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Sample records for acute encephalopathic crises

  1. ET-1 and ecNOS gene polymorphisms andsusceptibility to acute chest syndrome and painful vaso-occlusive crises in children with sickle cell anemia.

    PubMed

    Chaar, Vicky; Tarer, Vanessa; Etienne-Julan, Maryse; Diara, Jean Pierre; Elion, Jacques; Romana, Marc

    2006-09-01

    The association of endothelin 1 (ET-1) and endothelial constitutive nitric oxide synthase (ecNOS) gene polymorphisms (G5665T and T8002C, VNTR and T-786C respectively) with the occurrence of acute chest syndrome and painful vaso-occlusive crises was evaluated in homozygous SS children. This retrospective study reveals that ET-1 T8002 and ecNOS C-786 alleles are associated with, respectively, an increased and a decreased risk of acute chest syndrome.

  2. [The treatment of posner-schlossmann's syndrome. (acute glaucomatocyclitic crises) (author's transl)].

    PubMed

    Huismans, H

    1975-12-01

    In the surgery two patients with Posner-Schlossmann-Syndrome were observed for several months. The therapy of the acute attack secondary glaucoma was the combination of Diamox, Cortison - and Neosynephrine eye-drops. With Pilocarpine the I.O.P. lowering was insufficient. In one case corneal precipitates typical for Heterochromia complicata Fuchs were observed.

  3. Preventing Acute Malnutrition among Young Children in Crises: A Prospective Intervention Study in Niger

    PubMed Central

    Langendorf, Céline; Roederer, Thomas; de Pee, Saskia; Brown, Denise; Doyon, Stéphane; Mamaty, Abdoul-Aziz; Touré, Lynda W.-M.; Manzo, Mahamane L.; Grais, Rebecca F.

    2014-01-01

    Background Finding the most appropriate strategy for the prevention of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) in young children is essential in countries like Niger with annual “hunger gaps.” Options for large-scale prevention include distribution of supplementary foods, such as fortified-blended foods or lipid-based nutrient supplements (LNSs) with or without household support (cash or food transfer). To date, there has been no direct controlled comparison between these strategies leading to debate concerning their effectiveness. We compared the effectiveness of seven preventive strategies—including distribution of nutritious supplementary foods, with or without additional household support (family food ration or cash transfer), and cash transfer only—on the incidence of SAM and MAM among children aged 6–23 months over a 5-month period, partly overlapping the hunger gap, in Maradi region, Niger. We hypothesized that distributions of supplementary foods would more effectively reduce the incidence of acute malnutrition than distributions of household support by cash transfer. Methods and Findings We conducted a prospective intervention study in 48 rural villages located within 15 km of a health center supported by Forum Santé Niger (FORSANI)/Médecins Sans Frontières in Madarounfa. Seven groups of villages (five to 11 villages) were allocated to different strategies of monthly distributions targeting households including at least one child measuring 60 cm–80 cm (at any time during the study period whatever their nutritional status): three groups received high-quantity LNS (HQ-LNS) or medium-quantity LNS (MQ-LNS) or Super Cereal Plus (SC+) with cash (€38/month [US$52/month]); one group received SC+ and family food ration; two groups received HQ-LNS or SC+ only; one group received cash only (€43/month [US$59/month]). Children 60 cm–80 cm of participating households were assessed at each monthly distribution from

  4. Managing Crises.

    ERIC Educational Resources Information Center

    Nation, Carol

    1988-01-01

    Many school systems have started to go beyond programs focused on suicide prevention or drug abuse to encompass all types of school crises. School districts and individual schools across tha nation are formulating crisis management plans and in some states they have become mandatory. Basic procedures drawn from plans adopted by schools include the…

  5. When Crises Call

    ERIC Educational Resources Information Center

    Kisch, Marian

    2012-01-01

    Natural disasters, as well as crises of the man-made variety, call on leaders of school districts to manage scenarios impossible to predict and for which no amount of training can adequately prepare. One thing all major crises hold in common is their far-reaching effects, which can run the gamut from personal safety and mental well-being to the…

  6. Piracetam Facilitates the Anti-Amnesic but not Anti-Diabetic Activity of Metformin in Experimentally Induced Type-2 Diabetic Encephalopathic Rats.

    PubMed

    Pandey, Shruti; Garabadu, Debapriya

    2016-09-01

    Piracetam exhibits anti-amnesic activity in several animal models of dementia. However, its anti-amnesic potential has yet to be evaluated in type-2 diabetes mellitus (T2DM)-induced encephalopathy. Therefore, in the present study, piracetam (25, 50 and 100 mg/kg) was screened for anti-amnesic and anti-diabetic activity in T2DM-induced encephalopathic male rats. Subsequently, anti-amnesic and anti-diabetic activities were evaluated for piracetam, metformin and their combination in T2DM-induced encephalopathic animals. Rats received streptozotocin (45 mg/kg) and nicotinamide (110 mg/kg) injections on day-1 (D-1) of the experimental schedule and were kept undisturbed for 35 days to exhibit T2DM-induced encephalopathy. All drug treatments were continued from D-7 to D-35 in both experiments. Piracetam (100 mg/kg) attenuated loss in learning and memory in terms of increase in escape latency on D-4 (D-34) and decrease in time spent in the target quadrant on D-5 (D-35) of Morris water maze test protocol, and spatial memory in terms of reduced spontaneous alternation behavior in Y-maze test of encephalopathic rats. Additionally, piracetam attenuated altered levels of fasting plasma glucose and insulin, HOMA-IR and HOMA-B in encephalopathic animals, comparatively lesser than metformin. In the next experiment, combination of piracetam and metformin exhibited better anti-amnesic but not anti-diabetic activity than respective monotherapies in encephalopathic rats. Further, the combination attenuated reduced acetylcholine level and increased acetylcholinesterase activity, increased glycogen synthase kinase-3β level and decreased brain-derived neurotropic factor level in hippocampus and pre-frontal cortex of encephalopathic animals. Thus, piracetam could be used as an adjuvant to metformin in the management of dementia in T2DM-induced encephalopathy.

  7. Clinical review: The management of hypertensive crises

    PubMed Central

    Varon, Joseph; Marik, Paul E

    2003-01-01

    Hypertension is an extremely common clinical problem, affecting approximately 50 million people in the USA and approximately 1 billion individuals worldwide. Approximately 1% of these patients will develop acute elevations in blood pressure at some point in their lifetime. A number of terms have been applied to severe hypertension, including hypertensive crises, emergencies, and urgencies. By definition, acute elevations in blood pressure that are associated with end-organ damage are called hypertensive crises. Immediate reduction in blood pressure is required only in patients with acute end-organ damage. This article reviews current concepts, and common misconceptions and pitfalls in the diagnosis and management of patients with acutely elevated blood pressure. PMID:12974970

  8. Autopsy statistics on the relative frequency of acute myocardial infarction in the Japanese mental workers and the unemployed during the two oil-crises periods.

    PubMed

    Chang, N C; Kawai, S; Okada, R

    1989-03-20

    In order to investigate whether job induced emotional stress, arising from socioenvironmental disasters would act as a trigger for the onset of AMI, the author reviewed all pathological autopsies throughout Japan 15 years old and over. Data was obtained from publications of the "Annual of the Pathological Autopsy Cases in Japan" for the years 1966-1968 (a period of high economic growth), 1973-1975 (1974, the year of the first oil crisis), and 1978-1980 (1979, the year of the second oil crisis). Relative frequencies of AMI were significantly higher during the years of both oil crises than in both the preceding and following years (2.6% in 1973, 3.7% in 1974, 3.0% in 1975; 2.8% in 1978, 3.2% in 1979, and 2.0% in 1980), and in each of three years of the high economic growth period (1.9-2.2% in 1966-1968). The proportions of managers and officials among AMI victims were significantly higher in the years of both oil crises than in both the preceding and following years (13.4% in 1973, 17.5% in 1974, 12.5% in 1975; 11.6% in 1978, 15.8% in 1979, and 11.1% in 1980). Moreover, there was a significantly higher value in the year of first oil crisis than in each of three years of the high economic growth period (11.7-13.1% in 1966-1968). The proportions of "out of job" persons were also significantly higher in the years of both oil crises than in the preceding years (24.0% in 1973, 29.3% in 1974, 27.8% in 1975; 24.1% in 1978, 29.1% in 1979, and 27.4% in 1980). For 11,199 randomly selected autopsies, the proportions of AMI in the above two occupational groups were significantly higher in the years of both oil crises than in the preceding years. Moreover, the proportion of "out of job" persons was significantly higher in the year of first oil crisis than in each of three years of the high economic growth period. A similar trend was noted among professional and technical workers, with more AMI occurring in this group during the years of both oil crises than in both the preceding

  9. Review of book vestibular crises

    NASA Technical Reports Server (NTRS)

    Blagoveshchenskaya, N. S.

    1980-01-01

    The etiology, pathogenesis, clinical practice, treatment and rehabilitation of patients with vestibular crises is discussed. Classifications for vestibular disorders are given. Information on the frequency of vestibular crises is given.

  10. A Trp474Cys mutation in the alpha-subunit of beta-hexosaminidase causes a subacute encephalopathic form of G{sub M2} gangliosidosis, type 1

    SciTech Connect

    Petroulakis, E.; Cao, Z.; Salo, T.

    1994-09-01

    Mutations in the HEXA gene that encodes the {alpha}-subunit of the heterodimeric lysosomal enzyme {beta}-hexosaminidase A, or Hex A ({alpha}{beta}), cause G{sub M2} gangliosidosis, type 1. The infantile form (Tay-Sachs disease) results when there is no residual Hex A activity, while less severe and more variable clinical phenotypes result when residual Hex A activity is present. A non-Jewish male who presented with an acute psychotic episode at age 16 was diagnosed with a subacute encephalopathic form of G{sub M2} gangliosidosis. At age 19, chronic psychosis with intermittent acute exacerbations remains the most disabling symptom in this patient and his affected brother although both exhibit some ataxia and moderately severe dysarthria. We have found a 4 bp insertion (+TATC 1278) associated with infantile Tay-Sachs disease on one allele; no previously identified mutation was found on the second allele. SSCP analysis detected a shift in exon 13 and sequencing revealed a G1422C mutation in the second allele that results in a Trp474Cys substitution. The presence of the mutation was confirmed by the loss of HaeIII and ScrFI sites in exon 13 PCR products from the subjects and their father. The mutation was introduced into the {alpha}-subunit cDNA and Hex S ({alpha}{alpha}) and Hex A ({alpha}{beta}) were transiently expressed in monkey COS-7 cells. The Trp474Cys mutant protein had approximately 5% and 12% of wild-type Hex S and Hex A activity, respectively. Western blot analysis revealed a small amount of residual mature {alpha}-subunit and a normal level of precursor protein. We conclude that the Trp474Cys mutation is the cause of the Hex A deficiency associated with a subacute (juvenile-onset) phenotype in this patient. Like other mutations in exon 13 of HEXA, it appears to affect intracellular processing. Studies of the defect in intracellular processing are in progress.

  11. Five Potential Crises.

    ERIC Educational Resources Information Center

    Futurist, 1984

    1984-01-01

    Five areas that have great potential for becoming crises in the future are described: a warming of the earth's climate, changing weather patterns and growing seasons; water shortage; the decay of the physical infrastructure, e.g., decay of roads, bridges; breakdown of the international monetary and trading system; and nuclear warfare. (Author/RM)

  12. Forecasting potential crises

    SciTech Connect

    Neufeld, W.P.

    1984-04-01

    Recently, the Trend Analysis Program (TAP) of the American Council of Life Insurance commissioned the Futures Group of Glastonbury, Connecticut, to examine the potential for large-scale catastrophic events in the near future. TAP was specifically concerned with five potential crises: the warming of the earth's atmosphere, the water shortage, the collapse of the physical infrastructure, the global financial crisis, and the threat of nuclear war. We are often unprepared to take action; in these cases, we lose an advantage we might have otherwise had. This is the whole idea behind forecasting: to foresee possibilities and to project how we can respond. If we are able to create forecasts against which we can test policy options and choices, we may have the luxury of adopting policies ahead of events. Rather than simply fighting fires, we have the option of creating a future more to our choosing. Short descriptions of these five potential crises and, in some cases, possible solutions are presented.

  13. Managing Classroom Crises. Fastback 465.

    ERIC Educational Resources Information Center

    Hardin, Carlette Jackson; Harris, E. Ann

    This booklet explains the importance of teachers being trained to handle daily crises they face in their classrooms and to see crises as an opportunity for both students and teachers. It discusses the skills and attitudes teachers need in order to be effective crisis managers. After an introduction, three sections examine: "What Is a…

  14. Re-evaluation of bone pain in patients with type 1 Gaucher disease suggests that bone crises occur in small bones as well as long bones.

    PubMed

    Baris, Hagit N; Weisz Hubshman, Monika; Bar-Sever, Zvi; Kornreich, Liora; Shkalim Zemer, Vered; Cohen, Ian J

    2016-09-01

    Bone crises in type 1 Gaucher disease are reported in long bones and occasionally in weight bearing bones and other bones, but rarely in small bones of the hands and feet. We retrospectively examined the incidence of bone pain in patients followed at the Rabin Medical Center, Israel, before and following the initiation of enzyme replacement therapy (ERT) and evaluated them for bone crises. Of 100 type I Gaucher disease patients, 30 (30%) experienced one or more bone crises. Small bone crises represented 31.5% of all bone crises and were always preceded by crises in other bones. While the incidence of long bone crises reduced after the initiation of ERT, small bone crises increased. Almost 60% of patients with bone crises were of the N370S/84GG genotype suggesting a greater susceptibility of N370S/84GG patients to severe bone complications. These patients also underwent the greatest number of splenectomies (70.6% of splenectomised patients). Splenectomised patients showed a trend towards increased long and small bone crises after surgery. Active investigation of acute pain in the hands and feet in patients in our cohort has revealed a high incidence of small bone crises. Physicians should consider imaging studies to investigate unexplained pain in these areas.

  15. [Demography and crises in Algeria].

    PubMed

    Cherrad, S E

    1996-01-01

    This article argues that demographic factors are an underlying cause of the many political, economic, social, and cultural crises that Algeria has experienced over the course of the 1990s. The author suggests that although the demography of the country is generally ignored when these issues are discussed, the rapid rate of population growth, which has caused the population to double in about 20 years, and the continued dependency burden, due to the fact that over 50% of the population are under age 20, are major causes of the country's current malaise.

  16. Ethical Crises and Cultural Differences

    PubMed Central

    Meleis, Afaf Ibrahim; Jonsen, Albert R.

