However, the treatment protocols in current use are based on little evidence and the indication criteria for surgical intervention are unclear. Early suboccipital decompressive surgery may be life-saving, but the potential risk involved is unnecessary if the haemorrhage is benign and can be managed conservatively or with insertion of an external ventricular drain. Deterioration of the patients' state of consciousness has often been used as an indication for surgery, but clinical decline can be a fulminant process leading to death within a short time. Research on cerebellar haemorrhage so far has focused on identifying outcome predictors from which treatment algorithms can be derived. Large randomised controlled trials (RCTs) are lacking. However, RCTs are urgently needed, in order to improve the level of evidence, treatment decisions may be based on. Here, we review the available literature on complications, treatment and outcome of primary cerebellar haemorrhage (PCH). Finally we propose the design of a potential RCT. PMID:23659765

Witsch, Jens; Neugebauer, Hermann; Zweckberger, Klaus; Jüttler, Eric

2013-05-06

118

Risk assessment after acute upper gastrointestinal haemorrhage  

Microsoft Academic Search

The aim of this study was to establish the relative importance of risk factors for mortality after acute upper gastrointestinal haemorrhage, and to formulate a simple numerical scoring system that categorizes patients by risk. A prospective, unselected, multicentre, population based study was undertaken using standardised questionnaires in two phases one year apart. A total of 4185 cases of acute upper

T A Rockall; R F Logan; H B Devlin; T C Northfield

1996-01-01

119

Multimodal evoked potentials after subarachnoid haemorrhage.  

PubMed

In 59 comatose patients after subarachnoid haemorrhage somatosensory, visual, auditory and magnetic motor evoked potentials were registered. Evoked potentials proved to be of much less predictive value than in other causes of coma, such as head injury and others. While loss of cortical function was a safe predictor of a fatal outcome, preservation of evoked potentials has little prognostic relevance. PMID:7913522

Firsching, R

1994-02-01

120

Hyperbaric oxygen treatment for haemorrhagic radiation cystitis  

Microsoft Academic Search

SummaryRadiation-induced severe haemorrhagic cystitis is difficult to treat. Conventional treatments may decrease haematuria but do not affect the radiocystitis itself. Hyperbaric oxygen treatment has been reported to do both. We report the results of a prospective study of hyperbaric oxygen (20 sessions of 100% oxygen inhalation at 3 bar for 90 min in a multiplace hyperbaric chamber) to 40 patients

R. F. M Bevers; K. H Kurth; D. J Bakker

1995-01-01

121

In vitro inhibition of the replication of haemorrhagic septicaemia virus (VHSV) and African swine fever virus (ASFV) by extracts from marine microalgae.  

PubMed

We have screened for in vitro inhibition of viral replication with extracts from the following marine microalgae: Porphyridium cruentum, Phaeodactylum tricornutum, Tetraselmis suecica, Chlorella autotrophica, Dunaliella tertiolecta, Dunaliella bardawil, Isochrysis galbana, Isochrysis galbana var Tiso, Ellipsoidon sp. and Tetraselmis tetrathele. We have used as viral models two enveloped viruses of significant economic importance, the viral hemorrhagic septicemia virus (VHSV) of salmonid fish and the African swine fever virus (ASFV). The aqueous extracts from P. cruentum, C. autotrophica and Ellipsoidon sp., produced a significant inhibition of the in vitro replication of both viruses in a dose-dependent manner. That this inhibition could be due to sulfated polysaccharides was suggested because the same pattern of viral inhibition was obtained by using exocellular extracts from microalgae enriched in these compounds and/or dextran sulfate of high molecular weight. However, the inhibition of viral replication did not correlate with the percentage of sulfatation of the exocellular polysaccharides. Extracts from marine microalgae may have prophylactic utility against fish and mammalian viral diseases. PMID:10588334

Fabregas, J; García, D; Fernandez-Alonso, M; Rocha, A I; Gómez-Puertas, P; Escribano, J M; Otero, A; Coll, J M

1999-11-01

122

In vitro inhibition of the replication of haemorrhagic septicaemia virus (VHSV) and African swine fever virus (ASFV) by extracts from marine microalgae  

Microsoft Academic Search

We have screened for in vitro inhibition of viral replication with extracts from the following marine microalgae: Porphyridiumcruentum, Phaeodactylumtricornutum, Tetraselmissuecica, Chlorellaautotrophica, Dunaliellatertiolecta, Dunaliellabardawil, Isochrysisgalbana, IsochrysisgalbanavarTiso, Ellipsoidonsp. and Tetraselmistetrathele. We have used as viral models two enveloped viruses of significant economic importance, the viral hemorrhagic septicemia virus (VHSV) of salmonid fish and the African swine fever virus (ASFV). The aqueous extracts

J. Fabregas; D. Garc??a; M. Fernandez-Alonso; A. I. Rocha; P. Gómez-Puertas; J. M. Escribano; A. Otero; J. M. Coll

1999-01-01

123

Short communication In vitro inhibition of the replication of haemorrhagic septicaemia virus (VHSV) and African swine fever virus (ASFV) by extracts from marine microalgae  

Microsoft Academic Search

We have screened for in vitro inhibition of viral replication with extracts from the following marine microalgae: Porphyridium cruentum, Phaeodactylum tricornutum, Tetraselmis suecica, Chlorella autotrophica, Dunaliella tertiolecta, Dunaliella bardawil, Isochrysis galbana, Isochrysis galbana6ar Tiso, Ellipsoidon sp. and Tetraselmis tetrathele. We have used as viral models two enveloped viruses of significant economic importance, the viral hemorrhagic septicemia virus (VHSV) of salmonid

J. Fabregas; D. Garcia; M. Fernandez-Alonso; A. I. Rocha; P. Gomez-Puertas; J. M. Escribano; A. Otero; J. M. Coll

124

A study on blood culture positivity and C-reactive protein variability in neonatal septicaemia at neonatal intensive care unit of a tertiary care hospital.  

PubMed

Neonatal septicaemia is an important cause of neonatal morbidity and mortality. Blood culture is the gold standard for diagnosis of neonatal septicaemia. Several laboratory investigations are available to detect neonatal sepsis, one important is 'sepsis screen' which includes C-reactive protein (CRP), micro -ESR, total WBC count including immature to mature (VT) ratio and absolute neutrophil count. Blood culture was done among 210 samples from neonatal intensive care unit (NICU), RG Kar Medical College with suspected septicaemia along with CRP estimation. Among all the parameters, clinical correlation of CRP is significant; 65.2% of patients has blood culture positive. CRP positivity varied in different organisms. CRP is a non-specific acute phase reactant and rises significantly after 12 hours onwards. It can be used as an important parameter in infant at risk of septicaemia (significant > 6 mg/dl) and early institution of antimicrobials therapy. It has got prognostic value. PMID:23936958

Bhattacharyya, Kumkum; Bandyopadhyay, Maitreyi; Karmakar, Balai Chandra; Bhattacharya, Sujata; Banerjee, Parthajit; Chatterjee, Sumanta; Dutta, Riju

2012-12-01

125

Postmortem diagnosis of acute haemorrhagic pancreatitis.  

PubMed

Forensic pathologists can help in the investigation of sudden unexpected deaths in co-operation with the officials responsible for the maintenance of law and order to administer justice. Sudden unexpected deaths form the subject of medicolegal investigation if they occur in apparently healthy individuals, wherein an autopsy would shed light regarding the cause of death. A 4 year retrospective review of autopsy files at the Department of Forensic Medicine, Kasturba Medical College, Mangalore, South India was undertaken for cases of sudden unexpected deaths due to acute haemorrhagic pancreatitis occurring between May 2004 and April 2008. A total of seven cases of acute haemorrhagic pancreatitis diagnosed at autopsy as the cause of sudden unexpected death during the study period are discussed herein. PMID:20650420

Shetty, B Suresh Kumar; Boloor, Archith; Menezes, Ritesh G; Shetty, Mahabalesh; Menon, Anand; Nagesh, K R; Pai, Muktha R; Mathai, Alka Mary; Rastogi, Prateek; Kanchan, Tanuj; Naik, Ramadas; Salian, Preetham Raj; Jain, Vipul; George, Aneesh T

2010-05-13

126

Haemorrhagic pulmonary oedema: post-pulmonary embolectomy.  

PubMed Central

A case of haemorrhagic pulmonary oedema after successful pulmonary embolectomy is presented. The relevant literature is reviewed. Thirteen cases are analysed as well as the four survivors. The aetiology appears to be ischaemic damage of the capillary bed. This had previously been called incomplete infarction by Castleman. The incidence is low after acute pulmonary embolectomies but appears to be much higher after chronic endarterectomies, especially with severe pulmonary hypertension. Therapy is outlined. Images

Garvey, J W; Wisoff, G; Voletti, C; Hartstein, M

1976-01-01

127

Current diagnostic approaches to subarachnoid haemorrhage  

Microsoft Academic Search

Over the past decade, significant advances have been made in the field of subarachnoid haemorrhage (SAH). Prompt diagnosis with high-resolution CT and intensive critical care support remain key aspects of good patient management. Early identification and definitive treatment of underlying ruptured aneurysms is generally advocated to reduce the risk of re-bleeding, a complication with high mortality and morbidity. Although intra-arterial

Jean Marie U-King-Im; Brendan Koo; Rikin A. Trivedi; Nicholas J. Higgins; Keng Y. Tay; Justin J. Cross; Nagui M. Antoun; Jonathan H. Gillard

2005-01-01

128

Spontaneous cerebellar haemorrhage following lumbar fusion  

Microsoft Academic Search

Spontaneous cerebellar haemorrhage following spinal surgery is rare, with fewer than 20 patients reported in the literature. We present a 70-year-old woman who underwent a L5–S1 posterior lumbar interbody fusion for spondylolisthesis. Intraoperatively, an incidental durotomy occurred and was repaired uneventfully. A large amount of serosanguinous fluid was noted in the subfascial drain post-operatively. The patient became increasingly drowsy 36

Peter Khong; M. Jerry Day

2009-01-01

129

Severe intracranial haemorrhage in neonatal alloimmune thrombocytopenia.  

PubMed

Neonatal alloimmune thrombocytopenia is a rare (1/1000-5000 births) life-threatening disorder, caused by fetomaternal incompatibility for a fetal human platelet alloantigen inherited from the father, with production of maternal alloantibodies against fetal platelets, leading to severe thrombocytopenia and potential bleeding. Intracranial haemorrhage is the most feared complication. This report presents the case of a term newborn infant, born from caesarean section after a normal pregnancy, presenting signs of skin bleeding with different ages. Obstetric history included a previous spontaneous abortion after amniocentesis. Severe thrombocytopenia (4×10(9)/l platelets) was found and brain ultrasound showed multiple intracranial haemorrhages. Human platelet antigen (HPA) phenotyping showed maternal negative HPA-1a and paternal positive HPA-1a platelets. Strongly positive anti-HPA-1a and weakly positive anti-human leukocyte antigen class I alloantibodies were found in the mother. Multiple platelet transfusions, intravenous immunoglobulin and corticosteroid were given but favourable response was accomplished only after a compatible platelet transfusion. Brain MRI showed multiple subacute and chronic haemorrhages. PMID:22679192

Silva, Francisco; Morais, Sofia; Sevivas, Teresa; Veiga, Ricardo; Salvado, Ramon; Taborda, Adelaide

2011-09-04

130

C-reactive protein: a useful marker for guiding duration of antibiotic therapy in suspected neonatal septicaemia?  

PubMed

The study aimed to determine whether serum C-reactive protein (CRP) levels can be used to identify when antibiotics can safely be discontinued in cases of suspected neonatal septicaemia. Neonates with suspected neonatal septicaemia treated at a hospital in Al Ramadi city, Iraq, in 2005 had serum CRP and blood cultures (the gold standard) done at admission and at 48 hours, 4 days and 6 days after starting treatment. Of the 55 neonates, CRP was < or =6 mg/L at 48 hours in 37 (67.3%) and antibiotics could be stopped in 32 (82.5%), i.e., when blood culture was negative. The moderate sensitivity (78%) and negative predictive value (86%) of serum CRP in this study suggest that this test alone cannot be used for guiding duration of antibiotic treatment for neonatal sepsis. PMID:19554972

Al-Zwaini, E J

131

Acute Lower Gastrointestinal Haemorrhage Secondary to Small Bowel Ascariasis  

PubMed Central

Acute lower gastrointestinal haemorrhage secondary to small bowel ascariasis is extremely rare. A high level of suspicion should be maintained when dealing with acute gastrointestinal haemorrhage in migrants and travellers. Small bowel examination is warranted when carefully repeated upper and lower endoscopies have failed to elicit the source of bleeding. Appropriate test selection is determined by the availability of local expertise. We present a case of acute lower gastrointestinal haemorrhage secondary to jejunal ascariasis and a literature search on lower gastrointestinal haemorrhage associated with jejunal infestation with Ascaris.

Daphne Dewi, Stephen; Sze Li, Siow

2012-01-01

132

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

133

Thalamic haemorrhage vs internal capsule-basal ganglia haemorrhage: clinical profile and predictors of in-hospital mortality  

PubMed Central

Background There is a paucity of clinical studies focused specifically on intracerebral haemorrhages of subcortical topography, a subject matter of interest to clinicians involved in stroke management. This single centre, retrospective study was conducted with the following objectives: a) to describe the aetiological, clinical and prognostic characteristics of patients with thalamic haemorrhage as compared with that of patients with internal capsule-basal ganglia haemorrhage, and b) to identify predictors of in-hospital mortality in patients with thalamic haemorrhage. Methods Forty-seven patients with thalamic haemorrhage were included in the "Sagrat Cor Hospital of Barcelona Stroke Registry" during a period of 17 years. Data from stroke patients are entered in the stroke registry following a standardized protocol with 161 items regarding demographics, risk factors, clinical features, laboratory and neuroimaging data, complications and outcome. The region of the intracranial haemorrhage was identified on computerized tomographic (CT) scans and/or magnetic resonance imaging (MRI) of the brain. Results Thalamic haemorrhage accounted for 1.4% of all cases of stroke (n = 3420) and 13% of intracerebral haemorrhage (n = 364). Hypertension (53.2%), vascular malformations (6.4%), haematological conditions (4.3%) and anticoagulation (2.1%) were the main causes of thalamic haemorrhage. In-hospital mortality was 19% (n = 9). Sensory deficit, speech disturbances and lacunar syndrome were significantly associated with thalamic haemorrhage, whereas altered consciousness (odds ratio [OR] = 39.56), intraventricular involvement (OR = 24.74) and age (OR = 1.23), were independent predictors of in-hospital mortality. Conclusion One in 8 patients with acute intracerebral haemorrhage had a thalamic hematoma. Altered consciousness, intraventricular extension of the hematoma and advanced age were determinants of a poor early outcome.

Arboix, Adria; Rodriguez-Aguilar, Raquel; Oliveres, Montserrat; Comes, Emili; Garcia-Eroles, Luis; Massons, Joan

2007-01-01

134

Mycotic aneurysm of the small bowel presenting as gastrointestinal haemorrhage.  

PubMed

Since the advent of modern antibiotic therapy and active surgical treatment of bacterial endocarditis, septic embolization of the systemic circulation is rarely seen. An unusual presentation of a mycotic aneurysm with gastrointestinal haemorrhage in a patient with non-Hodgkin's lymphoma and aortic valvular endocarditis which had been managed by aortic valve replacement six weeks before the haemorrhage occurred is reported. PMID:6610817

Wilson, J W; Ellis, D; Leyden, M J; Thomas, R; Sullivan, J R

1984-07-21

135

Management of severe postpartum haemorrhage: an updated protocol  

Microsoft Academic Search

Intractable postpartum haemorrhage (PPH) is exceedingly rare. Most complications result from procrastination or lack of adherence to a structured protocol of management. Active management of the third stage of labour is highly effective in preventing PPH. If haemorrhage nevertheless occurs, the following measures are implemented in rapid succession until the bleeding stops: 1) methylergometrine maleate is administered, 2) the uterus

J. J. Amy

2006-01-01

136

Identification of the virus of rabbit haemorrhagic disease in Tunisia  

Microsoft Academic Search

During 1992 and 1993, outbreaks of an acute, highly fatal disease mainly affecting adult rabbits were observed in Tunisia. The clinical and pathological findings were consistent with rabbit haemorrhagic disease. A monoclonal antibody designated PG4G3 specific for surface determinants of the rabbit haemorrhagic disease virus was used to identify the aetiological agent by ELISA and by colloidal gold immunoelectron microscopy;

A. Bouslama; G. M. De Mia; S. Hammami; T. Aouina; H. Soussi; T. Frescura

1996-01-01

137

Intraventricular recombinant tissue plasminogen activator for lysis of intraventricular haemorrhage  

Microsoft Academic Search

A prospective series of 20 patients with moderate to severe intraventricular haemorrhage (IVH) was studied for the effect of intraventricular administration of recombinant tissue plasminogen activator (rt-PA) on reduction of haematoma volume and prognosis. On the day of haemorrhage ventriculostomy was performed and 2 to 5 mg of rt-PA were injected via the external ventricular drainage, followed by drainage closure

V Rohde; C Schaller; W E Hassler

1995-01-01

138

Epizootic occurrence of haemorrhagic nephritis enteritis virus infection of geese  

Microsoft Academic Search

Recent outbreaks of haemorrhagic nephritis enteritis in geese flocks of 3 to 10 weeks in age in Hungary were investigated. Mortality varied between 4% and 67%. Affected birds generally died suddenly. Occasional clinical signs included tremors of the head and neck, subcutaneous haemorrhages and excretion of faeces containing partly digested blood. At necropsy the most frequent findings were a turgid

Vilmos Palya; Éva Ivanics; Róbert Glávits; Ádám Dán; Tamás Mató; Péter Zarka

2004-01-01

139

Thrombus formation in a dilated torcula following aneurysmal subarachnoid haemorrhage.  

PubMed

A case of thrombus formation occurring within a dilation of the dural venous sinuses following aneurysmal sub-arachnoid haemorrhage is presented. Acute neurological deterioration accompanied propagation of the thrombus. The patient was anticoagulated on day 5 post-SAH with no haemorrhagic complications and made a full recovery. The optimum time to commence anticoagulation is not clear and is discussed. PMID:23451941

Haynes, H R; Visca, A; Renowden, S; Malcolm, G

2013-03-01

140

An unusual cause of delayed postpartum haemorrhage following caesarean section  

Microsoft Academic Search

Although less common in the UK, postpartum haemorrhage (PPH)—defined as blood loss of 500 ml or more within the first 24 h of delivery— remains a significant cause of maternal death worldwide. Haemorrhage between 24 h and 6 weeks post partum is termed “delayed PPH”. Common causes include retention of gestational products or endometritis. Bleeding can be sudden and profound,

S Samad; P Jonetzko; A P Hawkins; J Booth; G Thorpe-Beeston; R Marwood

2009-01-01

141

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.

2010-01-01

142

Thalamic haemorrhage vs internal capsule-basal ganglia haemorrhage: clinical profile and predictors of in-hospital mortality  

Microsoft Academic Search

BACKGROUND: There is a paucity of clinical studies focused specifically on intracerebral haemorrhages of subcortical topography, a subject matter of interest to clinicians involved in stroke management. This single centre, retrospective study was conducted with the following objectives: a) to describe the aetiological, clinical and prognostic characteristics of patients with thalamic haemorrhage as compared with that of patients with internal

Adrià Arboix; Raquel Rodríguez-Aguilar; Montserrat Oliveres; Emili Comes; Luis García-Eroles; Joan Massons

2007-01-01

143

The neuropathology of infant subdural haemorrhage.  

PubMed

Subdural haemorrhage (SDH) in the infant has a different pattern from that seen in the older child and adult. It is usually a widespread, bilateral, thin film, unlike the thick, space-occupying and often unilateral clot seen in older children and adults after trauma. Whether both arise by the same mechanism is unknown, but it seems unlikely. Most SDH is said to be due to trauma but in infants there are other, atraumatic causes. Birth is also important; recent MRI studies show an incidence of almost 50% in asymptomatic neonates. Traumatic SDH is said to result from rupture of bridging veins but new insights into the anatomy of infant dura suggest a dural origin for thin film subdural bleeding in young babies. Acute SDH usually rapidly resolves, but sometimes develops into a chronic fluid collection. Healing of SDH is by formation of a granulating membrane which may confer vulnerability to rebleeding, either spontaneously or after an otherwise innocuous event. SDH has a particular significance as one of the features of the triad (together with retinal haemorrhage and encephalopathy) associated with non-accidental injury. As the possibility of non-accidental injury is often first raised by a radiologic report of subdural bleeding, it becomes critically important in the interpretation of the scan appearances to understand the unique physiology and anatomy of the infant dura. PMID:19303229

Squier, Waney; Mack, Julie

2009-03-19

144

B7 Costimulation Molecules Encoded by Replication-Defective, vhs-Deficient HSV1 Improve Vaccine-Induced Protection against Corneal Disease  

Microsoft Academic Search

Herpes simplex virus 1 (HSV-1) causes herpes stromal keratitis (HSK), a sight-threatening disease of the cornea for which no vaccine exists. A replication-defective, HSV-1 prototype vaccine bearing deletions in the genes encoding ICP8 and the virion host shutoff (vhs) protein reduces HSV-1 replication and disease in a mouse model of HSK. Here we demonstrate that combining deletion of ICP8 and

Jane E. Schrimpf; Eleain M. Tu; Hong Wang; Yee M. Wong; Lynda A. Morrison

2011-01-01

145

Microangiography of the pancreas in experimental oedemic and haemorrhagic pancreatitis.  

PubMed

Microangiography of the pancreas was performed in five normal piglets and in 10 piglets with oedemic and haemorrhagic pancreatitis in order to evaluate the role of microcirculatory changes in experimental pancreatitis. Acute haemorrhagic pancreatitis was induced by intraductal infusion of trypsin-taurocholate and oedematous pancreatitis correspondingly by infusion of autologous diluted bile. Both types of pancreatitis were confirmed by histological examination. Microangiography of the control animals revealed well-filled arteries, arterioles and capillaries, which formed a dense capillary network. In the areas of histologically documented haemorrhagic pancreatitis, unfilled capillary nets were observed as empty areas in the microangiography. Other areas of focal extravasation of the contrast material could be seen. Arteries and arterioles were well filled. In oedematous pancreatitis, the microangiography was unchanged compared with the control. Conclusion: Acute experimental haemorrhagic pancreatitis is associated with severe disturbances in the capillary circulation of the pancreas, whereas in oedematous pancreatitis the microangiography of the pancreas is normal. PMID:3494299

Nuutinen, P; Kivisaari, L; Standertskjöld-Nordenstam, C G; Lempinen, M; Schröder, T

1986-01-01

146

Antibody recognition of the glycoprotein g of viral haemorrhagic septicemia virus (VHSV) purified in large amounts from insect larvae  

PubMed Central

Background There are currently no purification methods capable of producing the large amounts of fish rhabdoviral glycoprotein G (gpG) required for diagnosis and immunisation purposes or for studying structure and molecular mechanisms of action of this molecule (ie. pH-dependent membrane fusion). As a result of the unavailability of large amounts of the gpG from viral haemorrhagic septicaemia rhabdovirus (VHSV), one of the most dangerous viruses affecting cultured salmonid species, research interests in this field are severely hampered. Previous purification methods to obtain recombinant gpG from VHSV in E. coli, yeast and baculovirus grown in insect cells have not produced soluble conformations or acceptable yields. The development of large-scale purification methods for gpGs will also further research into other fish rhabdoviruses, such as infectious haematopoietic necrosis virus (IHNV), spring carp viremia virus (SVCV), hirame rhabdovirus (HIRRV) and snakehead rhabdovirus (SHRV). Findings Here we designed a method to produce milligram amounts of soluble VHSV gpG. Only the transmembrane and carboxy terminal-deleted (amino acid 21 to 465) gpG was efficiently expressed in insect larvae. Recognition of G21-465 by ß-mercaptoethanol-dependent neutralizing monoclonal antibodies (N-MAbs) and pH-dependent recognition by sera from VHSV-hyperimmunized or VHSV-infected rainbow trout (Oncorhynchus mykiss) was demonstrated. Conclusions Given that the purified G21-465 conserved some of its most important properties, this method might be suitable for the large-scale production of fish rhabdoviral gpGs for use in diagnosis, fusion and antigenicity studies.

2011-01-01

147

Incidence of intracerebral and subarachnoid haemorrhage in southern Sweden  

PubMed Central

OBJECTIVES—Spontaneuos intracranial haemorrhage—that is, mainly subarachnoid haemorrhage (SAH) and primary intracerebral haemorrhage (PICH)—constitutes an important part of all strokes. As previous epidemiological studies have demonstrated highly variable incidence rates, we conducted a large prospective investigation of all haemorrhagic strokes during a 1 year period.?METHODS—Twelve hospitals serving a defined population of 1.14 million in southern Sweden registered all cases with spontaneous intracranial haemorrhage, including those found dead outside hospitals, during 1996. All patients were examined with CT of the brain or underwent necropsy. Incidence rates adjusted to the Swedish population for age and sex, as well as location of haematoma and prevalence of risk factors were calculated.?RESULTS—A total of 106 patients with SAH and 341 patients with PICH were identified. The annual incidence/100 000 was 10.0 (6.4 for men and 13.5 for women) for SAH and 28.4 (32.2 for men and 24.7for women) for PICH when adjusted to the Swedish population. Subarachnoid haemorrhage affected twice as many women as men. The incidence of both types of haemorrhage increased with advancing age, but in particular, this was the case for supratentorial PICH. Lobar haematomas were the most common (51.6%) type of PICH. Among patients with PICH, 37% had hypertension, 41% other vascular disease, and 12% were on oral anticoagulation. Among patients with SAH, 28% had hypertension and 18% vascular disease before the haemorrhage but no one was on treatment with oral anticoagulation.?CONCLUSIONS—The incidence of PICH was high, especially for the older age groups. PICH was, on average, three times as common as SAH. The study underscores the importance of PICH and SAH as significant stroke subgroups.??

Nilsson, O; Lindgren, A; Stahl, N; Brandt, L; Saveland, H

2000-01-01

148

Specialized gastrointestinal units for the management of upper gastrointestinal haemorrhage.  

PubMed Central

In 1986, 292 patients were admitted to a joint medical-surgical gastrointestinal unit with upper gastrointestinal haemorrhage. Fourteen patients died (4.8%) a mortality considerably lower than recorded in most series. The low mortality may result from the use of a specialized gastrointestinal unit to which all patients with upper gastrointestinal haemorrhage are admitted and managed with strict protocols for resuscitation, transfusion and surgery.

Sanderson, J. D.; Taylor, R. F.; Pugh, S.; Vicary, F. R.

1990-01-01

149

Fulminant Staphylococcus lugdunensis septicaemia following a pelvic varicella-zoster virus infection in an immune-deficient patient: a case report  

PubMed Central

Introduction The deadly threat of systemic infections with coagulase negative Staphylococcus lugdunensis despite an appropriate antibiotic therapy has only recently been recognized. The predominant infectious focus observed so far is left-sided native heart valve endocarditis, but bone and soft tissue infections, septicaemia and vascular catheter-related bloodstream infections have also been reported. We present a patient with a fatal Staphylococcus lugdunensis septicaemia following zoster bacterial superinfection of the pelvic region. Case presentation A 71-year old male diagnosed with IgG kappa plasmocytoma presented with a conspicuous weight loss, a hypercalcaemic crisis and acute renal failure. After initiation of haemodialysis treatment his condition improved rapidly. However, he developed a varicella-zoster virus infection of the twelfth thoracic dermatome requiring intravenous acyclovir treatment. Four days later the patient presented with a fulminant septicaemia. Despite an early intravenous antibiotic therapy with ciprofloxacin, piperacillin/combactam and vancomycin the patient died within 48 hours, shortly before the infective isolate was identified as Staphylococcus lugdunensis by polymerase chain reaction. Conclusion Despite S. lugdunensis belonging to the family of coagulase-negative staphylococci with an usually low virulence, infections with S. lugdunensis may be associated with an aggressive course and high mortality. This is the first report on a Staphylococcus lugdunensis septicaemia following a zoster bacterial superinfection of the pelvic region.

2010-01-01

150

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.

2012-01-01

151

[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

2011-07-07

152

Endovascular treatment of massive retroperitoneal haemorrhage due to inferior adrenal artery injury. A case report.  

PubMed

Massive retroperitoneal haemorrhage because of adrenal bleeding following blunt trauma is a rare entity. We describe a 23-year-old woman with massive retroperitoneal haemorrhage as a result of inferior adrenal artery (IAA) disruption following a car accident. Superselective transcatheter embolization of the IAA using polyvinyl alcohol particles was performed successfully to control haemorrhage. To our knowledge, this is the second report of massive retroperitoneal haemorrhage caused by IAA disruption successfully treated by transcatheter embolization. PMID:12100332

Dinc, H; Sim?ek, A; Ozyavuz, R; Ozgür, G K; Gümele, H R

2002-05-01

153

Transcatheter arterial embolisation for haemorrhage from the inferior epigastric artery after acupuncture: a case report.  

PubMed

We report a rare case of haemorrhage from the inferior epigastric artery, which was injured after acupuncture. The haemorrhage was successfully controlled by transcatheter arterial embolisation. To the best of our knowledge, this is the first report describing the use of transcatheter arterial embolisation for inferior epigastric artery haemorrhage following acupuncture. PMID:23462648

Moon, Sang Won; Kim, Ki Hoon

2013-03-05

154

Pulmonary haemorrhage in a patient with Kikuchi disease.  

PubMed

Kikuchi disease is an immunologic disease and most commonly presents with cervical lymphadenopathy. It is usually self-limiting [1]. It is sometimes associated with systemic lupus erythematosus (SLE) [2], and can be associated with many complications including aseptic meningitis, neuropathy, brachial neuritis. It can also be associated with lymphoma, and may sometimes be misdiagnosed as such [3]. The following is the first reported case of Kikuchi disease associated with pulmonary haemorrhage. The patient died and no other cause of the pulmonary haemorrhage could be identified at post mortem. PMID:11499298

Wong, C Y; Law, G T; Shum, T T; Wong, K Y; Li, Y K

2001-04-01

155

Acute cardiac injury after subarachnoid haemorrhage: two case reports  

PubMed Central

It is well known that cardiopulmonary complications are often associated to subarachnoid haemorrhage. For appropriate therapeutic managing it is very important to distinguish acute coronary syndrome from neurogenic myocardial injury, which is a reversible condition. Furthermore, because the hearts of brain dead patients may be utilized for therapeutic purpose, it has became of importance to rule out erroneous diagnosis of cardiac ischemia in order to avoid rejection of hearts potential suitable for transplantation. We present a report of two female patients affected by cardiac complications caused by aneurismal subarachnoid haemorrhage admitted to our neurosurgical intensive care department.

2009-01-01

156

Acute cardiac injury after subarachnoid haemorrhage: two case reports.  

PubMed

It is well known that cardiopulmonary complications are often associated to subarachnoid haemorrhage. For appropriate therapeutic managing it is very important to distinguish acute coronary syndrome from neurogenic myocardial injury, which is a reversible condition. Furthermore, because the hearts of brain dead patients may be utilized for therapeutic purpose, it has became of importance to rule out erroneous diagnosis of cardiac ischemia in order to avoid rejection of hearts potential suitable for transplantation.We present a report of two female patients affected by cardiac complications caused by aneurismal subarachnoid haemorrhage admitted to our neurosurgical intensive care department. PMID:20062617

Marcì, Marcello; Savatteri, Paolino; Pizzuto, Antonino; Giammona, Giuseppe; Renda, Baldassare; Lojacono, Francesca; Sanfilippo, Nicola

2009-12-09

157

Spinal dural arteriovenous fistula with perimesencephalic subarachnoid haemorrhage  

Microsoft Academic Search

A case is reported of a 66 year old woman presenting with perimesencephalic subarachnoid haemorrhage (SAH) which was caused by a spinal dural arteriovenous fistula at the C1 level. The fistula drained into the venous system of the posterior cranial fossa through a perimedullary vein. The bleeding was thought to result from venous hypertension induced by the fistula. This case

Hiroyuki Hashimoto; Jun-ichi Iida; Yasushi Shin; Yasuo Hironaka; Toshisuke Sakaki

2000-01-01

158

A 4Year Consecutive Study of Post-Tonsillectomy Haemorrhage  

Microsoft Academic Search

Objective: To analyse consecutive material over a period of 4 years concerning the incidence and consequences of post-tonsillectomy haemorrhages (PTH). Design: Prospective study. Setting: University hospital. Participants: All non-oncological cases of tonsillectomy (TE) and adenotonsillectomy (TA) performed at the ENT department at the Karolinska University Hospital between March 2000 and April 2004. Main Outcome Measures: Rate, timing and classification of

Per Attner; Per-Olle Haraldsson; Claes Hemlin; Anne-Charlotte Hessén Söderman

2009-01-01

159

Intraventricular haemorrhage and posthaemorrhagic hydrocephalus: pathogenesis, prevention and future interventions  

Microsoft Academic Search

Intraventricular haemorrhage (IVH) is still a major complication of preterm birth with serious disability resulting. The fragile blood vessels in the germinal matrix below the ventricular lining and the instability of blood flow to this highly vascular area are the main mechanisms behind IVH. There is good evidence that corticosteroid therapy before preterm delivery reduces mortality and IVH substantially with

Andrew Whitelaw

2001-01-01

160

Postpartum haemorrhage occurrence and recurrence: a population-based study  

Microsoft Academic Search

Objective: To determine the risk of occurrence and recurrence of postpartum haemorrhage (excessive bleeding after childbirth) among women having at least two consecutive pregnancies. Design and setting: Population-based study using longitudinally linked hospital discharge and birth records from New South Wales for the period 1 January 1994 to 31 December 2002. Participants: All 125 295 women having at least a

Jane B Ford; Christine L Roberts; Jane C Bell; Charles S Algert; Jonathan M Morris

2007-01-01

161

Breathing-Impaired Speech after Brain Haemorrhage: A Case Study  

ERIC Educational Resources Information Center

|Results are presented from an auditory and acoustic analysis of the speech of an adult male with impaired prosody and articulation due to brain haemorrhage. They show marked effects on phonation, speech rate and articulator velocity, and a speech rhythm disrupted by "intrusive" stresses. These effects are discussed in relation to the speaker's…

Heselwood, Barry

2007-01-01

162

Dengue Haemorrhagic Fever in Thailand: Current Incidence and Vector Management  

Microsoft Academic Search

\\u000a Dengue, dengue haemorrhagic fever and dengue shock syndrome are endemic throughout South East Asia where they present a serious\\u000a public health concern. The current status of these diseases in Thailand is described along with the challenges that confront\\u000a those who seek to control the spread of these diseases.

Apiwat Tawatsin; Usavadee Thavara

163

Spinal arachnoiditis and cyst formation with subarachnoid haemorrhage.  

PubMed

We present the case of a 58-year-old lady with p-ANCA vasculitis who suffered a WFNS grade 1 subarachnoid haemorrhage (Fisher grade 1) secondary to a ruptured left posterior inferior cerebellar artery aneurysm and then developed a rare complication of radiologically progressive spinal arachnoiditis despite maintained clinical response to definitive treatment measures. PMID:22299598

Abhinav, Kumar; Bradley, Marcus; Aquilina, Kristian; Patel, Nikunj K

2012-02-02

164

Visual performance after interface haemorrhage during laser in situ keratomileusis  

Microsoft Academic Search

Aim: To study the visual performance in eyes with interface haemorrhage during laser assisted in situ keratomileusis (LASIK).Methods: Case records of 20 patients, who had bleeding from the limbal vessels in one eye during LASIK (group 1) and uncomplicated surgery in the fellow eye (group 2) were studied. The parameters evaluated were uncorrected visual acuity (UCVA) best corrected visual acuity

R B Vajpayee; R Balasubramanya; A Rani; N Sharma; J S Titiyal; R M Pandey

2003-01-01

165

Extradural vertebral artery dissecting aneurysm causing subarachnoid haemorrhage  

Microsoft Academic Search

The authors report the case of a 37-year-old man who presented with subarachnoid haemorrhage (SAH) after rupture of an extradural vertebral artery dissecting aneurysm. The patient underwent a left lateral suboccipital craniotomy with removal of the medial part of the occipital condyle and the fusiform dilatation was coated. The angiograms 3 months after surgery showed aneurysm resolution and normal vessel

Javier Fandino; Yasuhiro Yonekawa; Werner W Wichmann; Peter Roth

1999-01-01

166

Acute cardiac injury after subarachnoid haemorrhage: two case reports  

Microsoft Academic Search

It is well known that cardiopulmonary complications are often associated to subarachnoid haemorrhage. For appropriate therapeutic managing it is very important to distinguish acute coronary syndrome from neurogenic myocardial injury, which is a reversible condition. Furthermore, because the hearts of brain dead patients may be utilized for therapeutic purpose, it has became of importance to rule out erroneous diagnosis of

Marcello Marcì; Paolino Savatteri; Antonino Pizzuto; Giuseppe Giammona; Baldassare Renda; Francesca Lojacono; Nicola Sanfilippo

2009-01-01

167

Haemorrhagic diathesis in children associated with vitamin K deficiency  

Microsoft Academic Search

A haemorrhagic diathesis is described in infants; this is preceded and accompanied by constitutional symptoms such as fever, diarrhoea, vomiting, anorexia, and pallor. These children had a severe coagulation abnormality, due to deficiency of vitamin-K-dependent coagulation factors, and it was corrected by administration of vitamin K. No conclusion could be drawn as to the aetiology of this condition but some

Salman Taj-Eldin; Luay Al-Nouri; Omar Fakri

1967-01-01

168

Intracranial haemorrhage and use of selective serotonin reuptake inhibitors  

PubMed Central

Aims In the past few years an increasing number of bleeding disorders have been reported in association with the use of selective serotonin reuptake inhibitors (SSRIs), including serious cases of intracranial haemorrhage, raising concerns about the safety of this class of drugs. The present study was performed to test the hypothesis of an increased risk of intracranial haemorrhage associated with the use of SSRIs. Methods We carried out a case-control study nested in a cohort of antidepressants users with the UK-based General Practice Research Database (GPRD) as the primary source of information. The study cohort encompassed subjects aged between 18 and 79 years who received a first-time prescription for any antidepressant from January, 1990 to October, 1997. Patients with presenting conditions or treatments that could be associated with an increased risk of intracranial haemorrhage were excluded from the cohort. Patients were followed-up until the occurrence of an idiopathic intracranial haemorrhage. Up to four controls per case, matched on age, sex, calendar time and practice were randomly selected from the study cohort. We estimated adjusted odds ratios and 95% confidence intervals of intracranial haemorrhage with current use of SSRIs and other antidepressants as compared with nonuse using conditional logistic regression. Results We identified 65 cases of idiopathic intracranial haemorrhage and 254 matched controls. Current exposure to SSRIs was ascertained in 7 cases (10.8%) and 24 controls (9.7%) resulting in an adjusted OR (95%CI) of 0.8 (0.3,2.3). The estimate for ‘other antidepressants’ was 0.7 (0.3,1.6). The effect measures were not modified by gender or age. No effect related to dose or treatment duration was detected. The risk estimates did not change according to the location of bleeding (intracerebral or subarachnoid). Conclusions Our results are not compatible with a major increased risk of intracranial haemorrhage among users of SSRIs or other antidepressants at large. However, smaller but still relevant increased risks cannot be ruled out.

de Abajo, Francisco J; Jick, Hershel; Derby, Laura; Jick, Susan; Schmitz, Stephen

2000-01-01

169

Haemorrhagic liver syndrome of broiler chickens fed diets containing rapeseed products.  