    1983-01-01

    Generalizations about patients without careful attention to their cultural background, their values and norms could lead to a number of ethical crises. The informed consent, disclosure of diagnosis and prognosis, and discussions of termination of treatment are reflections of Western cultural values. They represent respect for autonomy of clients and respect for openness in communications. For patients from other cultures such practices have different meanings that may violate their own values. The result of such conflict in practices and meanings can render the relationship between patients and health care personnel difficult at best and distrustful at worst. PMID:6613119

  17. The Inevitable School Crises: Are You Ready?

    ERIC Educational Resources Information Center

    Quinn, Terrence

    2002-01-01

    Describes five-point crises-management plan: Assemble a school crises team, assign specific roles to each team member, delineate the responsibilities of each team member, conduct training for all staff members. Shares lessons learned in managing crisis situations. (PKP)

  18. Helping Students Cope with Fears and Crises.

    ERIC Educational Resources Information Center

    Walz, Garry R., Ed.; Bleuer, Jeanne C., Ed.

    This document consists of two modules extracted from a six-module larger work. Module 1 presents six articles on the topic of "helping students to cope with fears and crises." Module 2 contains 17 articles on "programs and practices for helping students cope with fears and crises." Article titles and authors are as follows: (1)…

  19. A teenager presents with fulminant hepatic failure and acute hemolytic anemia.

    PubMed

    Bose, Somnath; Sonny, Abraham; Rahman, Nadeem

    2015-03-01

    A teenager was admitted to an outside hospital ED following an episode of melena. He had been complaining of intermittent abdominal pain, nausea, malaise, and easy fatigability for 2 months, with significant worsening of symptoms 2 weeks prior to this episode. He had no significant medical, surgical, or family history. On presentation at the outside ED, he was found to be profoundly icteric and encephalopathic. Initial laboratories suggested anemia, acute kidney injury, and acute liver failure, leading to a presumptive diagnosis of acute fulminant liver failure necessitating transfer to our institution.

  20. Types of anaemic crises in paediatric patients with sickle cell anaemia seen in Enugu, Nigeria

    PubMed Central

    Juwah, A; Nlemadim, E; Kaine, W

    2004-01-01

    Background: Anaemic crises in paediatric patients with sickle cell anaemia are major causes of morbidity and mortality. Some children admitted to hospitals' emergency rooms or paediatric wards of the hospitals with severe anaemia die before blood transfusion. Aims and Methods: A total of 108 episodes of anaemic crises were prospectively evaluated in 108 patients with sickle cell anaemia attending the paediatric sickle cell clinic of the University of Nigeria Teaching Hospital, Enugu, Nigeria. Results: Hyper-haemolytic crises were the commonest types of anaemic crises in the patients studied. The mean haemoglobin concentration of 44.66 (SD 6.42) g/l in crises was significantly lower than the mean steady state level of 78.69 (SD 8.50) g/l. Reticulocytes, unconjugated serum bilirubin concentrations, and the presence of nucleated red blood cells were also increased. About 4.6% of patients were not jaundiced at presentation even though they were profoundly anaemic. Their haematological indices gradually returned to normal without marked changes in their serum bilirubin concentrations. These patients were probably in the early recovery phase of aplastic crises. The classical presentation of acute splenic sequestration crisis with a rapidly enlarging spleen and hypotension was not observed. This was probably because of its precipitate nature and accompanying circulatory collapse, which carried a high mortality rate. Minor forms of sequestration crises may have occurred in the liver and spleen. Conclusions: Malaria appeared to have played a role in precipitating some of the hyper-haemolytic episodes. Further studies to elucidate this role are required so that appropriate recommendations regarding malaria prophylaxis can be made in patients with sickle cell anaemia. PMID:15155406

  1. Dynamic Changes of Striatal and Extrastriatal Abnormalities in Glutaric Aciduria Type I

    ERIC Educational Resources Information Center

    Harting, Inga; Neumaier-Probst, Eva; Seitz, Angelika; Maier, Esther M.; Assmann, Birgit; Baric, Ivo; Troncoso, Monica; Muhlhausen, Chris; Zschocke, Johannes; Boy, Nikolas P. S.; Hoffmann, Georg F.; Garbade, Sven F.; Kolker, Stefan

    2009-01-01

    In glutaric aciduria type I, an autosomal recessive disease of mitochondrial lysine, hydroxylysine and tryptophan catabolism, striatal lesions are characteristically induced by acute encephalopathic crises during a finite period of brain development (age 3-36 months). The frequency of striatal injury is significantly less in patients diagnosed as…

  2. Prevalence and Predictors of Gastrostomy Tube and Tracheostomy Placement in Anoxic/Hypoxic Ischemic Encephalopathic Survivors of In-Hospital Cardiopulmonary Resuscitation in the United States

    PubMed Central

    Allareddy, Veerajalandhar; Rampa, Sankeerth; Nalliah, Romesh P.; Martinez-Schlurmann, Natalia I.; Lidsky, Karen B.; Allareddy, Veerasathpurush; Rotta, Alexandre T.

    2015-01-01

    Introduction Current prevalence estimates of gastrostomy tube (GT) /tracheostomy placement in hospitalized patients with anoxic/hypoxic ischemic encephalopathic injury (AHIE) post cardiopulmonary resuscitation (CPR) are unknown. We sought, to estimate the prevalence of AHIE in hospitalized patients who had CPR and to identify patient/hospital level factors that predict the performance of GT/tracheostomy in those with AHIE. Methods We performed a retrospective analysis of the Nationwide Inpatient Sample (years 2004–2010). All patients who developed AHIE following CPR were included. In this cohort the odds of having GT and tracheostomy was computed by multivariable logistic regression analysis. Patient and hospital level factors were the independent variables. Results During the study period, a total of 686,578 CPR events occurred in hospitalized patients. Of these, 94,336 (13.7%) patients developed AHIE. In this AHIE cohort, 6.8% received GT and 8.3% tracheostomy. When compared to the 40–49 yrs age group, those aged >70 yrs were associated with lower odds for GT (OR = 0.65, 95% CI:0.53–0.80, p<0.0001). Those aged <18 years & those >60 years were associated with lower odds for having tracheostomy when compared to the 40–49 years group (p<0.0001). Each one unit increase in co-morbid burden was associated with higher odds for having GT (OR = 1.23,p<0.0001) or tracheostomy (OR = 1.17, p<0.0001). Blacks, Hispanics, Asians/Pacific Islanders, and other races were associated with higher odds for having GT or tracheostomy when compared to whites (p<0.05). Hospitals located in northeastern regions were associated with higher odds for performing GT (OR = 1.48, p<0.0001) or tracheostomy (OR = 1.63, p<0.0001) when compared to those in Western regions. Teaching hospitals (TH) were associated with higher odds for performing tracheostomy when compared to non-TH (OR = 1.36, 1.20–1.54, p<0.0001). Conclusions AHIE injury occurs in a significant number of in-hospital arrests

  3. Crizanlizumab for the Prevention of Pain Crises in Sickle Cell Disease.

    PubMed

    Ataga, Kenneth I; Kutlar, Abdullah; Kanter, Julie; Liles, Darla; Cancado, Rodolfo; Friedrisch, João; Guthrie, Troy H; Knight-Madden, Jennifer; Alvarez, Ofelia A; Gordeuk, Victor R; Gualandro, Sandra; Colella, Marina P; Smith, Wally R; Rollins, Scott A; Stocker, Jonathan W; Rother, Russell P

    2017-02-02

    Background The up-regulation of P-selectin in endothelial cells and platelets contributes to the cell-cell interactions that are involved in the pathogenesis of vaso-occlusion and sickle cell-related pain crises. The safety and efficacy of crizanlizumab, an antibody against the adhesion molecule P-selectin, were evaluated in patients with sickle cell disease. Methods In this double-blind, randomized, placebo-controlled, phase 2 trial, we assigned patients to receive low-dose crizanlizumab (2.5 mg per kilogram of body weight), high-dose crizanlizumab (5.0 mg per kilogram), or placebo, administered intravenously 14 times over a period of 52 weeks. Patients who were receiving concomitant hydroxyurea as well as those not receiving hydroxyurea were included in the study. The primary end point was the annual rate of sickle cell-related pain crises with high-dose crizanlizumab versus placebo. The annual rate of days hospitalized, the times to first and second crises, annual rates of uncomplicated crises (defined as crises other than the acute chest syndrome, hepatic sequestration, splenic sequestration, or priapism) and the acute chest syndrome, and patient-reported outcomes were also assessed. Results A total of 198 patients underwent randomization at 60 sites. The median rate of crises per year was 1.63 with high-dose crizanlizumab versus 2.98 with placebo (indicating a 45.3% lower rate with high-dose crizanlizumab, P=0.01). The median time to the first crisis was significantly longer with high-dose crizanlizumab than with placebo (4.07 vs. 1.38 months, P=0.001), as was the median time to the second crisis (10.32 vs. 5.09 months, P=0.02). The median rate of uncomplicated crises per year was 1.08 with high-dose crizanlizumab, as compared with 2.91 with placebo (indicating a 62.9% lower rate with high-dose crizanlizumab, P=0.02). Adverse events that occurred in 10% or more of the patients in either active-treatment group and at a frequency that was at least twice as high

  4. Assessing Chaos in Sickle Cell Anemia Crises

    NASA Astrophysics Data System (ADS)

    Harris, Wesley; Le Floch, Francois

    2006-11-01

    Recent developments in sickle cell research and blood flow modeling allow for new interpretations of the sickle cell crises. With an appropriate set of theoretical and empirical equations describing the dynamics of the red cells in their environment, and the response of the capillaries to major changes in the rheology, a complete mathematical system has been derived. This system of equations is believed to be of major importance to provide new and significant insight into the causes of the disease and related crises. With simulations, it has been proven that the system transition from a periodic solution to a chaotic one, which illustrates the onset of crises from a regular blood flow synchronized with the heart beat. Moreover, the analysis of the effects of various physiological parameters exposes the potential to control chaotic solutions, which, in turn, could lead to the creation of new and more effective treatments for sickle cell anemia. .

  5. A model of international financial crises

    NASA Astrophysics Data System (ADS)

    Kaizoji, Taisei

    2001-10-01

    This paper proposes a model of international financial crises that is based on the statistical mechanics. In our model the international stock market is composed of two groups of traders mutually influencing each other with respect to their decision behavior, and financial contagion between markets occurs as a result of attempts by traders in the domestic market to imitate the behavior of traders who participate into exchange in a foreign market. This provides a channel through which a crisis in one market such as contemporaneous stock market crashes can be transmitted to other markets. We show that the model can explain the stylized facts characterizing periods of recent international financial crises.

  6. Phase Synchronization Detection of Financial Market Crises

    NASA Astrophysics Data System (ADS)

    Yang, Chun-Xia; Wu, Hong-Fa; Zhang, Ying-Chao; Xia, Bing-Ying; Itoh, Masaru

    Financial market is a complex system whose characteristic behaviors can be caught in corresponding time series. Analyzing such time series by appropriate methods will aid in making inferences and predictions. Here phase synchronization approach is used for visual pattern recognition of crises. Based on Empirical Mode Decomposition and the Hilbert transform, phase evolution of various rhythmic components exiting in the market is extracted. Then the concept of synchronization can be successfully applied to crises detection. Unlike other approaches, this detection distinguishes crises from normal state according to variations of interaction among rhythmic components. The empirical results mentioned here convince us of the fact that financial crises take place at the time when the adjustment processes of other quasi-periodic oscillations and the trend are out of synchronization. On the contrary, when other rhythmic oscillations can be synchronized with the trend, the market will develop healthily. The presence and duration of synchronization reflect dynamics of financial market. All these results will enlighten people to disclose its reasons and probe methods for controlling its pathological rhythms.

  7. Three Campus Crises: Lessons for Administrators.

    ERIC Educational Resources Information Center

    Rothman, Michael

    1992-01-01

    In October 1989-October 1991, Mills College (California) faced three crises: an earthquake; a strike over plans to convert to a coeducational institution; and a devastating fire in the area. The college has learned to focus its structural, human, political, and symbolic frames of reference; communicate; plan; consider the public; and develop…

  8. Dealing with Crises: One Principal's Experience.

    ERIC Educational Resources Information Center

    Foley, Charles F.

    1986-01-01

    The principal of Concord High School (New Hampshire) recounts the 1985-86 school year's four crises--the visits of teacher-astronaut Christa McAuliffe and Secretary of Education William Bennett, the shooting of a former student, and the Challenger space shuttle explosion. The greatest challenge was resuming the normal schedule and fielding media…

  9. Campus Communications in the Age of Crises

    ERIC Educational Resources Information Center

    McGuire, Patricia

    2007-01-01

    Recent catastrophes have brought about numerous critiques and changes to campus communications. In this article, the author shares the lessons she has learned from the crises she experienced during her 18 years of being the president of Trinity (Washington) University. Furthermore, Joan Hinde Stewart, president of Hamilton College, adds her…

  10. Early Life Crises of Habitable Planets

    SciTech Connect

    Pierrehumbert, Raymond

    2006-02-08

    There are a number of crises that a potentially habitable planet must avoid or surmount if its potential is to be realized. These include the runaway greenhouse, loss of atmosphere by chemical or physical processes, and long-lasting global glaciation. In this lecture I will present research on the climate dynamics governing such processes, with particular emphasis on the lessons to be learned from the cases of Early Mars and the Neoproterozoic Snowball Earth.

  11. Entropy Crises in Glasses and Random Heteropolymers.

    PubMed

    Wolynes, Peter G

    1997-01-01

    The concept of random first order transitions with configurational entropy crises provides a theoretical framework for understanding the glass transition. This paper discusses such transitions in exactly solvable spin glass models and in globular random heteropolymers and their relation to glass transitions in molecular fluids and polymers. The Vogel-Fulcher law is shown to be related to the search time through the energy landscape of an "entropic droplet."

  12. Early Life Crises of Habitable Planets

    ScienceCinema

    Pierrehumbert, Raymond [University of Chicago, Chicago, Illinois, United States

    2016-07-12

    There are a number of crises that a potentially habitable planet must avoid or surmount if its potential is to be realized. These include the runaway greenhouse, loss of atmosphere by chemical or physical processes, and long-lasting global glaciation. In this lecture I will present research on the climate dynamics governing such processes, with particular emphasis on the lessons to be learned from the cases of Early Mars and the Neoproterozoic Snowball Earth.

  13. An Attempt at an Eclectic Model of Nonnormative Crises.

    ERIC Educational Resources Information Center

    Walker, Alexis J.

    This paper addresses the theory and data from differing disciplines regarding the generic aspects of nonnormative crises (those unrelated to ontogeny or stage of the family life cycle) in order to increase understanding of the underlying processes involved. The first part of the paper reviews the literature on the study of family crises,…

  14. A Manual-Based Intervention to Address Clinical Crises and Retain Patients in the Treatment of Adolescents with Depression Study (TADS)

    ERIC Educational Resources Information Center

    May, Diane E.; Kratochvil, Christopher J.; Puumala, Susan E.; Silva, Susan G.; Rezac, Amy J.; Hallin, Mary J.; Reinecke, Mark A.; Vitiello, Benedetto; Weller, Elizabeth B.; Pathak, Sanjeev; Simons, Anne D.; March, John S.

    2007-01-01

    Objective: To describe a manual-based intervention to address clinical crises and retain participants in the Treatment for Adolescents with Depression Study (TADS). Method: The use of adjunct services for attrition prevention (ASAP) is described for adolescents (ages 12-17 years) during the 12-week acute treatment in TADS, from 2000 to 2003.…

  15. Identifying financial crises in real time

    NASA Astrophysics Data System (ADS)

    da Fonseca, Eder Lucio; Ferreira, Fernando F.; Muruganandam, Paulsamy; Cerdeira, Hilda A.