PubMed

Haemorrhagic livers were observed in male white rock chicks of one to four weeks old, that were fed diets supplemented with 50 per cent rapeseed meal and 50 per cent rapeseed full-fat seeds. The haemorrhagic lesions were comparable to those of the laying hens except for the absence of fatty degeneration. There were no substantial fibrotic lesions. Multifocal or solitary hepatocytic necrosis was observed around the haemorrhagic lesions, although the necrotic foci did not always accompany the haemorrhage. The reticulum only of the necrotic and haemorrhagic lesions was not demonstrated with silver strain. Association of hepatocytic necrosis with liver haemorrhage and absence of argyrophilic fibres suggested that the hepatocytic necrosis was the primary contributory factor for the development of the hepatic haemorrhage. PMID:928982

Yamashiro, S; Umemura, T; Bhatnagar, M K; David, L; Sadiq, M; Slinger, S J

1977-09-01

170

Tryptase Promotes Atherosclerotic Plaque Haemorrhage in ApoE-/- Mice  

PubMed Central

Tryptase, the most abundant mast cell (MC) granule protein, plays an important role in atherosclerosis plaque development. To test the hypothesis that tryptase participates directly in atherosclerosis plaque haemorrhage, the gene sequence and siRNA for tryptase were cloned into a lentivirus carrier and atherosclerosis plaque haemorrhage models in ApoE-/- mice were constructed. After a cuffing-cervical artery operation, the mice were randomly divided into 6 groups. Hematoxylin and eosin(HE) staining showed that the cervical artery plaque area was much larger in the tryptase overexpression group compared to the other groups, and there was greater artery stenosis. The artery stenosis from the cuff-side in all groups was more than 90%, except the siRNA group. Tryptase promotes plaque haemorrhage distinctively because 50% of the mice in the tryptase overexpression group had plaque haemorrhage, while only 10% in the siRNA group did. The immunohistochemistry of the cervical artery plaque showed that plasminogen activator inhibitor-1 (PAI-1) expression was the lowest while tissue plasminogen activator (tPA), CD31, CD34 and VEGF was the highest in the tryptase overexpression groups. This observation was completely contrary to what was observed in the siRNA group. Tryptase promoted bEnd.3 cell growth, migration and capillary-like tube formation, which suggests that tryptase can promote microvessel angiogenesis. PAI-1 expression was inhibited, while tPA expression was increased by tryptase in bEnd.3 cells. Our in vivo and in vitro studies suggest that trypase can promote atherosclerotic plaque haemorrhage by promoting angiogenesis and regulating the balance of PAI-1 and tPA. Thus, regulating tryptase expression in MCs may provide a potential target for atherosclerosis treatment.

Tian, Dai; Li, Xiaobo; Ning, Yanxia; Yin, Lianhua

2013-01-01

171

Cerebellar low-grade oligoastrocytoma presenting with subarachnoid haemorrhage.  

PubMed

Subarachnoid haemorrhage (SAH) associated with intra-axial tumours is extremely uncommon and is usually seen in association with intratumoural bleed. Tumours located near the ventricle or subarachnoid spaces have a higher propensity for SAH compared to intraparenchymal lesions. Low-grade tumours rarely demonstrate any evidence of bleed on imaging. Oligoastrocytomas of the posterior fossa are rare tumours in adults and their presentation with intratumoural haemorrhage and SAH is unknown. We report a unique case of cerebellar low-grade oligoastrocytoma that mimicked a tentorial-based extraaxial lesion on imaging and presented with SAH. Susceptibility-weighted magnetic resonance imaging is a useful imaging modality to demonstrate blood within and outside the tumour. PMID:22665014

Viswanathan, Gopalakrishnan; Nair, Suresh; Chandrasekhar, Kesavadas; Vishnupuri, Radhakrishnan

2012-01-01

172

Elevated urinary catecholamines and adrenal haemorrhage mimicking phaeochromocytoma.  

PubMed

A 51-year-old woman was admitted with left-sided flank pain initially thought to be renal colic. However, a CT urogram was normal. During the course of the admission the pain persisted and she developed severe sustained hypertension. A repeat CT scan of the abdomen revealed a 5×3 cm left adrenal abnormality consistent with haemorrhage, not seen on the original scan. Further assessment revealed elevated urine catecholamines and a short synacthen test showed a suboptimal cortisol response. The diagnosis was initially considered as a phaeochromocytoma, she received phenoxybenzamine with good resolution of hypertension and was referred for surgical opinion. However, serial urinary catecholamine concentrations returned to within the normal range and the diagnosis was revised to adrenal infarction and haemorrhage due to antiphospholipid syndrome. This case illustrates the importance of recognising adrenal infarction as a potential cause of 'pseudophaeochromocytoma'. PMID:22802465

Wordsworth, Simon; Thomas, Ben; Agarwal, Neera; Hoddell, Kate; Davies, Steve

2010-12-29

173

An unusual cause of delayed postpartum haemorrhage following caesarean section.  

PubMed

Although less common in the UK, postpartum haemorrhage (PPH)--defined as blood loss of 500 ml or more within the first 24 h of delivery--remains a significant cause of maternal death worldwide. Haemorrhage between 24 h and 6 weeks post partum is termed "delayed PPH". Common causes include retention of gestational products or endometritis. Bleeding can be sudden and profound, resulting in rapid cardiovascular collapse. A case of massive PPH 7 weeks after a caesarean section caused by a pseudoaneurysm of the uterine artery is reported. This case highlights diagnostic and therapeutic issues concerning this rare but potentially life-threatening condition and presents clinical features distinguishing it from other causes of PPH. Delay in diagnosis can result in repeated and catastrophic bleeding. PMID:19625573

Samad, S; Jonetzko, P; Hawkins, A P; Booth, J; Thorpe-Beeston, G; Marwood, R

2009-08-01

174

Beta-blockade benefits patients following a subarachnoid haemorrhage.  

PubMed

Previous studies have shown that ECG changes following a subarachnoid haemorrhage are associated with increased catecholamine levels, necrotic myocardial lesions, and a poor prognosis. Furthermore, beta-blockade using propranolol reverses some of the ECG changes and prevents necrotic myocardial lesions. This study was established to assess the affects of adrenergic blockade on morbidity and mortality following subarachnoid haemorrhage. Patients were admitted to the randomized double-blind between-patients study if they presented at the neurosurgical unit within 48 hours of a subarachnoid haemorrhage confirmed by lumbar puncture. Of 224 patients, the first 118 received an alpha-blocker, phentolamine 20 mg three-hourly, and either the beta-blocker propranolol 80 mg eight-hourly, or placebo. The last 106 patients received either propranolol or placebo. Treatment was continued for three weeks. Assessment at four weeks revealed significant improvements in the treated group for neurological deficit (p = 0.003) and death (p = 0.02). More treated patients underwent operation and those that did had a better outcome (p = 0.01). Assessment at one year showed that although patients had improved in both groups, patients in the treated group had significantly fewer neurological deficits (p = 0.003). There were fewer deaths in the treated group but this difference was not significant (p = 0.09). Possible mechanisms for this protective effect of propranolol may include a reduction in plasma renin activity, a reduction in pulmonary oedema, prevention of myocardial infarcts, and a reduction in cerebral oxygen requirements. It is concluded that early beta-blockade benefits patients with subarachnoid haemorrhage, in terms of fewer neurological deficits, for up to one year. PMID:2865145

Neil-Dwyer, G; Walter, P; Cruickshank, J M

1985-01-01

175

Haemorrhage and perforation of gastrointestinal neoplasms during chemotherapy.  

PubMed Central

Gastrointestinal haemorrhage and perforation are known complications of cytotoxic therapy for chemosensitive tumours involving the wall of the gut, in particular non-Hodgkin's lymphoma. These complications can be avoided by aggressive surgery before chemotherapy is started. When they do occur, early operative intervention is essential to reduce morbidity and mortality. We report 4 cases in whom delay in diagnosis and surgery led to 3 deaths and suggest a policy for the management of such cases in the future.

Randall, J.; Obeid, M. L.; Blackledge, G. R.

1986-01-01

176

Spontaneous intracerebral haemorrhage in adults: a literature overview  

Microsoft Academic Search

Summary  \\u000a Background. A large number of reports have analysed epidemiology, pathogenesis, symptomatology, diagnostics and options for medical and\\u000a surgical treatment of intracerebral haemorrhage. Nevertheless, management still remains controversial. The purpose of the\\u000a present review is to summarise the clinical data and derive a current updated management concept as a result.\\u000a \\u000a \\u000a Methods. The analysis was based on a Medline search to

D. Hänggi; H.-J. Steiger

2008-01-01

177

Haemorrhagic diathesis in children associated with vitamin K deficiency  

PubMed Central

A haemorrhagic diathesis is described in infants; this is preceded and accompanied by constitutional symptoms such as fever, diarrhoea, vomiting, anorexia, and pallor. These children had a severe coagulation abnormality, due to deficiency of vitamin-K-dependent coagulation factors, and it was corrected by administration of vitamin K. No conclusion could be drawn as to the aetiology of this condition but some possible causes are discussed. Images

Taj-Eldin, Salman; Al-Nouri, Luay; Fakri, Omar

1967-01-01

178

Surgical Trial in Lobar Intracerebral Haemorrhage (STICH II) Protocol  

PubMed Central

Background Within the spectrum of spontaneous intracerebral haemorrhage there are some patients with large or space occupying haemorrhage who require surgery for neurological deterioration and others with small haematomas who should be managed conservatively. There is equipoise about the management of patients between these two extremes. In particular there is some evidence that patients with lobar haematomas and no intraventricular haemorrhage might benefit from haematoma evacuation. The STICH II study will establish whether a policy of earlier surgical evacuation of the haematoma in selected patients will improve outcome compared to a policy of initial conservative treatment. Methods/Design an international multicentre randomised parallel group trial. Only patients for whom the treating neurosurgeon is in equipoise about the benefits of early craniotomy compared to initial conservative treatment are eligible. All patients must have a CT scan confirming spontaneous lobar intracerebral haemorrhage (?1 cm from the cortex surface of the brain and 10-100 ml in volume). Any clotting or coagulation problems must be corrected and randomisation must take place within 48 hours of ictus. With 600 patients, the study will be able to demonstrate a 12% benefit from surgery (2p < 0.05) with 80% power. Stratified randomisation is undertaken using a central 24 hour randomisation service accessed by telephone or web. Patients randomised to early surgery should have the operation within 12 hours. Information about the status (Glasgow Coma Score and focal signs) of all patients through the first five days of their trial progress is also collected in addition to another CT scan at about five days (+/- 2 days). Outcome is measured at six months via a postal questionnaire to the patient. Primary outcome is death or severe disability defined using a prognosis based 8 point Glasgow Outcome Scale. Secondary outcomes include: Mortality, Rankin, Barthel, EuroQol, and Survival. Trial Registration ISRCTN: ISRCTN22153967

2011-01-01

179

Prevention of upper gastrointestinal haemorrhage: current controversies and clinical guidance.  

PubMed

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; Beales, Ian L P

2013-09-01

180

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.

George, KJ; Roy, D; Shad, A

2012-01-01

181

Early heparin therapy in patients with spontaneous intracerebral haemorrhage.  

PubMed Central

In 68 patients with spontaneous intracerebral haemorrhage the effect of heparin treatment beginning on the second, fourth or tenth day was investigated. Early (day 2) low-dose heparin medication significantly lowered the incidence of pulmonary embolism. An increase in the number of patients with rebleeding was not observed. The results indicate that the early use of heparin in these patients is safe and can be recommended for the prevention of thromboembolic complications.

Boeer, A; Voth, E; Henze, T; Prange, H W

1991-01-01

182

Nosocomial ventriculitis due to Roseomonas gilardii complicating subarachnoid haemorrhage  

Microsoft Academic Search

Roseomonas gilardii is a pink-pigmented, non-fermentative, Gram-negative coccobacillus that has been recognized as a rare cause of human infections. We report the first case of ventriculitis caused by R. gilardii in a 54-year-old man with a subarachnoid haemorrhage secondary to a vertebral artery aneurysm; discuss previous reports of this organism as a nosocomial and community-acquired pathogen, laboratory diagnosis, and patient

Jason S. Nolan; Ken B. Waites

2005-01-01

183

Treatment of retrobulbar haemorrhage in accident and emergency departments.  

PubMed

Retrobulbar haemorrhage is a rare complication of orbital injury or surgery. After injury the first clinicians to see these patients are often the staff of accident and emergency departments. This survey was instigated after several patients had been referred to our care irreversibly blind. A multiple choice questionnaire was devised and sent to 90 doctors working in accident and emergency departments in Scotland. A total of 57 (63%) were returned of which 55 were complete enough to analyse. The range of respondents was: consultants (n = 6), associate specialists (n = 3), senior registrars (n = 3), registrars (n = 4), senior house officer (n = 35), and clinical assistants (n = 4). Twenty nine of the 35 senior house officers (83%) were unable to diagnose and treat retrobulbar haemorrhage. Most consultants, senior registrars, registrars and associate specialists were significantly better in the diagnosis and treatment of this condition (P = 0.001). We conclude that there is an unacceptably high incidence of blindness as a result of inappropriate diagnosis and treatment of retrobulbar haemorrhage. We have therefore designed a protocol for accident departments which should help reduce the incidence of blindness. PMID:8866062

Hislop, W S; Dutton, G N; Douglas, P S

1996-08-01

184

The role of endoscopy in early postoperative haemorrhage.  

PubMed

Diagnostic as well as therapeutic endoscopy has a decisive role in management of early postoperative haemorrhage. Endoscopy combines easy access to the upper and lower gastrointestinal tract and application of an array of interventional tools. In near future, even the small bowel will be accessible for diagnostic and therapeutic measures due to the advent of double-balloon enteroscopy. Thus, the endoscopist increasingly replaces the surgeon for diagnosis and therapy of postsurgical bleeding. Published data on frequency and aetiology of postoperative haemorrhage are scarce and mainly casuistic. Sources of gastrointestinal bleeding associated with surgery may be: anastomotic ulcers, mucosal ischaemia, 'stress' ulcers, reflux-induced lesions, coagulopathies (e.g. in sepsis or after organ transplantation) and aortoenteric fistula after bypass surgery. The endoscopist will frequently identify the culprit lesion and guide further management of the patient (e.g. endoscopic approach, repeated surgery, interventional radiology). All accessible lesions in postoperative haemorrhage should primarily be treated by endoscopic means, except aortoenteric fistulas. There is even a place for repeated endoscopy in recurrent bleeding. In the face of lacking controlled data, the endoscopist often has to rely on his personal experience in the selection of therapeutic options. PMID:15494279

Mayer, Gerhard; Lingenfelser, Thomas; Ell, Christian

2004-10-01

185

[New trends in neuromonitoring patients with with aneurysmal subarachnoid haemorrhage].  

PubMed

Neurointensive care of patients with subarachnoid haemorrhage is based on the theory that clinical outcome is the consequence of the primary haemorrhage and a number of secondary insults in the acute post haemorrhage period. Several neuromonitoring techniques have been introduced or accomplished into clinical practice in the last decade with the purpose of monitoring different but related aspects of brain physiology, such as cerebral blood flow (CBF), pressure within the cranial cavity, metabolism, and oxygenation. The aim of these techniques is to obtain information that can improve knowledge on brain pathophysiology, and especially to detect secondary insults which may cause permanent neurological damage if undetected and untreated in "real time", at the time when they can still be managed. These techniques include intracranial pressure (ICP) measurements, jugular venous oxygen saturation, near-infrared spectroscopy, brain tissue monitoring, and transcranial Doppler. The available devices are limited because they measure a part of complex process indirectly. Expense, technical difficulties, invasiveness, limited spatial or temporal resolution and the lack of sensitivity add to the limitation of any individual monitor. These problems have been partially addressed by the combination of several monitors known as multimodality monitoring. In this review, we describe the most common neuromonitoring methods in patients with subarachnoidal hemorrhage that can assess nervous system function, cerebral haemodynamics and cerebral oxygenation. PMID:18792577

Dostani?, M M; Stosi?, M M; Milakovi?, B D; Baljozovi?, B V; Jovanovi?, I B; Koji?, Z Z; Marinkovi?, D M; Markovi?, D J; Mili?, I S

2008-01-01

186

Arginine vasopressin: a promising rescue drug in the treatment of uncontrolled haemorrhagic shock.  

PubMed

Haemorrhagic shock is one of the most frequent types of shock. If haemorrhage cannot be controlled and fluid resuscitation as well as catecholamines are insufficient to stabilize cardiovascular function, uncontrolled haemorrhagic shock occurs. Several approaches have been suggested as promising alternatives to volume resuscitation. The rationale for the use of arginine vasopressin (AVP) is the pharmacologic amplification of the neuroendocrine stress response. AVP-mediated vasoconstriction is the first physiologic step to haemostasis and shifts blood away from the bleeding site towards the heart, lungs and brain. Particularly, when uncontrolled haemorrhage is accompanied by traumatic brain injury this may help to reduce secondary neurological damage. Since AVP can prevent acute death only transiently, it must comprehensively be combined with rapid hospital admission, immediate control of haemorrhage followed by aggressive fluid resuscitation and blood transfusion. This review article summarizes current experimental and clinical evidence on the use of AVP in uncontrolled haemorrhagic shock. PMID:18683476

Wenzel, Volker; Raab, Helmut; Dünser, Martin W

2008-06-01

187

Mechanism of functional residual capacity increase in haemorrhagic shock.  

PubMed

Shock was elicited in anaesthetized dogs by maintaining a haemorrhagic hypotension of 4 kPa until 30 per cent spontaneous refusion, followed by total reinfusion. Functional residual capacity (FRC) and minute ventilation increased considerably similarly to our previous experiments. Lactate content in both the external intercostal and the biceps femoris muscles increased significantly in advanced shock. The expiratory external abdominal oblique muscle showed electromyographic signs of fatigue. At the height of the FRC changes tonic contraction of the external intercostal muscle could be demonstrated electron microscopically. This tonic contraction is the main factor in the large FRC rise in late shock forming the basis of a hitherto unknown vicious circle. PMID:6230849

Nagy, S; Hantos, Z; Deavers, S I; Tóth, I; Klebniczki, J; Adamicza, A

1983-01-01

188

An unusual cause for an optic disc haemorrhage  

PubMed Central

A 51-year-old male on chemotherapy for myeloma presented initially with a unilateral optic disc haemorrhage and signs of optic neuropathy. This rapidly progressed to affect both eyes and within a few days he developed retinal features suggestive of progressive outer retinal necrosis. He was treated with intravenous acyclovir that was subsequently changed to ganciclovir when serological tests for cytomegalovirus were found to be positive for immunoglobulin M antibodies. His visual loss continued to deteriorate despite treatment, and he subsequently developed a retinal detachment in one eye. The causes of optic neuropathy in immunocompromised patients and the importance of eliminating an infective cause are discussed.

Baxter, Julia; Kailasanathan, Anusha; Chen, Hean

2011-01-01

189

Effect of nimodipine on outcome in patients with traumatic subarachnoid haemorrhage: a systematic review  

Microsoft Academic Search

Background Despite several randomised controlled trials, there is still much debate whether nimodipine improves outcome in patients with traumatic subarachnoid haemorrhage. A 2003 Cochrane review reported improved outcome with nimodipine in these patients; however, because the results of Head Injury Trial (HIT) 4 were only partly presented there is still discussion whether patients with traumatic subarachnoid haemorrhage should be treated

Mervyn DI Vergouwen; Marinus Vermeulen; Yvo BWEM Roos

2006-01-01

190

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

191

Safety and efficacy of an inactivated Carbopol-adjuvanted goose haemorrhagic polyomavirus vaccine for domestic geese  

Microsoft Academic Search

Haemorrhagic nephritis enteritis of the goose (HNEG) is an epizootic viral disease in domestic geese. The causal agent is a polyomavirus, namely goose haemorrhagic polyomavirus. To help control the disease, an inactivated vaccine was developed, based on viral particles produced in goose kidney cells. Viral material was quantified using real-time quantitative polymerase chain reaction, inactivated with ?-propiolactone and adjuvanted with

Jacqueline Gelfi; Michael Pappalardo; Carine Claverys; Brigitte Peralta; Jean-Luc Guérin

2010-01-01

192

Crimean-Congo haemorrhagic fever virus infection in the Western Province of Saudi Arabia  

Microsoft Academic Search

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

O. M. E. El-Azazy; E. M. Scrimgeour

1997-01-01

193

The effect of acute haemorrhage in the dog and man on plasma-renin concentration  

PubMed Central

1. The effect of acute haemorrhage on the plasma renin concentration was studied in the dog and man. 2. Plasma-renin concentration was regularly increased after the larger bleeds; after the smaller haemorrhages plasma-renin concentration remained unchanged. 3. The results are discussed in relation to current hypotheses concerning the control of renin and aldosterone secretion.

Brown, J. J.; Davies, D. L.; Lever, A. F.; Robertson, J. I. S.; Verniory, A.

1966-01-01

194

Spinal cord haemorrhage following herpes zoster: a possible complication of warfarin therapy  

Microsoft Academic Search

Haemorrhage is the most serious and common side-effect of warfarin therapy. Bleeding had commonly been observed in the gastrointestinal and genitourinary tracts as well as in the skin and subcutaneous tissue. Central nervous system bleeding has also been reported and has usually been associated with marked prolongation of the prothrombin time. Spinal cord haemorrhage has been infrequently observed. The patient

M. L. Friedland; E. G. Wittels

1982-01-01

195

Are systemic levels of non steroidal anti inflammatory drugs relevant to acute upper gastrointestinal haemorrhage?  

Microsoft Academic Search

It is uncertain as to the extent which gastrointestinal (GI) haemorrhage related to NSAIDs is due to a local, topical effect or to an action related to systemic absorption. We hypothesised that, should systemic drug concentrations be of importance, plasma levels of NSAIDs might be higher in patients who had developed GI haemorrhage, from controls who had not.

H. A. Wynne; M. D. Rawlins

1993-01-01

196

Recombinant subunit vaccine elicits protection against goose haemorrhagic nephritis and enteritis  

Microsoft Academic Search

Outbreaks of haemorrhagic nephritis and enteritis of geese (HNEG) have been reported in goose flocks in Hungary, Germany and France since 1969. HNEG is characterized by high morbidity and mortality rates in geese 3 to 10 weeks of age. The causative agent of HNEG is the goose haemorrhagic polyomavirus (GHPV), which has a circular double-stranded DNA genome encoding the structural

Tamás Mató; Zoltán Pénzes; Paloma Rueda; Carmen Vela; Veronika Kardi; Anna Zolnai; Ferenc Misák; Vilmos Palya

2009-01-01

197

Haemorrhagic syndrome of cattle associated with the feeding of sweet vernal (Anthoxanthum odoratum) hay containing dicoumarol  

Microsoft Academic Search

An outbreak of a haemorrhagic diathesis in cattle fed home produced hay is described. A similar syndrome was reproduced experimentally in calves by feeding them the hay. The experimental disease was characterised by increased prothrombin and partial thromboplastin times while the leucocyte and erythrocyte counts remained normal until the terminal haemorrhage. The calves ate well and grew well until the

DG Pritchard; LM Markson; PJ Brush; JA Sawtell; PA Bloxham

1983-01-01

198

Cerebral haemorrhage in arteriovenous malformation associated with Klippel-Trenaunay syndrome  

Microsoft Academic Search

The computed tomography, magnetic resonance imaging and angiographic findings are described in a patient with Klippel-Trenaunay syndrome, who also had a cerebral haemorrhage from an arteriovenous malformation. The resulting aphasia disappeared completely after resorption of the haemorrhage. In this syndrome, the occurrence of a cerebral angioma has not previously been mentioned in the literature.

H. Jaksch; H. Bewermeyer; H. A. Dreesbach; W.-D. Heiss

1986-01-01

199

The collagen-binding protein of Streptococcus mutans is involved in haemorrhagic stroke  

Microsoft Academic Search

Although several risk factors for stroke have been identified, one-third remain unexplained. Here we show that infection with Streptococcus mutans expressing collagen-binding protein (CBP) is a potential risk factor for haemorrhagic stroke. Infection with serotype k S. mutans, but not a standard strain, aggravates cerebral haemorrhage in mice. Serotype k S. mutans accumulates in the damaged, but not the contralateral

Kazuhiko Nakano; Kazuya Hokamura; Naho Taniguchi; Koichiro Wada; Chiho Kudo; Ryota Nomura; Ayuchi Kojima; Shuhei Naka; Yoshinori Muranaka; Min Thura; Atsushi Nakajima; Katsuhiko Masuda; Ichiro Nakagawa; Pietro Speziale; Nobumitsu Shimada; Atsuo Amano; Yoshinori Kamisaki; Tokutaro Tanaka; Kazuo Umemura; Takashi Ooshima

2011-01-01

200

Risk of cardiovascular events and death in the life after aneurysmal subarachnoid haemorrhage: a nationwide study.  

PubMed

BACKGROUND AND AIM: The increased mortality rates of survivors of aneurysmal subarachnoid haemorrhage have been attributed to an increased risk of cardiovascular events in a registry study in Sweden. Swedish registries have however not been validated for subarachnoid haemorrhage and Scandinavian incidences of cardiovascular disease differ from that in Western European countries. We assessed risks of vascular disease and death in subarachnoid haemorrhage survivors in the Netherlands. METHODS: From the Dutch hospital discharge register, we identified all patients with subarachnoid haemorrhage admission between 1997 and 2008. We determined the accuracy of coding of the diagnosis subarachnoid haemorrhage for patients admitted to our centre. Conditional on survival of three-months after the subarachnoid haemorrhage, we calculated standardized incidence and mortality ratios for fatal or nonfatal vascular diseases, vascular death, and all-cause death. Cumulative risks were estimated with survival analysis. RESULTS: The diagnosis of nontraumatic subarachnoid haemorrhage was correct in 95·4% of 1472 patients. Of 11?263 admitted subarachnoid haemorrhage patients, 6999 survived more than three-months. During follow-up (mean 5·1 years), 874 (12·5%) died. The risks of death were 3·3% within one-year, 11·3% within five-years, and 21·5% within 10 years. The standardized mortality ratio was 3·4 (95% confidence interval: 3·1 to 3·7) for vascular death and 2·2 (95% confidence interval: 2·1 to 2·3) for all-cause death. The standardized incidence ratio for fatal or nonfatal vascular diseases was 2·7 (95% confidence interval: 2·6 to 2·8). CONCLUSIONS: Dutch hospital discharge and cause of death registries are a valid source of data for subarachnoid haemorrhage, and show that the increased mortality rate in subarachnoid haemorrhage survivors is explained by increased risks for vascular diseases and death. PMID:22973950

Nieuwkamp, Dennis J; Vaartjes, Ilonca; Algra, Ale; Rinkel, Gabriel J E; Bots, Michiel L

2012-09-13

201

Beneficial effects of adrenergic blockade in patients with subarachnoid haemorrhage.  

PubMed Central

A total of 148 patients presenting within 48 hours of subarachnoid haemorrhage were assigned at random to receive standard management only or standard management and treatment with the adrenergic-blocking agents propranolol and phentolamine (or propranolol alone) for three weeks. One hundred and thirty-four patients completed the study. Assessment at four weeks showed a strong trend for less neurological deficit in the treated group, almost statistically significant (p=0.053) in the women. During the first month the treated group suffered fewer episodes of clinical deterioration consistent with cerebral arterial spasm: thus more treated patients underwent operation and those who did had a better outcome (p=0.030). At one year fewer were dead or disabled (unable to work) in the treated group; a significant difference for women (p=0.030). Possible mechanisms for these actions may include a reduction in pulmonary oedema, prevention of myocardial infarcts, a reduction in plasma renin activity, nd a reduction in cerebral oxygen requirements. It is concluded that early adrenergic blockade benefits patients (particularly women) with subarachnoid haemorrhage for up to one year in terms of lesser neurological deficit. Beta-blocker rather than alpha-blockade appears to be the useful component. A randomised, blind extension of the present study using long-acting propranolol and placebo has shown a significant (p=0.026) decrease in deaths and significantly (p=0.003) fewer poor results in the treatment group.

Walter, P; Neil-Dwyer, G; Cruickshank, J M

1982-01-01

202

Beneficial effects of adrenergic blockade in patients with subarachnoid haemorrhage.  

PubMed

A total of 148 patients presenting within 48 hours of subarachnoid haemorrhage were assigned at random to receive standard management only or standard management and treatment with the adrenergic-blocking agents propranolol and phentolamine (or propranolol alone) for three weeks. One hundred and thirty-four patients completed the study. Assessment at four weeks showed a strong trend for less neurological deficit in the treated group, almost statistically significant (p=0.053) in the women. During the first month the treated group suffered fewer episodes of clinical deterioration consistent with cerebral arterial spasm: thus more treated patients underwent operation and those who did had a better outcome (p=0.030). At one year fewer were dead or disabled (unable to work) in the treated group; a significant difference for women (p=0.030). Possible mechanisms for these actions may include a reduction in pulmonary oedema, prevention of myocardial infarcts, a reduction in plasma renin activity, nd a reduction in cerebral oxygen requirements. It is concluded that early adrenergic blockade benefits patients (particularly women) with subarachnoid haemorrhage for up to one year in terms of lesser neurological deficit. Beta-blocker rather than alpha-blockade appears to be the useful component. A randomised, blind extension of the present study using long-acting propranolol and placebo has shown a significant (p=0.026) decrease in deaths and significantly (p=0.003) fewer poor results in the treatment group. PMID:6805647

Walter, P; Neil-Dwyer, G; Cruickshank, J M

1982-06-01

203

Massive haemorrhagic necrosis of the liver after liver transplantation.  

PubMed Central

Six of the first 85 patients who received the first 100 liver transplantations carried out in Birmingham developed a syndrome of fulminant liver failure with distinctive clinical and pathological features. The typical clinical presentation was of an uneventual initial postoperative period, followed by a sudden deterioration in graft function, progressing rapidly to graft failure. All six patients died. The characteristic pathological changes were those of massive haemorrhage and hepatocyte necrosis with only mild inflammation and without occlusive lesions in large arteries or veins. These distinctive features differed from other recognised patterns of graft damage and seemed to comprise a specific post-transplant syndrome. The pathogenesis was not clear and in the absence of any definite aetiology it is suggested that the term "massive haemorrhagic necrosis" be used to describe these cases. Additional findings seen in five of the six cases were venoocclusive lesions (n = 4) and a combination of ductopenia and foam cell arteriopathy (n = 2). The presence of these associated lesions suggests that there may be an overlap with other types of graft damage. Images Fig 2 Fig 3 Fig 4 Fig 5 Fig 6 Fig 7

Hubscher, S G; Adams, D H; Buckels, J A; McMaster, P; Neuberger, J; Elias, E

1989-01-01

204

Risk factors associated with delayed haemorrhage after pancreatic resection  

PubMed Central

Background Delayed haemorrhage (DH) is a life-threatening complication of pancreatic resection (PR) and the mortality rate for DH is very high. However, the risk factors and prognostic factors associated with DH are rarely evaluated. Methods A pancreatic resection was performed on 457 patients. Delayed haemorrhage was defined as bleeding from the surgical site ?5 days after PR. Risk factors for DH were assessed according to demographics and pathological and operative parameters. Prognostic factors after DH were evaluated for the shock index (heart rate/systolic blood pressure) and systemic inflammatory response syndrome (SIRS) scores. Results Of the 457 patients, 11 (2.4%) experienced DH after PR. Logistic regression analysis showed that age >60 years and a diagnosis of malignant disease were risk factors for DH. The shock index and SIRS scores at the onset of DH were significantly higher in patients who died as compared with those patients that survived (P < 0.05). Discussion PR-associated DH carries an increased risk for patients aged >60 years with malignant disease. Prognostic factors were a shock index score ?0.7 and SIRS at the onset of DH.

Nakahara, Osamu; Takamori, Hiroshi; Ikeda, Osamu; Kuroki, Hideyuki; Ikuta, Yoshiaki; Chikamoto, Akira; Beppu, Toru; Yamashita, Yasuyuki; Baba, Hideo

2012-01-01

205

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

206

Long term outcome after subarachnoid haemorrhage of unknown aetiology  

PubMed Central

Background and purpose The aim of this study was to assess the long term outcome after non-aneurysmal subarachnoid haemorrhage (SAH). Methods 1154 patients with SAH were treated in our hospital between 1989 and 1999. From this patient population, 97 patients had a non-aneurysmal SAH. All hospital records and death certificates were studied and 33 patients were examined by MRI and MR angiography more than 9?years (mean 12?years) after the initial bleeding. Results The cohort consisted of 97 patients. Mean follow-up time was 9?years (range 0–19). During the follow-up period, 13 patients (13%) died. Four (4%) died from the initial bleeding less than 5?weeks after the initial haemorrhage. There was no delayed mortality due to SAH or subsequent bleedings. MR angiography revealed no new findings in 33 surviving patients. Conclusions Excess mortality during the first year after SAH was higher than 4%, and remained thereafter comparable with the general population. There were no rebleedings and MR imaging did not reveal any vascular pathology that could explain the earlier SAH.

Niskakangas, Tero T; Keski-Nisula, Leo H; Kahara, Veikko J; Ohman, Juha E

2011-01-01

207

'Fragile' liver and massive hepatic haemorrhage due to hereditary amyloidosis.  

PubMed Central

The first case of amyloidosis is reported in which spontaneous massive hepatic haemorrhage necessitated emergency liver transplantation. Liver transplantation, as a treatment for a failing liver due to amyloidosis has not been previously reported. At transplantation, the liver tissue was uncharacteristically friable, although the subsequent vascular and biliary anastomoses were uncomplicated. Histological examination of the liver showed a surprisingly modest amount of amyloid, which was shown immunohistochemically to be derived from lysozyme, and a striking absence of reticulin staining. Both the patient's father and paternal grandfather had died from spontaneous hepatic haemorrhage, and histological review of their liver tissue showed similarly modest deposition of lysozyme-derived amyloid associated with loss of reticulin staining. In each case the quantity of amyloid was far less than would be expected to interfere with the mechanical integrity of the liver. This is the only report of hepatic disintegration associated with absence of reticulin staining, and it is probable that the mechanism represents a novel secondary effect of the amyloid deposits in the livers of this family. Images Figure 1 Figure 2

Harrison, R F; Hawkins, P N; Roche, W R; MacMahon, R F; Hubscher, S G; Buckels, J A

1996-01-01

208

Life-threatening haemorrhage after 750 Le Fort I osteotomies and 376 SARPE procedures.  

PubMed

This study assessed the incidence, presenting symptoms, diagnosis, and management of patients with life-threatening postoperative haemorrhage after total Le Fort I osteotomy and surgically assisted rapid palatal expansion (SARPE). The medical records of 750 consecutive Le Fort I osteotomies and 376 consecutive SARPEs, both of which involved pterygomaxillary separation with a curved osteotome and a mallet, were analysed prospectively. Two cases of life-threatening haemorrhage were observed in the Le Fort I osteotomy group, both initiated on postoperative day 7. Anterior and posterior nasal packing were successful in one patient; the other required two embolizations for bleeding control (incidence of life-threatening postoperative haemorrhage: 2/750; confidence interval: 0.03-0.96%). In the SARPE group, one brisk epistaxis on the first postoperative day was controlled with anterior and posterior nasal packing under general anaesthesia. This haemorrhage was not considered life threatening (incidence of life-threatening postoperative haemorrhage: 0/376; confidence interval: 0-0.98%). In no case could the source of bleeding be established during re-explorative surgery or during diagnostic arteriography. The authors conclude that life-threatening haemorrhage is an exceptional finding after Le Fort I osteotomy; the observed incidence was 2/750, and life-threatening haemorrhage was not observed after SARPE in this series, despite the use of identical pterygomaxillary separation. PMID:22480877

Politis, C

2012-04-04

209

Local haemorrhage induced by Bothrops jararaca venom: relationship to neurogenic inflammation.  

PubMed

We investigated morphological alterations induced by s.c. injection of 2.5 microg of Bothrops jararaca venom in rats. Intense disorganisation of collagen fibres was observed 1 min after the venom injection, particularly at regions near vessels and nerves. Mast cells were degranulated, and erythrocytes were seen leaving venules throughout the endothelial junctions. At this time, damaged endothelial cells were not observed. In rats envenomed as above, but immediately after cardiorespiratory failure induced by deep ether anaesthesia, alterations in the connective tissue structures, as previously described, were not observed. The mediation of this haemorrhage was investigated by injecting the venom into the foot pad of mice and compared to the mediation of oedema. Local haemorrhage was significantly reduced in mice pre-treated with capsaicin or guanethidine or submitted to a surgical section of sciatic and saphenous nerves. In these animals, oedema was not affected. Groups treated with methysergide or morphine showed both haemorrhage and oedema significantly reduced. Indomethacin or dexamethasone pre-treatments significantly reduced the oedema, but not the haemorrhage. Moreover, in animals treated with promethazine or mepyramine, oedema and haemorrhage were not affected. These data suggest that local haemorrhage induced by Bothrops jararaca venom is partially controlled by serotonin and neurohumoral mediators. Furthermore, results indicate that haemorrhage and oedema are mediated by different pharmacological systems. PMID:10958383

Gonçalves, L R; Mariano, M

2000-01-01

210

Unattended fatal haemorrhage due to spontaneous peripheral varicose vein rupture--two case reports.  

PubMed

Venous haemorrhage is a rare complication of varicose veins of the legs. Varicosis is found in 15-50% of the population. Haemorrhage from ruptured varicose veins of the legs can occur spontaneously or after a minor trauma. More frequent complications of varicosis include peripheral oedema of the ankles, skin pigmentation and skin ulcers. In case of venous haemorrhage simple possibilities of first aid can be applied, therefore fatal haemorrhage is a rarity. Two cases of fatal varicose vein rupture are presented. A 58-year-old man and a 76-year-old woman, both living alone, were found dead in the bathrooms of their apartments. Significant traces of blood were found in all rooms. Both corpses showed typical signs of death from exsanguination. No traumatic lesion was found. Cause of the haemorrhage was a small lesion of the skin of the lower legs of the victims with continuation to an underlying superficial varicose vein. Misinterpretation of life-threatening varicose haemorrhage, unconsciousnous, alcohol or drug influence, old age and dementia can promote the death. In case of fatal haemorrhage the death scene can simulate crime due to massive traces of blood and may focus primarily on a non-natural death. However, police investigations and autopsy will disclose the rare cause of spontaneous natural death. PMID:20655677

Doberentz, E; Hagemeier, L; Veit, C; Madea, B

2010-07-23

211

Risk factors for haemorrhage during local intra-arterial thrombolysis for lower limb ischaemia.  