    2013-03-01

    Following the thermodynamic formulation of a multifractal measure that was shown to enable the detection of large fluctuations at an early stage, here we propose a new index which permits us to distinguish events like financial crises in real time. We calculate the partition function from which we can obtain thermodynamic quantities analogous to the free energy and specific heat. The index is defined as the normalized energy variation and it can be used to study the behavior of stochastic time series, such as financial market daily data. Famous financial market crashes-Black Thursday (1929), Black Monday (1987) and the subprime crisis (2008)-are identified with clear and robust results. The method is also applied to the market fluctuations of 2011. From these results it appears as if the apparent crisis of 2011 is of a different nature to the other three. We also show that the analysis has forecasting capabilities.

  16. Measuring complexity in Brazilian economic crises

    PubMed Central

    Mortoza, Letícia P. D.; Piqueira, José R. C.

    2017-01-01

    Capital flows are responsible for a strong influence on the foreign exchange rates and stock prices macroeconomic parameters. In volatile economies, capital flows can change due to several types of social, political and economic events, provoking oscillations on these parameters, which are recognized as economic crises. This work aims to investigate how these two macroeconomic variables are related with crisis events by using the traditional complex measures due to Lopez-Mancini-Calbet (LMC) and to Shiner-Davison-Landsberg (SDL), that can be applied to any temporal series. Here, Ibovespa (Bovespa Stock Exchange main Index) and the “dollar-real” parity are the background for calculating the LMC and SDL complexity measures. By analyzing the temporal evolution of these measures, it is shown that they might be related to important events that occurred in the Brazilian economy. PMID:28301506

  17. Constructing event trees for volcanic crises

    USGS Publications Warehouse

    Newhall, C.; Hoblitt, R.

    2002-01-01

    Event trees are useful frameworks for discussing probabilities of possible outcomes of volcanic unrest. Each branch of the tree leads from a necessary prior event to a more specific outcome, e.g., from an eruption to a pyroclastic flow. Where volcanic processes are poorly understood, probability estimates might be purely empirical - utilizing observations of past and current activity and an assumption that the future will mimic the past or follow a present trend. If processes are better understood, probabilities might be estimated from a theoritical model, either subjectively or by numerical simulations. Use of Bayes' theorem aids in the estimation of how fresh unrest raises (or lowers) the probabilities of eruptions. Use of event trees during volcanic crises can help volcanologists to critically review their analysis of hazard, and help officials and individuals to compare volcanic risks with more familiar risks. Trees also emphasize the inherently probabilistic nature of volcano forecasts, with multiple possible outcomes.

  18. Professional conduct of scientists during volcanic crises

    NASA Astrophysics Data System (ADS)

    IAVCEI SubcommitteeCrisis Protocols; Newhall, Chris; Aramaki, Shigeo; Barberi, Franco; Blong, Russell; Calvache, Marta; Cheminee, Jean-Louis; Punongbayan, Raymundo; Siebe, Claus; Simkin, Tom; Sparks, Stephen; Tjetjep, Barry; Newhall, Chris

    Stress during volcanic crises is high, and any friction between scientists can distract seriously from both humanitarian and scientific effort. Friction can arise, for example, if team members do not share all of their data, if differences in scientific interpretation erupt into public controversy, or if one scientist begins work on a prime research topic while a colleague with longer-standing investment is still busy with public safety work. Some problems arise within existing scientific teams; others are brought on by visiting scientists. Friction can also arise between volcanologists and public officials. Two general measures may avert or reduce friction: (a) National volcanologic surveys and other scientific groups that advise civil authorities in times of volcanic crisis should prepare, in advance of crises, a written plan that details crisis team policies, procedures, leadership and other roles of team members, and other matters pertinent to crisis conduct. A copy of this plan should be given to all current and prospective team members. (b) Each participant in a crisis team should examine his or her own actions and contribution to the crisis effort. A personal checklist is provided to aid this examination. Questions fall generally in two categories: Are my presence and actions for the public good? Are my words and actions collegial, i.e., courteous, respectful, and fair? Numerous specific solutions to common crisis problems are also offered. Among these suggestions are: (a) choose scientific team leaders primarily for their leadership skills; (b) speak publicly with a single scientific voice, especially when forecasts, warnings, or scientific disagreements are involved; (c) if you are a would-be visitor, inquire from the primary scientific team whether your help would be welcomed, and, in general, proceed only if the reply is genuinely positive; (d) in publications, personnel evaluations, and funding, reward rather than discourage teamwork. Models are

  19. Professional conduct of scientists during volcanic crises

    USGS Publications Warehouse

    ,; Newhall, Chris; Aramaki, Shigeo; Barberi, Franco; Blong, Russell; Calvache, Marta; Cheminee, Jean-Louis; Punongbayan, Raymundo; Siebe, Claus; Simkin, Tom; Sparks, Stephen; Tjetjep, Wimpy

    1999-01-01

    Stress during volcanic crises is high, and any friction between scientists can distract seriously from both humanitarian and scientific effort. Friction can arise, for example, if team members do not share all of their data, if differences in scientific interpretation erupt into public controversy, or if one scientist begins work on a prime research topic while a colleague with longer-standing investment is still busy with public safety work. Some problems arise within existing scientific teams; others are brought on by visiting scientists. Friction can also arise between volcanologists and public officials. Two general measures may avert or reduce friction: (a) National volcanologic surveys and other scientific groups that advise civil authorities in times of volcanic crisis should prepare, in advance of crises, a written plan that details crisis team policies, procedures, leadership and other roles of team members, and other matters pertinent to crisis conduct. A copy of this plan should be given to all current and prospective team members. (b) Each participant in a crisis team should examine his or her own actions and contribution to the crisis effort. A personal checklist is provided to aid this examination. Questions fall generally in two categories: Are my presence and actions for the public good? Are my words and actions collegial, i.e., courteous, respectful, and fair? Numerous specific solutions to common crisis problems are also offered. Among these suggestions are: (a) choose scientific team leaders primarily for their leadership skills; (b) speak publicly with a single scientific voice, especially when forecasts, warnings, or scientific disagreements are involved; (c) if you are a would-be visitor, inquire from the primary scientific team whether your help would be welcomed, and, in general, proceed only if the reply is genuinely positive; (d) in publications, personnel evaluations, and funding, reward rather than discourage teamwork. Models are

  20. Evidence on the Effectiveness of Water, Sanitation, and Hygiene (WASH) Interventions on Health Outcomes in Humanitarian Crises: A Systematic Review

    PubMed Central

    Ramesh, Anita; Blanchet, Karl; Ensink, Jeroen H. J.; Roberts, Bayard

    2015-01-01

    Background Water, sanitation, and hygiene (WASH) interventions are amongst the most crucial in humanitarian crises, although the impact of the different WASH interventions on health outcomes remains unclear. Aim To examine the quantity and quality of evidence on WASH interventions on health outcomes in humanitarian crises, as well as evaluate current evidence on their effectiveness against health outcomes in these contexts. Methods A systematic literature review was conducted of primary and grey quantitative literature on WASH interventions measured against health outcomes in humanitarian crises occurring from 1980–2014. Populations of interest were those in resident in humanitarian settings, with a focus on acute crisis and early recovery stages of humanitarian crises in low and middle-income countries. Interventions of interest were WASH-related, while outcomes of interest were health-related. Study quality was assessed via STROBE/CONSORT criteria. Results were analyzed descriptively, and PRISMA reporting was followed. Results Of 3963 studies initially retrieved, only 6 published studies measured a statistically significant change in health outcome as a result of a WASH intervention. All 6 studies employed point-of-use (POU) water quality interventions, with 50% using safe water storage (SWS) and 35% using household water treatment (HWT). All 6 studies used self-reported diarrhea outcomes, 2 studies also reported laboratory confirmed outcomes, and 2 studies reported health treatment outcomes (e.g. clinical admissions). 1 study measured WASH intervention success in relation to both health and water quality outcomes; 1 study recorded uptake (use of soap) as well as health outcomes. 2 studies were unblinded randomized-controlled trials, while 4 were uncontrolled longitudinal studies. 2 studies were graded as providing high quality evidence; 3 studies provided moderate and 1 study low quality evidence. Conclusion The current evidence base on the impact of WASH

  1. Improvements in haemolysis and indicators of erythrocyte survival do not correlate with acute vaso-occlusive crises in patients with sickle cell disease: a phase III randomized, placebo-controlled, double-blind study of the Gardos channel blocker senicapoc (ICA-17043).

    PubMed

    Ataga, Kenneth I; Reid, Marvin; Ballas, Samir K; Yasin, Zahida; Bigelow, Carolyn; James, Luther St; Smith, Wally R; Galacteros, Frederic; Kutlar, Abdullah; Hull, James H; Stocker, Jonathan W

    2011-04-01

    Red blood cell (RBC) hydration is regulated in part by the Ca(2+) -activated K(+) efflux (Gardos) channel. Senicapoc selectively blocks potassium efflux through the Gardos channel, reducing RBC dehydration and haemolysis, and increasing haemoglobin levels in sickle cell disease (SCD). This randomized, placebo-controlled trial was designed to determine the safety and clinical efficacy of senicapoc in SCD patients. One hundred and forty-five patients were randomized to receive senicapoc and 144 patients to receive placebo for 52 weeks. Consistent with a previous study, patients in the senicapoc group had significantly increased haematocrit, haemoglobin, and decreased numbers of both dense erythrocytes and reticulocytes when compared to the placebo group. The unblinded Data Monitoring Committee terminated this study early due to a lack of efficacy when it determined that, despite improvements in anaemia and haemolysis, no significant improvement in the rate of sickle cell painful crises was observed in patients treated with senicapoc compared to those on placebo (0·38 vs. 0·31, respectively). Comparisons of the times to first, second and third crises between the senicapoc and placebo groups were not statistically significant. Nausea and urinary tract infections occurred more frequently in the senicapoc group than placebo. Serious adverse events were similar in the two groups.

  2. Scientists' Perceptions of Communicating During Crises

    NASA Astrophysics Data System (ADS)

    Dohaney, J. A.; Hudson-Doyle, E.; Brogt, E.; Wilson, T. M.; Kennedy, B.

    2015-12-01

    To further our understanding of how to enhance student science and risk communication skills in natural hazards and earth science courses, we conducted a pilot study to assess the different perceptions of expert scientists and risk communication practitioners versus the perceptions of students. These differences will be used to identify expert views on best practice, and improve the teaching of communication skills at the University level. In this pilot study, a perceptions questionnaire was developed and validated. Within this, respondents (geoscientists, engineers, and emergency managers; n=44) were asked to determine their agreement with the use and effectiveness of specific communication strategies (within the first 72 hours after a devastating earthquake) when communicating to the public. In terms of strategies and information to the public, the respondents were mostly in agreement, but there were several statements which elicited large differences between expert responses: 1) the role and purpose of the scientific communication during crises (to persuade people to care, to provide advice, to empower people to take action); 2) the scientist's delivery (showing the scientists emotions and enthusiasm for scientific concepts they are discussing); and 3) the amount of data that is discussed (being comprehensive versus 'only the important' data). The most disagreed upon dimension was related to whether to disclose any political influence on the communication. Additionally, scientists identified that being an effective communicator was an important part of their job, and agreed that it is important to practice these skills. Respondents generally indicated that while scientists should be accountable for the science advice provided, they should not be held liable.

  3. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

    PubMed Central

    Patel, Nirali H; Romero, Sarah K; Kaelber, David C

    2012-01-01

    Hypertension (HTN) in the pediatric population is estimated to have a world-wide prevalence of 2%–5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1) safely lower blood pressure, and (2) treat/minimize acute end organ damage, while (3) identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8-hour period. PMID:27147865

  4. Assessment of economic vulnerability to infectious disease crises.

    PubMed

    Sands, Peter; El Turabi, Anas; Saynisch, Philip A; Dzau, Victor J

    2016-11-12

    Infectious disease crises have substantial economic impact. Yet mainstream macroeconomic forecasting rarely takes account of the risk of potential pandemics. This oversight contributes to persistent underestimation of infectious disease risk and consequent underinvestment in preparedness and response to infectious disease crises. One reason why economists fail to include economic vulnerability to infectious disease threats in their assessments is the absence of readily available and digestible input data to inform such analysis. In this Viewpoint we suggest an approach by which the global health community can help to generate such inputs, and a framework to use these inputs to assess the economic vulnerability to infectious disease crises of individual countries and regions. We argue that incorporation of these risks in influential macroeconomic analyses such as the reports from the International Monetary Fund's Article IV consultations, rating agencies and risk consultancies would simultaneously improve the quality of economic risk forecasting and reinforce individual government and donor incentives to mitigate infectious disease risks.

  5. Foreign exchange rate entropy evolution during financial crises

    NASA Astrophysics Data System (ADS)

    Stosic, Darko; Stosic, Dusan; Ludermir, Teresa; de Oliveira, Wilson; Stosic, Tatijana

    2016-05-01

    This paper examines the effects of financial crises on foreign exchange (FX) markets, where entropy evolution is measured for different exchange rates, using the time-dependent block entropy method. Empirical results suggest that financial crises are associated with significant increase of exchange rate entropy, reflecting instability in FX market dynamics. In accordance with phenomenological expectations, it is found that FX markets with large liquidity and large trading volume are more inert - they recover quicker from a crisis than markets with small liquidity and small trading volume. Moreover, our numerical analysis shows that periods of economic uncertainty are preceded by periods of low entropy values, which may serve as a tool for anticipating the onset of financial crises.

  6. The benefits of flexible team interaction during crises.

    PubMed

    Stachowski, Alicia A; Kaplan, Seth A; Waller, Mary J

    2009-11-01

    Organizations increasingly rely on teams to respond to crises. While research on team effectiveness during nonroutine events is growing, naturalistic studies examining team behaviors during crises are relatively scarce. Furthermore, the relevant literature offers competing theoretical rationales concerning effective team response to crises. In this article, the authors investigate whether high- versus average-performing teams can be distinguished on the basis of the number and complexity of their interaction patterns. Using behavioral observation methodology, the authors coded the discrete verbal and nonverbal behaviors of 14 nuclear power plant control room crews as they responded to a simulated crisis. Pattern detection software revealed systematic differences among crews in their patterns of interaction. Mean comparisons and discriminant function analysis indicated that higher performing crews exhibited fewer, shorter, and less complex interaction patterns. These results illustrate the limitations of standardized response patterns and highlight the importance of team adaptability. Implications for future research and for team training are included.

  7. Constraints to addressing food insecurity in protracted crises

    PubMed Central

    Maxwell, Daniel; Russo, Luca; Alinovi, Luca

    2012-01-01

    A substantial portion of the world's people have not made adequate progress toward overcoming hunger or achieving sustainable livelihoods. The classic approach to addressing chronic food insecurity has been a strategy of agricultural development, supplemented by humanitarian assistance in the event of a shock or crisis—an approach predicated on assumptions that do not fit the context of protracted crises. This article describes protracted crises and argues that they are sufficiently different to warrant special consideration, but there are unique constraints to engagement in protracted crises. The article explores the constraints promoting sustainable livelihoods in these contexts and proposes elements of an alternative approach. It evaluates the limited evidence available about such an approach and outlines important questions for further research. PMID:21646522

  8. The impact of digital technology on health of populations affected by humanitarian crises: Recent innovations and current gaps.

    PubMed

    Mesmar, Sandra; Talhouk, Reem; Akik, Chaza; Olivier, Patrick; Elhajj, Imad H; Elbassuoni, Shady; Armoush, Sarah; Kalot, Joumana; Balaam, Madeline; Germani, Aline; Ghattas, Hala

    2016-11-01

    Digital technology is increasingly used in humanitarian action and promises to improve the health and social well-being of populations affected by both acute and protracted crises. We set out to (1) review the current landscape of digital technologies used by humanitarian actors and affected populations, (2) examine their impact on health and well-being of affected populations, and (3) consider the opportunities for and challenges faced by users of these technologies. Through a systematic search of academic databases and reports, we identified 50 digital technologies used by humanitarian actors, and/or populations affected by crises. We organized them according to the stage of the humanitarian cycle that they were used in, and the health outcomes or determinants of health they affected. Digital technologies were found to facilitate communication, coordination, and collection and analysis of data, enabling timely responses in humanitarian contexts. A lack of evaluation of these technologies, a paternalistic approach to their development, and issues of privacy and equity constituted major challenges. We highlight the need to create a space for dialogue between technology designers and populations affected by humanitarian crises.

  9. Preparing for School Crises: Administrator Perceptions on Supports for Teachers

    ERIC Educational Resources Information Center

    Brophy, Chelsey M.; Maras, Melissa A.; Wang, Ze

    2015-01-01

    Traumatic events and crises involving schools and children often become high-profile occurrences; however, little attention is given to teachers and how they cope with crisis. The purpose of this study was to investigate administrators' perceptions of including additional support for teachers in school crisis policies. Specifically, the study…

  10. An Ecological Momentary Assessment of Relapse Crises in Dieting

    ERIC Educational Resources Information Center

    Carels, Robert A.; Douglass, Olivia M.; Cacciapaglia, Holly M.; O'Brien, William H.

    2004-01-01

    Much of the research on relapse crises in dieting has focused on isolated lapse events and relied heavily on retrospective self-report data. The present study sought to overcome these limitations by using ecological momentary assessment (EMA) techniques to examine situations of dietary temptation and lapse with a sample of obese, formerly…

  11. Danger and Opportunity: Institutional Identity Crises and Transformation

    ERIC Educational Resources Information Center

    Blumenfeld, Warren J.

    2006-01-01

    Using the theoretical lenses of Erik Erikson, Burton Clark, and Sonia Nieto, the author highlights the case of Colgate University--a private liberal arts university in central New York State--to consider larger issues of institutional identity by investigating points of crises bringing to the surface opposing forces, which struggle, on one hand,…

  12. The Crises and Freedoms of Researching Your Own Life

    ERIC Educational Resources Information Center

    Pearce, Caroline

    2010-01-01

    There has been much work highlighting the benefits of autoethnographic research yet little acknowledgement of the demands researching your own life makes on the emotional and mental wellbeing of the researcher. This paper explores the consequences that can arise as a result of autoethnographic research by detailing the crises involved in…

  13. Supporting Students with Disabilities during School Crises: A Teacher's Guide

    ERIC Educational Resources Information Center

    Clarke, Laura S.; Embury, Dusty Columbia; Jones, Ruth E.; Yssel, Nina

    2014-01-01

    Most schools have crisis plans to support student safety, but few plans address the complex needs of students with disabilities. School supports should include analysis of school plans and student strengths and needs to ensure that students with disabilities have the best opportunity to be safe in school crises. Recommendations include developing…

  14. Mental Health Aspects of Responding to Campus Crises

    ERIC Educational Resources Information Center

    Flynn, Christopher; Sharma, Micky M.

    2016-01-01

    Tragedy can strike a college campus in unpredictable and often horrific ways that may lead to traumatic responses for individuals and the entire campus community. Crises on campus demand an appropriate response to support the community, provide assistance to affected individuals and guide healing efforts.

  15. Resilience of natural gas networks during conflicts, crises and disruptions.

    PubMed

    Carvalho, Rui; Buzna, Lubos; Bono, Flavio; Masera, Marcelo; Arrowsmith, David K; Helbing, Dirk

    2014-01-01

    Human conflict, geopolitical crises, terrorist attacks, and natural disasters can turn large parts of energy distribution networks offline. Europe's current gas supply network is largely dependent on deliveries from Russia and North Africa, creating vulnerabilities to social and political instabilities. During crises, less delivery may mean greater congestion, as the pipeline network is used in ways it has not been designed for. Given the importance of the security of natural gas supply, we develop a model to handle network congestion on various geographical scales. We offer a resilient response strategy to energy shortages and quantify its effectiveness for a variety of relevant scenarios. In essence, Europe's gas supply can be made robust even to major supply disruptions, if a fair distribution strategy is applied.

  16. The Transition From Threat Situations to International Crises

    DTIC Science & Technology

    1976-09-01

    SEP 197& I.. nternational Relations Research Institut School of International Relations University of Southern California September 1976 THE...TRANSITION FROM THREAT SITUATIONS TO INTERNATIONAL CRISES TR&A Technical Report #34 Threat Recognition and Analysis Project "Approved for public release...the Advanced Research Projects Agency of the Department of Defense and was monitored by ONR under Contract No. N00014-76-C-0137. The views and

  17. [Political crises in Africa and infant and child mortality].

    PubMed

    Garenne, M

    1997-01-01

    Many African countries experienced severe political crises after independence, and in a number of cases the crises had significant demographic consequences, especially for child mortality. Data based on maternity histories allowed the reconstruction of child mortality trends over the past 20-30 years in Uganda, Ghana, Rwanda, Madagascar, and Mozambique. The indicator used was the child mortality quotient (number of deaths of under-5 children per 1000 births). Uganda's child mortality declined from 227/1000 in 1960 to 154/1000 in 1970, but the trend was reversed in 1971, when Idi Amin Dada came to power, and the rate reached 204/1000 in 1982 before beginning to decline again. The level of mortality remained high, however, and was still 160/1000 in 1988. Ghana suffered a political and economic crisis during 1979-84. Child mortality rose from 130/1000 in 1978 to 175/1000 in 1983. Mortality rates began a rapid decline after structural adjustment programs were begun, possibly due to improved management of health services. The child mortality rate in Rwanda increased from around 220/1000 in 1960 to 240/1000 in 1975, before beginning a decline in the late 1970s that reached 140/1000 by 1990. The period of political stability and relative prosperity during the 15-year reign of Juvenal Habyarimana was associated with the decline. Political crises marked by student and peasant uprisings were associated with Madagascar's child mortality rate increase from about 145/1000 in 1960 to 185/1000 in 1985. Mozambique was beset by civil war after independence, in which destruction of the health infrastructure was a strategy. The child mortality rate increased from 270/1000 to 470/1000 between 1975 and 1986, a peak war year. The factors by which political crises affect mortality so profoundly remain to be explained, but particular attention should be given to studying the health sector.

  18. EPA guidance on mental health and economic crises in Europe.

    PubMed

    Martin-Carrasco, M; Evans-Lacko, S; Dom, G; Christodoulou, N G; Samochowiec, J; González-Fraile, E; Bienkowski, P; Gómez-Beneyto, M; Dos Santos, M J H; Wasserman, D

    2016-03-01

    This European Psychiatric Association (EPA) guidance paper is a result of the Working Group on Mental Health Consequences of Economic Crises of the EPA Council of National Psychiatric Associations. Its purpose is to identify the impact on mental health in Europe of the economic downturn and the measures that may be taken to respond to it. We performed a review of the existing literature that yields 350 articles on which our conclusions and recommendations are based. Evidence-based tables and recommendations were developed through an expert consensus process. Literature dealing with the consequences of economic turmoil on the health and health behaviours of the population is heterogeneous, and the results are not completely unequivocal. However, there is a broad consensus about the deleterious consequences of economic crises on mental health, particularly on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse, and suicidal behaviour. Unemployment, indebtedness, precarious working conditions, inequalities, lack of social connectedness, and housing instability emerge as main risk factors. Men at working age could be particularly at risk, together with previous low SES or stigmatized populations. Generalized austerity measures and poor developed welfare systems trend to increase the harmful effects of economic crises on mental health. Although many articles suggest limitations of existing research and provide suggestions for future research, there is relatively little discussion of policy approaches to address the negative impact of economic crises on mental health. The few studies that addressed policy questions suggested that the development of social protection programs such as active labour programs, social support systems, protection for housing instability, and better access to mental health care, particularly at primary care level, is strongly needed.

  19. A Role for Science in Responding to Health Crises

    PubMed Central

    Brothers, Reginald; Murata, Christina E.

    2016-01-01

    The Department of Homeland Security's (DHS) Science and Technology (S&T) Directorate plays a role in public health that extends beyond biodefense. These responsibilities were exercised as part of the 2014-16 Ebola outbreak, leading to productive and beneficial contributions to the international public health response and improved operations in the United States. However, we and others have identified numerous areas for improvement. Based on our successes and lessons learned, we propose a number of ways that DHS, the interagency, and academia can act now to ensure improved responses to future public health crises. These include pre-developing scientific capabilities to respond agnostically to threats, and disease-specific master question lists to organize and inform initial efforts. We are generating DHS-specific playbooks and tools for anticipating future needs and capturing requests from DHS components and our national and international partners, where efforts will also be used to refine and exercise communication and information-sharing practices. These experiences and improvement efforts have encouraged discussions on the role of science in developing government policy, specifically responding to public health crises. We propose specific considerations for both scientists and government decision makers to ensure that the best available science is incorporated into policy and operational decisions to facilitate highly effective responses to future health crises. PMID:27482881

  20. A Systematic Review on Health Resilience to Economic Crises

    PubMed Central

    Glonti, Ketevan; Gordeev, Vladimir S.; Goryakin, Yevgeniy; Reeves, Aaron; Stuckler, David; McKee, Martin; Roberts, Bayard

    2015-01-01

    Background The health effects of recent economic crises differ markedly by population group. The objective of this systematic review is to examine evidence from longitudinal studies on factors influencing resilience for any health outcome or health behaviour among the general population living in countries exposed to financial crises. Methods We systematically reviewed studies from six electronic databases (EMBASE, Global Health, MEDLINE, PsycINFO, Scopus, Web of Science) which used quantitative longitudinal study designs and included: (i) exposure to an economic crisis; (ii) changes in health outcomes/behaviours over time; (iii) statistical tests of associations of health risk and/or protective factors with health outcomes/behaviours. The quality of the selected studies was appraised using the Quality Assessment Tool for Quantitative Studies. PRISMA reporting guidelines were followed. Results From 14,584 retrieved records, 22 studies met the eligibility criteria. These studies were conducted across 10 countries in Asia, Europe and North America over the past two decades. Ten socio-demographic factors that increased or protected against health risk were identified: gender, age, education, marital status, household size, employment/occupation, income/ financial constraints, personal beliefs, health status, area of residence, and social relations. These studies addressed physical health, mortality, suicide and suicide attempts, mental health, and health behaviours. Women’s mental health appeared more susceptible to crises than men’s. Lower income levels were associated with greater increases in cardiovascular disease, mortality and worse mental health. Employment status was associated with changes in mental health. Associations with age, marital status, and education were less consistent, although higher education was associated with healthier behaviours. Conclusions Despite widespread rhetoric about the importance of resilience, there was a dearth of studies

  1. Double crises in two-parameter dynamical systems

    SciTech Connect

    Stewart, H.B.; Ueda, Y.; Grebogi, C.; Yorke, J.A.

    1995-09-25

    A crisis is a sudden discontinuous change in a chaotic attractor as a system parameter is varied. We investigate phenomena observed when two parameters of a dissipative system are varied simultaneously, following a crisis along a curve in the parameter plane. Two such curves intersect at a point we call a double crisis vertex. The phenomena we study include the double crisis vertex at which an interior and a boundary crisis coincide, and related forms of double crisis. We show how an experimenter can infer a crisis from observations of other related crises at a vertex.

  2. Mobile Response Team Saves Lives in Volcano Crises

    USGS Publications Warehouse

    Ewert, John W.; Miller, C. Dan; Hendley, James W.; Stauffer, Peter H.

    1997-01-01

    The world's only volcano crisis response team, organized and operated by the USGS, can be quickly mobilized to assess and monitor hazards at volcanoes threatening to erupt. Since 1986, the team has responded to more than a dozen volcano crises as part of the Volcano Disaster Assistance Program (VDAP), a cooperative effort with the Office of Foreign Disaster Assistance of the U.S. Agency for International Development. The work of USGS scientists with VDAP has helped save countless lives, and the valuable lessons learned are being used to reduce risks from volcano hazards in the United States.

  3. Resolution of psychosocial crises associated with flying in space

    NASA Astrophysics Data System (ADS)

    Suedfeld, Peter; Brcic, Jelena

    2011-07-01

    Erikson (1959) proposed a theoretical basis for healthy psychosocial development. His theory posits eight critical conflict situations throughout one's lifetime, each of which can result in a favorable or unfavorable resolution. Autobiographies, memoirs, interviews, personal diaries, and oral histories of 97 international astronauts were content analyzed to assess reported resolutions of Erikson's psychosocial crises, regardless of chronological sequence. We made comparisons across flight phases (before, during, and after), gender, nationality of home space agency, and flight duration. Astronauts reported more favorable than unfavorable outcomes across flight phases and demographic variables. Differences across demographic variables and flight phases, as well as the changes as a result of the flight are discussed.

  4. Anticipating Economic Market Crises Using Measures of Collective Panic.

    PubMed

    Harmon, Dion; Lagi, Marco; de Aguiar, Marcus A M; Chinellato, David D; Braha, Dan; Epstein, Irving R; Bar-Yam, Yaneer

    2015-01-01

    Predicting panic is of critical importance in many areas of human and animal behavior, notably in the context of economics. The recent financial crisis is a case in point. Panic may be due to a specific external threat or self-generated nervousness. Here we show that the recent economic crisis and earlier large single-day panics were preceded by extended periods of high levels of market mimicry--direct evidence of uncertainty and nervousness, and of the comparatively weak influence of external news. High levels of mimicry can be a quite general indicator of the potential for self-organized crises.