PubMed

Assessment of clinical risk factors for haemorrhagic complications in patients undergoing intra-arterial thrombolysis for lower limb ischaemia. Retrospective reviews of consecutive patients subjected to intra-arterial thrombolysis due to lower limb ischemia at the Vascular Center, Malmö University Hospital, during a 5-year period from 2001 to 2005. Two hundred and twenty intra-arterial thrombolytic procedures were carried out in 195 patients (46% women), median age 73 years. Haemorrhagic complications were recorded in 72 procedures (33%), of which 13 were discontinued. Haemorrhage at the introducer and distant sites occurred in 53 and 32 procedures, respectively. Thrombolysis for occluded synthetic grafts was associated with higher risk of haemorrhage (P = 0.043). The platelet count was lower (P = 0.017) and the dose of alteplas higher (P = 0.041) in bleeders than in non-bleeders. Age was not associated with haemorrhage (P = 0.30). Two patients died during thrombolysis, one of them due to intracerebral haemorrhage. The grade of thrombolysis was an independent predictor of both in-hospital amputation (P < 0.001; OR 3.5 [95% CI 2.1-5.8]) and mortality (P = 0.021; OR 3.0 [95% CI 1.2-7.9]). The in-hospital amputation-free survival rate was 85% (188/220). Haemorrhage associated with thrombolysis is common, but does seldom require discontinuation of treatment. Insertion of introducers for local thrombolysis through synthetic grafts, lower platelet count and higher alteplas dose were found to be risk factors for haemorrhage. An algorithm for clinical management of haemorrhage has been proposed. PMID:20848161

Kuoppala, M; Åkeson, J; Svensson, P; Lindblad, B; Franzen, S; Acosta, S

2011-02-01

212

Acute haemorrhage associated with pancreatic pseudocyst and chronic pancreatitis.  

PubMed

The present study reports 18 patients operated on for chronic pancreatitis complicated by bleeding in the upper gastrointestinal tract, the peritoneal cavity or the retroperitoneal space. Damage to the splenic artery by a pancreatic pseudocyst was the most common reason for the bleeding (10 patients, 56%) and the most common site was the duodenum (10 patients, 56%). Eleven patients were treated by transcystic multiple suture ligations combined with external drainage of the pseudocyst, and seven by pancreatic resection or total pancreatectomy. Hospital mortality was 33% (6 patients); two patients had undergone transcystic suture ligation, and four pancreatic resection. Five patients needed a reoperation because of further bleeding, four of them having been treated initially by transcystic suture ligation. Our results suggest that haemostasis by suture ligation is a method to be recommended if the patient's condition has been exacerbated by severe haemorrhage. PMID:6334475

Kiviluoto, T; Schröder, T; Kivilaakso, E; Lempinen, M

1984-01-01

213

Rodent control programmes in areas affected by Bolivian haemorrhagic fever.  

PubMed

Bolivian haemorrhagic fever (BHF) caused by Machupo virus is acquired by contact with the excretions and secretions of Calomys callosus, an indigenous cricetine rodent which is preadapted to peridomestic habitats. It competes successfully with Mus musculus, but not with Rattus rattus. A successful disease control programme has functioned in Beni Department since 1964. It is based on trapping surveys and the detection of splenomegaly in Calomys rodents as an index of chronic virus infection. Mass trapping and poisoning are used initially, and regular trapping is employed to control Calomys populations in towns where disease has occurred. More than 1000 cases of BHF were recorded from 1960-1964, but less than 200 in the past 10 years. The cost of this programme is approximately $30 000 annually. PMID:182405

Mercado, R

1975-01-01

214

Massive colonic haemorrhage--the case for right hemicolectomy.  

PubMed Central

A total of 14 patients had operations for massive colonic haemorrhage. Of the seven who had a right hemicolectomy, four had the bleeding site localised, and three had only 'equivocal' indications of a right-sided source. One of these rebled 11 months later, but all survived and are well. Of the remaining patients, two had left-sided resection, one requiring an immediate second operation for rebleeding, and five, subtotal colectomy, of whom two died. A literature review confirms the suggestion that if the bleeding site has not been identified but, nevertheless, there are clues suggesting it to be right-sided, the best results will be obtained by right hemicolectomy. Left-sided resection should be used only when there is proof of left-sided bleeding, otherwise there will be an unacceptably high mortality. No clues, 'equivocal' indications of a left-sided source, or the presence of bilateral disease, should lead the operator to perform subtotal colectomy.

Milewski, P. J.; Schofield, P. F.

1989-01-01

215

[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

216

The surgical management of post-partum haemorrhage.  

PubMed

Life-threatening post-partum haemorrhage (PPH) occurs with a frequency of 1 per 1000 deliveries in the developed world. In the 1994-1996 Triennial Confidential Enquiry into Maternal Deaths in the United Kingdom primary PPH was responsible for five deaths. In this chapter we discuss briefly the assessment and initial medical management of the patient with primary PPH but concentrate on the surgical management where medical treatment has failed. The surgical management discussed includes both traditional or long-established management strategies together with newer, less radical surgical options, such as embolization techniques, uterine compression sutures and methods involving uterine tamponade, which are less hazardous to perform and have the advantage of preserving reproductive function. The recommendations of the reports from the Confidential Enquiries into Maternal Deaths in the UK are summarized at the end of the chapter. PMID:11866499

Tamizian, Onnig; Arulkumaran, S

2002-02-01

217

[Endovascular treatment of vasospasm following subarachnoid aneurysmal haemorrhage].  

PubMed

An endovascular treatment of vasospasm following a subarachnoid aneurysmal haemorrhage is to be implemented if the patient presents clinical or biological symptoms arguing for brain ischemia in conjunction with increased Doppler velocities despite well controlled systemic haemodynamic. Treatment might be either pharmacological or haemodynamic. Calcium and phosphodiesterase inhibitors can be administered. The former could also provide a neuroprotective effect as compared to the latter. In Europe, nimodipine is widely used whereas nicardipine and verapamil are the major molecules administered in North America where iv nimodipine is not FDA approved. Papaverine is less used nowadays because of its short duration of action and of the risk of aggravation of raised intracranial pressure. Balloon angioplasty has a long lasting effect but can be applied only to proximal spasm. Complications of its use are rare but life threatening. In some cases, both the pharmacological approach and the mechanical approach are used in combination. PMID:17935940

Abdennour, L; Lejean, L; Bonneville, F; Boch, A-L; Puybasset, L

2007-11-01

218

Haemorrhage and coagulopathy in the Defence Medical Services.  

PubMed

Over the past 12 years, the United Kingdom Defence Medical Services have evolved an integrated 'damage control resuscitation - damage control surgery' sequence for the management of patients sustaining complex injuries. During 2009, over 3200 units of blood products were administered as massive transfusions to severely injured UK personnel. An important part of the approach to traumatic bleeding is the early, empirical use of predefined ratios of blood and clotting products. As soon as control of bleeding is achieved, current practice is to switch towards a tailored transfusion, based on clinical and laboratory assessments, including point-of-care coagulation testing. A key goal is to provide resuscitation seamlessly throughout surgery, so that patients leave the operating room with their normal physiology restored. This article outlines the current management of haemorrhage and coagulation employed in Afghanistan from the point of wounding to transfer back to the National Health Service. PMID:23210556

Mercer, S J; Tarmey, N T; Woolley, T; Wood, P; Mahoney, P F

2013-01-01

219

A risk scoring system for prediction of haemorrhagic stroke.  

PubMed

The present pair-matched case control study was carried out at Government Medical College Hospital, Nagpur, India, a tertiary care hospital with the objective to devise and validate a risk scoring system for prediction of hemorrhagic stroke. The study consisted of 166 hospitalized CT scan proved cases of hemorrhagic stroke (ICD 9, 431-432), and a age and sex matched control per case. The controls were selected from patients who attended the study hospital for conditions other than stroke. On conditional multiple logistic regression five risk factors- hypertension (OR = 1.9. 95% Cl = 1.5-2.5). raised scrum total cholesterol (OR = 2.3, 95% Cl = 1.1-4.9). use of anticoagulants and antiplatelet agents (OR = 3.4, 95% Cl =1.1-10.4). past history of transient ischaemic attack (OR = 8.4, 95% Cl = 2.1- 33.6) and alcohol intake (OR = 2.1, 95% Cl = 1.3-3.6) were significant. These factors were ascribed statistical weights (based on regression coefficients) of 6, 8, 12, 21 and 8 respectively. The nonsignificant factors (diabetes mellitus, physical inactivity, obesity, smoking, type A personality, history of claudication, family history of stroke, history of cardiac diseases and oral contraceptive use in females) were not included in the development of scoring system. ROC curve suggested a total score of 21 to be the best cut-off for predicting haemorrhag stroke. At this cut-off the sensitivity, specificity, positive predictivity and Cohen's kappa were 0.74, 0.74, 0.74 and 0.48 respectively. The overall predictive accuracy of this additive risk scoring system (area under ROC curve by Wilcoxon statistic) was 0.79 (95% Cl = 0.73-0.84). Thus to conclude, if substantiated by further validation, this scorincy system can be used to predict haemorrhagic stroke, thereby helping to devise effective risk factor intervention strategy. PMID:16479901

Zodpey, S P; Tiwari, R R

220

High-grade intracranial chondrosarcoma presenting with haemorrhage.  

PubMed

Chondrosarcomas are rare sarcomas that produce malignant cartilage, infrequently arising as a primary intracranial tumour. We present a patient with intracranial chondrosarcoma with intratumoural haemorrhage arising in an unusual location and with unusual imaging findings. A 46-year-old man presented with headache, nausea, and vomiting over the previous 24hours. Physical and neurological examinations were normal. Cranial CT scans and MRI revealed a large right pre-frontal (subdural) and interhemispheric heterogeneous density associated with a frontal, partially calcified mass and midline shift. An awake craniotomy was performed. With the intra-operative quick section favouring subdural hematoma, the lesion was subtotally resected. Follow-up imaging confirmed residual mass. Pathology examination revealed a high-grade malignant neoplasm with chondroid differentiation, diagnosed as conventional Grade III chondrosarcoma. The patient was referred to oncology for follow-up and radiation therapy. Intracranial chondrosarcoma was first reported in 1899, and since then continues to be an extremely rare malignancy of the brain. These tumours commonly present as extra-axial masses, originating from the skull base, and produce symptoms due to progressive enlargement and compression of local structures. Unusual presentations of these tumours, such as vascularity, intratumoural haemorrhage, and intra-axial location, may complicate pre-surgical decision making by altering the provisional diagnosis prior to intervention. This patient emphasises the importance of careful analysis and incorporation of imaging findings into surgical decision making. Specific imaging characteristics that, in such unusual situations, are suggestive of chondrosarcoma should motivate an aggressive surgical approach to optimise adjuvant interventions. PMID:23746570

Little, Anjuli; Chung, Caroline; Perez-Ordonez, Bayardo; Mikulis, David; Valiante, Taufik A

2013-06-05

221

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

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. Ser(780) 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 Asp(780) > Ser(780) > Ala(780). Affinity-purified antibody against a peptide containing phospho-Ser-(780) recognizes wild-type Kex2p but not S(780)A Kex2p, showing that Ser(780) is phosphorylated in vivo; phosphorylation of Ser(780) is up-regulated by cell wall-damaging drugs. Finally, mutation of Ser(780) 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

2013-02-01

222

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

223

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

PubMed

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

2012-07-03

224

Non-accidental subdural haemorrhage in Hong Kong: incidence, clinical features, management and outcome  

Microsoft Academic Search

Objective  We aim to identify the incidence and the characteristics of non-accidental subdural haemorrhage in Hong Kong in children under the age of 5 years.Method  Eighteen children aged below 5 years presented with subdural haemorrhage without a history of significant trauma were studied. Clinical features and the work-up process for probable child abuse were analysed.Results  Sixteen combined case conferences were held, and eleven cases were

David T. F. Sun; X. L. Zhu; W. S. Poon

2006-01-01

225

Massive post-partum haemorrhage and management of disseminated intravascular coagulation  

Microsoft Academic Search

Death from haemorrhage fell in the last triennial report from 5.5 to 3.3 per million maternities in the UK. Although the Confidential Report into Maternal Deaths in the UK 1997–1999 continues to make recommendations in relation to the management of obstetric haemorrhage in an attempt to improve the overall level of care, it is disappointing that care was considered to

Sheila Macphail; Kate Talks

2004-01-01

226

Characteristics of intracranial aneurysms and subarachnoid haemorrhage in patients with polycystic kidney disease  

Microsoft Academic Search

.   Background and Purpose: Subarachnoid haemorrhage is a common cause of death in patients with autosomal dominant polycystic kidney disease (ADPKD),\\u000a but little is known about specific characteristics of subarachnoid haemorrhage and intracranial aneurysms in this group of\\u000a patients. We performed a systematic review on site, size and number of aneurysms, age at time of rupture, gender, and family\\u000a history

Esther W. Gieteling; Gabriel J. E. Rinkel

2003-01-01

227

Spinal arachnoiditis as a consequence of aneurysm-related subarachnoid haemorrhage.  

PubMed

Only a few case reports currently exist regarding symptomatic spinal arachnoiditis following aneurysm-related subarachnoid haemorrhage. We present three patients who developed symptomatic spinal arachnoiditis following spontaneous aneurysm rupture. Following initial aneurysm and subarachnoid haemorrhage management (including ventriculo-peritoneal shunt placement), all three patients developed gradually worsening neurological abnormalities, and subsequent imaging demonstrated spinal arachnoiditis. Despite spinal decompression, all three patients experienced progressively worsening neurological decline. PMID:23374556

van Heerden, Jolandi; McAuliffe, William

2012-09-05

228

Single versus bilateral external ventricular drainage for intraventricular fibrinolysis in severe ventricular haemorrhage  

Microsoft Academic Search

Background:Intraventricular fibrinolysis (IVF) through bilateral external ventricular drains (EVD) may provide better access of the thrombolytic agent to the intraventricular clot, potentially influencing clot clearance and outcome.Methods:Patients with spontaneous ganglionic intracerebral haemorrhage (ICH)<40 cm3 and intraventricular haemorrhage (IVH) with acute hydrocephalus have been treated with IVF. The decision for placement of one or two EVDs has been left to the

D Staykov; H B Huttner; J Lunkenheimer; B Volbers; T Struffert; A Doerfler; O Ganslandt; E Juettler; S Schwab; J Bardutzky

2010-01-01

229

LP or not LP, that is the question: gold standard or unnecessary procedure in subarachnoid haemorrhage?  

PubMed

OBJECTIVE: To measure the sensitivity of modern CT in patients presenting to the emergency department and evaluated for possible subarachnoid haemorrhage, with particular attention to those presenting within 12 h of ictus. DESIGN: Retrospective cohort study. SETTING: Large district general hospital emergency department seeing 73 500 new attendances per year. PARTICIPANTS: Patients presenting to the emergency department and screened for suspected subarachnoid haemorrhage. OUTCOME MEASURES: Subarachnoid haemorrhage was defined by either the presence of subarachnoid blood on CT, positive CSF spectrophotometry defined by national guidelines or aneurysm identified on subsequent angiography if either of the former were equivocal. RESULTS: 244 patients were screened for subarachnoid haemorrhage during the 24 months between March 2006 and April 2008 (mean age 48.5 years). The sensitivity of CT overall for subarachnoid haemorrhage was 93.8% (95% CI 84% to 98%) increasing to 95% (95% CI 82% to 99%) if performed within 12 h of ictus. CONCLUSIONS: While modern CT has a high sensitivity for the diagnosis of acute subarachnoid haemorrhage, particularly within 12 h of ictus, it is still not sufficient to act as the sole diagnostic tool, and patients with a negative CT will require further investigation with a lumbar puncture. PMID:23756363

Stewart, Hannah; Reuben, Adam; McDonald, James

2013-06-11

230

Electrocardiographic changes and their prognostic significance in subarachnoid haemorrhage  

PubMed Central

In a study on the prognostic significance of catecholamine-linked ECG changes in 40 cases of subarachnoid haemorrhage, there were 16 men of mean age 41 years (range 13-56) and 24 women of mean age 42 years (range 11-65). There were six deaths, and five of these patients had consistently abnormal ECGs. Analysis of the abnormal components of ECGs revealed that the presence of either a pathological Q wave or a raised S-T segment indicated a poor prognosis. The two patients with pathological Q waves both died, and the three patients with raised S-T segments all developed cerebral arterial spasm, one of whom died. A high incidence of peaked P waves, short P-R intervals, a long Q-Tc, and tall U waves occurred in the ECGs of six patients who died, the 15 patients with cerebral arterial spasm, and the seven patients who were later to develop cerebral arterial spasm. Three of the latter eventually died, in contrast with the single death in the 22 patients who did not develop cerebral arterial spasm and had a low incidence of P wave peaking, short P-R intervals, a long Q-Tc, and tall U waves. Various combinations of these four ECG changes, in addition to peaking of the T wave, indicated a bad prognosis irrespective of the type of treatment. The criteria for prognosis on the role of catecholamines in causing the ECG abnormalities are discussed.

Cruickshank, J. M.; Neil-Dwyer, G.; Brice, J.

1974-01-01

231

Dengue fever and dengue haemorrhagic fever in adolescents and adults  

PubMed Central

Dengue fever (DF) is endemic in tropical and subtropical zones and the prevalence is increasing across South-east Asia, Africa, the Western Pacific and the Americas. In recent years, the spread of unplanned urbanisation, with associated substandard housing, overcrowding and deterioration in water, sewage and waste management systems, has created ideal conditions for increased transmission of the dengue virus in tropical urban centres. While dengue infection has traditionally been considered a paediatric disease, the age distribution of dengue has been rising and more cases have been observed in adolescents and adults. Furthermore, the development of tourism in the tropics has led to an increase in the number of tourists who become infected, most of whom are adults. Symptoms and risk factors for dengue haemorrhagic fever (DHF) and severe dengue differ between children and adults, with co-morbidities and incidence in more elderly patients associated with greater risk of mortality. Treatment options for DF and DHF in adults, as for children, centre round fluid replacement (either orally or intravenously, depending on severity) and antipyretics. Further data are needed on the optimal treatment of adult patients.

Tantawichien, Terapong

2012-01-01

232

Long term follow up after perimesencephalic subarachnoid haemorrhage  

PubMed Central

OBJECTIVES—To evaluate the long term sequelae of perimesencephalic subarachnoid haemorrhage (PMSAH).?METHODS—Twenty one consecutive patients were studied. All patients were examined by CT, angiography, MRI, multimodal evoked potentials, and transcranial Doppler sonography. All relevant clinical data during hospital stay and outcome at discharge were obtained by reviewing the charts. Long term follow up was evaluated by reviewing the outpatient files and dedicated outpatient review. Patients were specifically questioned about their perceived recovery, residual complaints, and present occupational status.?RESULTS—Apart from the initial CT confirming the diagnosis of PMSAH all other examinations disclosed no abnormalities. None of the patients developed any complications during hospital stay, and all patients were discharged in good clinical condition and without neurological deficits. At long term follow up 62% of the patients had residual complaints consisting of headaches, irritability, depression, forgetfulness, weariness, and diminished endurance. Apart from four patients who had already retired before the PMSAH, only seven of the remaining 17 patients (41%) returned to their previous occupation, whereas nine patients (53%) retired from work and one man became unemployed. One patient had a recurrence of PMSAH 31 months after the first event.?CONCLUSION—PMSAH can have considerable long term psychosocial sequelae, and may also recur. Prognosis may not be as good as previously reported.??

Marquardt, G.; Niebauer, T.; Schick, U.; Lorenz, R.

2000-01-01

233

Three years prospective investigation of pituitary functions following subarachnoid haemorrhage.  

PubMed

Subarachnoid haemorrhage (SAH) is known to be related to pituitary dysfuntion in retrospective and short-term prospective studies. We aimed to investigate pituitary functions in patients with SAH in longer follow-up periods to demonstrate if pituitary hormone deficiencies recover, persist or new hormone deficiencies occur. Twenty patients with SAH, who were followed up for 3 years, were included in the present study. Patients were evaluated with basal hormone levels and glucagon stimulation test (GST).Serum basal cortisol and adrenocorticotropic hormone (ACTH) levels were found to be significantly elevated at 3rd year of SAH compared to 1st year. Other basal hormone levels at 3rd year did not show a significant change from the levels found at 1st year. One of the patients had ACTH deficiency at 1st year of SAH and recovered at 3rd year. Growth hormone (GH) deficiency, according to GST,was diagnosed in 4 patients. One patient with GH deficiency at first year was still deficient, 3 of them recovered and 3 patients were found to have new-onset GH deficiency 3 years after SAH. SAH is associated with anterior pituitary dysfunction and GH is the most frequently found deficient hormone in the patients. Although one year after SAH seems to be an appropriate time for the evaluation of pituitary functions, further follow-up may be required at least in some cases due to recovered and new-onset hormone deficiencies at 3rd year of SAH. PMID:22315089

Karaca, Z; Tanriverdi, F; Dagli, A T; Selcuklu, A; Casanueva, F F; Unluhizarci, K; Kelestimur, F

2013-03-01

234

[About stepwise uterine devascularization in early post-partum haemorrhages].  

PubMed

Bleedings are the leading cause for mother's mortality rate worldwide and that is why the authors face once more the abdominal operative methods for definite copying the early post partum haemorrhages (EPH). They share their experience gained already with 46 cases when EPH has definitively been copied by means of stepwise uterine devascularization of the vessels with atonic bleedings and ligation of a. iliaca interna presenting with laceration of the lower uterine segment and vagina as well. Hysterectomy has been performed only when the uterus has already exhausted its fertile capacities in a structural and functional aspect, e.g. after numerous abortions, deliveries and experienced Caesarean sections, intra-partum septic conditions, appoplexio uteri, etc. According to authors' opinion, the stepwise uterine devascularization is the method of choice for EPH surgical copying during which woman' fertility is, in fact, preserved. With this method, no complications typical of the various compression methods applied to overcome the puerperal bleedings such as B-Linch sutures, haemostatic sutures of 'multiple squares' type as well as U-shape compression sutures have been observed at all. PMID:19230260

Tsvetkov, K; Angelova, M; Monastirska, M; Tsvetkov, Ts

2008-01-01

235

Misoprostol for the prevention and treatment of postpartum haemorrhage.  

PubMed

Postpartum haemorrhage (PPH) causes preventable maternal deaths, mainly in low-income countries. Misoprostol has powerful uterotonic effects and, because it is well absorbed orally and sublingually, has the potential to be used more widely than would be possible with injectable uterotonics alone. Misoprostol is clearly less effective than oxytocin. Placebo-controlled studies have had variable results, although two recent trials in low-income communities have shown promising results. The main recognized side effects have been dose-related pyrexia and shivering, including occasional hyperpyrexia. In the randomized trials reported to date, there has been a trend to more deaths with misoprostol than with the control groups. The dose that has been most commonly used in clinical trials for preventing PPH is 600 microg orally. Meta-analysis of direct and adjusted indirect comparisons between 600 and 400 microg showed very similar effectiveness. To date, there is very limited evidence for the effectiveness of misoprostol, the lowest effective dose and the magnitude of adverse effects, both direct and indirect. The need for further research is a matter of great urgency. PMID:18786863

Hofmeyr, G Justus; Gülmezoglu, A Metin

2008-09-10

236

Disordered cerebro-vascular physiology in aneurysmal subarachnoid haemorrhage.  

PubMed

The technical problems of surgery for anterior circle aneurysm have in large measure been solved. The problem of reduced perfusion to the brain which characterises the patient with aneurysmal subarachnoid haemorrhage in a poor clinical condition demands more subtle physiological handling. It appears likely that maintenance of an intact cell membrane and blood brain barrier may be aided by the exhibition of pre and post-operative steriods, and that concentration on regional perfusion should be the main aim in post-operative management of such cases. This demands maintenance of adequate blood volume, avoidance of platelet stickiness, and utilisation of the pathological paralysis of autoregulation to improve flow to ischaemic zones by hypertensive agents if necessary. The possibility that early operation with evacuation of blood from the basal cisterns may in the end prevent the vascular damage and disordered vaso-reactivity which encourages the development of transient ischaemic deficits, is a concept which has to be actively pursued. The problem is a continuing one which has bedevilled aneurysm surgery for 25 years, but the omens suggest that a solution is appreciably nearer at hand. PMID:665340

Symon, L

1978-01-01

237

External diathermy treatment of proliferative diabetic retinopathy with vitreous haemorrhage.  

PubMed Central

Sixty-six cases of advanced proliferative diabetic retinopathy were treated by external diathermy. The eyes had extensive fibrovascular proliferations growing into the vitreous. All had some blood, recent and old, in the vitreous. The vitreous was extremely degenerated and retracted. All the patients had inadequate diabetic control. More than half were hypertensive, with reasonable medical control, while a few had some degree of renal failure, with lower limb oedema. None of the cases were suitable for photocoagulation. Thirty-two control eyes were followed up together with the treated eyes for one to eight years. Of 53 eyes of patients with maturity onset diabetes 28 improved, 12 remained unchanged, and 13 deteriorated. Only two eyes developed neovascular glaucoma, while eight of 13 eyes of patients with juvenile diabetes improved. Of the control eyes, one regressed spontaneously, six remained unchanged, and 25 deteriorated. Of these 25 eyes eight developed traction detachment, 10 suffered relentless attacks of vitreous haemorrhage, and seven developed neovascular glaucoma. External diathermy appears to be a logical approach to cases which could not be treated by either photocoagulation or vitrectomy.

Siam, A L

1986-01-01

238

Clinical relevance of cerebral autoregulation following subarachnoid haemorrhage.  

PubMed

Subarachnoid haemorrhage (SAH) is a form of stroke that is associated with substantial morbidity, often as a result of cerebral ischaemia that occurs in the following days. These delayed deficits in blood flow have been traditionally attributed to cerebral vasospasm (the narrowing of large arteries), which can lead to cerebral infarction and poor neurological outcome. Data from recent studies, however, show that treatment of vasospasm in patients with SAH, using targeted medication, does not translate to better neurological outcomes, and argue against vasospasm being the sole cause of the delayed ischaemic complications. Cerebral autoregulation-a mechanism that maintains stability of cerebral blood flow in response to changes in cerebral perfusion pressure-has been reported to fail after SAH, often before vasospasm becomes apparent. Failure of autoregulation, therefore, has been implicated in development of delayed cerebral ischaemia. In this Review, we summarize current knowledge about the clinical effect of disturbed cerebral autoregulation following aneurysmal SAH, with emphasis on development of delayed cerebral ischaemia and clinical outcome, and provide a critical assessment of studies of cerebral autoregulation in SAH with respect to the method of blood-flow measurement. Better understanding of cerebral autoregulation following SAH could reveal mechanisms of blood-flow regulation that could be therapeutically targeted to improve patient outcome. PMID:23419369

Budohoski, Karol P; Czosnyka, Marek; Kirkpatrick, Peter J; Smielewski, Peter; Steiner, Luzius A; Pickard, John D

2013-02-19

239

New insights into the structural elements involved in the skin haemorrhage induced by snake venom metalloproteinases.  

PubMed

Haemorrhage induced by snake venom metalloproteinases (SVMPs) is a complex phenomenon resulting in capillary disruption and extravasation. This study analysed structural elements important for the interaction of four Bothrops jararaca SVMPs of different domain organisation and glycosylation levels with plasma and extracellular matrix proteins: HF3 (P-III class) is highly glycosylated and ~80 times more haemorrhagic than bothropasin (P-III class), which has a minor carbohydrate moiety; BJ-PI (P-I class) is not haemorrhagic and the DC protein is composed of disintegrin-like/cysteine-rich domains of bothropasin. HF3, bothropasin and BJ-PI showed different degradation profiles of fibrinogen, fibronectin, vitronectin, von Willebrand factor, collagens IV and VI, laminin and Matrigel; however, only bothropasin degraded collagen I. In solid-phase binding assays HF3 and bothropasin interacted with fibrinogen, fibronectin, laminin, collagens I and VI; the DC protein bound only to collagens I and VI; however, no binding of BJ-PI to these proteins was detected. N-deglycosylation caused loss of structural stability of bothropasin and BJ-PI but HF3 remained intact, although its haemorrhagic and fibrinogenolytic activities were partially impaired. Nevertheless, N-deglycosylated HF3 bound with higher affinity to collagens I and VI, although its proteolytic activity upon these collagens was not enhanced. This study demonstrates that features of carbohydrate moieties of haemorrhagic SVMPs may play a role in their interaction with substrates of the extracellular matrix, and the ability of SVMPs to degrade proteins in vitro does not correlate to their ability to cause haemorrhage, suggesting that novel, systemic approaches are necessary for understanding the mechanism of haemorrhage generation by SVMPs. PMID:20664911

Oliveira, Ana K; Paes Leme, Adriana F; Asega, Amanda F; Camargo, Antonio C M; Fox, Jay W; Serrano, Solange M T

2010-07-20

240

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

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

1999-01-01

241

Gastro-intestinal haemorrhage risks of selective serotonin receptor antagonist therapy: a new look  

PubMed Central

AIMS (i) To determine the effects of selective serotonin reuptake inhibitors (SSRI) and other classes of antidepressants on upper gastro-intestinal (GI) haemorrhage and (ii) to assess the drug–drug interaction effects of antidepressants and warfarin or clopidogrel on the risk of GI haemorrhage. METHODS This was a population-based case control study in the General Practice Research Database (GPRD). Cases with a first episode of upper GI haemorrhage between 2000 and 2005 were matched with up to 10 controls. Exposure to the study drugs was defined by a prescription issued in the 90 days before the index date. Rate ratios were estimated using conditional logistic regression. RESULTS Four thousand and twenty-eight cases of GI haemorrhage and 40 171 controls were identified. The excess risk of GI haemorrhage with SSRI use was small (Rate Ratio [RR]: 1.3; 95% confidence interval [CI]: 1.1, 1.6) and null with exposure to tricyclic antidepressants (TCAs) (RR 1.0; 95% CI: 0.8, 1.3). The risk of GI haemorrhage was highest with venlafaxine use (RR: 1.9; 95% CI: 1.3, 2.6). There was no drug–drug interaction between warfarin anticoagulation and antidepressant use. CONCLUSIONS This study supports a small increased risk of upper GI haemorrhage with the use of SSRI antidepressants compared with the older TCA drugs, but to a lesser extent than previously reported due to confounding by alcohol use. The small elevation in risk of GI haemorrhage with SSRI and venlafaxine should be weighed against the therapeutic benefit of their use. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT The known biological effects of selective serotonin reuptake inhibitors (SSRI) on platelets are consistent with an increased risk of gastrointestinal haemorrhage in patients on SSRI therapy.Previous research supports this increased risk among SSRI users with a large increase in bleeding risk observed. WHAT THIS STUDY ADDS This large study was able to compare the effects of different classes of antidepressant as well as to test for drug–drug interactions with warfarin.The discovery of alcohol abuse as a strong confounder may partially explain the very high risks of bleed seen in previous studies that did not adjust for this confounder.

Opatrny, Lucie; Delaney, J A 'Chris'; Suissa, Samy

2008-01-01

242

[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

243

Clinical audit: a useful tool for reducing severe postpartum haemorrhages?  

PubMed Central

Objective Reducing the rate of severe postpartum haemorrhage (PPH) is a major challenge in obstetrics today. One potentially effective tool for improving the quality of care is the clinical audit, that is, peer evaluation and comparison of actual practices against explicit criteria. Our objective was to assess the impact of regular criteria-based audits on the prevalence of severe PPH. Design Quasi-experimental before-and-after survey Setting Two French maternity units in the Rhône-Alpes region, with different organisation of care. Participants All staff of both units. Intervention Quarterly clinical audit meetings at which a team of reviewers analysed all cases of severe PPH and provided feedback on quality of care and where all staff actively participated. Main outcome measures The primary outcome was the prevalence of severe PPH. Secondary outcomes included the global quality of care for women with severe PPH, including the performance rate for each recommended procedure. Differences in these variables between 2005 and 2008 were tested. Results The prevalence of severe PPH declined significantly in both units, from 1.52% to 0.96% of deliveries in the level III hospital (p=0.048) and from 2.08% to 0.57% in the level II hospital (p<0.001). From 2005 to 2008, the proportion of deliveries with severe PPH that were managed consistently with the guidelines increased for all of its main components, in both units. Conclusion Regular clinical audits of cases severe PPH were associated with a persistent reduction in the prevalence of severe PPH.

Dupont, Corinne; Deneux-Tharaux, Catherine; Touzet, Sandrine; Colin, Cyrille; Bouvier-Colle, Marie-Helene; Lansac, Jacques; Thevenet, Simone; Boberie-Moyrand, Claire; Piccin, Gaelle; Fernandez, Marie-Pierre; Rudigoz, Rene-Charles

2011-01-01

244

Periventricular haemorrhage in very low birth weight Malaysian neonates.  

PubMed

A prospective study was carried out to determine the incidence, clinical presentation, early outcome, and risk factors associated with periventricular haemorrhage (PVH) in 88 (84 per cent) of the 105 consecutive very low birth weight (VLBW) (< 1500 g) Malaysian neonates born in the Maternity Hospital, Kuala Lumpur. Based on the cranial ultrasound findings, PVH was detected in 86 of the 88 neonates (98 per cent, 95 per cent confidence intervals: 95 to 101). Seventeen (20 per cent) of them had grade I, 52 (61 per cent) had grade II, 7 (8 per cent) had grade III and 10 (12 per cent) had grade IV PVH. PVH was detected in all the affected neonates by the fifth day of life. Sixty-four neonates (74 per cent) were symptomatic when PVH was first detected. Shock (P < 0.01), pallor (P = 0.028), low haematocrit of less than 40 per cent (P < 0.01), convulsion (P < 0.001), and bulging of anterior fontanelle (P = 0.019) were significantly more common in the neonates with severe PVH (grades III or IV). Death occurred in 43/86 (50 per cent, 95 per cent confidence interval: 39-61 per cent) of the neonates with PVH before their first discharge from the hospital. Ventriculomegaly developed in 29/43 (67 per cent, 95 per cent confidence intervals: 54.4-81.4) of the survivors with PVH. Our study suggests that PVH is a common problem in the Malaysian VLBW neonates. To reduce the incidence and severity of this condition, prevention of preterm delivery and improvement in the basic facilities for neonatal care would help. PMID:8411316

Boo, N Y; Ong, L C; Lye, M S; Wong, K P; Mastura, M

1993-08-01

245

Intracranial haemorrhage among a population of haemophilic patients in Brazil.  

PubMed

Intracranial haemorrhage (ICH) is a common cause of morbidity and mortality in haemophilic patients. The overall incidence of ICH has been reported to range from 2.2% to 7.5% in patients with haemophilia. From 1987 to 2001, 401 haemophilic patients from the Serviço de Hemofilia, Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo were evaluated. The episodes of ICH were documented by CT scan and the anatomic location, clinical presentation, relationship to trauma and clinical factors, including the presence of HIV infection and the presence of inhibitor, were reviewed. Among 401 haemophilic patients, 45 ICH episodes in 35 (8.7%) patients with age ranging from 4 days to 49 years (mean 10.6 years) were observed. A history of recent trauma was documented in 24 (53.3%) cases. Seventeen (37.8%) episodes occurred in more than one site of bleeding, 12 (26.7%) were subdural, seven (15.5%) subarachnoid, four (8.9%) epidural, two (4.4%) intracerebral and one (2.2%) intraventricular. The most frequent symptoms were headache and drowsiness. All patients were submitted to replacement therapy and neurosurgical intervention was performed in eight (17.8%) patients. Despite the treatment, three (8.6%) haemophilia A patients died due to the ICH event and three presented late sequelae. The most important aspect of ICH management is the early replacement therapy in haemophilic patients. This prompt treatment will increase the chances of a better prognosis. Another impact measure consists in the administration of the deficient coagulation factor after every head trauma, even when considered minor. PMID:14511296

Antunes, S V; Vicari, P; Cavalheiro, S; Bordin, J O

2003-09-01

246

Haemorrhagic nephritis and enteritis of geese: pathomorphological investigations and proposed pathogenesis.  

PubMed

Haemorrhagic nephritis and enteritis of geese as a new disease was first described in Hungary in 1969. The authors identified the causative agent of the outbreaks occurring in 1969 as a polyomavirus by PCR in 2001. In order to study the pathogenesis of the virus, one-day-old goslings were infected with tissue homogenate that tested positive for polyomavirus by PCR. Morphological, light and transmission electron microscopic (TEM) examinations have revealed that goose haemorrhagic polyomavirus replicates in the endothelial cells of the blood vessels and capillaries of diseased birds. Infection causes damage and necrosis of the endothelial cells. The virus was not observed in the parenchymal cells. Oedema and haemorrhages found throughout the body may be due to the dysfunction or functional deficiency of endothelial cells damaged by the virus. PMID:15959979

Dobos-Kovács, M; Horváth, E; Farsang, A; Nagy, Edith; Kovács, Andrea; Szalai, F; Bernáth, S

2005-01-01

247

Elevation of intracranial pressure following transjugular intrahepatic portosystemic stent-shunt for variceal haemorrhage.  

PubMed

Increased intracranial pressure and cerebral oedema in patients with chronic liver disease is rare and is more typical of acute liver failure. Transjugular intrahepatic portosystemic stent-shunt is being increasingly used in the management of uncontrolled variceal haemorrhage in patients with cirrhosis. In our institution, a total of 160 patients has undergone transjugular intrahepatic porto-systemic stent-shunt for variceal haemorrhage; 56 of these procedures were emergencies for uncontrolled variceal haemorrhage. Four of these 56 patients developed features of acute liver failure, with marked deterioration in liver function tests and elevated intracranial pressure. This unusual but important complication of transjugular intrahepatic portosystemic stent-shunt has not been reported in the literature previously, and may have important consequences both for clinical practice and in the provision of further clues to understanding the pathogenesis of increased intracranial pressure in patients with liver diseases. PMID:9382983

Jalan, R; Dabos, K; Redhead, D N; Lee, A; Hayes, P C

1997-11-01

248

Epidural haemorrhage during embolisation: a rare complication of intra-arterial embolisation of vertebral metastases  

PubMed Central

Pre-operative embolisation of vertebral metastases has been known to effectively devascularise hypervascular vertebral tumours and to reduce intra-operative bleeding. However, the complications that occur during the procedure are rarely reported. This case study attempts to highlight one rare complication, which is epidural tumoural haemorrhage intra-procedure. It may occur due to the fragility of the tumour and presence of neovascularisation. A small arterial dissection may also have occurred due to a slightly higher pressure exerted during injection of embolising agent. Haemostasis was secured via injection of Histoacryl into the area of haemorrhage. The patient was able to undergo the decompression surgery and suffered no direct complication from the haemorrhage.

Hashim, H; Abdul Kadir, KA

2011-01-01

249

Field evidence for mechanical transmission of rabbit haemorrhagic disease virus (RHDV) by flies (Diptera: Calliphoridae) among wild rabbits in Australia  

Microsoft Academic Search

Field collected flies were screened for the presence of rabbit haemorrhagic disease virus (RHDV) by applying reverse transcriptase PCR (RT-PCR) in which primers specific to the capsid protein of the virus were used. The virus was detected in flies from locations where rabbit haemorrhagic disease (RHD) was reported and also soon after the release of RHDV in a `clean' area.

Sassan Asgari; Jonathan R. E Hardy; Ron G Sinclair; Brian D Cooke

1998-01-01

250

2012 outbreak of acute haemorrhagic conjunctivitis in Indian Ocean Islands: identification of Coxsackievirus A24 in a returned traveller.  

PubMed

In May 2012, a Coxsackievirus A24 haemorrhagic conjunctivitis was diagnosed in Marseille, France, in a traveller returning from the Comoros Islands. This case allowed identification of the cause of an ongoing outbreak of haemorrhagic conjunctivitis in Indian Ocean Islands, illustrating that returning travellers may serve as sentinels for infectious diseases outbreaks in tropical areas where laboratory investigation is limited. PMID:22687914

Aubry, C; Gautret, P; Nougairede, A; Dussouil, A S; Botelho-Nevers, E; Zandotti, C; De Lamballerie, X; Brouqui, P; Parola, P

2012-05-31

251

Effect of recombinant tissue plasminogen activator on clot lysis and ventricular dilatation in the treatment of severe intraventricular haemorrhage  

Microsoft Academic Search

Summary Twelve patients with severe intraventricular haemorrhage (IVH) underwent intraventricular thrombolysis with recombinant tissue plasminogen activator (rtPA). External ventricular drainage was performed in all patients within 24 hours of haemorrhage. Fibrinolytic therapy was started within 24 hours from the onset of symptoms in ten cases, and in two further cases after 48 hours and 5 days, respectively. Two to 5

L. Mayfrank; B. Lippitz; M. Groth; H. Bertalanffy; J. M. Gilsbach

1993-01-01

252

Acute upper gastrointestinal haemorrhage in west of Scotland: case ascertainment study.  

PubMed Central

OBJECTIVES: To determine the incidence and case fatality of acute upper gastrointestinal haemorrhage in the west of Scotland and to identify associated factors. DESIGN: Case ascertainment study. SETTING: All hospitals treating adults with acute upper gastrointestinal haemorrhage in the west of Scotland. SUBJECTS: 1882 patients aged 15 years and over treated in hospitals for acute upper gastrointestinal haemorrhage during a six month period. MAIN OUTCOME MEASURES: Incidence of acute upper gastrointestinal haemorrhage per 100,000 population per year, and case fatality. RESULTS: The annual incidence was 172 per 100,000 people aged 15 and over. The annual population mortality was 14.0 per 100,000. Both were higher among elderly people, men, and patients resident in areas of greater social deprivation. Overall case fatality was 8.2%. This was higher among those who bled as inpatients after admission for other reasons (42%) and those admitted as tertiary referrals (16%). Factors associated with increased case fatality were age, uraemia, pre-existing malignancy, hepatic failure, hypotension, cardiac failure, and frank haematemesis or a history of syncope at presentation. Social deprivation, sex, and anaemia were not associated with increased case fatality after adjustment for other factors. CONCLUSIONS: The incidence of acute upper gastrointestinal haemorrhage was 67% greater than the highest previously reported incidence in the United Kingdom, which may be partially attributable to the greater social deprivation in the west of Scotland and may be related to the increased prevalence of Helicobacter pylori. Fatality after acute upper gastrointestinal haemorrhage was associated with age, comorbidity, hypotension, and raised blood urea concentrations on admission. Although deprivation was associated with increased incidence, it was not related to the risk of fatality.

Blatchford, O.; Davidson, L. A.; Murray, W. R.; Blatchford, M.; Pell, J.

1997-01-01

253

[Intracerebral haemorrhage and postpartum cerebral angiopathy associated with the administration of sulprostone and norepinephrine].  

PubMed

We report the case of a 29-year-old female who had developed a postpartum cerebral angiopathy (PCA) complicated by an intracerebral haematoma and convulsions, after a postpartum haemorrhage with sulprostone and norepinephrine infusion. PCA is an under diagnosed neurovascular pathology, responsible of reversible and non-specific symptoms. However, it can be complicated by haemorrhagic or ischemic stroke with vital or functional risks. As PCA is favored by vasoactive treatments, their administration in peripartum period, when it is imperative, should be strictly controlled. PMID:22154454

Ruzic, Y; Tran-Van, D; Omarjee, A; Boukerrou, M; Winer, A

2011-12-06

254

Technetium labelled red blood cell scintigraphy in the diagnosis of intestinal haemorrhage.  

PubMed Central

99m-Technetium labelled red blood cell scintigraphy was used in the investigation of 15 adult patients with suspected small or large bowel bleeding requiring at least five units of blood (mean 14.3 units) and one neonate with rectal bleeding. Scintigraphy was found to be an accurate method of detecting the site of haemorrhage and was superior to angiography. This technique may be of particular value in patients with profuse colonic haemorrhage when the view at colonoscopy is poor. Images Fig. 1 Fig. 2 Fig. 3

Harvey, M. H.; Neoptolemos, J. P.; Watkin, E. M.; Cosgriff, P.; Barrie, W. W.

1985-01-01

255

Perimetric demonstration of spontaneous visual field recovery following occipital lobe haemorrhage.  

PubMed

A 45-year-old patient on lifelong warfarin therapy after a metal aortic valve replacement developed a homonymous visual field defect following an occipital lobe haemorrhage. The patient received only conservative management and yet described continued improvement in her visual field defect for up to 20 months following the initial cerebral insult. We present the first conclusive illustrative documentation of visual recovery in a patient with an occipital lobe haemorrhage with sequential automated perimetric assessments over an extended period of time. PMID:23988822

Lin, Siying; George, Badie Z; Wilson-Holt, Nicholas J

2013-08-29

256

Delayed Positivization of Cerebral Angiography in Reversible Cerebral Vasoconstriction Syndrome (RCVS) Presenting with Recurrent Subarachnoid Haemorrhage  

PubMed Central

Benign angiopathy of the central nervous system is a clinical syndrome with evidence of reversible cerebral vasoconstriction (RCVS). Haemorrhagic stroke, either subarachnoid or intracerebral is an unusual presentation of RCVS. We describe a case of RCVS presenting with a subarachnoid haemorrhage (SAH), with rebleeding and onset of hydrocephalus during the first week, and, notably, delayed evidence of typical angiographic features after two negative prior exams. Normalization of the angiographic vasculitic-like lesions was documented at month +6. Repeated cerebral angiograms are mandatory to exclude this kind of disease, and the uncommon presentation of this case reinforces this concept.

Quartuccio, Luca; Tuniz, Francesco; Petralia, Benedetto; Zanotti, Bruno; Skrap, Miran; De Vita, Salvatore

2012-01-01

257

Haemorrhagic low-grade fibromyxoid sarcoma: MR findings in two young women  

PubMed Central

Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft-tissue sarcoma characterised by a deceptively bland histological appearance and a paradoxically aggressive behaviour. LGFMS usually presents in young-to-middle-aged adults as a painless, slow-growing mass with the potential for local recurrence and metastasis despite low-grade histology. Several case reports have described variable MR findings of LGFMS without haemorrhage or necrosis. We report here on the MR findings in two young women with haemorrhagic LGFMS in the thigh.

Kim, S K; Jee, W-H; Lee, A W; Chung, Y G

2011-01-01

258

Haemorrhagic low-grade fibromyxoid sarcoma: MR findings in two young women.  

PubMed

Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft-tissue sarcoma characterised by a deceptively bland histological appearance and a paradoxically aggressive behaviour. LGFMS usually presents in young-to-middle-aged adults as a painless, slow-growing mass with the potential for local recurrence and metastasis despite low-grade histology. Several case reports have described variable MR findings of LGFMS without haemorrhage or necrosis. We report here on the MR findings in two young women with haemorrhagic LGFMS in the thigh. PMID:21697411

Kim, S K; Jee, W-H; Lee, A W; Chung, Y G

2011-07-01

259

Central choline suppresses plasma renin response to graded haemorrhage in rats.  

PubMed

Central administration of choline increases blood pressure in normotensive and hypotensive states by increasing plasma concentrations of vasopressin and catecholamines. We hypothesized that choline could also modulate the renin-angiotensin pathway, the third main pressor system in the body. Plasma renin activity (PRA), which serves as an index of the function of the peripheral renin-angiotensin system, was determined in rats subjected to graded haemorrhage following central choline administration. Intracerebroventricular (i.c.v.) injection of choline (12.5-150 microg), a precursor of the neurotransmitter acetylcholine (ACh), inhibited the increase in PRA in rats subjected to graded haemorrhage by sequential removal of 0.55 mL blood/100 g bodyweight. Choline, in the range 50-150 microg, increased blood pressure. Intraperitoneal (i.p.) administration of 150 microg choline failed to alter blood pressure and plasma renin responses to graded haemorrhage. Administration of a higher dose (90 mg/kg, i.p.) of choline decreased blood pressure and enhanced PRA in the first two blood samples obtained during the graded haemorrhage. Physostigmine (10 microg, i.c.v.), ACh (10 microg, i.c.v.), carbamylcholine (10 microg, i.c.v.) and cytidine 5'-diphosphocholine (CDP-choline; 250 microg, i.c.v.) increased blood pressure and attenuated plasma renin responses to graded haemorrhage. Inhibition of PRA by i.c.v. choline was abolished by i.c.v. pretreatment with mecamylamine (50 microg), but not atropine (10 microg). Blood pressure responses to choline (150 microg) were attenuated by pretreatment with both mecamylamine and atropine. Inhibition of PRA in response to central choline administration was associated with enhanced plasma vasopressin and catecholamine responses to graded haemorrhage. Pretreatment of rats with a vasopressin antagonist reversed central choline-induced inhibition of plasma renin responses to graded haemorrhage without altering the blood pressure response. In conclusion, central administration of choline inhibits the plasma renin response to graded haemorrhage. Nicotinic receptor activation and an increase in plasma vasopressin appear to be involved in this effect. PMID:18518880

Isbil-Buyukcoskun, Naciye; Ilcol, Yesim O; Cansev, Mehmet; Hamurtekin, Emre; Ozluk, Kasim; Ulus, Ismail H

2008-06-01

260

Internal iliac artery embolisation for the control of severe bladder and prostate haemorrhage.  

PubMed

Embolisation of the internal iliac artery was preformed under local anaesthesia in eight patients with severe bladder haemorrhage and in two with severe bleeding from the prostatic bed after prostatectomy. Good and effective control of the bleeding was achieved in six of the patients with bladder haemorrhage, with a partial response in the other two. Both patients with post-prostatectomy bleeding responded well to embolisation, with prompt cessation of the bleeding. This technique is recommended for the control of severe bleeding from the bladder or prostate in the seriously ill patient. PMID:3342300

Appleton, D S; Sibley, G N; Doyle, P T

1988-01-01

261

Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization.  

PubMed

The purpose of this retrospective study was to evaluate the role of transcatheter arterial embolization in the management of severe postpartum haemorrhage due to a ruptured pseudoaneurysm and to analyse the clinical symptoms that may suggest a pseudoaneurysm as a cause of postpartum haemorrhage. A retrospective search of our database disclosed seven women with severe postpartum haemorrhage in whom angiography revealed the presence of a uterine or vaginal artery pseudoaneurysm and who were treated using transcatheter arterial embolization. Clinical files were reviewed for possible clinical findings that could suggest pseudoaneurysm as a cause of bleeding. Angiography revealed extravasation of contrast material in five out of seven patients. Transcatheter arterial embolization allowed to control the bleeding in all patients and subsequently achieve vaginal suture in four patients with vaginal laceration. No complications related to transcatheter arterial embolization were noted. Only two patients had uterine atony, and inefficiency of sulprostone was observed in all patients. Transcatheter arterial embolization is an effective and secure technique for the treatment of severe postpartum haemorrhage due to uterine or vaginal artery pseudoaneurysm. Ineffectiveness of suprostone and absence of uterine atony should raise the possibility of a ruptured pseudoaneurysm. PMID:18270711

Soyer, Philippe; Fargeaudou, Yann; Morel, Olivier; Boudiaf, Mourad; Le Dref, Olivier; Rymer, Roland

2008-02-13

262

Prevention and treatment of medical and neurological complications in patients with aneurysmal subarachnoid haemorrhage  

Microsoft Academic Search

Treatment of patients with aneurysmal subarachnoid haemorrhage not only involves securing the aneurysm by endovascular coiling or surgical clipping but also prevention and treatment of the medical and neurological complications of the bleed. These acutely ill patients should be looked after in specialised centres by a multidisciplinary team that is available 24 h a day, 7 days a week. No

G J E Rinkel; C J M Klijn

2009-01-01

263

Arrest of Liver Haemorrhage Secondary to Percutaneous Liver Biopsy of a Haemangioma with Fibrin Glue  

PubMed Central

Background Haemorrhage resulting from blunt and penetrating injury to the liver remains a difficult therapeutic problem, often resulting in massive intraperitoneal blood loss. Perihepatic liver packing and inflow occlusive techniques in combination with finger fracture exploration of injuries to allow vessel ligation are the mainstays if treatment with normal liver parenchyma. More recently fibrin glue haemostatic agents have been used to arrest traumatic haemorrhage from the liver. We report a case of the use of fibrin glue to arrest the bleeding caused by the percutaneous biopsy of a liver haemangioma. Case Outline A 42 year-old woman underwent percutaneous diagnostic biopsy of a liver lesion and subsequently experienced shock secondary to massive bleeding from the biopsy site. At laparotomy there was massive bleeding from the puncture site of the liver lesion. Control of haemorrhage was obtained by injecting fibrin glue down the biopsy site tract. This manoeuvre resulted in complete arrest of haemorrhage with no adverse effect. Discussion The use of fibrin glue as a haemostatic agent in trauma is an important adjunct to perihepatic liver packing and finger fracture exploration of injuries. It may have exceptional utility in patients with penetrating trauma to the liver by direct intraparenchymal injection. This case illustrates that fibrin glue can be used to arrest bleeding from vascular tumours such as haemangiomas. It may help to minimise bleeding for all percutaneous liver biopsies.

Dixon, Elijah

2002-01-01

264

The Dieulafoy gastric malformation: an under-recognized cause of massive upper gastrointestinal haemorrhage.  

PubMed Central

The Dieulafoy gastric malformation is a rare cause of upper gastrointestinal haemorrhage. When no obvious bleeding lesion is seen at laparotomy this diagnosis ought to be considered. Three such cases were identified and treated with simple underrunning of the lesion with no mortality and minimal morbidity. Follow-up endoscopy in each patient showed complete healing of the lesion.

Welch, M.; Hoare, E. M.

1991-01-01

265

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

266

Comparison of endoscopic injection therapy versus the heater probe in major peptic ulcer haemorrhage  

Microsoft Academic Search

One hundred and twenty patients presenting with major peptic ulcer haemorrhage were randomised in a clinical trial comparing endoscopic injection and heater probe therapy. The two groups were well matched with regards to age, admission haemoglobin concentration, the presence of shock, non-steroidal anti-inflammatory drug usage and endoscopic findings. Permanent haemostasis was achieved in 87% of the injection group and 85%

C P Choudari; C Rajgopal; K R Palmer

1992-01-01

267

Intra-arterial thrombolysis in basilar artery occlusion and recent haemorrhagic stroke due to arteriovenous malformation  

Microsoft Academic Search

We report the case of a young patient suffering from a severe ischaemic stroke due to basilar artery occlusion occurring during selective digital subtraction angiography. This examination was performed in order to assess an arteriovenous malformation in posterior cerebral artery territory responsible for haemorrhagic stroke occurring 17 days before. Intra-arterial thrombolysis with urokinase was performed and basilar artery recanalization was

G Moscato; P Maritato; S Gallerini; C Sonnoli; R Padolecchia; G Orlandi

2004-01-01

268

The illegal introduction of rabbit haemorrhagic disease virus in New Zealand  

Microsoft Academic Search

Summary 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

Peter O'Hara

2006-01-01

269

Effect of propranolol and phentolamine on myocardial necrosis after subarachnoid haemorrhage  

Microsoft Academic Search

A study was set up to assess the effect on the clinical course of subarachnoid haemorrhage (SAH) of giving propranolol 80 mg eight-hourly plus phentolamine 20 mg three-hourly by mouth for three weeks. Out of the 90 patients studied, 14 died. Two of the deaths occurred in an open pilot study of 10 patients, the remaining 12 deaths occurring in

G Neil-Dwyer; P Walter; J M Cruickshank; B Doshi; P OGorman

1978-01-01

270

Dietary supplementation of tyrosine prevents the rapid fall in blood pressure during haemorrhage  

Microsoft Academic Search

Summary Previous studies have demonstrated the ability of tyrosine (TYR), the amino acid precursor of catecholamines, to increase blood pressure in rats made hypotensive by haemorrhage. Other studies have shown that supplementation of the diet with TYR can reverse certain neurochemical and behavioural consequences associated with acute stress. Such studies demonstrate that during conditions of enhanced neuronal firing catecholamine synthesis

F. A. Moya-Huff; J. M. B. Pinto; P. J. Kiritsy; T. J. Maher

1989-01-01

271

Haemorrhagic and perivenous encephalitis: a clinical-pathological review of 38 cases  

Microsoft Academic Search

Clinical and pathological data from eight cases of acute haemorrhagic leucoencephalitis (AHL) confirm the previously documented devastating features of this disease. Data from 30 cases of perivenous encephalitis (PVE) associated with viral diseases reveal pathological changes ranging from lymphocytic cuffing of vessels to severe vasculitis similar to the vasculitis of AHL. Relatively few cases show demyelination as a prominent feature.

M N Hart; K M Earle

1975-01-01

272

Revised national guidelines for analysis of cerebrospinal fluid for bilirubin in suspected subarachnoid haemorrhage  

Microsoft Academic Search

It is crucially important to detect subarachnoid haemorrhage (SAH) in all patients in whom it has occurred to select patients for angiography and preventative surgery. A computerized tomography (CT) scan is positive in up to 98% of patients with SAH presenting within 12 h, but is positive in only 50% of those presenting within one week. Cerebrospinal fluid (CSF) bilirubin

Anne Cruickshank; Peter Auld; Robert Beetham; Gillian Burrows; William Egner; Ian Holbrook; Geoff Keir; Emma Lewis; Dina Patel; I. Watson; P. White

2008-01-01

273

Typing of rabbit haemorrhagic disease virus from New Zealand wild rabbits  

Microsoft Academic Search

ExtractFollowing the outbreak of rabbit haemorrhagic disease virus (RHDV), commonly called rabbit calicivims disease (RCD) in Australasia, in Central Otago in August 1997, the virus has been spread throughout the South Island and lower North Island (Thompson and Clark, 1997). It is widely assumed that it has been introduced from Australia but there has been no evidence to confirm this.

J. S. OKeefe; J. Tempero; P. H. Atkinson; L. Pacciarini; F. Fallacara; G. W. Horner; J. Motha

1998-01-01

274

A recent epidemic of Coxsackie virus type A24 acute haemorrhagic conjunctivitis in Singapore  

Microsoft Academic Search

A recent epidemic of acute conjunctivitis in Singapore showed again the importance of Coxsackie virus type A24 variant as a causative agent of acute haemorrhagic conjunctivitis (AHC). Although the ocular manifestations appeared similar to those described for the 1970 and 1975 outbreaks, a markedly higher rate of respiratory involvements was noted. Not observed in previous epidemics were herpes-like vesicles in

M Yin-Murphy; Baharuddin-Ishak; M C Phoon; V T Chow

1986-01-01

275

Calcific haemorrhagic bursitis anterior to the knee mimicking a soft tissue sarcoma: report of two cases  

Microsoft Academic Search

We describe the radiological and pathological findings of two cases of calcific haemorrhagic bursitis, one involving the superficial infrapatellar bursa and the other the prepatellar bursa. It was the presence of dystrophic calcification within the lesion that suggested a mineralizing soft tissue sarcoma such as synovial sarcoma. As the radiographic and MR features of the two conditions can be similar

M. Stahnke; D. C. Mangham; A. M. Davies

2004-01-01

276

Iatrogenic secondary post-partum haemorrhage: apropos of two uncommon cases.  

PubMed

In this article we would like to highlight uterine pseudoaneurysm as a cause of secondary post-partum haemorrhage following Caesarean section. We would like to stress Doppler ultrasound scan as the initial screening modality for this condition. We also describe angioembolization as the prudent treatment option for this condition rather than resorting to surgery. PMID:16884432

Mammen, T; Shanthakumari, H; Gopi, K; Lionel, J; Ayyappan, A P; Kekre, A

2006-08-01

277

Risk of gastrointestinal haemorrhage with calcium antagonists in hypertensive persons over 67 years old  

Microsoft Academic Search

SummaryBackground Calcium antagonists are used frequently in management of hypertension. In addition to their cardiovascular effects, these drugs inhibit platelet aggregation. Therefore we examined whether the use of calcium antagonists was associated with an increased risk of gastrointestinal haemorrhage (GIH).Methods A prospective cohort study was conducted from 1985 through 1992 on 1636 hypertensive persons aged ?68 years living in three

M Pahor; P Carbonin; J. M Guralnik; R. J Havlik; C. D Furberg

1996-01-01

278

Detection of human antibodies to Crimean-Congo haemorrhagic fever virus using expressed viral nucleocapsid protein  

Microsoft Academic Search

Diagnosis of Crimean-Congo haemorrhagic fever (CCHF) virus infections is hampered by the problems of handling this human pathogen, which requires the highest levels of biological containment. Recombinant antigens were examined for their potential as non- hazardous diagnostic reagents. The nucleocapsid (N) gene of the Greek AP92 isolate of CCHF virus was sequenced from cloned PCR products and the open reading

Anthony C. Marriott; Thalia Polyzoni; Antony Antoniadis; Patricia A. Nuttall

1994-01-01

279

Role of nitric oxide on the replication of viral haemorrhagic septicemia virus (VHSV), a fish rhabdovirus  

Microsoft Academic Search

In the present work, we have studied the role of nitric oxide (NO) on the replication of viral haemorrhagic septicemia virus (VHSV), a virus which produces high mortalities in fish aquaculture worldwide and that is known to replicate in turbot (Scophthalmus maximus) head kidney macrophages. Viral infection of turbot kidney macrophages in vitro induced an up-regulation of NO production and

C. Tafalla; A. Figueras; B. Novoa

1999-01-01

280

Pelvic artery embolisation for severe post partum haemorrhage in a tertiary care centre in the UK  

Microsoft Academic Search

This study aims to determine the effectiveness of pelvic artery embolisation in 18 cases of severe post partum haemorrhage that occurred over a period of 7 years. The setting was based in a university affiliated tertiary referral centre in Hull. Over the 7 year period there were 42 000 deliveries of which 70% were normal, 23% caesareans and 7% delivered

C K Ruprai; R Jha; G Robinson; S Kanwar

2011-01-01

281

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

282

Haemorrhagic shock and encephalopathy syndrome: neurological course and predictors of outcome  

Microsoft Academic Search

The haemorrhagic shock and encephalopathy syndrome (HSES) is a devastating disease. The aetiology of this syndrome is unknown,\\u000a and, despite intensive treatment, the outcome is often fatal or associated with severe neurological sequelae. Objective: To assess the neurological features and potential prognostic markers of the disease. Design: Retrospective study. Setting: Division of Neuropaediatrics in a children's university hospital. Patients and

B. Thébaud; B. Husson; Y. Navelet; G. Huault; P. Landrieu; D. Devictor; G. Sebire

1999-01-01

283

Triple-H therapy in the management of aneurysmal subarachnoid haemorrhage  

Microsoft Academic Search

Cerebral vasospasm is a recognised but poorly understood complication for many patients who have aneurysmal subarachnoid haemorrhage and can lead to delayed ischaemic neurological deficit (stroke). Morbidity and mortality rates for vasospasm are high despite improvements in management. Since the middle of the 1970s, much has been written about the treatment of cerebral vasospasm. Hypervolaemia, hypertension, and haemodilution (triple-H) therapy

Jon Sen; Antonio Belli; Helen Albon; Laleh Morgan; Axel Petzold; Neil Kitchen

2003-01-01

284

Intrarectal formalin application, an effective treatment for grade III haemorrhagic radiation proctitis  

Microsoft Academic Search

Haemorrhagic radiation proctitis (HRP) is infrequently seen amongst the patients who are either undergoing or have undergone radiotherapy to the pelvis. We treated 16 documented cases of HRP, who did not respond to conventional steroid retention enemas, with 4% formalin application. It was observed that the rectal bleeding was controlled completely in 81% cases in median follow up of 11

Biswa Mohan Biswal; Punita Lal; Goura Kishore Rath; Nootan Kumar Shukla; Bidhu Kalyan Mohanti; Suryanarayana Deo

1995-01-01

285

The ovine fetal endocrine reflex responses to haemorrhage are not mediated by cardiac nerves  

PubMed Central

This study was designed to test the hypothesis that cardiac receptors tonically inhibit the secretion of renin, arginine vasopressin (AVP) and adrenocorticotropic hormone (ACTH) in late-gestation fetal sheep. Eight chronically catheterised fetal sheep between 122 and 134 days gestation were subjected to injection or infusion of saline or 4 % procaine into the pericardial space. Fetal blood pressure and heart rate were monitored and fetal blood samples were drawn to measure the response to these injections. Injection of procaine into the pericardial space effectively blocked cardiac nerves, as evidenced by a reduction in the variability of fetal heart rate and by the blockade of reflex reductions in fetal heart rate after intravenous injection of phenylephrine (an ?-adrenergic agonist which raises blood pressure). Injection of saline had no discernable effects on any of the measured variables. A single injection of procaine, followed by a slow infusion, produced a transient blockade of cardiac nerves. Multiple injections of procaine produced a sustained blockade of cardiac nerves and a sustained rise in fetal plasma renin activity and ACTH. In none of the experiments did procaine significantly alter fetal plasma AVP concentrations. In 11 fetuses between 121 and 134 days gestation, we combined the cardiac nerve blockade with slow haemorrhage to test the cardiac nerves as mediators of the endocrine response to haemorrhage in utero. Cardiac nerve blockade exaggerated the fetal blood gas response to haemorrhage somewhat but did not significantly alter the magnitude of the ACTH, AVP, or plasma renin activity response to haemorrhage. We conclude that cardiac nerves in the late-gestation fetal sheep have minor influences on plasma renin activity and ACTH in normovolaemic fetuses, but that changes in cardiac nerve activity do not mediate the endocrine responsiveness to haemorrhage.

Wood, Charles E

2002-01-01

286

Identifying Regional Variation in the Prevalence of Postpartum Haemorrhage: A Systematic Review and Meta-Analysis  

PubMed Central

Objective To provide regional estimates of the prevalence of maternal haemorrhage and explore the effect of methodological differences between studies on any observed regional variation. Methods We conducted a systematic review of the prevalence of maternal haemorrhage, defined as blood loss greater than or equal to 1) 500 ml or 2) 1000 ml in the antepartum, intrapartum or postpartum period. We obtained regional estimates of the prevalence of maternal and severe maternal haemorrhage by conducting meta-analyses and used meta-regression to explore potential sources of between-study heterogeneity. Findings No studies reported the prevalence of antepartum haemorrhage (APH) according to our definitions. The prevalence of postpartum haemorrhage (PPH) (blood loss ?500 ml) ranged from 7.2% in Oceania to 25.7% in Africa. The prevalence of severe PPH (blood loss ?1000 ml) was highest in Africa at 5.1% and lowest in Asia at 1.9%. There was strong evidence of between-study heterogeneity in the prevalence of PPH and severe PPH in most regions. Meta-regression analyses suggested that region and method of measurement of blood loss influenced prevalence estimates for both PPH and severe PPH. The regional patterns changed after adjusting for the other predictors of PPH indicating that, compared with European women, Asian women have a lower prevalence of PPH. Conclusions We found evidence that Asian women have a very low prevalence of PPH compared with women in Europe. However, more reliable estimates will only be obtained with the standardisation of the measurement of PPH so that the data from different regions are comparable.

Calvert, Clara; Thomas, Sara L.; Ronsmans, Carine; Wagner, Karen S.; Adler, Alma J.; Filippi, Veronique

2012-01-01

287

Timing of placental delivery to prevent post-partum haemorrhage: lessons learned from an abandoned randomised clinical trial.  

PubMed

It has been recognised that, if the length of the third stage of labour exceeds 30 min, then there is an increased risk of a post-partum haemorrhage. Recent information has suggested that 18 min is the optimal time for removal of the undelivered placenta to prevent a post-partum haemorrhage. A randomised trial comparing 20 vs. 30 min was stopped after an interim analysis because only eight of 1607 patients' placentas had not delivered by 20 min. A third stage of labour that exceeded 10 min was observed to be significantly correlated with an increased risk of post-partum haemorrhage. PMID:17116064

Magann, Everett F; Doherty, Dorota A; Briery, Christian M; Niederhauser, Amy; Morrison, John C

2006-12-01

288

Pituitary apoplexy can mimic acute meningoencephalitis or subarachnoid haemorrhage  

PubMed Central

Pituitary apoplexy is an uncommon but life-threatening condition that is often overlooked and underdiagnosed. We report a 45-year-old man who presented to our emergency department with a sudden onset headache, acute confusion, signs of meningeal irritation and ophthalmoplegia. An initial diagnosis of acute meningoencephalitis was made, which was amended to pituitary apoplexy following thorough investigation within the emergency department. A 45-year-old man was brought to our emergency department by ambulance with a history of sudden onset of frontal headache and acute confusion. His wife provided the history. There was no significant past medical history of diabetes, hypertension, recent travel abroad, exposure to sick contacts, involvement in outdoor pursuits such as hiking/cave diving, or trauma. He worked in a bank and had been well until 24 h prior to the onset of sudden headache, which was gradually worsening in nature and associated with increasing confusion. The patient's wife reported that he had neither experienced any fevers, night sweats, or coryzal symptoms nor received any recent vaccinations. He was not on any regular medications. He was a non-smoker and occasionally consumed alcohol. There was no significant family history. On examination in the ED, his temperature was 37.6°C, his pulse was 110/min, and he was normotensive and normoglycaemic. A macular blanching rash was noted over the patient's trunk. The patient was disoriented to time and place. Neurological examination revealed reduced GCS (11/15-E3, M6, V2), marked neck stiffness, a positive Kernig's sign and a right sixth nerve palsy. A provisional diagnosis of acute meningoencephalitis was made and the patient was started on a course of intravenous antibiotics with benzyl penicillin 1.2 g, cefotaxime 2 g and acyclovir 750 mg. Baseline blood investigations revealed hyponatraemia (122 mmol/l), a white-cell count of 11 × 109/l and a C-reactive protein > 250. Due to the sudden onset of the symptoms and lack of prodrome, an urgent CT head scan was performed to rule out a cerebrovascular event. The scan demonstrated an enlarged pituitary gland (3 cm in diameter) with impingement of the optic chiasm. The centre of the enlarged pituitary gland was noted to be hypodense in comparison to its periphery, which was consistent with a diagnosis of pituitary apoplexy. A subsequent MRI confirmed the diagnosis (Figure 1) of an enlarged sella containing abnormal soft tissue with increased signal intensity suggestive of haemorrhage (Figure 1A). Post-MRI a lumbar puncture was performed revealing glucose 3.4 mmol/l, protein 1.0 g/l, red cells of 53/mm3 and white cells of 174/mm3 with predominant neutrophilia. No organisms were seen, and CSF cultures and HSV DNA tests were found to be negative. Endocrinological investigations demonstrated low concentrations of thyroid hormones [TSH: 0.14 mIu/l (0.35-5.5 mlU/l), FT3: 1.1 nmol/l (1.2-3.0 nmol/l), FT4: 9.6 pmol/l (8-22 pmol/l)], gonadal hormones (LH: < 1 u/l) and prolactin: 16 u/l (<450 u/l). Serum FSH was 2.9 u/l (0.8-11.5 u/L) and cortisol 575 nmol/l (450-700 nmol/l). The patient was treated for hypopituitarism based on clinical and radiological findings with intravenous fluids, hydrocortisone (100 mg) and thyroxine (50 ?g) as loading doses in the ED. Within 24 h of commencement of therapy the patient's GCS rose to 15, and within 48 h there was marked improvement in the right sixth cranial nerve palsy. Formal visual field assessment demonstrated temporal visual field loss in the left eye. The patient was discharged to his usual residence a week later and follow-up was organised with both the endocrinologists and ophthalmologists. Follow-up MRI demonstrated that there was no significant change in either size or signal characteristics of the pituitary fossa mass (Figure 1B).

2011-01-01

289

Pituitary apoplexy can mimic acute meningoencephalitis or subarachnoid haemorrhage.  

PubMed

Pituitary apoplexy is an uncommon but life-threatening condition that is often overlooked and underdiagnosed. We report a 45-year-old man who presented to our emergency department with a sudden onset headache, acute confusion, signs of meningeal irritation and ophthalmoplegia. An initial diagnosis of acute meningoencephalitis was made, which was amended to pituitary apoplexy following thorough investigation within the emergency department.A 45-year-old man was brought to our emergency department by ambulance with a history of sudden onset of frontal headache and acute confusion. His wife provided the history. There was no significant past medical history of diabetes, hypertension, recent travel abroad, exposure to sick contacts, involvement in outdoor pursuits such as hiking/cave diving, or trauma. He worked in a bank and had been well until 24 h prior to the onset of sudden headache, which was gradually worsening in nature and associated with increasing confusion. The patient's wife reported that he had neither experienced any fevers, night sweats, or coryzal symptoms nor received any recent vaccinations. He was not on any regular medications. He was a non-smoker and occasionally consumed alcohol. There was no significant family history. On examination in the ED, his temperature was 37.6°C, his pulse was 110/min, and he was normotensive and normoglycaemic. A macular blanching rash was noted over the patient's trunk. The patient was disoriented to time and place. Neurological examination revealed reduced GCS (11/15-E3, M6, V2), marked neck stiffness, a positive Kernig's sign and a right sixth nerve palsy.A provisional diagnosis of acute meningoencephalitis was made and the patient was started on a course of intravenous antibiotics with benzyl penicillin 1.2 g, cefotaxime 2 g and acyclovir 750 mg. Baseline blood investigations revealed hyponatraemia (122 mmol/l), a white-cell count of 11 × 109/l and a C-reactive protein > 250. Due to the sudden onset of the symptoms and lack of prodrome, an urgent CT head scan was performed to rule out a cerebrovascular event. The scan demonstrated an enlarged pituitary gland (3 cm in diameter) with impingement of the optic chiasm. The centre of the enlarged pituitary gland was noted to be hypodense in comparison to its periphery, which was consistent with a diagnosis of pituitary apoplexy. A subsequent MRI confirmed the diagnosis (Figure 1) of an enlarged sella containing abnormal soft tissue with increased signal intensity suggestive of haemorrhage (Figure 1A).Post-MRI a lumbar puncture was performed revealing glucose 3.4 mmol/l, protein 1.0 g/l, red cells of 53/mm3 and white cells of 174/mm3 with predominant neutrophilia. No organisms were seen, and CSF cultures and HSV DNA tests were found to be negative. Endocrinological investigations demonstrated low concentrations of thyroid hormones [TSH: 0.14 mIu/l (0.35-5.5 mlU/l), FT3: 1.1 nmol/l (1.2-3.0 nmol/l), FT4: 9.6 pmol/l (8-22 pmol/l)], gonadal hormones (LH: < 1 u/l) and prolactin: 16 u/l (<450 u/l). Serum FSH was 2.9 u/l (0.8-11.5 u/L) and cortisol 575 nmol/l (450-700 nmol/l). The patient was treated for hypopituitarism based on clinical and radiological findings with intravenous fluids, hydrocortisone (100 mg) and thyroxine (50 ?g) as loading doses in the ED.Within 24 h of commencement of therapy the patient's GCS rose to 15, and within 48 h there was marked improvement in the right sixth cranial nerve palsy. Formal visual field assessment demonstrated temporal visual field loss in the left eye. The patient was discharged to his usual residence a week later and follow-up was organised with both the endocrinologists and ophthalmologists. Follow-up MRI demonstrated that there was no significant change in either size or signal characteristics of the pituitary fossa mass (Figure 1B). PMID:21975129

Sadek, Ahmed-Ramadan; Gregory, Stephen; Jaiganesh, Thiagarajan

2011-10-05

290

Cerebral haemorrhagic infarction in young patients with hereditary protein C deficiency: evidence for "spontaneous" cerebral venous thrombosis.  

PubMed Central

Among 53 patients with hereditary protein C deficiency belonging to 20 families three women were encountered who, aged 27, 34, and 38 respectively, had had cerebral haemorrhagic infarction, probably due to intracranial venous thrombosis. All three had also had venous thrombosis of the leg and pulmonary embolism either before or after their cerebral infarction. One patient sustained cerebral infarction while receiving an oral contraceptive, but infarction in the two others occurred "spontaneously." One patient also had an intraventricular and subarachnoid haemorrhage during the induction phase of coumarin treatment, which was assumed to have resulted from haemorrhagic infarction of the chorioid plexus, analogous to coumarin provoked haemorrhagic skin necrosis in protein C deficiency. Hereditary protein C deficiency should be considered in young patients with acute or subacute cerebral symptoms, especially if they have a family or personal history of venous thromboembolism. Images FIG 1 FIG 2 FIG 3 FIG 4 FIG 5 FIG 6

Wintzen, A R; Broekmans, A W; Bertina, R M; Briet, E; Briet, P E; Zecha, A; Vielvoye, G J; Bots, G T

1985-01-01

291

Protection of Monkeys against Machupo Virus by the Passive Administration of Bolivian Haemorrhagic Fever Immunoglobulin (Human Origin).  

National Technical Information Service (NTIS)

Bolivian haemorrhagic fever immunoglobulin of human origin, given either prior to or shortly after experimental infection with Machupo virus, protected rhesus and cynomolgus monkeys against initial clinical illness. Some survivors developed severe neurolo...

G. A. Eddy F. S. Wagner S. K. Scott B. J. Mahlandt

1975-01-01

292

Diffuse alveolar haemorrhage may be associated with intravitreal injection of bevacizumab in a patient with systemic risk factors  

PubMed Central

The authors present a rare case where acute respiratory failure occurred after the intravitreal bevacizumab injection for a branch retinal vein occlusion. Chest CT scan showed ground-glass opacity in the bilateral lung fields. The finding of bronchoalveolar lavage fluid revealed alveolar haemorrhage. Corticosteroid therapy resulted in a rapid improvement of respiratory failure. This report suggests that intravitreal injection of bevacizumab may be associated with diffuse alveolar haemorrhage and acute lung injury.