  5. Anticipating Economic Market Crises Using Measures of Collective Panic

    PubMed Central

    2015-01-01

    Predicting panic is of critical importance in many areas of human and animal behavior, notably in the context of economics. The recent financial crisis is a case in point. Panic may be due to a specific external threat or self-generated nervousness. Here we show that the recent economic crisis and earlier large single-day panics were preceded by extended periods of high levels of market mimicry—direct evidence of uncertainty and nervousness, and of the comparatively weak influence of external news. High levels of mimicry can be a quite general indicator of the potential for self-organized crises. PMID:26185988

  6. Propagation of crises in the virtual water trade network

    NASA Astrophysics Data System (ADS)

    Tamea, Stefania; Laio, Francesco; Ridolfi, Luca

    2015-04-01

    The international trade of agricultural goods is associated to the displacement of the water used to produce such goods and embedded in trade as a factor of production. Water virtually exchanged from producing to consuming countries, named virtual water, defines flows across an international network of 'virtual water trade' which enable the assessment of environmental forcings and implications of trade, such as global water savings or country dependencies on foreign water resources. Given the recent expansion of commodity (and virtual water) trade, in both displaced volumes and network structure, concerns have been raised about the exposure to crises of individuals and societies. In fact, if one country had to markedly decrease its export following a socio-economical or environmental crisis, such as a war or a drought, many -if not all- countries would be affected due to a cascade effect within the trade network. The present contribution proposes a mechanistic model describing the propagation of a local crisis into the virtual water trade network, accounting for the network structure and the virtual water balance of all countries. The model, built on data-based assumptions, is tested on the real case study of the Argentinean crisis in 2008-09, when the internal agricultural production (measured as virtual water volume) decreased by 26% and the virtual water export of Argentina dropped accordingly. Crisis propagation and effects on the virtual water trade are correctly captured, showing the way forward to investigations of crises impact and country vulnerability based on the results of the model proposed.

  7. Improving communication during volcanic crises on small, vulnerable islands

    NASA Astrophysics Data System (ADS)

    McGuire, W. J.; Solana, M. C.; Kilburn, C. R. J.; Sanderson, D.

    2009-05-01

    Increased exposure to volcanic hazard, particularly at vulnerable small islands, is driving an urgent and growing need for improved communication between monitoring scientists, emergency managers and the media, in advance of and during volcanic crises. Information gathering exercises undertaken on volcanic islands (Guadeloupe, St. Vincent and Montserrat) in the Lesser Antilles (eastern Caribbean), which have recently experienced - or are currently experiencing - volcanic action, have provided the basis for the compilation and publication of a handbook on Communication During Volcanic Emergencies, aimed at the principal stakeholder groups. The findings of the on-island surveys point up the critical importance of (1) bringing together monitoring scientists, emergency managers, and representatives of the media, well in advance of a volcanic crisis, and (2), ensuring that procedures and protocols are in place that will allow, as far as possible, effective and seamless cooperation and coordination when and if a crisis situation develops. Communication During Volcanic Emergencies is designed to promote and encourage both of these priorities through providing the first source-book addressing working relationships and inter-linkages between the stakeholder groups, and providing examples of good and bad practice. While targeting the volcanic islands of the eastern Caribbean, the source-book and its content are largely generic, and the advice and guidelines contained therein have equal validity in respect of improving communication before and during crises at any volcano, and have application to the communication issue in respect of a range of other geophysical hazards.

  8. Preventing crises in palliative care in the home. Role of family physicians and nurses.

    PubMed Central

    Howarth, G.; Willison, K. B.

    1995-01-01

    With the current shift to community care, the need for palliative care in the home involving the family physician has increased. Potential causes of crises in the home care of the dying are identified. Strategies to prevent crises are suggested that rely on a team's providing comprehensive and anticipatory care. PMID:7539653

  9. Classroom Killers? Hallway Hostages? How Schools Can Prevent and Manage School Crises.

    ERIC Educational Resources Information Center

    Trump, Kenneth S.

    This book attempts to dispel the myths and misconceptions surrounding the lessons learned from national school violence crises and shifting security threat trends. Its objective is to deliver balanced, practical, and cost-effective steps for preventing and managing school crises, including how to recognize "red flag" warnings of potential…

  10. Crises in EFL Proficiency and Teacher Development in the Context of International Donation and Transformation Discourses

    ERIC Educational Resources Information Center

    Birbirso, Dereje Tadesse

    2014-01-01

    Since 2000, Ethiopia has been working to come out of social crises, modernise itself and achieve the Millennium Development Goals. Although provided with billions of dollars by the West and their international agents, little has been changed and the crises seem never to abate, especially in the educational system. This study, thus, critically…

  11. Cinacalcet to prevent parathyrotoxic crises in hypercalcaemic patients awaiting parathyroidectomy

    PubMed Central

    Rostoker, Guy; Bellamy, Jean; Janklewicz, Philippe

    2011-01-01

    Primary hyperparathyroidism is the third most common endocrine disorder. Hypercalcaemia exceeding 3 mmol/l is a major risk factor for parathyrotoxic crises, and management of patients at risk remains a medical challenge. The authors recently managed three such patients referred for severe nephrolithiasis. All had severe hypercalcaemia (at least 3 mmol/l). Instead of the usual management, which involves hospitalisation in an intensive care environment (for about 5–7 days) for rehydration and infusion of intravenous bisphosphonates, followed by emergency parathyroidectomy, the three patients received ambulatory cinacalcet (not an approved indication), 30 mg twice a day. The serum calcium normalised in two cases and declined to a safe level in the third case, allowing minimally invasive parathyroidectomy to be performed at a date chosen according to the patients’ and surgeon’s respective schedules. The authors consider that cinacalcet may benefit severely hypercalcaemic patients awaiting surgery for primary hyperparathyroidism. PMID:22696718

  12. Scenarios for Evolving Seismic Crises: Possible Communication Strategies

    NASA Astrophysics Data System (ADS)

    Steacy, S.

    2015-12-01

    Recent advances in operational earthquake forecasting mean that we are very close to being able to confidently compute changes in earthquake probability as seismic crises develop. For instance, we now have statistical models such as ETAS and STEP which demonstrate considerable skill in forecasting earthquake rates and recent advances in Coulomb based models are also showing much promise. Communicating changes in earthquake probability is likely be very difficult, however, as the absolute probability of a damaging event is likely to remain quite small despite a significant increase in the relative value. Here, we use a hybrid Coulomb/statistical model to compute probability changes for a series of earthquake scenarios in New Zealand. We discuss the strengths and limitations of the forecasts and suggest a number of possible mechanisms that might be used to communicate results in an actual developing seismic crisis.

  13. Otto Stern, the Gdh Sum Rule and Various Spin Crises

    NASA Astrophysics Data System (ADS)

    Drechsel, D.

    2001-02-01

    The history of spin and anomalous magnetic moment is full of puzzles and "crises" from the first observations in the 1920's to the present day. The Gerasimov-Drell-Hearn sum rule connects the anomalous magnetic moment with the helicity dependent cross section for photoproduction, and as such checks the internal consistency of our understanding of the nucleon spin structure. Various generalizations of the sum rule have been proposed for the case of virtual photons, thus interpolating from the real photon point to deep inelastic scattering. A series of recent and newly proposed experiments with beam and target/recoil polarization will study this transition between the coherent spin-dependent response and the incoherent response of the partons in the scaling region.

  14. Investigation on financial crises with the negative-information-propagation-induced model

    NASA Astrophysics Data System (ADS)

    Fan, Feng-Hua; Deng, Yanbin; Huang, Yong-Chang

    2017-03-01

    We first argue about the similarity between the propagation phenomenon of negative information about potential deterioration of economic situation in group of investors and the propagation phenomenon of infectious disease in crowd Applying the negative-information-propagation-induced model built based on above argument, we investigate the relationship between the generation of financial crises and propagation effects of negative information We introduce the discrimination parameter to distinguish whether or not negative information will be propagated extensively in group of investors. We also introduce the target critical value of financial crises. By comparing the theoretically predicted ratio of the long term projected number of total investors to the total number of investors at some time as initial time with target critical value of financial crises, the model can provide real-time monitoring of whether the curve of total number of investors is progressing toward the direction of generating financial crises or running on track of financial markets safety. If at some time this ratio is computed to be less than the target critical value of financial crises, governments can take relevant measures to prevent the generation of financial crises in advance Governments' interference helps to recover the confidence of investors so that they never will again believe in negative information to continue their investment. Results from theoretical and numerical analysis show that the number of investors who hold the belief of potential deterioration of economic situation, and the number of investors who withdraw capital and depart from financial markets for avoiding business loss when governments make appropriate interference are lowered compared to that without appropriate governments' interference. The results show the effectiveness of governments in preventing financial crises from the viewpoint of the negative information-propagation-induced model, namely governments

  15. Acute fever and delayed leukoencephalopathy following low dose intraventricular methotrexate.

    PubMed Central

    Boogerd, W; vd Sande, J J; Moffie, D

    1988-01-01

    Nine out of 14 patients treated with intraventricular methotrexate (MTX) for meningeal carcinomatosis from breast carcinoma and surviving more than 4 months developed disseminated necrotising leukoencephalopathy (DNL). All four patients who had received both intraventricular MTX and whole brain radiotherapy developed DNL. Five of the six patients who experienced an acute febrile reaction with mild encephalopathic signs following intraventricular administration of MTX developed DNL after a mean time of 5 months and a low mean dose of 44 mg MTX. DNL was also noted in two patients without a previous febrile reaction or whole brain radiotherapy, following prolonged intraventricular MTX therapy after a mean time of 19.5 months and a mean dose of 147 mg MTX. These findings confirm the hazards of (1) high cumulative doses of intrathecal MTX and (2) combined intrathecal chemotherapy and whole brain radiotherapy. This study also suggests a possible relationship between an early and transient febrile reaction during intraventricular administration of MTX and the development of DNL. Images PMID:3225584

  16. Acute fever and delayed leukoencephalopathy following low dose intraventricular methotrexate.

    PubMed

    Boogerd, W; vd Sande, J J; Moffie, D

    1988-10-01

    Nine out of 14 patients treated with intraventricular methotrexate (MTX) for meningeal carcinomatosis from breast carcinoma and surviving more than 4 months developed disseminated necrotising leukoencephalopathy (DNL). All four patients who had received both intraventricular MTX and whole brain radiotherapy developed DNL. Five of the six patients who experienced an acute febrile reaction with mild encephalopathic signs following intraventricular administration of MTX developed DNL after a mean time of 5 months and a low mean dose of 44 mg MTX. DNL was also noted in two patients without a previous febrile reaction or whole brain radiotherapy, following prolonged intraventricular MTX therapy after a mean time of 19.5 months and a mean dose of 147 mg MTX. These findings confirm the hazards of (1) high cumulative doses of intrathecal MTX and (2) combined intrathecal chemotherapy and whole brain radiotherapy. This study also suggests a possible relationship between an early and transient febrile reaction during intraventricular administration of MTX and the development of DNL.

  17. Identity and intimacy crises and their relationship to internet dependence among college students.

    PubMed

    Huang, Ya-Rong

    2006-10-01

    In an attempt to test Kandell's proposition that internet dependents used the internet as a coping mechanism against underlying psychological issues, this study investigated the extent to which the fifth and sixth Eriksonian crises (identity, intimacy), were related to internet dependence (online chatting, gaming) among college students. Students spending more than 10 hours per week on chatting/gaming were classified as dependents. On the basis of a national sample of freshmen in Taiwan, this study found that the dependents scored significantly lower on most of the measures that reflected the successful resolution of the crises, and higher on the measures that reflected unsuccessful resolution of the crises. Kandell's proposition was supported.

  18. Multiple crises and global health: New and necessary frontiers of health politics

    PubMed Central

    Schrecker, Ted

    2012-01-01

    The world economy is entering an era of multiple crises, involving finance, food security and global environmental change. This article assesses the implications for global public health, describes the contours of post-2007 crises in food security and finance, and then briefly indicates the probable health impacts. There follows a discussion of the crisis of climate change, one that will unfold over a longer time frame but with manifestations that may already be upon us. The article then discusses the political economy of responses to these crises, noting the formidable obstacles that exist to equitable resolution. The article concludes by noting the threat that such crises present to recent progress in global health, arguing that global health researchers and practitioners must become more familiar with the relevant social processes, and that proposed solutions that neglect the continuing importance of the nation-state are misdirected. PMID:22657093

  19. Multiple crises and global health: new and necessary frontiers of health politics.

    PubMed

    Schrecker, Ted

    2012-01-01

    The world economy is entering an era of multiple crises, involving finance, food security and global environmental change. This article assesses the implications for global public health, describes the contours of post-2007 crises in food security and finance, and then briefly indicates the probable health impacts. There follows a discussion of the crisis of climate change, one that will unfold over a longer time frame but with manifestations that may already be upon us. The article then discusses the political economy of responses to these crises, noting the formidable obstacles that exist to equitable resolution. The article concludes by noting the threat that such crises present to recent progress in global health, arguing that global health researchers and practitioners must become more familiar with the relevant social processes, and that proposed solutions that neglect the continuing importance of the nation-state are misdirected.

  20. The impact of economic crises on social inequalities in health: what do we know so far?

    PubMed

    Bacigalupe, Amaia; Escolar-Pujolar, Antonio

    2014-07-25

    Since 2008, Western countries are going through a deep economic crisis whose health impacts seem to be fundamentally counter-cyclical: when economic conditions worsen, so does health, and mortality tends to rise. While a growing number of studies have presented evidence on the effect of crises on the average population health, a largely neglected aspect of research is the impact of crises and the related political responses on social inequalities in health, even if the negative consequences of the crises are primarily borne by the most disadvantaged populations. This commentary will reflect on the results of the studies that have analyzed the effect of economic crises on social inequalities in health up to 2013. With some exceptions, the studies show an increase in health inequalities during crises, especially during the Southeast Asian and Japanese crises and the Soviet Union crisis, although it is not always evident for both sexes or all health or socioeconomic variables. In the Nordic countries during the nineties, a clear worsening of health equity did not occur. Results about the impacts of the current economic recession on health equity are still inconsistent. Some of the factors that could explain this variability in results are the role of welfare state policies, the diversity of time periods used in the analyses, the heterogeneity of socioeconomic and health variables considered, the changes in the socioeconomic profile of the groups under comparison in times of crises, and the type of measures used to analyze the magnitude of social inequalities in health. Social epidemiology should further collaborate with other disciplines to help produce more accurate and useful evidence about the relationship between crises and health equity.

  1. Monitoring the acute phase response to vaso-occlusive crisis in sickle cell disease.

    PubMed Central

    Stuart, J; Stone, P C; Akinola, N O; Gallimore, J R; Pepys, M B

    1994-01-01

    AIMS--To identify suitable acute phase proteins as objective markers of tissue ischaemia during painful vaso-occlusive crises in sickle cell disease. METHODS--The prodromal and established phases of 14 vaso-occlusive crises were studied longitudinally in 10 patients with sickle cell anaemia. Automated solid phase enzyme immunoassays were used to measure the fast responding acute phase proteins C-reactive protein and serum amyloid A protein. Slower responding glycoproteins (fibrinogen, orosomucoid, sialic acid and concanavalin-A binding) were measured in parallel. RESULTS--C-reactive protein and serum amyloid A protein increased early in crisis, sometimes within the early (prodromal) phase. Crises that resolved within 24 hours in hospital showed a minor and transient rise compared with crises that required treatment for four days or more. In eight crises treated by patients at home the acute phase response ranged from minor to a level consistent with extensive tissue ischaemia. CONCLUSIONS--Sensitive enzyme immunoassays for C-reactive protein and serum amyloid A protein are of potential value for monitoring the onset of tissue ischaemia in sickle cell crisis and for confirming subsequent resolution. PMID:7510726

  2. ["Snow" and "Walpurgisnacht". Hans Castorp's exemplary maturation crises in "Zauberberg"].

    PubMed

    Heinrich, K; Walter, C

    1995-01-01

    On the occasion of a rather incidental visit in the sanatorium "Berghof" at Davos, Hans Castorp, the--as to his primary personality--asthenic and low-profile protagonist of the "Zauberberg" is gradually getting caught up in the maelstrom of the there prevailing timelessness and irresponsibility, this being interrupted solely by two tapering to crisis episodes: his amouressness to Mme. Chauchat as an erotic crisis and by the visionary daydream during a snowstorm about the abilities of men as a cognitive, mental crisis. Both events are triggered by a pathoid irritability, following the maxim of Th. Mann that illness, decay and death as borderline experiences may be the presupposition for cognition and reversal. Both crises end without consequences--the "Zauberberg" is the negation of the novel of education and development in the narrower sense. The unsuccessfulness and undecidedness of Hans Castorp's existence culminate in the open end of the novel, regarding his surviving on the battle field, and is in strict contrast to Adrian Leverkühn's determined autoinfection with Lues with the aim of artistic perfection and the creative break-through of "Doctor Faustus". Hans Castorp's regression and self-fragmentation within the decadent-morbid atmosphere of the sanatorium lead to his storming into the battles of the First World War as a last and existential crisis; it is here where finally the individual and national fate are merging. Hans Castorp becomes the paradigma of the German pre-war bourgeoisie and its crisis-prone development.

  3. Neonatal cardiomyopathies and metabolic crises due to oxidative phosphorylation defects.

    PubMed

    Schiff, Manuel; Ogier de Baulny, Hélène; Lombès, Anne

    2011-08-01

    Neonatal cardiomyopathies due to mitochondrial oxidative phosphorylation (OXPHOS) defects are extremely severe conditions which can be either isolated or included in a multi-organ disease, with or without metabolic crises, of which profound lactic acidosis is the prominent feature. Cardiomyopathy is more often hypertrophic than dilated. Antenatal manifestations such as fetal cardiomyopathy, arrhythmia and/or hydrops have been reported. Pathophysiological mechanisms are complex, going beyond ATP deficiency of the high-energy-consuming neonatal myocardium. Birth is a key metabolic period when the myocardium switches ATP production from anaerobic glycolysis to mitochondrial fatty acid oxidation and OXPHOS. Heart-specificity of the defect may be related to the specific localization of the defect, to the high myocardium dependency on OXPHOS, and/or to interaction between the primary genetic alteration and other factors such as modifier genes. Therapeutic options are limited but standardized diagnostic procedures are mandatory to confirm the OXPHOS defect and to identify its causal mutation, allowing genetic counseling and potential prenatal diagnosis.

  4. Preventing food crises using a food policy approach.

    PubMed

    Timmer, C Peter

    2010-01-01

    A food crisis occurs when rates of hunger and malnutrition rise sharply at local, national, or global levels. This definition distinguishes a food crisis from chronic hunger, although food crises are far more likely among populations already suffering from prolonged hunger and malnutrition. A food crisis is usually set off by a shock to either supply or demand for food and often involves a sudden spike in food prices. It is important to remember that in a market economy, food prices measure the scarcity of food, not its value in any nutritional sense. Except in rare circumstances, the straightforward way to prevent a food crisis is to have rapidly rising labor productivity through economic growth and keep food prices stable while maintaining access by the poor. The formula is easier to state than to implement, especially on a global scale, but it is good to have both the objective, reducing short-run spikes in hunger, and the deep mechanisms, pro-poor economic growth and stable food prices, clearly in mind. A coherent food policy seeks to use these mechanisms, and others, to achieve a sustained reduction in chronic hunger over the long run while preventing spikes in hunger in the short run.

  5. Communications Contingency Plan: Planning for Crises and Controversy. Phase 1

    NASA Technical Reports Server (NTRS)

    Treise, Deborah; Bernstein, Arla G.; Yates, Brad

    1998-01-01

    Interviews were conducted with a variety of Marshall Space Flight Center personnel and local media representatives in Huntsville, Alabama, in order to identify the current perceptions of these individuals regarding communication effectiveness between MSFC and the media. The purposes of the Phase One report are to (1) assess the need for a contingency plan for communicating in situations of crisis and controversy; (2) identify goals and objectives for the planning process; and (3) provide recommendations for future planning activities to achieve the goals and objectives outlined in Phase One. It is strongly recommended that MSFC personnel who are involved in communications with the media participate in a facilitated, strategic communications planning process in order to develop Phase Two of the Communications Contingency Plan (CCP). Phase Two will address (1) the categorizing, ranking and prioritizing of crises and controversies; (2) the development of action steps and implementation strategies for the CCP; and (3) the development of a monitoring and evaluation process for ongoing plan effectiveness.

  6. Impact of the topology of global macroeconomic network on the spreading of economic crises.

    PubMed

    Lee, Kyu-Min; Yang, Jae-Suk; Kim, Gunn; Lee, Jaesung; Goh, Kwang-Il; Kim, In-mook

    2011-03-31

    Throughout economic history, the global economy has experienced recurring crises. The persistent recurrence of such economic crises calls for an understanding of their generic features rather than treating them as singular events. The global economic system is a highly complex system and can best be viewed in terms of a network of interacting macroeconomic agents. In this regard, from the perspective of collective network dynamics, here we explore how the topology of the global macroeconomic network affects the patterns of spreading of economic crises. Using a simple toy model of crisis spreading, we demonstrate that an individual country's role in crisis spreading is not only dependent on its gross macroeconomic capacities, but also on its local and global connectivity profile in the context of the world economic network. We find that on one hand clustering of weak links at the regional scale can significantly aggravate the spread of crises, but on the other hand the current network structure at the global scale harbors higher tolerance of extreme crises compared to more "globalized" random networks. These results suggest that there can be a potential hidden cost in the ongoing globalization movement towards establishing less-constrained, trans-regional economic links between countries, by increasing vulnerability of the global economic system to extreme crises.

  7. Science during crisis: the application of social science during major environmental crises

    USGS Publications Warehouse

    Machlis, Gary; Ludwig, Kris; Manfredo, Michael J.; Vaske, Jerry J.; Rechkemmer, Andreas; Duke, Esther

    2014-01-01

    Historical and contemporary experience suggests that science plays an increasingly critical role in governmental and institutional responses to major environmental crises. Recent examples include major western wildfires (2009), the Deepwater Horizon oil spill (2010), the Fukushima nuclear accident (2011), and Hurricane Sandy (2012). The application of science during such crises has several distinctive characteristics, as well as essential requirements if it is to be useful to decision makers. these include scope conditions that include coupled natural/human systems, clear statement of uncertainties and limitations, description of cascading consequences, accurate sense of place, estimates of magnitude of impacts, identification of beneficiaries and those adversely affected, clarity and conciseness, compelling visualization and presentation, capacity to speak "truth to power", and direct access to decision makers. In this chapter, we explore the role and significance of science – including all relevant disciplines and focusing attention on the social sciences – in responding to major environmental crises. We explore several important questions: How is science during crisis distinctive? What social science is most useful during crises? What distinctive characteristics are necessary for social science to make meaningful contributions to emergency response and recovery? How might the social sciences be integrated into the strategic science needed to respond to future crises? The authors, both members of the Department of the Interior's innovative Strategic Sciences Group, describe broad principles of engagement as well as specific examples drawn from history, contemporary efforts (such as during the Deepwater Horizon oil spill), and predictions of environmental crises still to be confronted.

  8. Impact of the Topology of Global Macroeconomic Network on the Spreading of Economic Crises

    PubMed Central

    Lee, Kyu-Min; Yang, Jae-Suk; Kim, Gunn; Lee, Jaesung; Goh, Kwang-Il; Kim, In-mook

    2011-01-01

    Throughout economic history, the global economy has experienced recurring crises. The persistent recurrence of such economic crises calls for an understanding of their generic features rather than treating them as singular events. The global economic system is a highly complex system and can best be viewed in terms of a network of interacting macroeconomic agents. In this regard, from the perspective of collective network dynamics, here we explore how the topology of the global macroeconomic network affects the patterns of spreading of economic crises. Using a simple toy model of crisis spreading, we demonstrate that an individual country's role in crisis spreading is not only dependent on its gross macroeconomic capacities, but also on its local and global connectivity profile in the context of the world economic network. We find that on one hand clustering of weak links at the regional scale can significantly aggravate the spread of crises, but on the other hand the current network structure at the global scale harbors higher tolerance of extreme crises compared to more “globalized” random networks. These results suggest that there can be a potential hidden cost in the ongoing globalization movement towards establishing less-constrained, trans-regional economic links between countries, by increasing vulnerability of the global economic system to extreme crises. PMID:21483794

  9. Energy crises and cooperation: Do international institutions matter?

    NASA Astrophysics Data System (ADS)

    Chakarova, Vessela P.

    The risk of an oil supply disruption still exists. Oil reserves are increasingly concentrated in a handful of unreliable regimes, plagued by piracy and terrorism. Natural disasters and chokepoint incidents have increased in frequency. In addition, oil is expected to remain a significant part of the energy mix up until 2030. By that time Europe will be importing 90% of its oil. Thus, oil supply security will become an increasingly important feature of European politics. One way to counter the noxious consequences of an oil disruption is to cooperate. International cooperation is a critical factor in any type of crisis, however, it is especially important when it comes to a finite, highly concentrated and critical commodity like oil. The lack of coordination might lead to scrambling and oil hoarding, which dramatically exacerbate the crisis. Yet cooperation in the oil issue-area has been the subject of only a few studies, none of which provides a systematic and comprehensive analysis. They are also limited in their scope and findings. This dissertation aims to partially fill this lacuna. It employs a structured focused comparison to study European consumer countries' cooperation in times of oil supply shortages. There have been fifteen such crises since the Second World War, three of which with dramatic consequences for the world economy. The analysis evaluates European cooperative efforts in seven of these cases, starting with the Abadan crisis in 1951. The cases are selected on the basis of their magnitude and economic impact. In particular, I look at intergovernmental negotiations within existing international bodies prior to, during and immediately after the crisis. The findings suggest that institutions are more likely to facilitate interstate cooperation in the presence of a strong leader (a hegemon) - a role, which in the case of the oil issue-area was assumed by the US until the early 1970s.

  10. Abdominal injuries in communal crises: The Jos experience

    PubMed Central

    Ojo, Emmanuel Olorundare; Ozoilo, Kenneth N.; Sule, Augustine Z.; Ugwu, Benjamin T.; Misauno, Michael A.; Ismaila, Bashiru O.; Peter, Solomon D.; Adejumo, Adeyinka A.

    2016-01-01

    Background: Abdominal injuries contribute significantly to battlefield trauma morbidity and mortality. This study sought to determine the incidence, demographics, clinical features, spectrum, severity, management, and outcome of abdominal trauma during a civilian conflict. Materials and Methods: A prospective analysis of patients treated for abdominal trauma during the Jos civil crises between December 2010 and May 2012 at the Jos University Teaching Hospital. Results: A total of 109 victims of communal conflicts with abdominal injuries were managed during the study period with 89 (81.7%) males and 20 (18.3%) females representing about 12.2% of the total 897 combat related injuries. The peak age incidence was between 21 and 40 years (range: 3–71 years). The most frequently injured intra-abdominal organs were the small intestine 69 (63.3%), colon 48 (44%), and liver 41 (37.6%). Forty-four (40.4%) patients had extra-abdominal injuries involving the chest in 17 (15.6%), musculoskeletal 12 (11%), and the head in 9 (8.3%). The most prevalent weapon injuries were gunshot 76 (69.7%), explosives 12 (11%), stab injuries 11 (10.1%), and blunt abdominal trauma 10 (9.2%). The injury severity score varied from 8 to 52 (mean: 20.8) with a fatality rate of 11 (10.1%) and morbidity rate of 29 (26.6%). Presence of irreversible shock, 3 or more injured intra-abdominal organs, severe head injuries, and delayed presentation were the main factors associated with mortality. Conclusion: Abdominal trauma is major life-threatening injuries during conflicts. Substantial mortality occurred with loss of nearly one in every 10 hospitalized victims despite aggressive emergency room resuscitation. The resources expenditure, propensity for death and expediency of timing reinforce the need for early access to the wounded in a concerted trauma care systems. PMID:26957819

  11. Crucial crises in biology: life in the deep biosphere.

    PubMed

    Guerrero, R

    1998-12-01

    The origin and evolution of life on Earth are the result of a series of crises that have taken place on the planet over about 4500 millions of years since it originated. Biopoiesis (origin of life), ecopoiesis (origin of ecosystems) and the first ecosystems (stromatolites and microbial mats), as well as eukaryopoiesis (origin of nucleated cells) are revised. The paper then focuses on the study of the deep biosphere, describing ecosystems never found before, which are independent of solar radiation and have changed previous assumptions about the requirements of life; even the concept of biosphere, as Vernadsky defined it, has increased its scope. Since the discovery, in 1987, of bacteria growing in the crevices of rocks at 500 m deep, in boreholes drilled near the Savanna River, Aiken, South Carolina, other bacteria have been found in the deep subsurface reaching depths of about 3 km (e.g., in the Columbia River Basalt Group, near Richland, Washington state), in an anaerobic, hot, high-pressure environment. Some kinds of microorganisms can thrive at such depths, living in many cases a geochemical existence, by using very specialized metabolisms, which depend on the local environments. The existence of organisms independent from photosynthetic production is the most outstanding, novel feature of the deep biosphere. Living beings might not need other energy and chemical sources than those which occur in the development of all planetary bodies. Life, therefore, could even be an ineluctable outcome of planetary evolution and, as a corollary, a natural continuation of the usual development of physical phenomena in the universe.