Seto, Ruriko; Yamada, Hideto; Wada, Hiroshi; Osawa, Makoto; Nagao, Taishi; Nakano, Yasutaka

2011-01-01

293

Cardiac and regional haemodynamic effects of histamine N-methyltransferase inhibitor metoprine in haemorrhage-shocked rats  

Microsoft Academic Search

Objective and design:The increase in central histamine concentrations after inhibition of histamine N-methyltransferase (HNMT) activity is associated with the reversal of critical haemorrhagic hypotension, therefore the present study examines cardiac and regional haemodynamic effects of HNMT inhibitor metoprine in haemorrhage-shocked rats. Material:Cardiovascular parameters were measured in 72 and central histamine concentrations in 12 male Wistar rats anaesthetised with ketamine\\/xylazine. Treatment:Metoprine

J. Jochem; H. Jordana

2004-01-01

294

Work in progress report - Cardiac general Factors associated with deep sternal wound infection and haemorrhage following cardiac surgery in Victoria  

Microsoft Academic Search

Serious non-fatal complications of cardiac surgery include deep sternal wound infection (DSWI) and haemorrhage. Understanding the factors associated with these complications (both pre-operatively and intra-operatively) may aid in the prevention and avoidance of such complications. The aim of the current report is to identify factors associated with DSWI and haemorrhage for all patients undergoing cardiac surgical procedures in Victorian public

Penelope J. Robinson; Baki Billah; Karin Leder; Christopher M. Reida; Australia Baker

2010-01-01

295

Meningococcal septicaemia and purpura fulminans in children - surgical management and outcome: a 22 year review of 68 patients Rode H, FCS (SA) FRCS(Ed) • Millar AJW, FRCS (Eng) (Ed) FRACSArgent A, FCPAEDS (SA) MMed (Paed) • Hudson D, FCS (SA) FRCS (Eng) • Davies J, FC PATH (SA)  

Microsoft Academic Search

Meningococcal septicaemia complicated by purpura fulminans remains a devastating illness with rapid onset, debilitating morbidity and high mortality. The clinical course of management of 68 children (average age 3.4 years) with purpura fulminans seen over a 22 year period is described. All patients received maximum systemic support. Standard surgical techniques were utilised for skin grafting and amputations. Overall mortality was

Rode H; Argent A; Hudson D; Davies J

296

Surgeons' attitudes to the operative management of duodenal ulcer perforation and haemorrhage.  

PubMed Central

The currently preferred operative management of duodenal ulcer haemorrhage and perforation was assessed by means of a questionnaire sent to 274 consultant general surgeons in England. A 70% response rate was achieved. Simple closure, with or without H2 antagonist treatment, was the most popular management of a perforated acute duodenal ulcer. For perforation of a chronic duodenal ulcer occurring during H2 antagonist therapy, truncal vagotomy and drainage was the definitive procedure of choice. There was no consensus about the operative management of perforation complicating non-steroidal anti-inflammatory drug treatment in the elderly patient. Proximal gastric vagotomy appears to have few advocates in the definitive management of either duodenal ulcer perforation or haemorrhage. Of our sample 70% selected truncal vagotomy and drainage with underrunning of the ulcer as the operative treatment of choice for bleeding. Endoscopic coagulation appears to be used only rarely.

Stringer, M. D.; Cameron, A. E.

1988-01-01

297

Safety and efficacy of an inactivated Carbopol-adjuvanted goose haemorrhagic polyomavirus vaccine for domestic geese.  

PubMed

Haemorrhagic nephritis enteritis of the goose (HNEG) is an epizootic viral disease in domestic geese. The causal agent is a polyomavirus, namely goose haemorrhagic polyomavirus. To help control the disease, an inactivated vaccine was developed, based on viral particles produced in goose kidney cells. Viral material was quantified using real-time quantitative polymerase chain reaction, inactivated with beta-propiolactone and adjuvanted with Carbopol, an acrylic acid polymer. Carbopol proved to be more immunogenic than aluminium hydroxide and was totally safe when administered to young goslings and breeders alike. Carbopol-adjuvanted vaccine induced a high serological response. Moreover, goslings hatched from vaccinated breeders were protected against viral challenge, indicating that maternally-derived neutralizing antibodies (MDA) were efficiently transferred. MDA were still detectable 15 days post-hatch. Clinical trials will be necessary to accurately evaluate a vaccine-based HNEG control strategy under field conditions. PMID:20390545

Gelfi, Jacqueline; Pappalardo, Michael; Claverys, Carine; Peralta, Brigitte; Guerin, Jean-Luc

2010-04-01

298

Cervical tourniquet in case of uncontrollable haemorrhage during caesarean section owing to a placenta accreta.  

PubMed

This case report describes a 38-year-old woman in whom a primary caesarean section for placenta previa was complicated by postpartum haemorrhage due to a placenta accreta. Despite tamponade with a Bakri balloon and placement of a B-Lynch suture, the amount of blood loss could not be effectively reduced. The blood loss was eventually minimised by the placement of a Penrose drain around the cervix as a cervical tourniquet. We think that a cervical tourniquet is an effective method of stopping haemorrhage during caesarean section, as shown in this case report, and we consider this technique to be a valuable addition to several existing methods through which fertility is preserved by preventing emergency hysterectomy. PMID:23608864

Huijgen, Q C A; Gijsen, A F; Hink, E; Van Kesteren, P J M

2013-04-22

299

Haemorrhagic effects of sodium heparin and calcium heparin prophylaxis in patients undergoing mastectomy.  

PubMed

In a double-blind prospective clinical trial 75 consecutive patients undergoing mastectomy were randomly allocated to one of three groups. Twenty-five patients received perioperative anti-thromboembolic therapy with sodium heparin and 25 with calcium heparin. The remaining 25 patients were given anti-embolism stockings but no heparin. The total postoperative blood loss and period of drainage did not differ between the two groups given heparin, but a total of 10 of these 50 patients suffered haemorrhagic complications in the form of severe bruising or haematoma postoperatively. Of the patients given no heparin, none suffered haemorrhagic complications and the blood loss following the first 24-hour postoperative period was significantly less than in the groups given heparin. PMID:2681717

Lee, R E; Ho, K N; Karran, S J; Taylor, I

1989-06-01

300

Unilateral spatial neglect due to a haemorrhagic contusion in the right frontal lobe.  

PubMed

We report two cases of unilateral spatial neglect associated with an isolated right frontal lobe lesion. Case 1 was a 59-year-old, right-handed man, who developed a left hemiplegia, disorientation, and frontal lobe neglect associated with a haemorrhagic contusion following a head injury. Case 2 was a 55-year-old, right-handed man, who also developed disorientation and frontal lobe neglect secondary to a haemorrhagic contusion following a head injury. 99mTc HM-PAO SPECT revealed an isolated reduction in the regional cerebral blood flow (CBF) around the haematoma in the frontal lobe; blood flow to remaining parts of the brain was normal. Damage to the right frontal lobes of these patients was confirmed as being the cause of the unilateral spatial neglect in accordance with the results of CBF studies. PMID:8568520

Maeshima, S; Terada, T; Nakai, K; Nishibayashi, H; Ozaki, F; Itakura, T; Komai, N

1995-10-01

301

Coincidence of ischemic stroke and recurrent brain haemorrhage in a patient with Klippel-Trenaunay Syndrome.  

PubMed

Cerebrovascular manifestations in Klippel-Trenaunay Syndrome (KTS) have been reported but are extremely rare. Case reports describe brain embolism in KTS-associated coagulopathy as well as bleeding due to arteriovenous malformations. We describe a 45-year-old patient with KTS and both acute ischemic stroke and repeated cerebral haemorrhage. The underlying aetiology of both events remained undetermined despite extensive diagnostic work-up, including coagulation tests and dynamic MR angiography. It is most likely that both a pathological coagulation and increased vessel fragility comparable to amyloid angiopathy were responsible for the combined brain lesions in this patient. We conclude that KTS is a very rare but relevant aetiology of cerebral ischemia and that anticoagulation treatment in these cases should be carefully considered as the risk of cerebral haemorrhage is probably elevated. PMID:23830597

Beume, Lena A; Fuhrmann, Silke C; Reinhard, Matthias; Harloff, Andreas

2013-07-03

302

Transcatheter coil embolotherapy: a safe and effective option for major colonic haemorrhage  

PubMed Central

Background—The management of major colonic bleeding is problematic. A proportion of patients require emergency surgery which is associated with high morbidity and mortality. Percutaneous embolotherapy, previously considered a high risk procedure in the colon, may provide an alternative treatment in this group of patients. ?Aims—To assess the safety and efficacy of embolotherapy in the treatment of life threatening colonic haemorrhage. ?Patients and methods—Thirty eight patients with fresh haemorrhage per rectum were referred for surgery because of failed conservative treatment. All underwent angiography; in 14 a bleeding site or vascular abnormality was detected. A coaxial catheter was directed to the most distal bleeding artery and this was embolised with platinum coils. ?Results—Detection of a bleeding site correlated with haemodynamic stability at the time of angiography (r=1 for a systolic blood pressure less than 100 mm Hg). Bleeding sites or vascular abnormalities were detected and embolised in 14 patients (37%). In 12/14 there was immediate and sustained haemodynamic improvement; two continued to bleed and required emergency hemicolectomy (14%). Three developed ischaemic complications (21.4%); these were managed conservatively and required no intervention. The 30 day mortality was 7.1% in the embolotherapy group and 10.5% in the overall group of 38patients. ?Conclusion—Colonic embolotherapy for life threatening haemorrhage is an effective, relatively safe procedure with a low incidence of major complications. Its use depends on the identification of a focal bleeding point or vascular abnormality, which in turn depends on the haemodynamic stability of the patient at the time of angiography. ?? Keywords: colonic haemorrhage; embolisation; angiography; angiodysplasia; diverticular disease

Nicholson, A; Ettles, D; Hartley, J; Curzon, I; Lee, P; Duthie, G; Monson, J

1998-01-01

303

An epidemic of acute haemorrhagic conjunctivitis caused by enterovirus 70 in Okinawa, Japan, in 1994  

Microsoft Academic Search

· Background: Although enterovirus 70 (EV70) has been identified as the major aetiological agent of acute haemorrhagic conjunctivities\\u000a (ACH),no EV70 strain has been isolated by cell culture method since 1988. Therefore, recent clinical and epidemiological characteristics\\u000a of AHC caused by EV70 have not been clarified. · Methods: Clinical and serological studies were carried out on patients during\\u000a the AHC epidemic

Eiichi Uchio; Kenji Yamazaki; Hideo Ishikawa; Isao Matsunaga; Yoshimori Asato; Koki Aoki; Shigeaki Ohno

1999-01-01

304

Pulmonary and cardiac sequelae of subarachnoid haemorrhage: time for active management?  

Microsoft Academic Search

Cardiac injury and pulmonary oedema occurring after acute neurological injury have been recognised for more than a century.\\u000a Catecholamines, released in massive quantities due to hypothalamic stress from subarachnoid haemorrhage (SAH), result in specific\\u000a myocardial lesions and hydrostatic pressure injury to the pulmonary capillaries causing neurogenic pulmonary oedema (NPO).\\u000a The acute, reversible cardiac injury ranges from hypokinesis with a normal

C. S. A. Macmillan; I. S. Grant; P. J. D. Andrews

305

Elevated local skin temperature impairs cutaneous vasoconstrictor responses to a simulated haemorrhagic challenge while heat stressed.  

PubMed

During a simulated haemorrhagic challenge, syncopal symptoms develop sooner when individuals are hyperthermic relative to normothermic. This is due, in part, to a large displacement of blood to the cutaneous circulation during hyperthermia, coupled with inadequate cutaneous vasoconstriction during the hypotensive challenge. The influence of local skin temperature on these cutaneous vasoconstrictor responses is unclear. This project tested the hypothesis that local skin temperature modulates cutaneous vasoconstriction during simulated haemorrhage in hyperthermic humans. Eight healthy participants (four men and four women; 32 ± 7 years old; 75.2 ± 10.8 kg) underwent lower-body negative pressure to presyncope while heat stressed via a water-perfused suit sufficiently to increase core temperature by 1.2 ± 0.2 °C. At forearm skin sites distal to the water-perfused suit, local skin temperature was either 35.2 ± 0.6 (mild heating) or 38.2 ± 0.2 °C (moderate heating) throughout heat stress and lower-body negative pressure, and remained at these temperatures until presyncope. The reduction in cutaneous vascular conductance during the final 90 s of lower-body negative pressure, relative to heat-stress baseline, was greatest at the mildly heated site (-10 ± 15% reduction) relative to the moderately heated site (-2 ± 12%; P = 0.05 for the magnitude of the reduction in cutaneous vascular conductance between sites), because vasoconstriction at the moderately heated site was either absent or negligible. In hyperthermic individuals, the extent of cutaneous vasoconstriction during a simulated haemorrhage can be modulated by local skin temperature. In situations where skin temperature is at least 38 °C, as is the case in soldiers operating in warm climatic conditions, a haemorrhagic insult is unlikely to be accompanied by cutaneous vasoconstriction. PMID:22903981

Pearson, J; Lucas, R A I; Crandall, C G

2012-08-17

306

Adrenomedullin augments the neurohumoral response to haemorrhage in non-pregnant but not in pregnant sheep  

Microsoft Academic Search

Adrenomedullin (ADM) is a novel peptide with actions which include reduction of arterial pressure and inter- action with a number of hormone systems. In order to assess possible interactions with the renin-angiotensin system (RAS) and the hypothalamo-pituitary-adrenal (HPA) axis, we have examined neurohumoral responses to hypotensive haemorrhage (15 ml\\/kg over 15 min) with or without co-infusions of ADM (5·5 pmol\\/kg

C J Charles; M T Rademaker; A M Richards; M G Nicholls

2001-01-01

307

Effects of mu-opioid receptor agonists on circulatory responses to simulated haemorrhage in conscious rabbits.  

PubMed Central

1. Cardiac output, arterial pressure, heart rate, systemic vascular conductance, respiratory rate and arterial blood PO2 and PCO2 were measured in unanaesthetized rabbits. Haemorrhage was simulated by inflating a cuff placed around the inferior vena cava so that cardiac output fell at a constant rate of about 8% of its resting value per min. 2. The effects of drug treatments on resting haemodynamic and respiratory variables, and on the haemodynamic response to simulated haemorrhage, were tested. The treatments were; 4th ventricular (-)-naloxone HCl (10-100 nmol), 4th ventricular H-Tyr-D-Ala-Gly-MePhe-NH(CH2)2OH (DAMGO; 30-300 pmol), and i.v. morphine sulphate (0.5-5.0 mumol kg-1). The interactions of graded 4th ventricular doses of naloxone (3-100 nmol) with the actions of DAMGO (100-300 pmol) on these responses were also assessed. 3. After sham treatments, the circulatory response to simulated haemorrhage had two phases. During the first compensatory phase, systemic vascular conductance fell, heart rate rose, and mean arterial pressure fell by only about 7 mmHg. A second decompensatory phase supervened when cardiac output had fallen by about 50%. At this point systemic vascular conductance rose abruptly and arterial pressure fell to less than or equal to 40 mmHg. 4. Low 4th ventricular doses of naloxone (10-30 nmol) and DAMGO (30-100 pmol) had no discernible effect on the circulatory response to simulated haemorrhage. Higher doses of naloxone (30-100 nmol) and DAMGO (100-300 pmol) prevented the decompensatory phase. These high doses of naloxone and DAMGO lowered resting heart rate without affecting the other haemodynamic or respiratory variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Evans, R. G.; Ludbrook, J.

1990-01-01

308

Possible mechanism to induce protein kinase C-dependent arterial smooth muscle contraction after subarachnoid haemorrhage  

Microsoft Academic Search

Summary A possible mechanism for the induction of protein kinase C (PKC)-dependent vascular contraction independent to the increase of intracellular Ca++ was investigated in the pathogenesis of cerebral vasospasm in the double subarachnoid haemorrhage (SAH) model. The level of 1,2-diacylglycerol (DAG), which is an intrinsic PKC activator, significantly increased from days 4 to 7 in the basilar artery after the

S. Ohta; J. Nishihara; Y. Oka; H. Todo; Y. Kumon; S. Sakaki

1995-01-01

309

Cimetidine prevents suppression of delayed hypersensitivity in an animal model of haemorrhagic shock  

Microsoft Academic Search

Background: Cimetidine reverses immunosuppression following trauma, however, its effect on pure haemorrhagic shock is unknown. Methods: Mice sensitized by injection of sheep red blood cells (SRBCs), were subjected to cardiac puncture and randomized to a control group-A (n=11) and three shock groups (35% of blood volume extracted): group-S had no treatment (n=16), group-CP received cimetidine 50mg\\/kg intraperitoneally (n=16), group-CW received

Peter MacD Hewitt; Neil Armstrong; Patricia Bowrey; Maya Cherian; David Lawson Morris

2002-01-01

310

Can a preoperative bevacizumab injection prevent recurrent postvitrectomy diabetic vitreous haemorrhage?  

Microsoft Academic Search

AimsTo evaluate the recurrence rate of vitreous haemorrhage (VH) in patients treated with one intravitreal bevacizumab (IVB) injection (2.5 mg\\/0.1 ml) before planned pars plana vitrectomy for treatment of diabetic non-clearing VH.MethodsProspective pilot study of 32 eyes of 31 consecutive diabetic patients who underwent IVB injection within 1 week before surgery for persistent VH in the presence of active proliferative

M R Romano; S K Gibran; J Marticorena; D Wong; H Heimann

2009-01-01

311

Intracranial haemorrhage following lumbar myelography: case report and review of the literature  

Microsoft Academic Search

We describe a subacute intracranial subdural haematoma following lumbar myelography. This rare but potentially life-threatening\\u000a complication has been reported both after lumbar myelography and following lumbar puncture for spinal anaesthesia. We review\\u000a 16 previously reported cases of intracranial haemorrhage following lumbar myelography, and discuss the pathogenesis. In all\\u000a reported cases post-puncture headache was the leading symptom and should therefore be

O. Suess; R. Stendel; S. Baur; A. Schilling; M. Brock

2000-01-01

312

Forecasting Dengue Haemorrhagic Fever Cases in Southern Thailand using ARIMA Models  

Microsoft Academic Search

A univariate time-series analysis method has been used to model and forecast the monthly number of dengue haemorrhagic fever (DHF) cases in southern Thailand. We developed autoregressive integrated moving average (ARIMA) models on the data collected between 1994-2005 and then validated the models using the data collected between January-August 2006. The results showed that the regressive forecast curves were consistent

S. Promprou; M. Jaroensutasinee; K. Jaroensutasinee

2006-01-01

313

Time-Series Analysis of Dengue Fever\\/Dengue Haemorrhagic Fever in Myanmar since 1991  

Microsoft Academic Search

This study assessed the current situation and trends of dengue fever\\/dengue haemorrhagic fever (DF\\/DHF) in Myanmar and its states\\/divisions. It made forecasts from the epidemiological standpoint and also attempted a comparison with Thailand. Between 1991 and 2001, the distribution of DF\\/DHF showed upward trends with cyclical pattern and seasonal variation. Heterogenous distribution of DF\\/DHF in Myanmar was evident. According to

Vector Borne

314

Current Status of Dengue\\/Dengue Haemorrhagic Fever in WHO South-East Asia Region  

Microsoft Academic Search

Dengue fever\\/dengue haemorrhagic fever (DF\\/DHF) is the most important emerging viral disease affecting nearly half of the world's population. It is estimated that there are between 50 to 100 million cases of DF and about 500 000 cases of DHF which require hospitalization every year. In the WHO South-East Asia Region, over the past 15 years, DF\\/DHF has become a

Chusak Prasittisuk; A. G. Andjaparidze; Vijay Kumar

315

Travelling waves in the occurrence of dengue haemorrhagic fever in Thailand  

Microsoft Academic Search

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

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

2004-01-01

316

Transcranial Cerebral Oximetry Related to Transcranial Doppler After Aneurysmal Subarachnoid Haemorrhage  

Microsoft Academic Search

Summary  ?Noninvasive methods for detecting cerebral artery vasospasm, still a serious complication following aneurysmal subarachnoid\\u000a haemorrhage, are of vital interest. Up-to-date transcranial Doppler ultrasound (TCD) has proved to be sensitive in detecting\\u000a vasospasm in the middle cerebral artery, but has less accuracy for other cerebral arteries. Transcranial cerebral oximetry\\u000a (TCCO) is a new noninvasive technique which may increase the reliability for

A. Ekelund; P. Kongstad; H. Säveland; B. Romner; P. Reinstrup; K.-A. Kristiansson; L. Brandt

1998-01-01

317

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

2012-06-26

318

Intra-Arterial Infusion of Fasudil Hydrochloride for Treating Vasospasm Following Subarachnoid Haemorrhage  

Microsoft Academic Search

Summary  ?In this pilot study we treated cerebral vasospasm in patients with subarachnoid haemorrhage to assess intra-arterial fasudil\\u000a hydrochloride. We analysed effects of intra-arterial infusion on angiographically evident cerebral vasospasm in 10 patients\\u000a including 3 with symptoms of vasospasm. Over 10 to 30 min 15 to 60 mg was administered via the proximal internal carotid artery\\u000a or vertebral artery following standard

E. Tachibana; T. Harada; M. Shibuya; K. Saito; M. Takayasu; Y. Suzuki; J. Yoshida

1999-01-01

319

Cerebral haemorrhage in long-term survivors of childhood acute lymphoblastic leukaemia  

Microsoft Academic Search

Modern treatment of childhood acute lymphoblastic leukaemia (ALL) has dramatically improved the prognosis for children with\\u000a this disease. Therapeutic approaches consist of multimodal chemotherapy and radiotherapy with significant long-term side-effects.\\u000a We report on 4 children out of a group of 120 newly diagnosed patients with ALL, who survived the disease for more than 2\\u000a years and developed a cerebral haemorrhage

T. Humpl; K. Brühl; J. Bohl; M. Schwarz; P. Stoeter; P. Gutjahr

1997-01-01

320

Cerebrospinal fluid analyses for the diagnosis of subarachnoid haemorrhage and experience from a Swedish study. What method is preferable when diagnosing a subarachnoid haemorrhage?  

PubMed

Abstract Subarachnoid haemorrhage (SAH) has a high mortality and morbidity rate. Early SAH diagnosis allows the early treatment of a ruptured cerebral aneurysm, which improves the prognosis. Diagnostic cerebrospinal fluid (CSF) analyses may be performed after a negative computed tomography scan, but the precise analytical methods to be used have been debated. Here, we summarize the scientific evidence for different CSF methods for SAH diagnosis and describe their implementation in different countries. The principle literature search was conducted using PubMed and Scopus with the search items "cerebrospinal fluid", "subarachnoid haemorrhage", and "diagnosis". CSF analyses for SAH include visual examination, red blood cell counts, spectrophotometry for oxyhaemoglobin or bilirubin determination, CSF cytology, and ferritin measurement. The methods vary in availability and performance. There is a consensus that spectrophotometry has the highest diagnostic performance, but both oxyhaemoglobin and bilirubin determinations are susceptible to important confounding factors. Visual inspection of CSF for xanthochromia is still frequently used for diagnosis of SAH, but it is advised against because spectrophotometry has a superior diagnostic accuracy. A positive finding of CSF bilirubin is a strong indicator of an intracranial bleeding, whereas a positive finding of CSF oxyhaemoglobin may indicate an intracranial bleeding or a traumatic tap. Where spectrophotometry is not available, the combination of CSF cytology for erythrophages or siderophages and ferritin is a promising alternative. PMID:23729569

Nagy, Karin; Skagervik, Ina; Tumani, Hayrettin; Petzold, Axel; Wick, Manfred; Kühn, Hans-Jürgen; Uhr, Manfred; Regeniter, Axel; Brettschneider, Johannes; Otto, Markus; Kraus, Jörg; Deisenhammer, Florian; Lautner, Ronald; Blennow, Kaj; Shaw, Leslie; Zetterberg, Henrik; Mattsson, Niklas

2013-05-01

321

Postoperative haemorrhage following transurethral resection of the prostate (TURP) and photoselective vaporisation of the prostate (PVP)  

PubMed Central

INTRODUCTION Intractable haemorrhage after endoscopic surgery, including transurethral resection of the prostate (TURP) and photoselective vaporisation of the prostate (PVP), is uncommon but a significant and life-threatening problem. The knowledge and technical experience to deal with this complication may not be wide-spread among urologists and trainees. We describe our series of TURPs and PVPs and the incidence of postoperative bleeding requiring intervention. PATIENTS AND METHODS We retrospectively reviewed 437 TURPs and 590 PVPs over 3 years in our institution. We describe the conservative, endoscopic and open prostatic packing techniques used for patients who experienced postoperative bleeding. RESULTS Of 437 TURPs, 19 required endoscopic intervention for postoperative bleeding. Of 590 PVPs, two patients were successfully managed endoscopically for delayed haemorrhage at 7 and 13 days post-surgery, respectively. In one TURP and one PVP patient, endoscopic management was insufficient to control postoperative haemorrhage and open exploration and packing of the prostatic cavity was performed. CONCLUSIONS Significant bleeding after endoscopic prostatic surgery is still a potentially life-threatening complication. Prophylactic measures have been employed to reduce peri-operative bleeding but persistent bleeding post-endoscopic prostatic surgery should be treated promptly to prevent the risk of rapid deterioration. We demonstrated that the technique of open prostate packing may be life-saving.

Lynch, Mark; Sriprasad, Seshadri; Subramonian, Kesavapillai; Thompson, Peter

2010-01-01

322

Transferrin receptor 1 is a cellular receptor for New World haemorrhagic fever arenaviruses  

PubMed Central

At least five arenaviruses cause viral haemorrhagic fevers in humans. Lassa virus, an Old World arenavirus, uses the cellular receptor ?-dystroglycan to infect cells1. Machupo, Guanarito, Junin and Sabia viruses are New World haemorrhagic fever viruses that do not use ?-dystroglycan2. Here we show a specific, high-affinity association between transferrin receptor 1 (TfR1) and the entry glycoprotein (GP) of Machupo virus. Expression of human TfR1, but not human transferrin receptor 2, in hamster cell lines markedly enhanced the infection of viruses pseudotyped with the GP of Machupo, Guanarito and Junin viruses, but not with those of Lassa or lymphocytic choriomeningitis viruses. An anti-TfR1 antibody efficiently inhibited the replication of Machupo, Guanarito, Junin and Sabia viruses, but not that of Lassa virus. Iron depletion of culture medium enhanced, and iron supplementation decreased, the efficiency of infection by Junin and Machupo but not Lassa pseudoviruses. These data indicate that TfR1 is a cellular receptor for New World haemorrhagic fever arenaviruses.

Radoshitzky, Sheli R.; Abraham, Jonathan; Spiropoulou, Christina F.; Kuhn, Jens H.; Nguyen, Dan; Li, Wenhui; Nagel, Jane; Schmidt, Paul J.; Nunberg, Jack H.; Andrews, Nancy C.; Farzan, Michael; Choe, Hyeryun

2011-01-01

323

Tranexamic acid and upper gastrointestinal haemorrhage--a double-blind trial.  

PubMed Central

The efficacy of antifibrinolytic therapy in the management of acute upper gastrointestinal haemorrhage has been investigated in a double-blind clinical trial. Two-hundred patients were studied using tranexamic acid, a potent antifibrinolytic agent. Of these, 103 were in the treatment group and 97 in the control group. Patients were analysed to determine severity of initial blood loss, transfusion requirements, together with the incidence of recurrent bleeding, surgical intervention, and death. Final diagnosis as to the site of bleeding was arrived at using endoscopy, barium studies, and the findings at operation and necropsy. The groups were well matched as regards severity of initial haemorrhage, age, sex, aetiological diagnosis, and precipitating factors. A significant difference was observed in the requirement for surgical intervention to control continuing or recurrent haemorrhage. Twenty-three of 97 in the control group and seven of 103 in the treatment group required surgery.There appeared to be a reduction in the transfusion rate after the first three days of hospitalization in the treatment group. There were no significant differences in mortality or in side-effects between the two groups.

Biggs, J C; Hugh, T B; Dodds, A J

1976-01-01

324

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

2012-01-01

325

Surveillance and laboratory detection system of Crimean-Congo haemorrhagic fever in Iran.  

PubMed

Crimean-Congo haemorrhagic fever (CCHF) is a viral zoonotic disease with a high mortality rate in humans. The CCHF virus (CCHFV) is transmitted to humans through the bite of Ixodid ticks or by contact with blood or tissues of infected livestock. In addition to zoonotic transmission, CCHFV can be spread from person to person and is one of the rare haemorrhagic fever viruses able to cause nosocomial outbreaks in hospitals. Crimean-Congo haemorrhagic fever is a public health problem in many regions of the world such as Eastern Europe, Asia, the Middle East and Africa. In addition to clinical symptoms, the diagnosis of CCHF is based on the use of serological tests for the detection of immunoglobulin M and immunoglobulin G antibodies and on the use of molecular tools such as RT-PCR. From 1970 to 1978, serological and epidemiological studies were performed in humans and in livestock of Iran. After two decades and observations of CCHF in some provinces of Iran, a CCHF surveillance and detection system was established in 1999, leading to a dramatically decreased mortality rate from 20% (year 2000) to 2% (year 2007). PMID:18666963

Chinikar, S; Goya, M M; Shirzadi, M R; Ghiasi, S M; Mirahmadi, R; Haeri, A; Moradi, M; Afzali, N; Rahpeyma, M; Zeinali, M; Meshkat, M

2008-08-01

326

Duodenal Wedge Resection for Large Gastrointestinal Stromal Tumour Presenting with Life-Threatening Haemorrhage  

PubMed Central

Background. Duodenal gastrointestinal stromal tumours (GISTs) are an uncommon malignancy of the gastrointestinal (GI) tract. We present a case of life-threatening haemorrhage caused by a large ulcerating duodenal GIST arising from the third part of the duodenum managed by a limited duodenal wedge resection. Case Presentation. A 61-year-old patient presented with acute life-threatening gastrointestinal bleeding. After oesophagogastroduodenoscopy failed to demonstrate the source of bleeding, a 5?cm ulcerating exophytic mass originating from the third part of the duodenum was identified at laparotomy. A successful limited wedge resection of the tumour mass was performed. Histopathology subsequently confirmed a duodenal GIST. The patient remained well at 12-month followup with no evidence of local recurrence or metastatic spread. Conclusion. Duodenal GISTs can present with life-threatening upper GI haemorrhage. In the context of acute haemorrhage, even relatively large duodenal GISTs can be treated by limited wedge resection. This is a preferable alternative to duodenopancreatectomy with lower morbidity and mortality but comparable oncological outcome.

Shaw, Alexander; Jeffery, John; Dias, Laura; Nazir, Sarfraz

2013-01-01

327

Vasopressin clearance and secretion during haemorrhage in normal dogs and in dogs with experimental diabetes insipidus  

PubMed Central

1. The secretion of vasopressin in response to haemorrhagic shock has been investigated in anaesthetized dogs. 2. The changes in the plasma concentrations of vasopressin were followed over a period of 5 hr, during which the arterial blood pressure was kept constant at 40 mm Hg. It was found that vasopressin concentration in plasma rose to a high peak shortly after the onset of shock and gradually declined thereafter. Five hours later, it was still 3·5 times higher than control. Re-transfusion of blood was followed by a return to control levels. 3. The clearance of vasopressin was calculated before and during shock in normal dogs and in dogs with experimental diabetes insipidus. Soon after the onset of shock, the clearance rate dropped to one quarter of its normal level but slowly recovered, returning to near control values at the fifth hour of shock. Clearance rates did not vary as a function of infusion rates, suggesting that there is no maximal transport rate for the removal of the hormone over the entire secretory range found in normal and hypotensive dogs. 4. From the clearance rates and from the plasma concentrations of endogenously secreted vasopressin it has been possible to calculate the approximate secretory rates of the hormone in response to shock. Secretion rose to a very high level, some 40 times greater than control, at the onset of shock. This was followed by a fairly constant secretory plateau. At the fifth hour of shock secretion was 3·5 times higher than control. 5. The half-life of vasopressin was measured in normal and hypotensive dogs. Control measurements confirm the generally accepted value of approximately 5 min. The half-life was significantly higher in the early stage of shock, but returned to control values in the later stage. 6. Haemorrhage experiments performed in normal and diabetic dogs suggest that vasopressin may play a part in the development of irreversible haemorrhagic shock: all normal animals died within a few hours of retransfusion, whereas four out of eight diabetic dogs similarly treated survived a 24 hr observation period. In a separate set of experiments, eight diabetic dogs were subjected to the haemorrhage procedure while receiving a constant infusion of vasopressin: only two of these survived. Surviving dogs showed none of the characteristic lesions of irreversible haemorrhagic shock.

Errington, M. L.; E Silva, M. Rocha

1972-01-01

328

[Buttock necrosis after subtotal hysterectomy, bilateral internal iliac arteries ligature and pelvic embolization for control of severe post-partum haemorrhage].  

PubMed

Post-partum haemorrhage remains a major cause of maternal mortality. Surgical management may be needed in patients with hemodynamic instability. Arterial embolization may be needed in case of persisting haemorrhage despite initial surgical management. We report a case of buttock necrosis occurring after pelvic embolization to control refractory post-partum haemorrhage and failed subtotal hysterectomy with bilateral internal iliac arteries ligation. To the best of our knowledge, this is the first case of buttock necrosis complicating a severe post-partum haemorrhage reported in the literature. PMID:19896781

Zanati, J; Resch, B; Roman, H; Brabant, G; Sentilhes, L; Verspyck, E; Henriet, E; Sergent, F; Houzé de L'aulnoit, D; Marpeau, L; Clavier, E

2009-11-06

329

Neutralization of the haemorrhagic activities of viperine snake venoms and venom metalloproteinases using synthetic peptide inhibitors and chelators.  

PubMed

Envenoming by the West African saw-scaled viper, Echis ocellatus resembles that of most vipers, in that it results in local blistering, necrosis and sometimes life-threatening systemic haemorrhage. While effective against systemic envenoming, current antivenoms have little or no effect against local tissue damage. The major mediators of local venom pathology are the zinc-dependant snake venom metalloproteinases (SVMPs). The high degree of structural and functional homology between SVMPs and their mammalian relatives the matrix metalloproteinases (MMPs) suggests that substrate/inhibitor interactions between these subfamilies are likely to be analogous. In this study, four recently developed MMP inhibitors (MMPIs) (Marimastat, AG-3340, CGS-270 23A and Bay-12 9566) are evaluated in addition to three metal ion chelators (EDTA, TPEN and BAPTA) for their ability to inhibit the haemorrhagic activities of the medically important E. ocellatus venom and one of its haemorrhagic SVMPs, EoVMP2. As expected, the metal ion chelators significantly inhibited the haemorrhagic activities of both whole E. ocellatus venom and EoVMP2, while the synthetic MMPIs show more variation in their efficacies. These variations suggest that individual MMPIs show specificity towards SVMPs and that their application to the neutralization of local haemorrhage may require a synthetic MMPI mixture, ensuring that a close structural component for each SVMP is represented. PMID:17196631

Howes, J-M; Theakston, R D G; Laing, G D

2006-11-30

330

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.

Chattopadhyay, Saurabh; Tripathi, Chandrabhal

2010-01-01

331

Liver, meconium, haemorrhage: the value of T1-weighted images in fetal MRI  

Microsoft Academic Search

Background  Ultrafast T2-weighted (T2-W) MRI sequences are currently considered a routine technique for fetal MR imaging. Limited experience exists with fetal T1-weighted (T1-W) imaging techniques.Objective  To determine MRI patterns of some fetal abdominal or haemorrhagic disorders with particular respect to the diagnostic value of T1-W images.Materials and methods  In addition to standard T2-W single-shot sequences, T1-W single-shot and\\/or multislice sequences were employed in

Jan Zizka; Pavel Elias; Karel Hodik; Jaroslav Tintera; Vera Juttnerova; Zdenek Belobradek; Ludovit Klzo

2006-01-01

332

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.

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

2012-01-01

333

Rest tremor and extrapyramidal symptoms after midbrain haemorrhage: clinical and 18F-dopa PET evaluation.  

PubMed Central

A 25 year old man had an acute subarachnoid haemorrhage due to the rupture of a right peduncular subthalamic arteriovenous malformation. Seven months later he developed a left rest tremor associated with mild bilateral extrapyramidal symptoms and responsive to levodopa treatment. Surface EMG recording showed synchronous activity of agonist and antagonist muscles in the left limbs. A PET 18F-dopa study showed a large decrease of the Ki value in the right striatum. One year after the stroke a persistent postural component developed in the tremor. Images

Defer, G L; Remy, P; Malapert, D; Ricolfi, F; Samson, Y; Degos, J D

1994-01-01

334

Developmental venous anomaly (DVA) with arterial component: a rare cause of intracranial haemorrhage  

Microsoft Academic Search

Introduction  To examine the clinical and radiologic findings of patients with developmental venous anomaly (DVA) associated with intracranial\\u000a haemorrhage but unrelated to cavernoma.\\u000a \\u000a \\u000a \\u000a Methods  Computed tomography (CT) was used to obtain intracranial images from seven patients ranging in age from 6 to 51 years. Magnetic\\u000a resonance imaging (MRI) was then performed on six patients, and two patients were further examined via CT angiography.

Ismail Oran; Yilmaz Kiroglu; Alaattin Yurt; Fisun Demircivi Ozer; Feridun Acar; Tayfun Dalbasti; Baki Yagci; Akif Sirikci; Cem Calli

2009-01-01

335

[Hantavirus infection as the cause of haemorrhagic fever with renal syndrome].  

PubMed

Hantavirus is an RNA virus that can cause potentially fatal pulmonary and renal diseases in humans. Infections with Hantaviruses occur through inhalation of aerosol from rodent faeces, urine or saliva. The predominant virus type in Denmark is the Puumala virus, which causes the mildest form of haemorrhagic fever with renal syndrome, the so-called nephropathia epidemica (NE) with good prognosis (mortality 0.1-0.4%). The incidence of Hantavirus-infection in Denmark is about ten cases a year. The diagnosis of Hantavirus-infection is based on serology and/or polymerase chain reaction in blood or urine. PMID:23121908

Redal-Baigorri, Belén; Chen Nielsen, Xiaohui; Martin-Iguacel, Raquel

2012-10-29

336

Nonawakening following general anaesthesia after ventriculo-peritoneal shunt surgery: An acute presentation of intracerebral haemorrhage  

PubMed Central

Emergence from general anaesthesia has been a process characterized by large individual variability. Delayed emergence from anaesthesia remains a major cause of concern both for anaesthesiologist and surgeon. The principal factor for delayed awakening from anaesthesia is assumed to be the medications and anaesthetic agents used in the perioperative period. However, sometimes certain non-anaesthetic events may lead to delayed awakening or even non-awakening from general anaesthesia. We report the non-anaesthetic cause (acute intracerebral haemorrhage) for non-awakening following ventriculo-peritoneal shunt surgery.

Deuri, Achyut; Goswami, Devalina; Samplay, Mukesh; Das, Jyotirmoy

2010-01-01

337

Intracranial transthecal subarachnoid fat emboli and subarachnoid haemorrhage arising from a sacral fracture and dural tear  

PubMed Central

We present the case of a 28-year-old man with an unusual aetiology of lipid-dense material in the subarachnoid space. CT of the head at presentation was normal. MRI of the spine revealed a defect in the dura at L5/S1, with avulsed left L5 and S1 nerve roots. Haematoma and marrow fat were observed in close relation to the dural tear adjacent to the sacral fracture. Head CT and MRI subsequently demonstrated new lipid-dense material and haemorrhage in the subarachnoid space after sacral instrumentation, presumably owing to transthecal displacement of fatty marrow.

Woo, J K H; Malfair, D; Vertinsky, T; Heran, M K S; Graeb, D

2010-01-01

338

High-dose tranexamic acid reduces blood loss in postpartum haemorrhage  

Microsoft Academic Search

Introduction  Our purpose in conducting this study was to determine whether administration of high-dose tranexamic acid (TA) at the time\\u000a of diagnosis of postpartum haemorrhage (PPH) could reduce blood loss.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  This was a randomised, controlled, multicentred, open-label trial. Women with PPH >800 mL following vaginal delivery were\\u000a randomly assigned to receive TA (loading dose 4 g over 1 hour, then infusion

Anne-Sophie Ducloy-Bouthors; Brigitte Jude; Alain Duhamel; Françoise Broisin; Cyril Huissoud; Hawa Keita-Meyer; Laurent Mandelbrot; Nadia Tillouche; Sylvie Fontaine; Françoise Le Goueff; Sandrine Depret-Mosser; Benoit Vallet; Sophie Susen

2011-01-01

339

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.

2013-01-01

340

Recurrent non-aneurysmal, metastatic intraparenchymal haemorrhages following resection of atrial myxoma - case report and literature review.  

PubMed

Atrial myxomas are the commonest cardiac neoplasms. The most common extra-cardiac manifestations are embolic infarcts from tumour embolisation. Infrequently, aneurysm formation and intracranial haemorrhages also occur. Incredibly rare are space-occupying lesions and malignant transformation. The authors report a case of a previously healthy middle-aged lady who developed recurrent and expanding intraparenchymal haemorrhages following resection of a left atrial myxoma without any primary disease recurrence. The case described is completely different from the described literature in that her intracranial vasculature was free of aneurysms on angiography despite central nervous system haemorrhage and no myxomatous or malignant features were seen on histology of the resected symptomatic occipital lesion. The authors compare this case to the available literature and also provide a literature review. PMID:23104629

Raza, Emmon; Kamal, Ayeesha Kamran

2012-10-26

341

Listening to the head and not the heart: subarachnoid haemorrhage associated with severe acute left ventricular failure.  

PubMed

Headache is a very common presenting symptom in the emergency department, and distinguishing subarachnoid haemorrhage from more benign causes of headache can be challenging. This particular presentation of subarachnoid haemorrhage was made more difficult by concurrent-related cardiac pathophysiology. This case report describes the evolving differential diagnosis of a 54-year-old woman initially presenting with headache and confusion, with signs and investigations suggestive of ST elevation myocardial infarction and resultant left ventricular failure. The importance of prompt primary percutaenous coronary intervention left clinicians with a difficult decision about which specialty was most appropriate for the patient to be transferred to. Ultimately the symptoms were explained by radiographic confirmation of subarachnoid haemorrhage and subsequent adrenergic storm, causing myocyte injury and myocardial contractile dysfunction. This patient was transferred for coiling of a ruptured cerebral artery berry aneurysm. Her left ventricular failure improved from severe to mild within 48 h of presentation. PMID:23988819

King, Christopher

2013-08-29

342

Role of histamine and acid back-diffusion in modulation of gastric microvascular permeability and haemorrhagic ulcers in betel-quid-fed rats  

Microsoft Academic Search

Evidence concerning the pathogenesis of gastric haemorrhagic ulcer produced by betel quid chewing (BQC) is lacking. This research first proposes that alterations of mast cell histamine release and gastric acid back-diffusion are important in modulating gastric microvascular permeability and mucosal haemorrhagic ulcer in BQC-fed rats. The effects of several histamine receptor antagonists on this ulcer model also were evaluated. Male

Chen-Road Hung; Hui-Ming Chen

2004-01-01

343

A serial cross-sectional study of the prevalence of rabbit haemorrhagic disease on three farms in the lower North Island of New Zealand  

Microsoft Academic Search

AIM: To estimate over a 3-year period following the first release of rabbit haemorrhagic disease virus (RHDV) the prevalence of rabbit haemorrhagic disease (RHD) and the abundance of rabbits (Oryctolagus cuniculus) in an area that historically had low rabbit densities.METHODS: Three farms grazing predominantly sheep and beef cattle, located close together and with low initial rabbit densities, were selected for

J Henning; P Davies

2005-01-01

344

Clostridium perfringens type A beta2 toxin in elephant (Elephas maximus indicus) and pygmy hog (Sus salvanius) with haemorrhagic enteritis in Assam, India  

Microsoft Academic Search

This paper reported the investigation of haemorrhagic enteritis in female elephant (Elephas maximus indicus) and pygmy hog (Sus salvanius) at the Assam State Zoo, Guwahati, Assam, India. An eight year old female elephant and two and half year old female pygmy hog developed haemorrhagic enteritis of unknown cause maintained at the zoo died within four days. Bacteriological investigation revealed that

Arunava Das; Yahya Mazumder; Biman K. Dutta; Bibek R. Shome; Komal M. Bujarbaruah; Gauri D. Sharma

2008-01-01

345

False aneurysm of the uterine pedicle: an uncommon cause of post-partum haemorrhage after caesarean section treated with selective arterial embolization.  

PubMed

We report three cases of post-partum haemorrhage following caesarean delivery attributed to a false aneurysm of the uterine pedicle and treated with artery embolization. These lesion were probably post-traumatic in origin related to hysterotomy. Angiographic study of the anterior division of hypogastric arteries confirmed the diagnosis and embolization of the false aneurysm was successful in controlling the haemorrhage. PMID:11435004

Descargues, G; Douvrin, F; Gravier, A; Lemoine, J P; Marpeau, L; Clavier, E

2001-07-01

346

Fasudil, a protein kinase inhibitor, prevents the development of endothelial injury and neutrophil infiltration in a two-haemorrhage canine subarachnoid model  

Microsoft Academic Search

We examined the possible prophylactic potential of fasudil, a protein kinase inhibitor, on the development of endothelial injury and neutrophil infiltration after subarachnoid haemorrhage (SAH). Using the two haemorrhage canine model, fasudil (3 mg\\/kg) was infused intravenously for 30 min twice daily (days 1–7) and related histological changes were observed by light and electron microscopy. On day 7 characteristic features

Shin-ichi Satoh; Yasuhiro Yamamoto; Yoshinori Toshima; Ichiro Ikegaki; Toshio Asano; Yoshio Suzuki; Masato Shibuya

1999-01-01

347

Primary intracerebral haemorrhage in Malaysia: in-hospital mortality and outcome in patients from a hospital based registry.  

PubMed

Primary intracerebral haemorrhage (ICH) results in significant morbidity and mortality among patients. There is a paucity of epidemiological data on this condition in Malaysia. The purpose of this hospital based study was to define the clinical profile in patients with primary spontaneous intracerebral haemorrhage at University of Malaya Medical Centre (UMMC) and to determine the mortality rate of intracerebral haemorrhage at the time of discharge, the prognostic factors and one year outcome of this cohort of patients. Sixty-six patients were admitted at the Neurosurgical unit of University of Malaya Medical Centre for a period of 13 months from March 2002 to March 2003. Fifty percent of the subjects were female. The mean age was 61.6 +/- 16.7 years. Among our patients with intracerebral haemorrhage, the common risk factors were: hypertension (80.3%), diabetes mellitus (25.7%) and smoking (27.2%). Common presenting features for our series were: weakness (61.8%), LOC (58.5%), headache (56.3%) and speech disturbances (45.3%). On neuroimaging, the lesions were seen in basal ganglia/thalamus (45.1%), lobar (32.9%), brainstem (13.4%) and cerebelli (8.5%). The overall 30 days mortality rate for intracerebral haemorrhage (ICH) was 43.9%. The important predictors of for mortality were the GCS score on admission (p < 0.0001), haematoma volume > 30 mls (p < 0.0001), evidence of intraventricular extension (p = 0.011) and ICH score (p < 0.0001). At one year follow up, 48.5% (n = 32) were dead, 33.3% (n = 11) obtained good recovery, 36.4% (n = 12) moderate disability, 18.2% (n = 6) severe disability and 3% remain vegetative state. The overall mortality rate for our series of patients with primary intracerebral haemorrhage is quite similar to previously published epidemiological studies. ICH scoring is useful in the prognostication. PMID:18551935

Sia, S F; Tan, K S; Waran, V

2007-10-01

348

The release of transforming growth factor-beta following haemorrhage: its role as a mediator of host immunosuppression.  

PubMed Central

Haemorrhage in the absence of trauma is reported to induce a profound depression in cell-mediated immunity. Recent studies have drawn attention to the cytokine transforming growth factor-beta (TGF-beta) that, while important in wound healing, also has marked immunosuppressive effects. The aim of this study was to determine whether: (1) haemorrhage induces an increase in circulating TGF-beta and if this is associated with the loss of host immunoresponsiveness; and (2) administration of monoclonal antibody (mAb) to TGF-beta following haemorrhage ablates these changes. To determine this, C3H/HeN mice were bled to and maintained at a mean arterial pressure of 35 mmHg for 1 hr. This required removing approximately 50% of the circulating blood volume. Following this period of hypotension, the mice were adequately resuscitated. Blood samples obtained at 24 and 72 hr, but not at 2 hr, following haemorrhage showed a significant elevation in plasma TGF-beta levels when compared to shams. At 24 hr, the increase of TGF-beta in the plasma was associated with decreases in both concanavalin A (Con A)-induced splenocyte proliferation and splenic macrophage antigen presentation. Treating animals with neutralizing antibody (animals received 200 micrograms mAb against bovine TGF-beta 1,2,3/mouse intraarterially) not only reduced the levels of TGF-beta in the blood at 24 hr, but also restored splenocyte functions, such as Con A-induced proliferation, interleukin-2 (IL-2) release, and the capacity of splenic macrophages to present antigen. However, elevated levels of prostaglandin E2 (PGE2) seen in plasma during haemorrhage were only partially depressed by the antibody treatment. These results indicate that the release of TGF-beta contributes to the protracted (> or = 24 hr) suppression of cell-mediated immunity following haemorrhage.

Ayala, A; Meldrum, D R; Perrin, M M; Chaudry, I H

1993-01-01

349

Effects of current and waveform on the incidence of breast meat haemorrhages in electrically stunned broiler chicken carcases.  

PubMed

The effects of the current and its waveform on the prevalence of broken bones and breast meat haemorrhages in electrically stunned broiler chickens were examined at two poultry processing plants. Increasing the current over the range from 68 to 115 mA per bird had very little effect on the carcase quality, but increased the incidence of broken furculum and coracoid bones in birds stunned with a sinusoidal alternating current (AC). Clipping a sinusoidal AC with a thyristor had a pronounced effect on the carcase quality, and resulted in more broken bones and breast meat haemorrhages. PMID:7502464

Gregory, N G; Wilkins, L J; Wotton, S B; Middleton, A L

1995-09-01

350

A case report of orbital haemorrhage associated with endoscopic sinus surgery and reversible sight loss: a multidisciplinary approach to management.  

PubMed

We report a case of intraoperative orbital haemorrhage as a complication of endoscopic sinus surgery performed under general anaesthesia. Initial unilateral complete visual loss occurred, but recovered due to accurate and early diagnosis combined with urgent surgical intervention. This patient's case is reported to illustrate the importance of early recognition of clinical signs and how a stepwise approach to management can result in a favourable visual outcome. Moreover, the mechanisms and pathophysiology of visual loss due to orbital haemorrhage following endoscopic sinus surgery are discussed. PMID:23387463

Sood, Vaneeta; Rejali, Darius; Stocker, Judith; Pagliarini, Sergio; Ahluwalia, Harpreet; Mehta, Purnima

2013-02-01

351

Lethal, oedema, haemorrhagic activity of spotted butterfish (Scatophagus argus, Linn) sting extract and its neutralization by antiserum and pharmacological antagonists.  

PubMed

An attempt has been made in this communication to develop antiserum in rabbit against Scatophagus. argus sting extract. Antiserum did not neutralized the sting extract induced proinflammatory and haemorrhagic activity but successfully neutralized lethality upto 2LD50. Cyproheptadine, indomethacin and BW 755C pretreatment significantly reduced sting extract induced proinflammatory activity. The haemorrhagic activity of sting extract was significantly inhibited by temperature, UV-exposure, EDTA, cyproheptadine, indomethacin and BW 755C pretreatment. The results conclude that the local effects of S.argus venom is likely to be mediated through release of mediators and may be encountered by pharmacological antagonists better than the antiserum. PMID:15991572

Muhuri, D; Dasgupta, S C; Gomes, A

2005-06-01

352

Effect of propranolol and phentolamine on myocardial necrosis after subarachnoid haemorrhage.  

PubMed

A study was set up to assess the effect on the clinical course of subarachnoid haemorrhage (SAH) of giving propranolol 80 mg eight-hourly plus phentolamine 20 mg three-hourly by mouth for three weeks. Out of the 90 patients studied, 14 died. Two of the deaths occurred in an open pilot study of 10 patients, the remaining 12 deaths occurring in patients in a randomised double-blind placebo-controlled study. Postmortem examination was carried out on 12 of the patients, six of whom had been receiving placebo and six propranolol plus phentolamine. Necrotic myocardial lesions were present in the hearts of all six patients (age range 30-59 years) who died while taking placebo (all had had abnormal electrocardiograms (ECGs). In contrast, no necrotic lesions were found in the hearts of the six patients (age range 28-59) who died while receiving the drugs (all had previously had normal ECGs). We conclude that the necrotic myocardial lesions were induced by catecholamines and that propranolol had a cardioprotective effect. While death from a further haemorrhage in cases of SAH is not affected by propranolol and phentolamine, propranolol may have a beneficial effect in other potentially lethal stresses. PMID:361155

Neil-Dwyer, G; Walter, P; Cruickshank, J M; Doshi, B; O'Gorman, P

1978-10-01

353

Effect of propranolol and phentolamine on myocardial necrosis after subarachnoid haemorrhage.  

PubMed Central

A study was set up to assess the effect on the clinical course of subarachnoid haemorrhage (SAH) of giving propranolol 80 mg eight-hourly plus phentolamine 20 mg three-hourly by mouth for three weeks. Out of the 90 patients studied, 14 died. Two of the deaths occurred in an open pilot study of 10 patients, the remaining 12 deaths occurring in patients in a randomised double-blind placebo-controlled study. Postmortem examination was carried out on 12 of the patients, six of whom had been receiving placebo and six propranolol plus phentolamine. Necrotic myocardial lesions were present in the hearts of all six patients (age range 30-59 years) who died while taking placebo (all had had abnormal electrocardiograms (ECGs). In contrast, no necrotic lesions were found in the hearts of the six patients (age range 28-59) who died while receiving the drugs (all had previously had normal ECGs). We conclude that the necrotic myocardial lesions were induced by catecholamines and that propranolol had a cardioprotective effect. While death from a further haemorrhage in cases of SAH is not affected by propranolol and phentolamine, propranolol may have a beneficial effect in other potentially lethal stresses. Images FIG 2

Neil-Dwyer, G; Walter, P; Cruickshank, J M; Doshi, B; O'Gorman, P

1978-01-01

354

Therapeutic effects of intravenous infusion of hyperoxygenated solution on acute haemorrhagic shock in rabbits.  

PubMed

Tissue anoxia is the main mechanism of the shock reaction. Here, the effect of hyperoxygenated solution (HOS) on acute haemorrhagic shock was studied in rabbits. At 60 min after shock, rabbits were infused intravenously with hyperoxygenated solution at 10 (HOS1 group) or 20 ml/kg (HOS2 group) or with Ringer's solution at 10 ml/kg (RS group). Compared with values before shock, values after shock were lower for mean arterial pressure (MAP), more negative for base excess (BE) and higher for blood lactate (BL) and blood viscosity. After infusion, MAP declined more slowly in the HOS1 and HOS2 groups than in the RS group. At 30 and 60 min after infusion, arterial partial pressure of oxygen (PaO(2)) and oxygen saturation (SaO(2)) were higher and BE was less negative in the HOS1 and HOS2 groups than in the RS group, BL was lower in the HOS1 and HOS2 groups than in the RS group, and PaO(2) and SaO(2) were higher in the HOS2 group than in the HOS1 group. It was concluded that HOS infusion can rectify changes in vital signs more effectively than Ringer's solution after acute haemorrhagic shock in rabbits. PMID:22117985

Xu, H; Han, L C; Gao, W; Sun, X X; Zhou, Y; Meng, X Z; Zhang, H; Xu, L X

2011-01-01

355

A case report of haemorrhagic-aneurismal bone cyst of the mandible  

PubMed Central

Haemorrhagic-aneurismal bone cysts (HABCs) are quite rare, benign, non-neoplastic, expansive, and vascular locally destructive lesions. They are generally considered sequelae of an earlier trauma causing an overflow of blood into the bone. HABCs are classified as pseudocysts and they should be differentiated from true cysts because their treatment is different. Since few of these cysts involve subjective symptoms, most are discovered accidentally during radiography, while a sure diagnosis is likely to be obtained only during surgery, on discovery of a non-epithelialised cavity. Here, we report a typical case of a haemorrhagic-mandibular cyst in a 13-year-old girl, which was treated by opening the cavity and scraping its walls following diagnostic arteriography and post-operative transcutaneous intralesional embolization. No further complications were recorded in the post-operative period, although the convalescence lasted for a time longer than expected, because of anemia. No further surgery was performed. She has been disease-free for two years. Evaluation of intralesional blood flow is important for HABCs because of the hemorrhagic risk in surgery. Embolization seems to be a useful procedure in the treatment of HABCs and could be tried as the treatment modality in the standard protocol for the treatment of HABCs.

Grecchi, Francesco; Zollino, Ilaria; Candotto, Valentina; Gallo, Francesco; Rubino, Giuseppe; Bianco, Raffaella; Carinci, Francesco

2012-01-01

356

[Trends in risk factors, clinical characteristics and prognosis in primary intracerebral haemorrhage (1986-2004).  

PubMed

BACKGROUND AND OBJECTIVES: Cardiovascular risk factors, clinical features and early outcome of first-ever primary intracerebral haemorrhage (PIH) from 1986 to 2004 using the Sagrat Cor Hospital of Barcelona Stroke Registry were assessed, and compared with data from patients with first-ever ischemic stroke. PATIENTS AND METHODS: The study population consisted of 380 patients with PIH and 2,082 patients with ischemic stroke. Secular trends for the periods 1986-1992, 1993-1998 and 1999-2004 were analyzed. RESULTS: Age increased significantly (P<.001) throughout the 3 study periods and there was a significant increase in the percentage of patients with atrial fibrillation, chronic obstructive pulmonary disease (COPD) and lobar topography. The use of brain magnetic resonance imaging (MRI) also increased significantly throughout the study periods. In comparison with ischemic stroke in-hospital death was more frequent (28,2 vs. 12%) and lacunar syndrome (9,5 vs. 31,4%) and symptom-free patients at discharge were less frequent in the intracerebral haemorrhage group (6,1 vs. 18,3%). CONCLUSIONS: Significant changes over a 19-year period included an increase in the patient's age, frequency of COPD and atrial fibrillation and use of MRI imaging studies. PIH is a severe subtype of stroke with a higher risk of early death and lower asymptomatic frequency at discharge than ischemic cerebral infarct. PMID:23768852

Arboix, Adrià; Massons, Joan; García-Eroles, Luís; Grau-Olivares, Marta; Targa, Cecília; Comes, Emili; Oliveres, Montserrat

2013-06-11

357

Milder winters in northern Scandinavia may contribute to larger outbreaks of haemorrhagic fever virus.  

PubMed

The spread of zoonotic infectious diseases may increase due to climate factors such as temperature, humidity and precipitation. This is also true for hantaviruses, which are globally spread haemorrhagic fever viruses carried by rodents. Hantaviruses are frequently transmitted to humans all over the world and regarded as emerging viral diseases. Climate variations affect the rodent reservoir populations and rodent population peaks coincide with increased number of human cases of hantavirus infections. In northern Sweden, a form of haemorrhagic fever called nephropathia epidemica (NE), caused by the Puumala hantavirus (PUUV) is endemic and during 2006-2007 an unexpected, sudden and large outbreak of NE occurred in this region. The incidence was 313 cases/100,000 inhabitants in the most endemic areas, and from January through March 2007 the outbreak had a dramatic and sudden start with 474 cases in the endemic region alone. The PUUV rodent reservoir is bank voles and immediately before and during the peak of disease outbreak the affected regions experienced extreme climate conditions with a record-breaking warm winter, registering temperatures 6-9 degrees C above normal. No protective snow cover was present before the outbreak and more bank voles than normal came in contact with humans inside or in close to human dwellings. These extreme climate conditions most probably affected the rodent reservoir and are important factors for the severity of the outbreak. PMID:20052429

Evander, Magnus; Ahlm, Clas

2009-11-11

358

Bilateral Decompressive Craniectomy for Refractory Intracranial Hypertension in a Child with Severe ITP-Related Intracerebral Haemorrhage  

Microsoft Academic Search

We report a 13-month-old infant who developed acutely elevated intracranial pressure (ICP) as a result of a spontaneous intracerebral haemorrhage (ICH), secondary to idiopathic thrombocytopenic purpura (ITP). Her ICP remained severely elevated despite aggressive medical measures, with persistent obtundation, right hemiparesis and a dilated left pupil. Bilateral decompressive craniectomies (DCs) were performed, which resulted in a rapid decline in ICP.

Adrianna Ranger; Artur Szymczak; Douglas Fraser; Marina Salvadori; Lawrence Jardine

2009-01-01

359

An early warning system for Crimean-Congo haemorrhagic fever seasonality in Turkey based on remote sensing technology  

Microsoft Academic Search

In the last few years, Crimean-Congo haemorrhagic fever (CCHF) has been reported as an emerging tick- borne disease in Turkey. This paper deals with the preparation of an early warning system, aimed to predict the begin- ning of the CCHF season in Turkey based on a clear, simple and repeatable remotely-sensed signal. Decadal (mean of 10 days) values of the

Agustin Estrada-Peña; Zati Vatansever; Aysen Gargili; Turan Buzgan

2007-01-01

360

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

361

Diffuse alveolar haemorrhage may be associated with intravitreal injection of bevacizumab in a patient with systemic risk factors  

Microsoft Academic Search

The authors present a rare case where acute respiratory failure occurred after the intravitreal bevacizumab injection for a branch retinal vein occlusion. Chest CT scan showed ground-glass opacity in the bilateral lung fields. The finding of bronchoalveolar lavage fluid revealed alveolar haemorrhage. Corticosteroid therapy resulted in a rapid improvement of respiratory failure. This report suggests that intravitreal injection of bevacizumab

Ruriko Seto; Hideto Yamada; Hiroshi Wada; Makoto Osawa; Taishi Nagao; Yasutaka Nakano

2011-01-01

362

Bench-to-bedside review: Optimising emergency reversal of vitamin K antagonists in severe haemorrhage – from theory to practice  

Microsoft Academic Search

ABSTRACT: Critical care physicians are increasingly facing patients receiving oral anticoagulation for either cessation of major haemorrhage or to reverse the effects of vitamin K antagonists ahead of emergency surgery. Rapid reversal of anticoagulation is particularly essential in cases of life-threatening bleeding. In these situations, guidelines recommend the concomitant administration of prothrombin complex concentrates (PCCs) and oral or intravenous vitamin

Bernard Vigué

2009-01-01

363

Seroconversion in an industrial unit of rabbits infected with a non-pathogenic rabbit haemorrhagic disease-like virus  

Microsoft Academic Search

A serological survey of 238 rabbits for antirabbit haemorrhagic disease virus (RHDV) antibodies was made in an industrial rabbitry where no signs of the disease had been reported for four years. Seroconversion was repeatedly detected and was due to a calicivirus antigenically related to RHDV but without its pathogenicity. There was a seroprevalence of 33.3 per cent among young animals

L. Capucci; A. Nardin; A. Lavazza

1997-01-01

364

Isolation of a haemorrhagic protein toxin (SA-HT) from the Indian venomous butterfish (Scatophagus argus, Linn) sting extract.  

PubMed

A haemorrhagic protein toxin (SA-HT) was isolated and purified from the spine extract of the Indian venomous butterfish, S. argus Linn, by two step ion exchange chromatography. The toxin was homogeneous in native and SDS-PAGE gel. SDS-molecular weight of the toxin was found to be 18.1 +/- 0.09 kDa. SA-HT produced severe haemorrhage on stomach wall but devoid of cutaneous haemorrhage. UV, EDTA, trypsin, protease, cyproheptadine, indomethacin, acetylsalicylic acid and BW755C treatment significantly antagonized the haemorrhagic activity of SA-HT. The toxin produced dose and time dependent oedema on mice hind paw, which was significantly encountered by cyproheptadine, indomethacin and BW755C. SA-HT increased capillary permeability on guinea pig dorsal flank. On isolated guineapig ileum, rat fundus and uterus, SA-HT produced slow contraction which was completely antagonised by prostaglandin blocker SC19220. On isolated rat duodenum, SA-HT produced slow relaxation. SA-HT significantly increased plasma plasmin, serum MDA level and decreased serum SOD level indicating the possible involvement of cyclooxygenase and lipooxygenase pathway. PMID:15233468

Karmakar, S; Muhuri, D C; Dasgupta, S C; Nagchaudhuri, A K; Gomes, A

2004-05-01

365

Point-of-care testing of coagulation and fibrinolytic status during postpartum haemorrhage: developing a thrombelastography®-guided transfusion algorithm.  

PubMed

Thrombelastography® is a monitor of coagulation and fibrinolytic status, with point-of-care applications in managing haemorrhaging patients. Advocates have suggested a possible role in managing obstetric haemorrhage. This study aims to develop a pregnancy-specific thrombelastography-guided transfusion algorithm, which could be integrated into the management of postpartum haemorrhage. In this prospective observational study, 57 healthy, term-parturients provided pre-caesarean whole blood specimens for thrombelastography analyses. Specimens were processed according to a standardised protocol involving simultaneous analyses using three assays: native (non-activated); kaolin-activated; and kaolin and tissue factor-activated (RapidTEG®). For each assay, the following thrombelastography parameters were measured: reaction time (minutes); clot formation kinetics time (minutes); maximum amplitude (mm); and a angle (degree). Subsequent reference values were used to establish assay-specific reference intervals. For all thrombelastography parameters studied, reference values obtained using a non-activated assay differed from the corresponding values obtained using activated assays, and also demonstrated greater inter-sample variability. From the assay-specific reference intervals obtained, it was possible to establish a pregnancy-specific thrombelastography-guided transfusion algorithm. Specific features of this transfusion algorithm included the preferential use of activated assays, the need for duplicates and a recommendation that an initial baseline thrombelastography measurement is established for subsequent serial comparisons. This transfusion algorithm has been developed to assist with assessment of coagulation and fibrinolytic status during postpartum haemorrhage. PMID:23194210

Hill, J S; Devenie, G; Powell, M

2012-11-01

366

Immunogenic properties of rabbit haemorrhagic disease virus structural protein VP60 expressed by a recombinant baculovirus: an efficient vaccine  

Microsoft Academic Search

We have constructed a recombinant baculovirus containing the gene encoding the structural protein VP60 from the Spanish field isolate AST\\/89 of rabbit haemorrhagic disease virus (RHDV). Infection of cultured Spodoptera frugiperda Sf9 cells with this recombinant virus resulted in the production of high yields of VP60 protein which did not seem to assemble to form virus like particles, but was

M. Soledad Marín; José M. Martín Alonso; Luís I. Pérez Ordoyo García; J. Antonio Boga; José L. Argüello-Villares; Rosa Casais; Karunakarannair Venugopal; Wenrong Jiang; Ernest A. Gould; Francisco Parra

1995-01-01

367

An audit of aneurysmal subarachnoid haemorrhage: earlier resuscitation and surgery reduces inpatient stay and deaths from rebleeding.  

PubMed Central

OBJECTIVE--To audit the outcome in patients with subarachnoid haemorrhage (SAH) after a change in management strategy. METHODS--A retrospective analysis of patients with aneurysmal subarachnoid haemorrhage over a 20 month period (phase 1) was followed by a prospective analysis of patients presenting during the next 20 months (phase 2) in which a protocol driven management regime of immediate intravenous fluid resuscitation and earlier surgery was pursued. Patients in this phase were grouped into those receiving early (within four days of subarachnoid haemorrhage) and late (after four days of subarachnoid haemorrhage) surgery. In phase 1, 75 out of a total of 92 patients underwent surgery on (median) day 12. From phase 2, 109 patients out of a total of 129 underwent surgery on (median) day 4, 58 of which had their surgery within 4 days of the subarachnoid haemorrhage. Patients in each phase/group were well matched for demographic features, site of aneurysm, and severity of subarachnoid haemorrhage. RESULTS--The surgical morbidity and mortality were no different in the two phases (P < 0.92; chi2 test). The management outcomes in the two phases of the study were also no different (P < 0.52). However, there was a significant reduction in the rebleed rate in patients undergoing surgery within four days of the subarachnoid haemorrhage in phase 2 (P < 0.0001) with an associated trend towards reduced incidence of postoperative ischaemia (P = 0.06) and mortality (P = 0.11). Operating earlier in phase 2 of the trial resulted in a lower total hospital inpatient stay of 15.8 (95% CI 13.1-18.5) days for survivors compared with 25.7 (95% CI 21.6-29.8) days in the late group (P < 0.00001; t test). CONCLUSIONS--surgical morbidity and mortality seemed independent of the timing of aneurysm surgery. Early surgery within four days was associated with a highly significant reduction in rebleed rate, and in the duration of total hospital inpatient stay. Images

Whitfield, P C; Moss, H; O'Hare, D; Smielewski, P; Pickard, J D; Kirkpatrick, P J

1996-01-01

368

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)

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

1994-01-01

369

Laparoscopic management of massive spontaneous external haemorrhage from the umbilical varix due to recanalisation of the paraumbilical vein in a patient with 'Child's Class A' liver cirrhosis.  

PubMed

Spontaneous external haemorrhage from the umbilical varix is an extremely rare complication of portal hypertension. Bleeding is usually into the peritoneal cavity and the treatment involves urgent laparotomy and ligation of the bleeding varices. We describe a cirrhotic 38-year-old man who presented with spontaneous external haemorrhage from the umbilical varix which was successfully managed laparoscopically by in-situ distal clipping and proximal transcutaneous ligation of the recanalised paraumbilical veins. We therefore feel that laparoscopy can be safely and effectively employed to control external haemorrhage from the umbilical varix associated with liver cirrhosis. This novel technique can help avoid a laparotomy and also help preserve the umbilicus. PMID:22623827

Zachariah, Sanoop K; Krishnankutty, Sreejith L; Raja, Nirmalan

2012-04-01

370

Laparoscopic management of massive spontaneous external haemorrhage from the umbilical varix due to recanalisation of the paraumbilical vein in a patient with 'Child's Class A' liver cirrhosis  

PubMed Central

Spontaneous external haemorrhage from the umbilical varix is an extremely rare complication of portal hypertension. Bleeding is usually into the peritoneal cavity and the treatment involves urgent laparotomy and ligation of the bleeding varices. We describe a cirrhotic 38-year-old man who presented with spontaneous external haemorrhage from the umbilical varix which was successfully managed laparoscopically by in-situ distal clipping and proximal transcutaneous ligation of the recanalised paraumbilical veins. We therefore feel that laparoscopy can be safely and effectively employed to control external haemorrhage from the umbilical varix associated with liver cirrhosis. This novel technique can help avoid a laparotomy and also help preserve the umbilicus.

Zachariah, Sanoop K; Krishnankutty, Sreejith L; Raja, Nirmalan

2012-01-01

371

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

PubMed

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 and safe burial practices, and laboratory confirmation. Twelve cases and ten deaths were reported (lethality 83%). A transmission tree was constructed from a sample collected by a medical team. This outbreak was remarkable by its short duration and limited size. Increased awareness among these previously affected populations and the rapid response of the healthcare system probably contributed to its extinction. PMID:21605882

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

2011-05-24

372

Environmental risk factors for haemorrhagic fever with renal syndrome in a French new epidemic area.  

PubMed

In France, haemorrhagic fever with renal syndrome (HFRS) is endemic along the Belgian border. However, this rodent-borne zoonosis caused by the Puumala virus has recently spread south to the Franche-Comté region. We investigated the space-time distribution of HFRS and evaluated the influence of environmental factors that drive the hantavirus reservoir abundance and/or the disease transmission in this area. A scan test clearly indicated space-time clustering, highlighting a single-year (2005) epidemic in the southern part of the region, preceded by a heat-wave 2 years earlier. A Bayesian regression approach showed an association between a variable reflecting biomass (normalized difference vegetation index) and HFRS incidence. The reasons why HFRS cases recently emerged remain largely unknown, and climate parameters alone do not reliably predict outbreaks. Concerted efforts that combine reservoir monitoring, surveillance, and investigation of human cases are warranted to better understand the epidemiological patterns of HFRS in this area. PMID:20822577

Viel, J-F; Lefebvre, A; Marianneau, P; Joly, D; Giraudoux, P; Upegui, E; Tordo, N; Hoen, B

2010-09-08

373

Isolated hypoplastic circumflex coronary artery: a rare cause of haemorrhagic myocardial infarction in a young athlete  

PubMed Central

Hypoplastic coronary artery disease is a rare condition that may lead to myocardial infarction and sudden death. Here we describe for the first time an isolated hypoplasia of the left circumflex artery (LCX). An otherwise healthy and athletically active 16-year-old boy was admitted to the intensive care unit (ICU) after out-of-hospital cardiac arrest. He died 12 hours after the initial event. Autopsy revealed an isolated hypoplastic LCX and acute haemorrhagic infarction in the posterolateral myocardium. The existence of isolated hypoplasia of the LCX challenges our understanding of coronary artery development. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1558483061962648

2013-01-01

374

Use of ELISAs in field studies of rabbit haemorrhagic disease (RHD) in Australia.  

PubMed Central

ELISA techniques developed for the veterinary diagnosis of Rabbit Haemorrhagic Disease (RHD) in domestic rabbits were used for studying the epidemiology of RHD in Australian wild rabbits. The combination of ELISA techniques that distinguished IgA, IgG and IgM antibody responses and a longitudinal data set, mainly based on capture-mark-recapture of rabbits, provided a reliable basis for interpreting serology and set the criteria used to classify rabbits' immunological status. Importantly, young with maternal antibodies, immune rabbits and rabbits apparently re-exposed to RHD were readily separated. Three outbreaks of RHD occurred in 1996-7. The timing of RHD outbreaks was mainly driven by recruitment of young rabbits that generally contracted RHD after they lost their maternally derived immunity. Young that lost maternal antibodies in summer were not immediately infected, apparently because transmission of RHDV slows at that time, but contracted RHD in the autumn when conditions were again suitable for disease spread.

Cooke, B. D.; Robinson, A. J.; Merchant, J. C.; Nardin, A.; Capucci, L.

2000-01-01

375

Geographical gradient of mean age of dengue haemorrhagic fever patients in northern Thailand.  

PubMed

Dengue haemorrhagic fever (DHF) is caused by dengue virus transmitted by Aedes mosquitoes; mean age of patients varies temporally and geographically. Variability in age of patients may be due to differences in transmission intensity or demographic structure. To compare these two hypotheses, the mean age of DHF patients from 90 districts in northern Thailand (1994-1996, 2002-2004) was regressed against (i) Aedes abundance or (ii) demographic variables (birthrate, average age) of the district. We also developed software to quantify direction and strength of geographical gradients of these variables. We found that, after adjusting for socioeconomics, climate, spatial autocorrelation, the mean age of patients was correlated only with Aedes abundance. The geographical gradient of mean age of patients originated from entomological, climate, and socioeconomic gradients. Vector abundance was a stronger determinant of mean age of patients than demographic variables, in northern Thailand. PMID:21733256

Nagao, Y; Tawatsin, A; Thammapalo, S; Thavara, U

2011-05-09

376

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

PubMed

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 and removal of blood clot, the ipsilateral third nerve recovered before the contralateral third nerve. Clinical findings localised the contralateral third nerve lesion to an extra-axial site. The possible mechanisms of contralateral third nerve compression are discussed. This seems to be the first example of pupillary enlargement as a false localising sign from a contralateral, supratentorial, intraparenchymal mass lesion. PMID:8089685

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

1994-09-01

377

Subarachnoid haemorrhage with bilateral intracranial vertebral artery dissecting aneurysms treated by staged endovascular stenting.  

PubMed

Bilateral vertebral artery dissecting aneurysms (VADAs) presenting with subarachnoid haemorrhage (SAH) are an exceedingly rare and deadly clinical dilemma. Prompt intervention in the case of unilateral VADAs is advocated to prevent rebleed; however, in the case of bilateral VADAs, the optimal therapeutic intervention is unclear. We describe the case of a patient presenting with SAH with bilateral VADAs treated by staged endovascular stenting. This led to resolution of the aneurysms with patency of both vertebral arteries. Stent-based therapy of the symptomatic aneurysm followed by staged stenting of the asymptomatic, contralateral aneurysm appears to be a viable treatment option. This method allows the ability to preserve flow in both vertebral arteries with minimal changes in flow characteristics that may threaten the contralateral, asymptomatic VADA, and appears to be the ideal treatment in these rare cases. PMID:23417929

Wilkinson, David Andrew; Wilson, Thomas J; Stetler, William R; Pandey, Aditya S

2013-02-15

378

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.