  12. "Peer2Peer" – A university program for knowledge transfer and consultation in dealing with psychosocial crises in med-school and medical career

    PubMed Central

    Vajda, Christian

    2016-01-01

    Objective: Medical students are exposed to various psychosocial problems and challenges. Specific consultations services and programs can support them. “Peer2Peer” is such a consultation program and was implemented at the Medical University of Graz. It focusses on crisis intervention, psychosocial stress management, junior mentoring as well as student education in this field. Besides, it also offers student tutors of the program practical skills trainings. The program was restructured in winter term 2014/15. Methods: On the one hand, “Peer2Peer” gives insights into topics such as the current state of research concerning the students’ psychological strain and psychosocial crises in acutely stressful situations and preventive approaches for coping with these kinds of situations on the other hand. These aspects are taught by means of elective courses, lectures and workshops. Furthermore, “Peer2Peer” provides consultation services by student tutors who give face-to-face advice if required. These tutors receive ongoing training in organizational and professional issues. Results: Since the summer term of 2015, 119 students have been trained (via lectures and elective courses), while 61 contacts (short consultation) and 33 contacts (full consultation) have been supervisied. In total, two psychotherapeutic and one psychosocial follow ups were recommended. There are seven students who participate as tutors in the program. Conclusions: The “Peer2Peer” program is intended to enable a low-threshold access for medical students facing psychosocial crises situations and to help them in dealing with stress and learning problems. An increase in support contacts from the summer term of 2015 to the winter term of 2015/16 can be considered a success. A first evaluation of the different components of the program started in the winter semester of 2015/16. The student tutors have not only acquired practical skills in dealing with students in crises situations but also

  13. Global effects of local food-production crises: a virtual water perspective

    PubMed Central

    Tamea, Stefania; Laio, Francesco; Ridolfi, Luca

    2016-01-01

    By importing food and agricultural goods, countries cope with the heterogeneous global water distribution and often rely on water resources available abroad. The virtual displacement of the water used to produce such goods (known as virtual water) connects together, in a global water system, all countries participating to the international trade network. Local food-production crises, having social, economic or environmental origin, propagate in this network, modifying the virtual water trade and perturbing local and global food availability, quantified in terms of virtual water. We analyze here the possible effects of local crises by developing a new propagation model, parsimonious but grounded on data-based and statistically-verified assumptions, whose effectiveness is proved on the Argentinean crisis in 2008–09. The model serves as the basis to propose indicators of crisis impact and country vulnerability to external food-production crises, which highlight that countries with largest water resources have the highest impact on the international trade, and that not only water-scarce but also wealthy and globalized countries are among the most vulnerable to external crises. The temporal analysis reveals that global average vulnerability has increased over time and that stronger effects of crises are now found in countries with low food (and water) availability. PMID:26804492

  14. Crises Management in the Oil and Gas Industry: The Niger Delta Experience

    NASA Astrophysics Data System (ADS)

    Odemene, Glory C.

    The Niger Delta crises escalated beyond the borders of the Nigerian nation to become an issue that affected individuals and corporations around the world. This study led to the discovery of how the local crises escalated with international implications. This discovery was accomplished by addressing how the Niger Delta crises escalated from villages to international scenes, with notable impacts on the environment, health, safety, security, and financial segments of local, international, private, and corporate entities. Using Sweeny's crisis decision theory and Lazarus and Folkman's coping theory, the study considered the coping strategies of community members, the decisions, and actions they took in response to the management approaches of the government and the oil and gas companies (OGCs). This qualitative study utilized historical narrative to collect data by interviewing 4 participants who lived and worked in the region during the crises. NVivo was used for manual and automatic coding of data, as well as for categorization and connection of codes. Content analysis of identified codes and categories revealed the themes and trends in the experiences narrated by participants. Findings include the root causes, trend of escalation, and management strategies of the government and the OGCs that influenced the crises. These findings will help to influence policies and practices in the region and enhance effective management of current and emerging conflicts, with possibilities of restoring stability and security in the areas and in the nation at large.

  15. Global effects of local food-production crises: a virtual water perspective.

    PubMed

    Tamea, Stefania; Laio, Francesco; Ridolfi, Luca

    2016-01-25

    By importing food and agricultural goods, countries cope with the heterogeneous global water distribution and often rely on water resources available abroad. The virtual displacement of the water used to produce such goods (known as virtual water) connects together, in a global water system, all countries participating to the international trade network. Local food-production crises, having social, economic or environmental origin, propagate in this network, modifying the virtual water trade and perturbing local and global food availability, quantified in terms of virtual water. We analyze here the possible effects of local crises by developing a new propagation model, parsimonious but grounded on data-based and statistically-verified assumptions, whose effectiveness is proved on the Argentinean crisis in 2008-09. The model serves as the basis to propose indicators of crisis impact and country vulnerability to external food-production crises, which highlight that countries with largest water resources have the highest impact on the international trade, and that not only water-scarce but also wealthy and globalized countries are among the most vulnerable to external crises. The temporal analysis reveals that global average vulnerability has increased over time and that stronger effects of crises are now found in countries with low food (and water) availability.

  16. Global effects of local food-production crises: a virtual water perspective

    NASA Astrophysics Data System (ADS)

    Tamea, Stefania; Laio, Francesco; Ridolfi, Luca

    2016-01-01

    By importing food and agricultural goods, countries cope with the heterogeneous global water distribution and often rely on water resources available abroad. The virtual displacement of the water used to produce such goods (known as virtual water) connects together, in a global water system, all countries participating to the international trade network. Local food-production crises, having social, economic or environmental origin, propagate in this network, modifying the virtual water trade and perturbing local and global food availability, quantified in terms of virtual water. We analyze here the possible effects of local crises by developing a new propagation model, parsimonious but grounded on data-based and statistically-verified assumptions, whose effectiveness is proved on the Argentinean crisis in 2008–09. The model serves as the basis to propose indicators of crisis impact and country vulnerability to external food-production crises, which highlight that countries with largest water resources have the highest impact on the international trade, and that not only water-scarce but also wealthy and globalized countries are among the most vulnerable to external crises. The temporal analysis reveals that global average vulnerability has increased over time and that stronger effects of crises are now found in countries with low food (and water) availability.

  17. Acute intermittent porphyria with SIADH and fluctuating dysautonomia.

    PubMed

    Nabin, A; Thapa, L J; Paudel, R; Rana, P V S

    2012-01-01

    Three cases of acute intermittent porphyria are reported. While in first case severe pain in abdomen with intermittent exacerbation was the only presentation, the second patient presented as accelerated hypertension and acute abdominal crises in whom the clinical course was characterized by development of deep coma due to inappropriate secretion of antidiuretic hormone before she made complete recovery. The third patient, initially manifested as acute encephalitic syndrome. After initial improvement, she developed features of acute intermittent porphyria i.e. acute abdomen, neuropsychiatric symptoms, and rapidly progressing acute motor neuropathy leading to respiratory and bulbar paralysis. In addition, she developed severe and fluctuating dysautonomia leading to cardiac arrest and fatal termination. The importance of early diagnosis, recognition of autonomic disturbances, prompt treatment and counseling for avoidance of precipitating factors is stressed.

  18. Government management of two media-facilitated crises involving dioxin contamination of food.

    PubMed

    Jacob, Casey J; Lok, Corie; Morley, Katija; Powell, Douglas A

    2011-03-01

    Incidents become crises through a constant and intense public scrutiny facilitated by the media. Two incidents involving dioxin contamination of food led to crises in Belgium and the Republic of Ireland in 1999 and 2008, respectively. Thought to cause cancer in humans, dioxins reached the food supply in both incidents through the contamination of fat used for animal feed. The food and agricultural industries connected to each incident relied on crisis management activities of federal governments to limit adverse public reaction. Analysis of the management of the two crises by their respective federal governments, and a subsequent review of crisis management literature, led to the development of an effective crisis management model. Such a model, appropriately employed, may insulate industries associated with a crisis against damaged reputations and financial loss.

  19. How do economic crises affect migrants’ risk of infectious disease? A systematic-narrative review

    PubMed Central

    Karanikolos, Marina; Williams, Gemma; Mladovsky, Philipa; King, Lawrence; Pharris, Anastasia; Suk, Jonathan E.; Hatzakis, Angelos; McKee, Martin; Noori, Teymur; Stuckler, David

    2015-01-01

    Background: It is not well understood how economic crises affect infectious disease incidence and prevalence, particularly among vulnerable groups. Using a susceptible-infected-recovered framework, we systematically reviewed literature on the impact of the economic crises on infectious disease risks in migrants in Europe, focusing principally on HIV, TB, hepatitis and other STIs. Methods: We conducted two searches in PubMed/Medline, Web of Science, Cochrane Library, Google Scholar, websites of key organizations and grey literature to identify how economic changes affect migrant populations and infectious disease. We perform a narrative synthesis in order to map critical pathways and identify hypotheses for subsequent research. Results: The systematic review on links between economic crises and migrant health identified 653 studies through database searching; only seven met the inclusion criteria. Fourteen items were identified through further searches. The systematic review on links between economic crises and infectious disease identified 480 studies through database searching; 19 met the inclusion criteria. Eight items were identified through further searches. The reviews show that migrant populations in Europe appear disproportionately at risk of specific infectious diseases, and that economic crises and subsequent responses have tended to exacerbate such risks. Recessions lead to unemployment, impoverishment and other risk factors that can be linked to the transmissibility of disease among migrants. Austerity measures that lead to cuts in prevention and treatment programmes further exacerbate infectious disease risks among migrants. Non-governmental health service providers occasionally stepped in to cater to specific populations that include migrants. Conclusions: There is evidence that migrants are especially vulnerable to infectious disease during economic crises. Ring-fenced funding of prevention programs, including screening and treatment, is important for

  20. The Impact of Prolonged Economic Downturns and Economic Crises on the Nursing Profession.

    PubMed

    Phua, Kai-Lit; Hue, Jia-Wern

    2015-01-01

    Prolonged economic downturns and economic crises are affecting nations around the world, including developed countries such as Portugal, Spain, and Greece. In the United States, recovery from the latest economic crisis has been accompanied by a persistently high rate of unemployment. To a large extent, the impacts on the nursing profession may depend on the severity of economic downturns and their duration in the country of employment of nurses. Nurses in certain areas of patient care (such as mental health) may also be more strongly affected because of the impact of economic crises and high unemployment on morbidity patterns. Emigration of nurses may also increase as a result of prolonged economic crisis.

  1. Seven Destructive Seismic Crises in 12th Century Syria

    NASA Astrophysics Data System (ADS)

    Guidoboni, E.; Bernardini, F.

    2002-12-01

    Between 1114 and 1170 Syria was struck by 7 seismic crises: 5 were great earthquakes (August and November 1114, November 1115, June 1117, June 1170), amongst which that of 29th June 1170 represents one of the most destructive events of the Middle-Eastern and Mediterranean area. Instead 2 were long and violent tremor sequences without a real main shock: the first one went on from October 1138 to June 1139, the second from September 1156 to May 1159. Until now all of these seismic events had been known mostly through Arab sources. However, owing to the particular political and military situation in the Syria of that period, such sources could not provide a complete frame of reference. Indeed, in those years in the territories of Syria and present-day Lebanon, some Latin States had been formed due to the military invasion of the Frankish Crusades. Furthermore, Syria was a privileged territory of travellers from various countries heading towards Palestine. Hence, basing ourselves on complex and diversified types of sources, precious new data have emerged written in Latin, Frankish, Greek, Armenian and Syrian. At the same time, the contribution of the Arab sources has been broadened. The overall picture that has emerged offers a new observational basis that has allowed us to date, differentiate, localise and thoroughly evaluate the elements of at least 5 of these earthquakes (the best documented ones: November 1114, 1115, 1138-39, 1156-59 and 1170). Overall nearly 90 hit locations have been identified, about 30 of which new and unknown to the previous studies. It has thus been possible for the first time to shed light on the intense seismic activity that affected this region in the dark ages. In just less than 60 years all of the vast territory that includes present-day Lebanon, north-eastern Syria and south-eastern Turkey was repeatedly struck. The earthquakes of 13th November 1114 and 29th November 1115 (until today often muddled up), and the sequence in 1138-39 hit

  2. Successful career women at midlife: crises and transitions.

    PubMed

    Lieblich, A

    1986-01-01

    Recent theories and studies have gradually clarified some of the psychological processes of middle age. Most interesting are the contributions that maintain different developmental processes for women and men. Three of the major theories in the area seem to converge in proposing a process of gradual cross-sex transition in adulthood, the result of which may be a more integrated or androgynous personality structure in the second half of life. A different model of adult development, centered on midlife crisis, was proposed by Levinson et al. as a universal stage in men's life cycle. Similar theory and research about women are not as conclusive. The present study investigated in depth the life history of twenty-five American career women at midlife. Such women sociologically combine feminine and masculine roles and may be considered as a test case for the theories. The transitions experienced by these women during their lifetimes were categorized into "masculine" or "feminine" types. It was found that they were distributed about equally between the two types of transitions, thus excluding a simple biological approach. Acute midlife crisis was reported by only about a third of the sample. It is proposed that the double role protects these women from acute crisis.

  3. Crises and Opportunities: The Futures of Scholarly Publishing. ACLS Occasional Paper, No. 57

    ERIC Educational Resources Information Center

    Alonso, Carlos J.; Davidson, Cathy N.; Unsworth, John M.; Withey, Lynne

    2003-01-01

    Presented herein are papers presented at a session entitled "Crises and Opportunities: The Future of Scholarly Publishing," from the American Council of Learned Societies (ACLS) Annual Meeting, May 10, 2003. Four speakers approached this topic from different standpoints: as leaders of learned societies, as senior university officials, from the…

  4. Lessons Learned from School Crises and Emergencies, Vol. 1, Issue 2, Fall 2006

    ERIC Educational Resources Information Center

    US Department of Education, 2006

    2006-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. School and student names have been changed to protect identities. Information for this publication was gathered through a series of interviews with school stakeholders involved in the actual incident. This "Lessons Learned" issue…

  5. Bibliography of Selected Literature in the 1970s Related to Crises, Family Stress, Coping and Adaptation.

    ERIC Educational Resources Information Center

    Chesser, Barbara

    This bibliography of literature from the 1970s related to crises, family stress, coping, and adaptation contains references of particular interest to professionals in the areas of counseling, education, and family social, psychological and health services. The bibliography is divided into 26 categories; references are classified according to major…

  6. THE "FREE SPEECH" CRISES AT BERKELEY, 1964-1965--SOME ISSUES FOR SOCIAL AND LEGAL RESEARCH.

    ERIC Educational Resources Information Center

    LUNSFORD, TERRY F.

    AN EXAMINATION WAS MADE OF THE ISSUES AND EVENTS OF THE "FREE SPEECH" CRISES ON THE BERKELEY CAMPUS OF THE UNIVERSITY OF CALIFORNIA IN AN ATTEMPT TO PROVIDE THE BASIS FOR MORE SYSTEMATIC AND DISPASSIONATE STUDY OF CERTAIN ISSUES BEHIND THE STUDENT PROTESTS, AND TO STIMULATE SOCIAL AND LEGAL RESEARCH ON THESE ISSUES. FOLLOWING AN…

  7. Identity Crises in Love and at Work: Dispositional Optimism as a Durable Personal Resource

    ERIC Educational Resources Information Center

    Andersson, Matthew A.

    2012-01-01

    Using the 2004 General Social Survey (N = 453), the identity stress process is investigated in terms of crises in intimate relationships and at the workplace. I discuss dispositional optimism as a psychological resource that is relatively independent of the situation and the self, making it ideal for structurally disadvantaged actors and for…

  8. Risks and Crises for Healthcare Providers: The Impact of Cloud Computing

    PubMed Central

    Glasberg, Ronald; Hartmann, Michael; Tamm, Gerrit

    2014-01-01

    We analyze risks and crises for healthcare providers and discuss the impact of cloud computing in such scenarios. The analysis is conducted in a holistic way, taking into account organizational and human aspects, clinical, IT-related, and utilities-related risks as well as incorporating the view of the overall risk management. PMID:24707207

  9. The Nigerian State and Global Economic Crises: Socio-Political Implications and Policy Challenges

    ERIC Educational Resources Information Center

    Olaopa, O. R.; Ogundari, I. O.; Akindele, S. T.; Hassan, O. M.