McLeod, David

2007-01-01

379

Long-time octreotide in an adolescent with severe haemorrhagic gastrointestinal vascular malformation  

PubMed Central

Gastrointestinal vascular malformations are a rare cause of acute or chronic blood loss. Usually they are treated by endoscopic obliteration or surgical resection. When such a therapy is inapplicable, pharmacotherapy may be required. At the age of 15 years, our female patient suffered from transfusion dependent recurrent gastrointestinal haemorrhage due to multiple gastrointestinal vascular malformations. Gastroscopy, coloscopy and capsule endoscopy revealed numerous foci making both endoscopic obliteration and complete surgical resection impossible. Neither regular transfusions nor substitution with coagulation factors were helpful. However, subcutaneous octreotide resulted in immediate stop of bleeding. Initial treatment by daily subcutaneous injections was followed by monthly depot application. Over 3 years only 2 transfusions had to be given. The patient required thyroxin substitution, otherwise, no side effects occurred and the girl had a good quality of life. The authors conclude that octreotide is safe and effective in gastrointestinal angiodysplasias inaccessible to endoscopy or surgery.

Classen, Carl Friedrich; Haffner, Dieter; Hauenstein, Christina; Wolf, Ricarda; Kyank, Ulrike

2011-01-01

380

Acute alcohol intoxication reduces mortality, inflammatory responses and hepatic injury after haemorrhage and resuscitation in vivo  

PubMed Central

BACKGROUND AND PURPOSE Haemorrhagic shock and resuscitation (H/R) induces hepatic injury, strong inflammatory changes and death. Alcohol intoxication is assumed to worsen pathophysiological derangements after H/R. Here, we studied the effects of acute alcohol intoxication on survival, liver injury and inflammation after H/R, in rats. EXPERIMENTAL APPROACH Rats were given a single oral dose of ethanol (5 g·kg?1, 30%) or saline (control), 12 h before they were haemorrhaged for 60 min and resuscitated (H/R). Sham groups received the same procedures without H/R. Measurements were made 2, 24 and 72 h after resuscitation. Survival was assessed 72 h after H/R. KEY RESULTS Ethanol increased survival after H/R three-fold and also induced fatty changes in the liver. H/R-induced liver injury was amplified by ethanol at 2 h but inhibited 24 h after H/R. Elevated serum IL-6 levels as well as hepatic IL-6 and TNF-? gene expression 2 h after H/R were reduced by ethanol. Ethanol enhanced serum IL-1? at 2 h, but did not affect increased hepatic IL-1? expression at 72 h after H/R. Local inflammatory markers, hepatic infiltration with polymorphonuclear leukocytes and intercellular adhesion molecule 1 expression decreased after ethanol compared with saline, following H/R. Ethanol reduced H/R-induced I?B? activation 2 h after H/R, and NF-?B-dependent gene expression of MMP9. CONCLUSIONS AND IMPLICATIONS Ethanol reduced H/R-induced mortality at 72 h, accompanied by a suppression of proinflammatory changes after H/R in ethanol-treated animals. Binge-like ethanol exposure modulated the inflammatory response after H/R, an effect that was associated with NF-?B activity.

Relja, B; Hohn, C; Bormann, F; Seyboth, K; Henrich, D; Marzi, I; Lehnert, M

2012-01-01

381

Endoplasmic Reticulum Quality Control Is Involved in the Mechanism of Endoglin-Mediated Hereditary Haemorrhagic Telangiectasia  

PubMed Central

Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant genetic condition affecting the vascular system and is characterised by epistaxis, arteriovenous malformations and mucocutaneous and gastrointestinal telangiectases. This disorder affects approximately 1 in 8,000 people worldwide. Significant morbidity is associated with this condition in affected individuals, and anaemia can be a consequence of repeated haemorrhages from telangiectasia in the gut and nose. In the majority of the cases reported, the condition is caused by mutations in either ACVRL1 or endoglin genes, which encode components of the TGF-beta signalling pathway. Numerous missense mutations in endoglin have been reported as causative defects for HHT but the exact underlying cellular mechanisms caused by these mutations have not been fully established despite data supporting a role for the endoplasmic reticulum (ER) quality control machinery. For this reason, we examined the subcellular trafficking of twenty-five endoglin disease-causing missense mutations. The mutant proteins were expressed in HeLa and HEK293 cell lines, and their subcellular localizations were established by confocal fluorescence microscopy alongside the analysis of their N-glycosylation profiles. ER quality control was found to be responsible in eight (L32R, V49F, C53R, V125D, A160D, P165L, I271N and A308D) out of eleven mutants located on the orphan extracellular domain in addition to two (C363Y and C382W) out of thirteen mutants in the Zona Pellucida (ZP) domain. In addition, a single intracellular domain missense mutant was examined and found to traffic predominantly to the plasma membrane. These findings support the notion of the involvement of the ER's quality control in the mechanism of a significant number, but not all, missense endoglin mutants found in HHT type 1 patients. Other mechanisms including loss of interactions with signalling partners as well as adverse effects on functional residues are likely to be the cause of the mutant proteins' loss of function.

Ali, Bassam R.; Ben-Rebeh, Imen; John, Anne; Akawi, Nadia A.; Milhem, Reham M.; Al-Shehhi, Nouf A.; Al-Ameri, Mouza M.; Al-Shamisi, Shamma A.; Al-Gazali, Lihadh

2011-01-01

382

Serum glial fibrillary acidic protein as a biomarker for intracerebral haemorrhage in patients with acute stroke  

PubMed Central

Background Biomarkers of stroke are an evolving field of clinical research. A serum marker which can differentiate between haemorrhagic and ischaemic stroke in the very early phase would help to optimise acute stroke management. Objective To examine whether serum glial fibrillary acidic protein (GFAP) identifies intracerebral haemorrhage (ICH) in acute stroke patients. Methods A pilot study assessing 135 stroke patients admitted within six hours after symptom onset. Diagnosis of ICH (n?=?42) or ischaemic stroke (n?=?93) was based on brain imaging. GFAP was determined from venous blood samples obtained immediately after admission, using a research immunoassay. Results GFAP was detectable in the serum of 39 patients (34 of 42 (81%) with ICH, and five of 93 (5%) with ischaemic stroke). Serum GFAP was substantially raised in patients with ICH (median 11?ng/l, range 0 to 3096?ng/l) compared with patients with ischaemic stroke (median 0?ng/l, range 0 to 14?ng/l, p<0.001). Using receiver operating characteristic curve analysis , a cut off point of 2.9?ng/l provided a sensitivity of 0.79 and a specificity of 0.98 for the identification of ICH in acute stroke (positive predictive value 0.94, negative predictive value 0.91; p<0.001). Conclusions Serum GFAP can reliably detect ICH in the acute phase of stroke. Further evaluation of the usefulness of GFAP as an early diagnostic marker of ICH is now required, with the aim of optimising cause specific emergency management.

Foerch, C; Curdt, I; Yan, B; Dvorak, F; Hermans, M; Berkefeld, J; Raabe, A; Neumann-Haefelin, T; Steinmetz, H; Sitzer, M

2006-01-01

383

Differential diagnostic yield of lumbar puncture in investigation of suspected subarachnoid haemorrhage: a retrospective study.  

PubMed

The diagnostic algorithm of computerized tomography (CT) and lumbar puncture (LP) for suspected subarachnoid haemorrhage (SAH) has lately been challenged by the advancement of radiological techniques, such as higher resolution offered by newer generation CT-scanners and increased availability of CT-angiography. A purely radiological workup of suspected SAH offers great advantages for both patients and the health care system, but the risks of abandoning LP in this setting are not well investigated. We have characterized the differential diagnostic yield of LP in the investigation of suspected SAH by a retrospective study. From the hospital laboratory database, we analyzed the medical records of all patients who had undergone CSF-analysis in search of subarachnoid bleeding during 2009-2011. A total of 453 patients were included. In 14 patients (3%) the LP resulted in an alternative diagnosis, the most common being aseptic meningitis. Two patients (0.5%) received treatment for herpes meningitis. Five patients (1%) with subarachnoid haemorrhages were identified. Among these, the four patients presenting with thunderclap headache had non-aneurysmal bleedings and did not require surgical intervention. We conclude that the differential diagnostic yield of LP in investigation of suspected SAH is low, which indicates that alternative diagnoses is not a reason to keep LP in the workup when a purely radiological strategy has been validated. However, algorithms should be developed to increase the recognition of aseptic meningitis. One hundred and fifty-three patients (34%) were admitted to undergo LP, which estimates the number of hospital beds that might be made available by a radiological diagnostic algorithm. PMID:23358626

Brunell, Anna; Ridefelt, Peter; Zelano, Johan

2013-01-29

384

Geographic and Seasonal Variation in the Impact of Rabbit Haemorrhagic Disease on European Rabbits, Oryctolagus cuniculus , and Rabbit Damage in Australia  

Microsoft Academic Search

Within 12 months of its escape from an island study site in October 1995, rabbit haemorrhagic disease virus (RHDV) spread\\u000a naturally and rapidly through much of southern Australia (Kovaliski 1998). During the next year, RHDV was deliberately released\\u000a in European rabbit, Oryctolagus cuniculus, populations where rabbit haemorrhagic disease (RHD) had not been detected (Neave 1999). This ensured that few rabbit

Greg Mutze; Peter Bird; Brian Cooke; Robert Henzell

385

Antiquities (VHS 3/4 inch) (Video).  

National Technical Information Service (NTIS)

The video was produced in 35mm motion picture film as a theatrical short. With narration by Mercedes McCambridge, it tells the story of grave robbing and pot hunting for native American artifacts in the American southwest, and what the U.S. Department of ...

1982-01-01

386

Antiquities (VHS 1/2 inch) (Video).  

National Technical Information Service (NTIS)

The video was produced in 35mm motion picture film as a theatrical short. With narration by Mercedes McCambridge it tells the story of grave robbing and pot hunting for native American artifacts in the American southwest, and what the U.S. Department of t...

1982-01-01

387

Voice (VHS 1/2 inch) (Video).  

National Technical Information Service (NTIS)

Produced and directed by Gerald Krell, 'The Voice' documents five of the most turbulent decades in the world's history and pays tribute to America's overseas radio service, The Voice of America (VOA). Through historic VOA broadcasts and classic newsreel a...

1992-01-01

388

Solutions (VHS 1/2 inch) (Video).  

National Technical Information Service (NTIS)

The tape provides an introduction of the new suggestion program 'Solutions' nationally. Thurman Davis, GSA's Deputy Administrator makes remarks 5 regional stories are told by the participants, using interviews. Some stories are about succussful suggestion...

1995-01-01

389

The effect of alphaxalone-alphadolone, propofol, and pentobarbitone anaesthesia on the ?-endorphin and ACTH response to haemorrhage in the pig.  

PubMed

In the literature there appears to be variability in reported levels of certain hormones during haemorrhage, specifically adrenocorticotrophic hormone (ACTH) and ?-endorphin. It is possible that this variability may be due to the choice of anaesthetic. Therefore, the effect of 3 common research-only anaesthetic agents (alphaxalone-alphadolone, propofol, and pentobarbitone) on ACTH and ?-endorphin levels during haemorrhage was assessed in pigs. Animals were divided into 3 groups: group I received alphaxalone-alphadolone (n = 5), group II received propofol (n = 6), and group III received pentobarbitone (n = 6). Pigs were subjected to a continuous fixed-volume haemorrhage under one of the above anaesthetics while being mechanically ventilated. ACTH and ?-endorphin levels increased significantly during haemorrhage under propofol and pentobarbitone anaesthesia but not with alphaxalone-alphadolone. For ACTH there was no significant difference between the groups, whereas for ?-endorphin there was a significant difference between the propofol- and pentobarbitone-anaesthetized pigs. The increase in heart rate during haemorrhage was significantly different between the alphaxalone-alphadolone and propofol as well as between the propofol and pentobarbitone groups. The drop in blood pressure was only significantly different between the alphaxalone-alphadolone- and propofol-anaesthetized pigs. These results indicate that the choice of anaesthetic agent can affect the hormone response to haemorrhage and may account for the variable hormone levels reported in the published literature to date. PMID:21812530

Ruane-O'Hora, Therese; Hall, W J; Markos, F

2011-07-01

390

Postpartum Haemorrhage and Eclampsia: Differences in Knowledge and Care-seeking Behaviour in Two Districts of Bangladesh  

PubMed Central

In high- and low-performing districts of Bangladesh, the study explored the demand-side of maternal healthcare by looking at differences in perceived knowledge and care-seeking behaviours of women in relation to postpartum haemorrhage or eclampsia. Haemorrhage and eclampsia are two major causes of maternal mortality in Bangladesh. The study was conducted during July 2006–December 2007. Both postpartum bleeding and eclampsia were recognized by women of different age-groups as severe and life-threatening obstetric complications. However, a gap existed between perception and actual care-seeking behaviours which could contribute to the high rate of maternal deaths associated with these conditions. There were differences in care-seeking practices among women in the two different areas of Bangladesh, which may reflect sociocultural differences, disparities in economic and educational opportunities, and a discrimination in the availability of care.

Anwar, Iqbal; Khan, Jasmin; Blum, Lauren S.; Moran, Allisyn C.; Botlero, Roslin; Koblinsky, Marge

2009-01-01

391

Assessment of exotic fish disease introduction and establishment in the United Kingdom via live fish transporters.  

PubMed

Live fish transporters returning empty from mainland Europe may mechanically introduce exotic pathogens and parasites to the UK. A qualitative risk assessment approach was adopted to investigate the likelihood of introduction and establishment in rainbow trout farms of viral haemorrhagic septicaemia (VHS), infectious haematopoietic necrosis (IHN) and Gyrodactylus salaris via this route. A scenario tree was developed and estimates made for the likelihood of each step based on a review of the available information. The level of uncertainty associated with each step was qualitatively assessed. The likelihood of a lorry becoming contaminated with any of the 3 hazards was only greater than negligible if the lorry made movements between farms in mainland Europe. In these circumstances, the overall likelihood of introduction and establishment was extremely low (would occur very rarely), extremely low to negligible and very low (would occur rarely) for VHS, IHN and G. salaris, respectively. A high level of uncertainty existed due to the lack of data on farm-level prevalence, minimum infectious dose (of the viral hazards) and the large variability in duration and conditions of transport. A telephone survey of live fish transporters found that cleaning and disinfection practices after return to the UK were implemented. Currently, no UK-based transporters make movements between farms in mainland Europe. Thus, the likelihood that UK-owned transporters may become infected is negligible. Changes in the way in which UK-based live fish transporters operate in mainland Europe need to be monitored and development of a code of practice to minimise the risk of disease introduction considered. PMID:19326789

Peeler, E J; Thrush, M A

2009-02-12

392

Presenile dementia and cerebral haemorrhage linked to a mutation at codon 692 of the ?-amyloid precursor protein gene  

Microsoft Academic Search

Several families with an early-onset form of familial Alzheimer's disease have been found to harbour mutations at a specific codon (717) of the gene for the beta-amyloid precursor protein (APP) on chromosome 21. We now report, a novel base mutation in the same exon of the APP gene which co-segregates in one family with presenile dementia and cerebral haemorrhage due

Lydia Hendriks; Duijn van C. M; Patrick Cras; Marc Cruts; Wim Van Hul; Frans van Harskamp; Andrew Warren; Melvin G. McInnis; Stylianos E. Antonarakis; Jean-Jacques Martin; Broeckhoven van C; A. Hofman

1992-01-01

393

Protection of monkeys against Machupo virus by the passive administration of Bolivian haemorrhagic fever immunoglobulin (human origin).  

PubMed

Bolivian haemorrhagic fever immunoglobulin of human origin, given either prior to or shortly after experimental infection with Machupo virus, protected rhesus and cynomolgus monkeys against initial clinical illness. Some survivors developed severe neurological signs 30-47 days after virus inoculation and died 4-6 days later. Results from one of the experiments suggested that the development of neurological signs was associated more frequently with high doses of immunoglobulin than with intermediate or low doses. PMID:182406

Eddy, G A; Wagner, F S; Scott, S K; Mahlandt, B J

1975-01-01

394

Relationship between presence of vasoconstrictor activity in cerebrospinal fluid and time after subarachnoid haemorrhage from rupture of cerebral arterial aneurysms.  

PubMed Central

The relationship between clinical condition and vasoconstrictor factors in cerebrospinal fluid was studied in 19 patients for up to six weeks after subarachnoid haemorrhage. Vasoconstrictor activity was assayed biologically. Sixteen of 19 patients improved as vasoconstrictor activity declined; this pattern was not significantly influenced by surgery. Serial angiography was performed on three patients and a qualitative relationship was shown between arterial dilatation, clinical improvement, and reduced pharmacological activity.

Hunt, T M; Du Boulay, G H; Blaso, W P; Forster, D M; Boullin, D J

1979-01-01

395

The effect of ketamine on intracranial pressure during haemorrhagic shock under the conditions of both spontaneous breathing and controlled ventilation  

Microsoft Academic Search

Summary Seventeen piglets of both sexes, seven with O2\\/air-buprenorphine anaesthesia and controlled ventilation, and ten unanaesthetized animals with normal, spontaneous respiration, were used for the study. The intracranial pressure of both groups of animals was raised by insufflation of an epidural ballon and the arterial blood pressure was reduced to approximately 70% of the original value by controlled haemorrhage. 0.5

E. Pfenninger; A. Griinert; I. Bowdler; J. Kilian

1985-01-01

396

How well do we investigate patients with suspected subarachnoid haemorrhage? The continuing need for cerebrospinal fluid investigations  

Microsoft Academic Search

Objective: To demonstrate the extent of compliance with established guidelines for the investigation of suspected subarachnoid haemorrhage (SAH) and the implications of non-compliance.Design: Prospective observational study of practice in three hospitals in the Trent region.Setting: One teaching hospital with a tertiary neuroscience referral centre and two large district general hospitals.Participants: 50 consecutive patients from each centre referred for suspected SAH

M L A Schofield; E Lorenz; T J Hodgson; S Yates; P D Griffiths

2004-01-01

397

A hereditary haemorrhagic telangiectasia family with pulmonary involvement is unlinked to the known HHT genes,endoglin and ALK-1  

Microsoft Academic Search

BACKGROUNDPulmonary arteriovenous malformations (PAVMs) occur in over 25% of patients with the autosomal dominant disorder hereditary haemorrhagic telangiectasia (HHT). Mutations in two genes, endoglin andALK-1, are known to cause HHT. Each encodes a protein expressed on vascular endothelial cells and involved in signalling by members of the transforming growth factor (TGF)-? superfamily. To date, PAVMs have not been detected inALK-1

G M F Wallace; C L Shovlin

2000-01-01

398

Major haemorrhage related to surgery in patients with type 1 and possible type 1 von Willebrand disease  

Microsoft Academic Search

Summary Patients with von Willebrand disease (VWD) frequently bleed under a challenge.The aim of our study was to identify predictive markers of perioperative major haemorrhage in type 1 (VWF:RCo = 15-30 IU dl-1) and possible type 1 (VWF:RCo = 31-49 IU dl-1)VWD patients.We recorded perioperative bleeding complications previous to diagnosis and laboratory parameters in 311 patients with 498 surgical procedures.The

Adriana Inés Woods; Alicia Noemí Blanco; Roberto Chuit; Susana Sara Meschengieser; Ana Catalina Kempfer; Cristina Elena Farías; María Angela Lazzari

2008-01-01

399

Intracerebral haemorrhages: are there any differences in baseline characteristics and intra-hospital mortality between hospitaland population-based registries?  

Microsoft Academic Search

A better understanding of the natural history of intracerebral haemorrhages (ICH) with cohorts representing the whole spectrum\\u000a of the disease is necessary to improve treatment. Our aim was to identify potential differences in baseline characteristics\\u000a and short-term outcomes of patients with non-traumatic ICH, included in a hospital- and in a population-based stroke registry.\\u000a \\u000a We compared 373 patients recruited in a

Charlotte Cordonnier; Matthieu P. Rutgers; Frédéric Dumont; Marta Pasquini; Jean-Paul Lejeune; Delphine Garrigue; Yannick Béjot; Xavier Leclerc; Maurice Giroud; Didier Leys; Hilde Hénon

2009-01-01

400

Successful treatment of severe myocardial failure after postpartum haemorrhage with the use of an intra-aortic balloon pump  

Microsoft Academic Search

We report a 29-year-old primigravid who developed cardiac failure following postpartum haemorrhage unresponsive to volume\\u000a resuscitation and therapy with catecholamines and phosphodiesterase-inhibitors. Transoesophageal echocardiography (TEE) demonstrated\\u000a left atrial and ventricular dilatation and global left ventricular hypokinesis. No elevation of serum MB-isoenzyme fraction\\u000a was detected and other organ functions remained stable. Although emergency cardiac transplantation was considered in the presented\\u000a patient,

A. Mayr; W. Lederer; M. Mörtl; J. Margreiter; M. Hoi; W. Hasibeder; N. Mutz

1999-01-01

401

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

PubMed Central

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 on quantitative and qualitative data collected via questionnaires completed in the first week postpartum and at two and four months postpartum, by 206 women participating in a multicentre study of women's experiences of a significant primary postpartum haemorrhage (blood loss of 1500 mL or more in the 24 hours following childbirth, and/or a peripartum fall in haemoglobin (Hb) concentration to 7g/dL or less, or of ? 4g/dL). Results Among women with a significant PPH, 63% fully breastfed their babies from birth, whereas 85% said they had hoped to do so (p < 0.001). Only 52% of mothers who intended to either fully or partially breastfeed were able to give their baby the opportunity to suckle within an hour of the birth. Delays were longer in women with greater estimated blood loss and women with the longest delays in breastfeeding were less likely to initiate full breastfeeding. 70% of women with PPH of < 2000 mL were fully breastfeeding in the first postpartum week, whereas less than 50% of those with blood loss ? 3000 mL were able to do so. Overall, 58% of women with significant PPH were fully breastfeeding at two and 45% at four months postpartum. In qualitative data, three major themes were identified: 1) Difficulty initiating or sustaining breastfeeding, 2) Need for education and support; and 3) Emotional sequelae. Conclusions Following a significant PPH, women with greater blood loss are less likely to initiate and sustain full breastfeeding and this may be related, in part, to delays in initial contact with their baby as a consequence of the PPH. These findings have implications for postnatal care as these women may require greater support, education and assistance in initiating and sustaining breastfeeding. In particular, enabling the opportunity for the newborn to suckle as soon as is practicable should be encouraged.

2010-01-01

402

Carbetocin versus oxytocin in caesarean section with high risk of post-partum haemorrhage  

PubMed Central

Summary Objectives the aims of the present study were to compare the haemodynamic effects of oxytocin and carbetocin and to assess the efficacy of these two drugs in terms of blood loss and the additional uterotonic needed in caesarean section at high risk of primary post-partum haemorrhage. Methods women in the carbetocin group (group A) received a bolus of 100 ?g IV; women in the control group (group B) received 20 IU of oxytocin in 1000 ml of 0,9% Na-Cl solution IV (150 mL/hour). The main parameter evaluated was the haemodynamic effects of drugs and the need for additional uterotonic agents. In addition we compared the drop in haemoglobin level, the uterine tone, the uterine fundal state and the diuresis. Results regarding the haemodynamic effects, both drugs have a hypotensive effect, but we found a greater reduction in blood pressure within the oxytocin group. Significantly more women needed additional uterotonic agents in the oxytocin group (23,5% vs 0%, p<0.01), though there was no significant difference in estimated blood loss and in the drop haemoglobin level (p>0.05). There was a significant difference in the diuresis, higher in carbetocin group (1300 ml ± 450 ml vs 1100 ml ± 250 ml, p=0.01). Conclusions a single injection of carbetocin appears to be more effective than a continuous infusion of oxytocin to prevent the PPH, with a similar haemodynamic profile and minor antidiuretic effect.

Larciprete, Giovanni; Montagnoli, Carlotta; Frigo, Mariagrazia; Panetta, Valentina; Todde, Cristina; Zuppani, Benedetta; Centonze, Chiara; Bompiani, Alessandro; Malandrenis, Ioannis; Cirese, Alio; Valensise, Herbert

2013-01-01

403

Individual patient data subgroup meta-analysis of surgery for Spontaneous Supratentorial Intracerebral Haemorrhage  

PubMed Central

Background and purpose By 2010 there had been 14 published trials of surgery for intracerebral haemorrhage reported in systematic reviews or to the authors, but the role and timing of operative intervention remains controversial and the practice continues to be haphazard. This study attempted to obtain individual patient data from each of the 13 studies published since 1985 in order to better define groups of patients that might benefit from surgery. Methods Authors of identified published papers were approached by mail, email and at conferences and invited to take part in the study. Data were obtained from 8 studies (2186 cases). Individual patient data included patient's age, GCS at presentation, volume and site of haematoma, presence of IVH, method of evacuation, time to randomisation and outcome. Results Meta-analysis indicated that there was improved outcome with surgery if it was undertaken within 8 hours of ictus (p = 0.003), or the volume of the haematoma was 20-50ml. (p = 0.004), or the GCS was between 9 and 12 (p = 0.0009), or the patient was aged between 50 and 69 (p = 0.01). In addition there was some evidence that more superficial haematomas with no IVH might also benefit (p = 0.09). Conclusions There is evidence that surgery is of benefit if undertaken early before the patient deteriorates. This work identifies areas for further research. Ongoing studies in subgroups of patients, such as STICH II, will confirm whether these interpretations can be replicated.

Gregson, Barbara A; Broderick, Joseph P; Auer, Ludwig M; Batjer, Hunt; Chen, Xian-Cheng; Juvela, Seppo; Morgenstern, Lewis B; Pantazis, George C; Teernstra, Onno PM; Wang, Wen-Zhi; Zuccarello, Mario; Mendelow, A David

2012-01-01

404

Recurrent non-aneurysmal subarachnoid haemorrhage in Takayasu arteritis: is the cause immunological or mechanical?  

PubMed

Aneurysmal subarachnoid haemorrhage (SAH) is rarely associated with Takayasu's arteritis (TA). The present report describes a 21-year-old woman with recurrent SAH and TA. In addition, she also had recurrent spells of postural weakness in the bilateral lower limb occurring at the same time. Sequential CT of the head and MRI showed bilateral cortical SAH. Vascular imaging with MR angiogram and CT angiogram showed bilateral subclavian arteries and left common carotid artery occlusion with multiple hypertrophied collaterals vessels in the neck. There was no evidence of aneurysms in the intracranial vasculature in the conventional angiogram. The CT angiogram of the aorta showed severe stenosis of the abdominal aorta above the renal arteries. The patient was treated with immunomodulatory therapy and had a favourable outcome without further recurrence at end of 1 year of follow-up. A review of the literature showed 21cases with aneurysmal SAH and three cases non-aneurysmal SAH in patients with TA have been reported. Various factors are responsible for the reorganisation of the intracranial of the arteries in patients with chronic vasculitis in the presence of extracranial stenosis and occlusion, which could possibly explain the SAH in absence of aneurysm in patients with TA. PMID:23771963

Shuaib, Umar Ashfaq; Kate, Mahesh; Homik, Joanne; Jerrakathil, Thomas

2013-06-13

405

Rethinking WHO guidance: review of evidence for misoprostol use in the prevention of postpartum haemorrhage.  

PubMed

This article describes and critically appraises clinical trials assessing misoprostol effectiveness in preventing primary postpartum haemorrhage (PPH) in home and community settings in low- and middle-income countries. Of 172 identified studies of misoprostol use in labour only six fulfilled the inclusion criteria. All trials used 600 ?g misoprostol in the intervention arm; three assessed misoprostol alongside components of active management of the third-stage labour (AMTSL), two used expectant management of labour and one allowed birth attendants to choose management practice. The three AMTSL studies showed no significant differences in PPH incidence or referral to higher centres and only one study showed significant decrease in severe PPH using misoprostol. One expectant management study and the choice of management by birth attendants study found significant decreases in PPH incidence with misoprostol. All studies showed significantly increased risk of shivering with misoprostol. Studies were biased by use of alternative uterotonics in the control arm, confounding management practices, and subjective assessment and, with one exception, exclusion of high-risk women. PPH incidence fell in both the control and intervention groups in both the landmark papers that informed the World Health Organization (WHO) decision to admit misoprostol to the Essential Medicines List. This suggests factors other than misoprostol use are crucial. Current evidence does not support misoprostol use in home and community settings in low- and middle-income countries for PPH prevention. WHO should rethink its recent decision to include misoprostol on the Essential Medicines List. PMID:22907551

Chu, Christina S; Brhlikova, Petra; Pollock, Allyson M

2012-08-01

406

Reassortment and migration analysis of Crimean-Congo haemorrhagic fever virus.  

PubMed

Crimean-Congo haemorrhagic fever virus (CCHFV) is a tick-borne virus with high pathogenicity to humans. CCHFV contains a three-segment [small (S), medium (M) and large (L)] genome and is prone to reassortment. Investigation of identified reassortment events can yield insight into the evolutionary history of the virus, while migration events reflect its geographical dissemination. While many studies have already considered these issues, they have investigated small numbers of isolates and lack statistical support for their findings. Here, we consider a larger set of 30 full genomes to investigate reassortment using recombination methods, as well as two sets of partial S segments comprising 393 isolates, reflecting a broader geographical range, to investigate migration events. Phylogenetic analysis revealed that the S segment showed strong geographical subdivision, but this was less apparent in the M and L segments. A total of 16 reassortment events with 22 isolates were identified with strong statistical support. Migration analysis on the partial S segments identified both long- and short-range migration events that spanned the entire geographical region in which the CCHFV has been isolated, reflecting the complex processes associated with the dissemination of the virus. PMID:23939975

Zhou, Zhaorui; Deng, Fei; Han, Na; Wang, Hualin; Sun, Surong; Zhang, Yujiang; Hu, Zhihong; Rayner, Simon

2013-08-12

407

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

408

Measurement of total circulating blood volume following subarachnoid haemorrhage: methodological aspects.  

PubMed Central

The total circulating blood volume (TCBV) and total body/venous haematocrit ratio (Htb/Hv) was determined by simultaneous measurement of the red cell volume (RCV) and the plasma volume (PV) in 10 subarachnoid haemorrhage (SAH) patients, 10 supine bedresting control patients and 20 ambulant out-patients. The mean Htb/Hv of the SAH patients, 0.866, was found to be significantly lower than that of the supine controls, 0.908, and the ambulant patients, 0.909, (p less than 0.01). Using the ratio 0.866 the total circulating blood volume of the SAH patients was calculated from either their RCV or their PV and compared with their measured TCBV. Expressed as a percentage of measured TCBV the mean errors of these single volume determinations were 2.84% and 1.76% respectively. The significance of these changes in the Htb/Hv ratio of SAH patients is discussed in relation to the circulatory disturbances they suffer.

Nelson, R J; Roberts, J; Ackery, D M; Pickard, J D

1987-01-01

409

Effect of peroral antacid treatment in patients with acute upper gastrointestinal haemorrhage: a randomized controlled trial.  

PubMed

During recent years, it has been reported that antacids have a beneficial prophylactic effect in critically ill patients regarding upper gastrointestinal bleeding. In these trials rather complicated treatment schedules and high doses of antacids were used. The present study was designed to investigate the therapeutic efficacy of a more practical antacid treatment regimen in patients with haematemesis and/or melaena. Ninety patients, hospitalized for haematemesis and/or melaena within the past 24 hours, were included to double-blind treatment with antacids or placebo for 7 days. The dose, 20 ml liquid antacid (Balancid) with a neutralizing capacity of 105 mmol, was administered each second hour during waking hours. The groups were comparable regarding incidence of ulcer disease, age, sex, acid secretion, and usage of aspirin. Continuous bleeding or rebleeding was recorded in 15 of the 43 patients in the antacid group (34.9%), compared to 19 of the 47 patients in the placebo group (40.4%), the difference not being statistically significant. Furthermore, the requirement of blood transfusions was not significantly different in the two groups. In conclusion, the haemostatic effect of the antacid treatment regimen used in the present study was not significantly superior to placebo in patients with endoscopically verified acute upper gastrointestinal haemorrhage. PMID:6755651

Kittang, E; Aadland, E; Oyen, D; Holm, H A; Berstad, A; Pytte, R; Qvigstad, T; Tommelstad, T

1982-01-01

410

Deposition of collagen IV and aggrecan in leptomeningeal arteries of hereditary brain haemorrhage with amyloidosis.  

PubMed

Hereditary Cystatin C Amyloid Angiopathy (HCCAA) is a rare genetic disease in Icelandic families caused by a mutation in the cystatin C gene, CST3. HCCAA is classified as a cerebral amyloid angiopathy and mutant cystatin C forms amyloid deposits in cerebral arteries resulting in fatal haemorrhagic strokes in young adults. The aetiology of HCCAA pathology is not clear and there is, at present, no animal model of the disease. The aim of this study was to increase understanding of the cerebral vascular pathology of HCCAA patients with an emphasis on structural changes within the arterial wall of affected leptomeningeal arteries. Examination of post-mortem samples revealed extensive changes in the walls of affected arteries characterised by deposition of extracellular matrix constituents, notably collagen IV and the proteoglycan aggrecan. Other structural abnormalities were thickening of the laminin distribution, intimal thickening concomitant with a frayed elastic layer, and variable reduction in the integrity of endothelia. Our results show that excess deposition of extracellular matrix proteins in cerebral arteries of HCCAA is a prominent feature of the disease and may play an important role in its pathogenesis. PMID:23973860

Snorradottir, Asbjorg Osk; Isaksson, Helgi J; Kaeser, Stephan A; Skodras, Angelos A; Olafsson, Elias; Palsdottir, Astridur; Bragason, Birkir Thor

2013-08-20

411

Oral administration of attenuated Salmonella typhimurium containing a DNA vaccine against rabbit haemorrhagic disease.  

PubMed

The use of attenuated Salmonella typhimurium as a bactofection vehicle for the oral delivery of a DNA vaccine against rabbit haemorrhagic disease virus (RHDV) was investigated. The DNA vaccine plasmid pcDNA3.1-VP60, which encodes the viral capsid protein VP60, was transformed into the attenuated S. typhimurium strain SL7207. The resulting recombinant bacteria, named as SL/pcDNA3.1-VP60, were orally used to immunise rabbits. The successful delivery of the DNA plasmid was confirmed by the detected VP60 transcription in the rabbit intestines through the reverse transcription polymerase chain reaction. In addition, the RHDV-specific humoral and cell-mediated immune response that was induced by SL/pcDNA3.1-VP60 was detected by the enzyme-linked immunosorbent assay as well as the assays for T lymphocyte proliferation and cytokines secretion. The significant protection of immunised rabbits against the RHDV strain XA/China/2010 at 42 d post-immunisation was demonstrated. This study is the first report about the efficient usage of attenuated Salmonella as a live vector for the oral delivery of a DNA vaccine against RHDV. PMID:23270916

Qiu, Li; Wang, Xinglong; Hao, Huafang; Mu, Guohui; Dang, Ruyi; Wang, Jia; Zhang, Shuxia; Du, Enqi; Yang, Zengqi

2012-12-24

412

Modelling the transmission dynamics of acute haemorrhagic conjunctivitis: application to the 2003 outbreak in Mexico.  

PubMed

We model an outbreak of acute haemorrhagic conjunctivitis (AHC) using a simple epidemic model that includes susceptible, infectious, reported, and recovered classes. The model's framework considers the impact of underreporting and behaviour changes on the transmission rate and is applied to a recent epidemic of AHC in Mexico, using a fit to the cumulative number of cases to estimate model parameters, which agree with those derived from clinical studies. The model predicts a 'mean time from symptomatic onset to diagnosis' of 1.43 days (95 per cent CI: 1-2.5) and that the final size of the Mexican epidemic was underreported by 39 per cent. We estimate that a primary infectious case generates approximately 3 secondary cases (R0* = 2.64, SD 0.65). We explore the impact of interventions on the final epidemic size, and estimate a 36 per cent reduction in the transmission rate due to behaviour changes. The effectiveness of the behaviour changes in slowing the epidemic is evident at 21.90 (SD 0.19) days after the first reported case. Results therefore support current public health policy including expeditious announcement of the outbreak and public health information press releases that instruct individuals on avoiding contagion and encourage them to seek diagnosis in hospital clinics. PMID:16158395

Chowell, G; Shim, E; Brauer, F; Diaz-Dueñas, P; Hyman, J M; Castillo-Chavez, C

2006-06-15

413

A recent epidemic of Coxsackie virus type A24 acute haemorrhagic conjunctivitis in Singapore.  

PubMed

A recent epidemic of acute conjunctivitis in Singapore showed again the importance of Coxsackie virus type A24 variant as a causative agent of acute haemorrhagic conjunctivitis (AHC). Although the ocular manifestations appeared similar to those described for the 1970 and 1975 outbreaks, a markedly higher rate of respiratory involvements was noted. Not observed in previous epidemics were herpes-like vesicles in the conjunctiva and eyelids of one patient and vesicles in the buccal mucosa and lips of another from whom Coxsackie virus A24 was isolated. The most interesting finding in this study was the isolation of five wild (non-Sabin) poliovirus type 1 strains. Three strains were obtained from conjunctival and two from throat swabs of patients with mild to severe conjunctivitis. It is conceivable that the rare reports of polio-like paralysis or radiculomyelitis accompanying or following AHC in a few Asian countries could be attributed to concurrent infections with a poliovirus and either enterovirus type 70 or Coxsackie virus type A24. PMID:3024697

Yin-Murphy, M; Baharuddin-Ishak; Phoon, M C; Chow, V T

1986-11-01

414

Abdominal Wall Haemorrhage After Robotic-Assisted Radical Prostatectomy: Is it a Complication of Robotic Surgery?  

PubMed

OBJECTIVE: Robotic-assisted radical prostatectomy (RARP) is the minimally invasive surgical treatment for patients with localized prostate cancer. Perioperative or postoperative complications following RARP have been reported in some studies and severe postoperative bleeding after RARP is rare, but hemodynamic instability may necessitate open surgical exploration and be associated with considerable morbidity. We reported postoperative bleeding cases, which is a kind of complication associated with robotic surgery and requiring massive transfusion after RARP. PATIENTS AND METHODS: From August 2009 to May 2012, 317 consecutive patients who underwent RARP performed at our institution were analyzed. Patients with serious postoperative bleeding that caused hemodynamic instability after surgery were enrolled. RESULTS: A total of 5 among 317 (1.6%) patients had bleeding requiring postoperative transfusion. In these cases, mean operative time was 114minutes. The mean estimated blood loss was 110ml during operation. In these patients, hematocrit (Hct) levels gradually fell after surgery and ecchymosis was detected on the side and posterior walls of the abdomen on the second day. The mean preoperative Hct was 44.3% and mean lowest Hct was 23.1%. All patients were successfully treatment without surgical exploration. CONCLUSIONS: Robotic radical prostatectomy has proven to be a safe surgical treatment with low morbidity. However, postoperative bleeding can reach serious problems. This is the first study to explain haemorrhage, associated with possible risk of robotic surgery. PMID:23768503

Tasci, A I; Simsek, A; Tugcu, V; Bitkin, A; Sonmezay, E; Torer, B D

2013-06-12

415

Preliminary study of the effect of acute antemortem haemorrhage on postmortem abdominal impedance in rats.  

PubMed

Studies over many years have revealed a consistent, inverse relationship between extracellular impedance of the rat abdomen and postmortem interval (PMI). Recent studies have shown that this relationship can be improved by correcting measured impedances to their theoretically predicted values at an arbitrarily chosen temperature of 40 degrees C, thus rendering them independent of the tissues' temperature at the time of impedance measurement. The present study, undertaken as a part of an ongoing effort to identify variables which might influence postmortem rate of change in abdominal impedance, was aimed at studying the possible effect of acute antemortem haemorrhage on abdominal impedance. Sudden loss of approximately 30% of the total blood volume, immediately prior to the death was without statistically significant effect on the pattern of postmortem change in abdominal impedance. Thus, in the control and experimental rats, respectively, impedance decreased progressively from 58.7 +/- 1.8 and 68.0 +/- 11.3 omega, 1 h postmortem, to 31.5 +/- 2.2 and 33.7 +/- 4.7 omega at a postmortem interval of 120 h (n = 6 in each group). In both groups, the relationship between impedance and postmortem interval was either linear or curvilinear. These findings are believed to mitigate in favour of continued effort to examine the potential usefulness of abdominal impedance, as an index of postmortem interval, under conditions encountered in routine forensic investigation. PMID:12175952

Querido, David

2002-07-17

416

Bluetongue and epizootic haemorrhagic disease virus in local breeds of cattle in Kenya.  

PubMed

The presence of bluetongue virus (BTV) and Epizootic Haemorrhagic Disease virus (EHDV) in indigenous calves in western Kenya was investigated. Serum was analysed for BTV and EHDV antibodies. The population seroprevalences for BTV and EHDV for calves at 51 weeks of age were estimated to be 0.942 (95% CI 0.902-0.970) and 0.637 (95% CI 0.562-0.710), respectively, indicating high levels of circulating BTV and EHDV. The odds ratio of being positive for BTV if EHDV positive was estimated to be 2.57 (95% CI 1.37-4.76). When 99 calves were tested for BTV and EHDV RNA by real-time RT-PCR, 88.9% and 63.6% were positive, respectively. Comparison of the serology and real-time RT-PCR results revealed an unexpectedly large number of calves that were negative by serology but positive by real-time RT-PCR for EHDV. Eight samples positive for BTV RNA were serotyped using 24 serotype-specific real-time RT-PCR assays. Nine BTV serotypes were detected, indicating that the cattle were infected with a heterogeneous population of BTVs. The results show that BTV and EHDV are highly prevalent, with cattle being infected from an early age. PMID:23261160

Toye, P G; Batten, C A; Kiara, H; Henstock, M R; Edwards, L; Thumbi, S; Poole, E J; Handel, I G; Bronsvoort, B M deC; Hanotte, O; Coetzer, J A W; Woolhouse, M E J; Oura, C A L

2012-12-20

417

Lumbar drains may reduce the need for permanent CSF diversion in spontaneous subarachnoid haemorrhage.  

PubMed

Subarachnoid haemorrhage (SAH) is well known to induce hydrocephalus. This is often, initially, treated with external ventricular drainage (EVD). We recently started, also, using lumbar drains (LD) in patients refractory to removal of their EVD as a bridge to permanent CSF diversion. LD were placed in 25 patients with spontaneous SAH. LD remained in place a mean of 6.7 days (range 4-16) prior to removal. Patients had a median Fisher Grade of 4, Hunt-Hess score of 4, and WFNS score of 4. Only 4 of 25 patients (16%) progressed to the need of permanent shunting, one of which occurred after delayed recurrent aneurysm rupture. Only 7 of 25 patients developed symptomatic vasospasm despite their high median Fisher Grade. Both the shunt rate and the symptomatic vasospasm rate in this series are much less than the historical series predict. This suggests that lumbar drains may reduce the need for shunting and decrease the rate of symptomatic vasospasm. PMID:23190179

Ormond, D R; Dressler, A; Kim, S; Ronecker, J; Murali, R

2012-11-28

418

Spontaneous Thrombosis of an Orbital Arteriovenous Malformation Revealing Hereditary Haemorrhagic Telangiectasia (Rendu-Osler-Weber Disease)  

PubMed Central

Summary Hereditary Haemorrhagic Telangiectasia (HHT) is a genetic disorder responsible for cutaneous or mucosal telangiectasia and arteriovenous malformations (AVMs). The most frequent locations are lung and brain. In contrast, orbital AVMs are very rare. We describe a case of symptomatic orbital arteriovenous malformation due to spontaneous thrombosis. A 65-year-old woman was referred for chronic right eye proptosis associated with dilation of conjunctival vessels with a jellyfish pattern. Right visual acuity was 20/40 and intraocular pressure was 40 mmHg. Personal and familial history of recurrent epistaxis, associated with multiple telangiectasia within lips and palate, led to the diagnosis of HHT. Magnetic resonance imaging (MRI) completed with cerebral angiography found a giant and occluded AVM within the right orbit. Other AVMs were also found in brain and chest, confirming the diagnosis. Antiglaucomatous eyedrops were added to reduce intraocular pressure and a steroid therapy was begun. Two months later, visual acuity decreased in the right eye, due to a central retinal vein thrombosis. In conclusion, Most brain or pulmonary AVM can be treated by embolization. By contrast, this treatment in case of orbital location can lead to central retinal artery and/or central retinal vein occlusion, which may also appear as a spontaneous complication of the orbital AVM. Therapeutic management of orbital AVM is thus not standardized, and the balance between spontaneous and iatrogenic risk of visual loss has to be taken into account.

Van Went, C.; Ozanne, A.; Saliou, G.; Dethorey, G.; De Monchy, I.; Krings, T.; Ducreux, D.; Labetoulle, M.

2011-01-01

419

Nicardipine in the treatment of aneurysmal subarachnoid haemorrhage: a meta-analysis of published data.  

PubMed

Nicardipine is a dihydropyridine-type Ca(2+) channel blocker with a powerful antihypertensive activity and a unique cerebrovascular profile. Recent studies have examined nicardipine for the treatment of patients with aneurysmal subarachnoid haemorrhage (SAH), but have shown inconsistent results. In the current study, a meta-analysis was performed to assess the clinical effectiveness of nicardipine in the prevention of cerebral vasospasm in patients who had suffered from aneurysmal SAH. Medline, EMBASE, and PubMed databases were searched for the controlled trials evaluating nicardipine for treating SAH after a ruptured aneurysm, without language restrictions. Moreover, a manual search of the bibliographies of relevant articles was also conducted. Two researchers of the present study independently performed the literature search and the data extraction. The meta-analyses were performed using the software RevMan 4.2.10 (provided by the Cochrane Collaboration, Oxford, UK). Five published manuscripts involving 1,154 patients were included in this meta-analysis. Nicardipine infusion reduced the risk of poor outcome (death, vegetative state, or dependency) and mortality, with an odds ratio (OR) of 0.58 [95 % confidence interval (CI) 0.37-0.90] and 0.45 (95 % CI 0.15-1.29), respectively. This meta-analysis suggests that nicardipine therapy reduces the likelihood of poor outcome and mortality in patients after aneurysmal SAH. PMID:23111775

Huang, Ren-qiang; Jiang, Fu-gang; Feng, Zi-min; Wang, Tian-yi

2012-10-31

420

Case Report: Meningioma with Intra-tumoural Haemorrhage Secondary to Ruptured Distal Anterior Cerebral Artery Aneurysm  

PubMed Central

Background: Brain tumours that are associated with cerebral aneurysms are rare occurrences, whereas the coexistence of brain tumours and intra-tumoural aneurysms is even rarer. There have been 12 brain tumour cases that have been reported in the literature that describe an aneurysm within a brain tumour, with 4 of these tumours being meningiomas. Case description: A 34-year-old male patient presented with sudden-onset headache, and an inter-hemispheric meningioma with intra-tumoural bleeding was found due to a ruptured embedded anterior cerebral artery aneurysm. The aneurysm was diagnosed incidentally on the third cerebral angiogram, while the initial 2 angiograms were negative. The patient was treated with endovascular aneurysm embolisation that was followed by tumour resection. Conclusion: This paper is the first case report to describe the coexistence of a meningioma and an aneurysm, which presented with intra-tumoural haemorrhage that was negative on the initial cerebral angiogram. Unlike previous case reports, the aneurysm in this case was located with an anterior cerebral artery distribution.

Alnaami, Ibrahim

2013-01-01

421

Increased serum levels of interleukin 6 are associated with severe intraventricular haemorrhage in extremely premature infants  

PubMed Central

Background: Intraventricular haemorrhage (IVH) and periventricular leucomalacia (PVL) in premature infants presumably have many causes. It has been proposed that inflammatory processes in the fetomaternal unit play an important role in the pathogenesis of these lesions. Objective: To study the correlation of postpartum serum interleukin 6 (IL6) concentration as a marker of inflammation and neonatal cerebral morbidity in preterm infants < 28 weeks of gestational age. Methods: A total of 88 infants were grouped according to maximum serum IL6 levels within 12 hours post partum: group A (n = 50), ? 100 pg/ml; group B (n = 38), > 100 pg/ml. Ultrasound studies and clinical assessment were performed routinely. Results: IVH was noted significantly more often in group B (24/38; 63%) than in group A (19/50; 38%) (p = 0.02). In a multiple logistic regression model, raised serum IL6 independently predicted development of severe IVH (odds ratio 8.4; 95% confidence interval 2.85 to 24.9; p = 0.0001). Conclusions: Raised serum IL6 may serve as a marker for severe IVH in infants < 28 weeks of gestational age. Although cerebral morbidity in premature infants is determined by different variables, the identification of systemic inflammation can help to define the need for anti-inflammatory strategies to prevent cerebral morbidity.

Heep, A; Behrendt, D; Nitsch, P; Fimmers, R; Bartmann, P; Dembinski, J

2003-01-01

422

Possible aetiology of haemorrhagic shock and encephalopathy syndrome in the Negev area of Israel.  

PubMed

A retrospective study was performed for all patients diagnosed with haemorrhagic shock and encephalopathy syndrome (HSES) over an 11 year period (1984-94). Soroka University Medical Centre is the only medical facility in the southern Negev region of Israel serving a population of about 400,000 residents, consisting primarily of two ethnic populations, Jews and Bedouins. Twenty patients, 17 Bedouin and three Jews, were diagnosed with HSES. The annual incidence of HSES for infants under the age of 1 year was 5:10,000 for Bedouins and 0.6:10,000 for Jews. Patients ranged in age from 6 to 32 weeks and arrived at the hospital late at night or early morning (2:00 am to 11:00 am), during the winter or early spring (November to April). All were healthy before admission, with short prodromal symptoms of upper respiratory tract or gastrointestinal infection noted in 10 cases. Most infants had markedly high body temperature on arrival. A history of overwrapping and/or excessive heating was obtained in four of 20 infants. Bacteriological and virological cultures were negative in all infants. One infant died and neurological sequelae were observed in all survivors. The high prevalence of hyperpyrexia during sleep in the presence of negative microbiological results with no evidence of excessive heating, and the high incidence of HSES among a closed and culturally isolated society known to have a high incidence of congenital malformations, may support previous assumptions that HSES results from hyperpyrexia, originating in most cases from a 'physiological' heat induced trigger, which starts and peaks during the night in previously healthy infants who are genetically susceptible. PMID:8984922

Sofer, S; Yerushalmi, B; Shahak, E; Berenstein, T; Schulman, H

1996-10-01

423

Current management of intracerebral haemorrhage in China: a national, multi-centre, hospital register study  

PubMed Central

Background We aimed to examine current practice of the management and secondary prevention of intracerebral haemorrhage (ICH) in China where the disease is more common than in Western populations. Methods Data on baseline characteristics, management in-hospital and post-stroke, and outcome of ICH patients are from the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment) study, a multi-centre, prospective, 62 hospital registry in China during 2006-07. Results Nearly all ICH patients (n = 1572) received an intravenous haemodiluting agent such as mannitol (96%) or a neuroprotectant (72%), and there was high use of intravenous traditional Chinese medicine (TCM) (42%). Neurosurgery was undertaken in 137 (9%) patients; being overweight, having a low Glasgow Coma Scale (GCS) score on admission, and Total Anterior Circulation Syndrome (TACS) clinical pattern on admission, were the only baseline factors associated with this intervention in multivariate analyses. Neurosurgery was associated with nearly three times higher risk of death/disability at 3 months post-stroke (odd ratio [OR] 2.60, p < 0.001). Continuation of antihypertensives in-hospital and at 3 and 12 months post-stroke was reported in 732/935 (78%), 775/935 (83%), and 752/935 (80%) living patients with hypertension, respectively. Conclusions The management of ICH in China is characterised by high rates of use of intravenous haemodiluting agents, neuroprotectants, and TCM, and of antihypertensives for secondary prevention. The controversial efficacy of these therapies, coupled with the current lack of treatments of proven benefit, is a call for action for more outcomes based research in ICH.

2011-01-01

424

Cognitive domain deficits in patients with aneurysmal subarachnoid haemorrhage at 1 year  

PubMed Central

Background Cognitive domain deficits can occur after aneurysmal subarachnoid haemorrhage (aSAH) though few studies systemically evaluate its impact on 1-year outcomes. Objective We aimed to evaluate the pattern and functional outcome impact of cognitive domain deficits in aSAH patients at 1?year. Methods We carried out a prospective observational study in Hong Kong, during which, 168 aSAH patients (aged 21–75?years and had been admitted within 96?h of ictus) were recruited over a 26-month period. The cognitive function was assessed by a domain-specific neuropsychological assessment battery at 1?year after ictus. The current study is registered at ClinicalTrials.gov of the US National Institutes of Health (NCT01038193). Results Prevalence of individual domain deficits varied between 7% to 15%, and 13% had two or more domain deficits. After adjusting for abbreviated National Institute of Health Stroke Scale and Geriatric Depressive Scale scores, unfavourable outcome (Modified Rankin Scale 3–5) and dependent instrumental activity of daily living (Lawton Instrumental Activity of Daily Living<15) were significantly associated with two or more domain deficits and number of cognitive domain deficits at 1?year. Two or more domain deficits was independently associated with age (OR, 1.1; 95% CI 1.1 to 1.2; p<0.001) and delayed cerebral infarction (OR, 6.1; 95% CI 1.1 to 33.5; p=0.036), after adjustment for years of school education. Interpretation In patients with aSAH, cognitive domain deficits worsened functional outcomes at 1?year. Delayed cerebral infarction was an independent risk factor for two or more domain deficits at 1?year.

Wong, George Kwok Chu; Lam, Sandy Wai; Ngai, Karine; Wong, Adrian; Siu, Deyond; Poon, Wai Sang; Mok, Vincent

2013-01-01

425

Misoprostol for prevention and treatment of postpartum haemorrhage: A systematic review.  

PubMed

Background: Postpartum haemorrhage (PPH) is a leading cause of maternal mortality especially in the developing world. Misoprostol, a highly effective drug is highly effective in inducing uterine contractions and has been proposed as a low-cost, easy-to-use intervention for PPH.Objective: This study assessed evidence of the effectiveness of misoprostol for the prevention and treatment of PPH.Method: Databases searched included MEDLINE, PUBMED, CINHAL, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE. Reference lists and conference proceedings were also searched for more studies. Three studies included in the meta-analysis were limited to randomised controlled trials (RCT). Two reviewers independently screened all articles for methodological quality using a standardised instrument adapted from the Cochrane Collaboration website. Data were entered in Review Manager 5.1 software for analysis.Results: Three trials (n = 2346) compared misoprostol to a placebo. Misoprostol was shown not to be effective in reducing PPH (risk ratios [RR] 0.65; 95% confidence interval [CI] 0.40-1.06). Only one trial reported on the need for a blood transfusion (RR 0.14; 95% CI 0.02-1.15). Shivering (RR 2.75; 95% CI 2.26-3.34) and pyrexia (RR 5.34; 95% CI 2.86-9.96) were significantly more common with misoprostol than with a placebo.Conclusion: The use of misoprostol was not associated with any significant reduction in the incidence of PPH. Therefore, in order to verify the efficacious use of misoprostol in the treatment of PPH, specialised investigations of its dose and routes of administration for clinically significant effects and acceptable side effects are warranted. PMID:23718882

Olefile, Kabelo M; Khondowe, Oswell; M'rithaa, Doreen

2013-04-19

426

Postpartum Haemorrhage in Canada and France: A Population-Based Comparison  

PubMed Central

Objective Maternal mortality ratio due to postpartum haemorrhage (PPH) is higher in France than in Canada. We explored this difference by comparing PPH features between these two countries. Methods Using data between 2004 and 2006, we compared the incidence, risk factors, causes and use of second-line treatments, of PPH between France (N?=?6,660 PPH) and Canada (N?=?9,838 PPH). We assessed factors associated with PPH through multivariate logistic models. Results PPH incidence, overall (4.8% (95% CI 4.7–4.9) in Canada and 4.5% (95% CI 4.4–4.7) in France), and after vaginal delivery (5.3% (95%CI 5.2–5.4) in Canada and 4.8 (95%CI 4.7–4.9) in France), were significantly higher in Canada than in France, but not after caesarean delivery. Women delivering without PPH were similar between the two populations, except for macrosomia (11% in Canada, 7% in France, p<0.001), caesarean delivery (27% in Canada, 18% in France, p<0.001), and episiotomy (17% in Canada, 34% in France, p<0.001). After vaginal delivery, factors strongly associated with PPH were multiple pregnancy, operative delivery and macrosomia in both populations, and episiotomy only in France (Odds Ratio 1.39 (95% CI 1.23–1.57)). The use of second-line treatments for PPH management was significantly more frequent in France than in Canada after both vaginal and caesarean delivery. Conclusion PPH incidence was not higher in France than in Canada and there was no substantial difference in PPH risk factors between the 2 countries. Greater use of second-line treatments in PPH management in France suggests a more frequent failure of first-line treatments and a higher rate of severe PPH, which may be involved in the higher maternal mortality ratio due to PPH.

Bonnet, Marie-Pierre; Basso, Olga; Bouvier-Colle, Marie-Helene; Dupont, Corinne; Rudigoz, Rene-Charles; Fuhrer, Rebecca; Deneux-Tharaux, Catherine

2013-01-01

427

Viral load and immune response dynamics in patients with haemorrhagic fever with renal syndrome.  

PubMed

Haemorrhagic fever with renal syndrome (HFRS) in Slovenia can be caused by infection with either Dobrava (DOBV) or Puumala (PUUV) virus, but a clear difference in disease severity is observed. We hypothesized that the wide spectrum of disease observed among HFRS patients might be related to differing immune responses and viral load kinetics. To test this hypothesis we analysed sequential blood samples from 29 HFRS patients hospitalized in Slovenia. Measuring viral RNA in patient samples revealed that viraemia lasts for longer than previously believed, with DOBV or PUUV-infected patients having viraemias lasting on average 30 days or 16 days, respectively. DOBV-infected patients were found to have a higher viral load than the PUUV-infected patients (10(7) vs. 10(5) RNA copies/mL). Both DOBV and PUUV-infected patients had IgM at the time of hospital admission, but there was a difference in IgG antibody dynamics, with only a minority of DOBV-infected patients having IgG antibodies. In our study, elevated levels of IL-10, TNF-? and IFN-? were detected in all of the samples regardless of the causative agent. In DOBV-infected patients the decrease in cytokine secretion level appeared around day 20 post-infection, while in PUUV-infected patients the change was earlier. In general, our findings point toward notable differences between PUUV and DOBV infections, in terms of viral load and antibody and cytokine response dynamics, all of which may be reflected in differing disease severities and clinical outcomes. PMID:23573903

Korva, M; Saksida, A; Kejžar, N; Schmaljohn, C; Avši?-Županc, T

2013-04-10

428

Intracranial haemorrhage in von Willebrand disease: a report on six cases.  

PubMed

The incidence of intracranial haemorrhage (ICH) in von Willebrand disease (VWD) is not well documented. We describe our single centre experience regarding ICH in children with VWD and identify how such children presented and were managed. Thirty-three head trauma events leading to medical attention occurred in 24 of 153 children with VWD followed in our institution. In only 15 of these were computed tomography (CT) imaging studies performed; seven in children with type 1 VWD, one in a child with type 2N VWD and seven in children with type 3 VWD. In six of these 15 episodes an ICH was identified: two children with type 1 VWD, one child with type 2N VWD and three children with type 3 VWD. In two of the 6 cases an ICH was only confirmed following a second CT scan. Neurological symptoms, including vomiting (noted in all six), headache, irritability, lethargy and/or alteration in the level of consciousness were present in all children with confirmed ICH. In contrast vomiting, irritability and alterations in level of consciousness were never present in those children without confirmed ICH. All three children with type 3 VWD who experienced an ICH were commenced on long-term prophylaxis. ICH, although rare, does occur in children with VWD and particularly in children with type 3 VWD. A much larger cohort of patients with VWD experiencing an ICH is needed to make recommendations regarding treatment of such events, including the role of prophylaxis in patients with more severe forms of VWD. PMID:23556472

Labarque, V; Stain, A M; Blanchette, V; Kahr, W H A; Carcao, M D

2013-04-05

429

Predictors of good outcome in medium to large spontaneous supratentorial intracerebral haemorrhages  

PubMed Central

Objective: To determine potential predictors of good outcome in primary medium to large intracerebral haemorrhages (ICH) which could be useful for selecting patients for surgical procedures. Methods: Subjects were 138 patients with spontaneous hemispheric ICH >20 ml. They were non-surgically treated and were admitted consecutively to 15 hospitals within the first 12 hours of symptom onset (mean (SD), 5.8 (3.1) hours). Haematoma volume was measured on computed tomography (CT) at admission. Stroke severity was assessed by the Canadian stroke scale (CSS). Good outcome was defined as modified Rankin score ?2 at three months. Results: At the end of the follow up period, 45 patients (32.6%) had good outcome. Baseline stroke severity, systolic and diastolic blood pressure, body temperature, and acute phase reaction biochemical markers (ESR, C-reactive protein, fibrinogen, neutrophil count) were significantly associated with good outcome in bivariate analyses. Of the initial CT scan variables, intraventricular contamination, deep location, mass effect, and greater ICH volume were related to poor outcome. On multiple logistic regression analysis, cortical location of bleeding (odds ratio 3.79 (95% confidence interval 1.2 to 12.01); p = 0.023), high CSS score (OR 2.3 (1.6 to 3.1); p<0.0001), and low fibrinogen concentrations (OR 0.92 (0.87 to 0.97); p = 0.001) were independent predictors of good outcome. These three factors correctly classified 85% of patients. Conclusions: Good outcome in medium to large ICH can be predicted on admission by three readily assessable factors (CSS score, ICH location, and fibrinogen levels). These predictors may be helpful in selecting patients for surgical treatment.

Castellanos, M; Leira, R; Tejada, J; Gil-Peralta, A; Davalos, A; Castillo, J; t for

2005-01-01

430

Bone marrow depletion with haemorrhagic diathesis in calves in Germany: characterization of the disease and preliminary investigations on its aetiology.  

PubMed

Since 2007 a new fatal haemorrhagic diathesis in calves has been observed in all areas of Germany. Analysis of 56 cases submitted for necropsy allowed its characterization. Calves fell ill within the first month of life independent of breed and sex. Only single or a few animals per herd were affected. Petechial and ecchymotic haemorrhages in many organs and tissues, particularly in skin, subcutis and gastrointestinal tract, were major findings in all animals. Microscopically a severe depletion of bone marrow cells was always observed. Lymphocytic depletion (43%) and inflammatory lesions (46%) were less frequently observed. Blood analysis of five animals indicated an aplastic pancytopenia. The resulting thrombocytopenia is regarded as major pathomechanism of this Haemorrhagic Disease Syndrome (HDS). Pedigree analysis gave no indication of hereditary disease. Tests for specific toxins such as S-(1,2-Dichlorovinyl)-L-cysteine (DCVC), furazolidone, or mycotoxins resulting in bone marrow depletion were negative. Bacterial infections, Bovine Viral Diarrhoea Virus, and Bluetongue Virus were ruled out as cause of the disease. HDS shares similarities with a circoviral infection in chickens (chicken infectious anaemia). A broad-spectrum PCR allowed detection of circoviral DNA in 5 of 25 HDS cases and in 1 of 8 non-HDS cases submitted for necropsy. Sequencing of the whole viral genome revealed a high similarity (up to 99%) with Porcine Circovirus type 2b. Single bone marrow cells stained weakly positive for PCV2 antigen by immunohistochemistry in 1 of 8 tested HDS animals. This is the first report of circovirus detection in cattle in Germany. The exact cause of HDS still remains unknown. A multifactorial aetiology involving infection, poisoning, immunopathy, or a genetic predisposition is conceivable. Additional research is necessary to clarify the pathogenesis and the potential role of PCV2 in HDS. PMID:20135908

Kappe, Eva C; Halami, Mohammad Yahya; Schade, Benjamin; Alex, Michaela; Hoffmann, Doris; Gangl, Armin; Meyer, Karsten; Dekant, Wolfgang; Schwarz, Bernd-Andreas; Johne, Reimar; Buitkamp, Johannes; Böttcher, Jens; Müller, Hermann

431

Snakebites and ethnobotany in the northwest region of Colombia. Part III: neutralization of the haemorrhagic effect of Bothrops atrox venom.  

PubMed

Thirty-one of 75 extracts of plants used by traditional healers for snakebites, had moderate or high neutralizing ability against the haemorrhagic effect of Bothrops atrox venom from Antioquia and Chocó, north-western Colombia. After preincubation of several doses of every extract (7.8-4000 microg/mouse) with six minimum haemorrhagic doses (10 microg) of venom, 12 of them demonstrated 100% neutralizing capacity when the mixture was i.d. injected into mice (18-20 g). These were the stem barks of Brownea rosademonte (Caesalpiniaceae) and Tabebuia rosea (Bignoniaceae); the whole plants of Pleopeltis percussa (Polypodiaceae), Trichomanes elegans (Hymenophyllaceae) and Senna dariensis (Caesalpiniaceae); rhizomes of Heliconia curtispatha (Heliconiaceae); leaves and branches of Bixa orellana (Bixaceae), Philodendron tripartitum (Araceae), Struthanthus orbicularis (Loranthaceae) and Gonzalagunia panamensis (Rubiaceae); the ripe fruits of Citrus limon (Rutaceae); leaves, branches and stem of Ficus nymphaeifolia (Moraceae). Extracts of another 19 species showed moderate neutralization (21-72%) at doses up to 4 mg/mouse, e.g. the whole plants of Aristolochia grandiflora (Aristolochiaceae), Columnea kalbreyeriana (Gesneriaceae), Sida acuta (Malvaceae), Selaginella articulata (Selaginellaceae) and Pseudoelephantopus spicatus (Asteraceae); rhizomes of Renealmia alpinia (Zingiberaceae); the stem of Strychnos xinguensis (Loganiaceae); leaves, branches and stems of Hyptis capitata (Lamiaceae), Ipomoea cairica (Convolvulaceae), Neurolaena lobata (Asteraceae), Ocimum micranthum (Lamiaceae), Piper pulchrum (Piperaceae), Siparuna thecaphora (Monimiaceae), Castilla elastica (Moraceae) and Allamanda cathartica (Apocynaceae); the macerated ripe fruits of Capsicum frutescens (Solanaceae); the unripe fruits of Crescentia cujete (Bignoniaceae); leaves and branches of Piper arboreum (Piperaceae) and Passiflora quadrangularis (Passifloraceae). When the extracts were independently administered by oral, i.p. or i.v. route either before or after an i.d. venom injection (10 microg), neutralization of haemorrhage dropped below 25% for all the extracts. Additionally, B. rosademonte and P. percussa extracts were able to inhibit the proteolytic activity of B. atrox venom on casein. PMID:11025161

Otero, R; Núñez, V; Barona, J; Fonnegra, R; Jiménez, S L; Osorio, R G; Saldarriaga, M; Díaz, A

2000-11-01

432

Hereditary haemorrhagic telangiectasia with extensive liver involvement is not caused by either HHT1 or HHT2.  

PubMed Central

Hereditary haemorrhagic telangiectasia (HHT) is a genetically heterogeneous dominant disorder. Two disease loci have been mapped to chromosomes 9q3 and 12q. In a large pedigree, with an unusually high number of patients with liver vascular malformations, both previously mapped loci have been excluded. The loci for two other inherited vascular malformation diseases, cerebral cavernous malformations and multiple cutaneous and mucosal venous malformations, have also been excluded. Thus we conclude that at least a third, as yet unmapped, HHT locus does exist, possibly associated with high frequency of liver involvement.

Piantanida, M; Buscarini, E; Dellavecchia, C; Minelli, A; Rossi, A; Buscarini, L; Danesino, C

1996-01-01

433

The Risk of Haemorrhage after Image Guided Stereotactic Biopsy of Intra-Axial Brain Tumours – A Prospective Study  

Microsoft Academic Search

Summary  ?Objective. To analyze prospectively the frequency and the risk of symptomatic and asymptomatic haemorrhage after image guided stereotactic\\u000a biopsy of intra-axial brain tumours.\\u000a \\u000a ?Methods. The study was conducted within a time frame of 24 months (April 1998–April 2000). 326 patients (150 males, 176 females; mean\\u000a age 56.8 years) were included and 345 computerized tomography (CT)-guided stereotactic biopsies were performed\\/supervised\\u000a by

F. W. Kreth; A. Muacevic; R. Medele; K. Bise; T. Meyer; H.-J. Reulen

2001-01-01

434

Dynamic 4D MR angiography versus multislice CT angiography in the evaluation of vascular hepatic involvement in hereditary haemorrhagic telangiectasia  

Microsoft Academic Search

Purpose  Hereditary haemorrhagic telangiectasia (HHT), or Rendu-Osler-Weber disease, is a rare autosomal dominant disorder characterised\\u000a by mucocutaneous or visceral vascular abnormalities that may be widely distributed throughout the cardiovascular system. The\\u000a purpose of this study was to compare multislice computed tomography angiography (MSCTA) and 4D dynamic contrast-enhanced magnetic\\u000a resonance angiography (D-MRA) for evaluating vascular hepatic involvement in patients with HHT.\\u000a \\u000a \\u000a \\u000a \\u000a Materials

A. Scardapane; A. Stabile Ianora; C. Sabbà; M. Moschetta; P. Suppressa; L. Castorani; G. Angelelli

435

High-dose tranexamic acid reduces blood loss in postpartum haemorrhage  

PubMed Central

Introduction Our purpose in conducting this study was to determine whether administration of high-dose tranexamic acid (TA) at the time of diagnosis of postpartum haemorrhage (PPH) could reduce blood loss. Methods This was a randomised, controlled, multicentred, open-label trial. Women with PPH >800 mL following vaginal delivery were randomly assigned to receive TA (loading dose 4 g over 1 hour, then infusion of 1 g/hour over 6 hours) or not. In both groups, packed red blood cells (PRBCs) and colloids could be used according to French guidelines. The use of additional procoagulant treatments was permitted only in cases involving intractable bleeding. The primary objective was to assess the efficacy of TA in the reduction of blood loss in women with PPH, and the secondary objectives were the effect of TA on PPH duration, anaemia, transfusion and the need for invasive procedures. Results A total of 144 women fully completed the protocol (72 in each group). Blood loss between enrolment and 6 hours later was significantly lower in the TA group than in the control group (median, 173 mL; first to third quartiles, 59 to 377) than in controls (221 mL; first to third quartiles 105 to 564) (P = 0.041). In the TA group, bleeding duration was shorter and progression to severe PPH and PRBC transfusion was less frequent than in controls (P < 0.03). Invasive procedures were performed in four women in the TA group and in seven controls (P = NS). PPH stopped after only uterotonics and PRBC transfusion in 93% of women in the TA group versus 79% of controls (P = 0.016). Mild, transient adverse manifestations occurred more often in the TA group than in the control group (P = 0.03). Conclusions This study is the first to demonstrate that high-dose TA can reduce blood loss and maternal morbidity in women with PPH. Although the study was not adequately powered to address safety issues, the observed side effects were mild and transient. A larger international study is needed to investigate whether TA can decrease the need for invasive procedures and reduce maternal morbidity in women with PPH. Trial registration Controlled Trials ISRCTN09968140.

2011-01-01

436

Marked splenic hyperaemia during post-haemorrhagic hypotension in the rat, rabbit and cat.  

PubMed Central

1. The regulation of the splenic perfusion during normal and pathological conditions is incompletely understood. We studied the time course of splenic blood flow during the initial (0-24 h) development of haemorrhagic anaemia in awake and anaesthetized rats, as well as in awake rabbits and cats. Another group of rats had either normovolaemic anaemia or beginning polycythaemia. 2. The microsphere method was used to measure splenic blood flow. The awake rats were rendered anaemic either by a heavy (1.5% of body weight) or a moderate (0.7% of body weight) bleeding (hypovolaemia), by haemolysis (normovolaemia) or by bleeding (1.5% of body weight) followed by transfusion of autologous plasma (normovolaemia). Polycythaemia was induced with injections of erythropoietin. The anaesthetized rats as well as the awake rabbits and cats were also bled heavily (1.5% of body weight). 3. In awake rats, splenic blood flow increased to 215% of control within the first 5 min after bleeding. The perfusion declined nearly to baseline over the next 24 h. A similar, but less prominent splenic hyperaemia was detected in the awake rabbits and cats. However, this hyperaemic response was not detected in the normovolaemic, the polycythaemic or the anaesthetized and bled rats. 4. Administration of the adrenergic beta-blocking agent propranolol prior to bleeding significantly attenuated the splenic hyperaemia in the awake rats, while the alpha-blocking agent phentolamine or the cholinergic blocking agent atropine had no effect. 5. Concomitant with the initial increase in splenic perfusion, cardiac output increased to 123% of control in the awake, heavily bled rats. In the bled, anaesthetized rats cardiac output decreased to 91% of control 5 min after bleeding. A decrease in cardiac output to 64 and 70% of control was observed in the awake rabbits and cats, respectively. 6. Immediately following the bleeding, we noticed a substantial release of platelets from the rat spleen. 7. It appears that a heavy acute blood loss in awake rats, rabbits and cats elicits a marked reduction in splenic vascular tone, perhaps mediated by beta-adrenergic receptor activity. Anaesthesia abolished this response in rats. Possibly, the induced hypovolaemia triggered an accelerated release of platelets from the rat spleen, dependent on an augmented splenic blood flow.

Iversen, P O; Benestad, H B; Nicolaysen, G

1992-01-01

437

Marked splenic hyperaemia during post-haemorrhagic hypotension in the rat, rabbit and cat.  

PubMed

1. The regulation of the splenic perfusion during normal and pathological conditions is incompletely understood. We studied the time course of splenic blood flow during the initial (0-24 h) development of haemorrhagic anaemia in awake and anaesthetized rats, as well as in awake rabbits and cats. Another group of rats had either normovolaemic anaemia or beginning polycythaemia. 2. The microsphere method was used to measure splenic blood flow. The awake rats were rendered anaemic either by a heavy (1.5% of body weight) or a moderate (0.7% of body weight) bleeding (hypovolaemia), by haemolysis (normovolaemia) or by bleeding (1.5% of body weight) followed by transfusion of autologous plasma (normovolaemia). Polycythaemia was induced with injections of erythropoietin. The anaesthetized rats as well as the awake rabbits and cats were also bled heavily (1.5% of body weight). 3. In awake rats, splenic blood flow increased to 215% of control within the first 5 min after bleeding. The perfusion declined nearly to baseline over the next 24 h. A similar, but less prominent splenic hyperaemia was detected in the awake rabbits and cats. However, this hyperaemic response was not detected in the normovolaemic, the polycythaemic or the anaesthetized and bled rats. 4. Administration of the adrenergic beta-blocking agent propranolol prior to bleeding significantly attenuated the splenic hyperaemia in the awake rats, while the alpha-blocking agent phentolamine or the cholinergic blocking agent atropine had no effect. 5. Concomitant with the initial increase in splenic perfusion, cardiac output increased to 123% of control in the awake, heavily bled rats. In the bled, anaesthetized rats cardiac output decreased to 91% of control 5 min after bleeding. A decrease in cardiac output to 64 and 70% of control was observed in the awake rabbits and cats, respectively. 6. Immediately following the bleeding, we noticed a substantial release of platelets from the rat spleen. 7. It appears that a heavy acute blood loss in awake rats, rabbits and cats elicits a marked reduction in splenic vascular tone, perhaps mediated by beta-adrenergic receptor activity. Anaesthesia abolished this response in rats. Possibly, the induced hypovolaemia triggered an accelerated release of platelets from the rat spleen, dependent on an augmented splenic blood flow. PMID:1593473

Iversen, P O; Benestad, H B; Nicolaysen, G

1992-03-01

438

Ebola haemorrhagic fever outbreak in Masindi District, Uganda: outbreak description and lessons learned  

PubMed Central

Background Ebola haemorrhagic fever (EHF) is infamous for its high case-fatality proportion (CFP) and the ease with which it spreads among contacts of the diseased. We describe the course of the EHF outbreak in Masindi, Uganda, in the year 2000, and report on response activities. Methods We analysed surveillance records, hospital statistics, and our own observations during response activities. We used Fisher's exact tests for differences in proportions, t-tests for differences in means, and logistic regression for multivariable analysis. Results The response to the outbreak consisted of surveillance, case management, logistics and public mobilisation. Twenty-six EHF cases (24 laboratory confirmed, two probable) occurred between October 21st and December 22nd, 2000. CFP was 69% (18/26). Nosocomial transmission to the index case occurred in Lacor hospital in Gulu, outside the Ebola ward. After returning home to Masindi district the index case became the origin of a transmission chain within her own extended family (18 further cases), from index family members to health care workers (HCWs, 6 cases), and from HCWs to their household contacts (1 case). Five out of six occupational cases of EHF in HCWs occurred after the introduction of barrier nursing, probably due to breaches of barrier nursing principles. CFP was initially very high (76%) but decreased (20%) due to better case management after reinforcing the response team. The mobilisation of the community for the response efforts was challenging at the beginning, when fear, panic and mistrust had to be countered by the response team. Conclusions Large scale transmission in the community beyond the index family was prevented by early case identification and isolation as well as quarantine imposed by the community. The high number of occupational EHF after implementing barrier nursing points at the need to strengthen training and supervision of local HCWs. The difference in CFP before and after reinforcing the response team together with observations on the ward suggest a critical role for intensive supportive treatment. Collecting high quality clinical data is a priority for future outbreaks in order to identify the best possible FHF treatment regime under field conditions.

2011-01-01

439

A long diagnostic delay in patients with Hereditary Haemorrhagic Telangiectasia: a questionnaire-based retrospective study  

PubMed Central

Background The difficulty in establishing a timely correct diagnosis is a relevant matter of concern for several rare diseases. Many rare-disease-affected patients suffer from considerable diagnostic delay, mainly due to their poor knowledge among healthcare professionals, insufficient disease awareness among patients’ families, and lack of promptly available diagnostic tools. Hereditary Haemorrhagic Telangiectasia (HHT) is an autosomal-dominantly inherited vascular dysplasia, affecting 1:5,000-10,000 patients. HHT is characterized by high variabilit