    2012-01-01

    This article discusses how economic reforms, as a reaction to the effects of the global financial crises, have intensified popular unrests and redefined the composition, interests, and socio-economic and political attitudes of Nigeria's increasingly complex social strata. We relied basically on secondary data to analyze some of the fundamental…

  10. Reacting to Crises: The Risk-Averse Nature of Contemporary American Public Education

    ERIC Educational Resources Information Center

    Moran, Peter

    2015-01-01

    Over the past several decades, numerous arguments have been made advancing the notion that the failings of the public education system in the United States have placed the nation's national security or economic prosperity at risk. This article will examine some of these "crises" and explore how arguments claiming that the shortcomings of…

  11. Past Adolescence, into and across Adulthood: Career Crises and Major Decisions

    ERIC Educational Resources Information Center

    Bakshi, Anuradha J.

    2011-01-01

    Career-related crises and major decisions, support for these, and job satisfaction were surveyed in 124 varied individuals from Mumbai, India. All participants were in the post-career-entry stage and engaged in paid work; they differed with regard to age (range 18-75 years), sex, marital status, religion, education, occupation, income, and…

  12. Give Us This Day Our Daily Bread: Manufacturing Crises in Education.

    ERIC Educational Resources Information Center

    Cizek, Gregory J.

    1999-01-01

    The model currently guiding educational policy development--constructing crises and crafting solutions--has a long, unproductive history. To shrug off American education's perpetual crisis mode, educators should expand their descriptive vocabularies, apply the "so what" test, adopt demonstrably effective solutions, eschew a crisis…

  13. Random Acts of Senseless Video: An Organizational Psychology Perspective on the "Identity Crises" of Corporate Television.

    ERIC Educational Resources Information Center

    Gutenko, Gregory

    Corporate television suffers from at least two "identity crises": departmental isolation, and the lack of a legitimate identity for the corporate video product itself. Video departments are not usually viewed and accepted by the organizational whole as natural evolutions of a historically defined and behaviorally integrated system. The…

  14. Prevention of Targeted School Violence by Responding to Students' Psychosocial Crises: The NETWASS Program

    ERIC Educational Resources Information Center

    Leuschner, Vincenz; Fiedler, Nora; Schultze, Martin; Ahlig, Nadine; Göbel, Kristin; Sommer, Friederike; Scholl, Johanna; Cornell, Dewey; Scheithauer, Herbert

    2017-01-01

    The standardized, indicated school-based prevention program "Networks Against School Shootings" combines a threat assessment approach with a general model of prevention of emergency situations in schools through early intervention in student psychosocial crises and training teachers to recognize warning signs of targeted school violence.…

  15. Variations of Young Germans' Informal Conceptions of Financial and Economic Crises Phenomena

    ERIC Educational Resources Information Center

    Aprea, Carmela; Sappa, Viviana

    2014-01-01

    The development of a sound understanding of financial and economic crises phenomena must be considered an important goal within the scope of citizenship, economic and social science education. As with every other educational endeavour, this intention requires solid information about what informal conceptions learners hold about this specific…

  16. Comparing emerging and mature markets during times of crises: A non-extensive statistical approach

    NASA Astrophysics Data System (ADS)

    Namaki, A.; Koohi Lai, Z.; Jafari, G. R.; Raei, R.; Tehrani, R.

    2013-07-01

    One of the important issues in finance and economics for both scholars and practitioners is to describe the behavior of markets, especially during times of crises. In this paper, we analyze the behavior of some mature and emerging markets with a Tsallis entropy framework that is a non-extensive statistical approach based on non-linear dynamics. During the past decade, this technique has been successfully applied to a considerable number of complex systems such as stock markets in order to describe the non-Gaussian behavior of these systems. In this approach, there is a parameter q, which is a measure of deviation from Gaussianity, that has proved to be a good index for detecting crises. We investigate the behavior of this parameter in different time scales for the market indices. It could be seen that the specified pattern for q differs for mature markets with regard to emerging markets. The findings show the robustness of the stated approach in order to follow the market conditions over time. It is obvious that, in times of crises, q is much greater than in other times. In addition, the response of emerging markets to global events is delayed compared to that of mature markets, and tends to a Gaussian profile on increasing the scale. This approach could be very useful in application to risk and portfolio management in order to detect crises by following the parameter q in different time scales.

  17. Marketing Crises in Tourism: Communication Strategies in the United States and Spain.

    ERIC Educational Resources Information Center

    Gonzalez-Herrero, Alfonso; Pratt, Cornelius B.

    1998-01-01

    Compares crisis-response strategies of marketing-communication professionals in tourism organizations (TOs) in the United States and Spain. Reports the extent to which they use proven crisis-management strategies. Indicates significant differences between the countries' TOs in both their extant plans for responding to marketing crises and in their…

  18. Nine Going on Seventeen: Boundary Crises in the Cultural Map of Childhood/Adolescence.

    ERIC Educational Resources Information Center

    Mitchell, Claudia; Reid-Walsh, Jacqueline

    Boundary crises for girls moving into adolescence were studied by analyzing "Seventeen" magazine to contribute to the discourse around redefining childhood. The border between childhood and adolescence appears to be moving downward, and as the boundary goes down, the moral panic in society often goes up. To analyze "Seventeen,"…

  19. Reclaiming Paedeia in an Age of Crises: Education and the Necessity of Wisdom

    ERIC Educational Resources Information Center

    Ozolinš, Janis Talivaldis

    2015-01-01

    Education needs to prepare students to have understanding of themselves, of their relationships to others, to have an ability to make good moral and other judgements and to act on these. If education has a role to play in the alleviation of the crises facing the world, then there is some urgency in reflecting on what kind of education is needed in…

  20. Development of encephalopathic features similar to Reye syndrome in rabbits.

    PubMed Central

    Kang, E S; Olson, G; Jabbour, J T; Solomon, S S; Heimberg, M; Sabesin, S; Griffith, J F

    1984-01-01

    The progression of neurological abnormalities through four or five clinically distinguishable levels of deepening coma and the development of a fatty liver are the hallmarks of Reye syndrome. A number of animal models have been described that result in fatty liver formation with minimal, static, or catastrophic neurological changes. In this study, we attempted to produce neurological features in rabbits that reflected a rostral-caudal progression of abnormalities that could be categorized into clinically distinguishable levels reminiscent of Reye syndrome. This was accomplished by the intracisternal administration of 0.5-25 mg of 11,14-icosadienoic acid (20:2 omega 6) suspended in a mixture of rabbit serum and isotonic saline solution. A reproducible, dose-titratable spectrum of at least four levels of deepening coma could be produced at will. Increases in serum glutamate-oxaloacetate transaminase and creatine kinase and changes in serum glucose resulted 1-2 hr after the neurological abnormalities were evoked. Other unsaturated fatty acids produced similar responses. Those tested included 18:1 omega 9, 18:2 omega 6, 18:3 omega 3, 20:3 omega 6, 20:4 omega 6, and 22:4 omega 6 fatty acids. Saturated fatty acids, including 6:0, 8:0, 16:0, 18:0, and 20:0, failed to elicit these effects. The abnormalities were sustained for 30-120 min after a single dose. Full recovery was observed in some animals that had not reached the fourth level of our grading system for coma. Pretreatment of the rabbits with aspirin modulated the neurological abnormalities. Twenty micrograms of bee venom melittin, which activates endogenous phospholipase A2, administered intracisternally into rabbits also produced signs of level 3 (our grading system) coma for several hours. These findings suggest a possible role for polyunsaturated fatty acids in the development of Reye syndrome and offer a means of producing the neurological components of that syndrome in a laboratory animal. Images PMID:6592608

  1. Vulnerability of countries to food-production crises propagating in the virtual water trade network

    NASA Astrophysics Data System (ADS)

    Tamea, S.; Laio, F.; Ridolfi, L.

    2015-12-01

    In recent years, the international trade of food and agricultural commodities has undergone a marked increase of exchanged volumes and an expansion of the trade network. This globalization of trade has both positive and negative effects, but the interconnectedness and external dependency of countries generate complex dynamics which are often difficult to understand and model. In this study we consider the volume of water used for the production of agricultural commodities, virtually exchanged among countries through commodity trade, i.e. the virtual water trade. Then, we set up a parsimonious mechanistic model describing the propagation, into the global trade network, of food-production crises generated locally by a social, economic or environmental event (such as war, economic crisis, drought, pest). The model, accounting for the network structure and the virtual water balance of all countries, bases on rules derived from observed virtual water flows and on data-based and statistically verified assumption. It is also tested on real case studies that prove its capability to capture the main features of crises propagation. The model is then employed as the basis for the development of an index of country vulnerability, measuring the exposure of countries to crises propagating in the virtual water trade network. Results of the analysis are discussed within the context of socio-economic and environmental conditions of countries, showing that not only water-scarce, but also wealthy and globalized countries, are among the most vulnerable to external crises. The temporal analysis for the period 1986-2011 reveals that the global average vulnerability has strongly increased over time, confirming the increased exposure of countries to external crises which may occur in the virtual water trade network.

  2. Cystitis - acute

    MedlinePlus

    Uncomplicated urinary tract infection; UTI - acute cystitis; Acute bladder infection; Acute bacterial cystitis ... cause. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  3. Currency crises and the evolution of foreign exchange market: Evidence from minimum spanning tree

    NASA Astrophysics Data System (ADS)

    Jang, Wooseok; Lee, Junghoon; Chang, Woojin

    2011-02-01

    We examined the time series properties of the foreign exchange market for 1990-2008 in relation to the history of the currency crises using the minimum spanning tree (MST) approach and made several meaningful observations about the MST of currencies. First, around currency crises, the mean correlation coefficient between currencies decreased whereas the normalized tree length increased. The mean correlation coefficient dropped dramatically passing through the Asian crisis and remained at the lowered level after that. Second, the Euro and the US dollar showed a strong negative correlation after 1997, implying that the prices of the two currencies moved in opposite directions. Third, we observed that Asian countries and Latin American countries moved away from the cluster center (USA) passing through the Asian crisis and Argentine crisis, respectively.

  4. Subsequent biotic crises delayed marine recovery following the late Permian mass extinction event in northern Italy.

    PubMed

    Foster, William J; Danise, Silvia; Price, Gregory D; Twitchett, Richard J

    2017-01-01

    The late Permian mass extinction event was the largest biotic crisis of the Phanerozoic and has the longest recovery interval of any extinction event. It has been hypothesised that subsequent carbon isotope perturbations during the Early Triassic are associated with biotic crises that impeded benthic recovery. We test this hypothesis by undertaking the highest-resolution study yet made of the rock and fossil records of the entire Werfen Formation, Italy. Here, we show that elevated extinction rates were recorded not only in the Dienerian, as previously recognised, but also around the Smithian/Spathian boundary. Functional richness increases across the Smithian/Spathian boundary associated with elevated origination rates in the lower Spathian. The taxonomic and functional composition of benthic faunas only recorded two significant changes: (1) reduced heterogeneity in the Dienerian, and (2) and a faunal turnover across the Smithian/Spathian boundary. The elevated extinctions and compositional shifts in the Dienerian and across the Smithian/Spathian boundary are associated with a negative and positive isotope excursion, respectively, which supports the hypothesis that subsequent biotic crises are associated with carbon isotope shifts. The Spathian fauna represents a more advanced ecological state, not recognised in the previous members of the Werfen Formation, with increased habitat differentiation, a shift in the dominant modes of life, appearance of stenohaline taxa and the occupation of the erect and infaunal tiers. In addition to subsequent biotic crises delaying the recovery, therefore, persistent environmental stress limited the ecological complexity of benthic recovery prior to the Spathian.

  5. Markets during world oil supply crises: an analysis of industry, consumer, and governmental response

    SciTech Connect

    Erfle, Stephen; Pound, John; Kalt, Joseph

    1981-04-01

    An analysis of the response of American markets to supply crises in world oil markets is presented. It addresses four main issues: the efficiency of the operation of American oil markets during oil supply crises; the problems of both economic efficiency and social equity which arise during the American adaptation process; the propriety of the Federal government's past policy responses to these problems; and the relationship between perceptions of the problems caused by world oil crises and the real economic natures of these problems. Specifically, Chapter 1 presents a theoretical discussion of the effects of a world supply disruption on the price level and supply availability of the world market oil to any consuming country including the US Chapter 2 provides a theoretical and empirical analysis of the efficiency of the adaptations of US oil product markets to higher world oil prices. Chapter 3 examines the responses of various groups of US oil firms to the alterations observed in world markets, while Chapter 4 presents a theoretical explanation for the price-lagging behavior exhibited by firms in the US oil industry. Chapter 5 addresses the nature of both real and imagined oil market problems in the US during periods of world oil market transition. (MCW)

  6. Subsequent biotic crises delayed marine recovery following the late Permian mass extinction event in northern Italy

    PubMed Central

    Danise, Silvia; Price, Gregory D.; Twitchett, Richard J.

    2017-01-01

    The late Permian mass extinction event was the largest biotic crisis of the Phanerozoic and has the longest recovery interval of any extinction event. It has been hypothesised that subsequent carbon isotope perturbations during the Early Triassic are associated with biotic crises that impeded benthic recovery. We test this hypothesis by undertaking the highest-resolution study yet made of the rock and fossil records of the entire Werfen Formation, Italy. Here, we show that elevated extinction rates were recorded not only in the Dienerian, as previously recognised, but also around the Smithian/Spathian boundary. Functional richness increases across the Smithian/Spathian boundary associated with elevated origination rates in the lower Spathian. The taxonomic and functional composition of benthic faunas only recorded two significant changes: (1) reduced heterogeneity in the Dienerian, and (2) and a faunal turnover across the Smithian/Spathian boundary. The elevated extinctions and compositional shifts in the Dienerian and across the Smithian/Spathian boundary are associated with a negative and positive isotope excursion, respectively, which supports the hypothesis that subsequent biotic crises are associated with carbon isotope shifts. The Spathian fauna represents a more advanced ecological state, not recognised in the previous members of the Werfen Formation, with increased habitat differentiation, a shift in the dominant modes of life, appearance of stenohaline taxa and the occupation of the erect and infaunal tiers. In addition to subsequent biotic crises delaying the recovery, therefore, persistent environmental stress limited the ecological complexity of benthic recovery prior to the Spathian. PMID:28296886

  7. Early Cretaceous CO2 Pulses: Trigger of Carbon Cycle Perturbations and of Biocalcification Crises

    NASA Astrophysics Data System (ADS)

    Weissert, H.; Wissler, L.; Hennig, S.

    2003-04-01

    The Early Cretaceous C-isotope curve is marked by several positive carbon isotope anomalies with an amplitude of 2-3 ppm and lasting up to millions of years. The two most prominent of these excursions are of Late Valanginian and Aptian age. Isotopic mass balance models suggest that positive carbon isotope excursions reflect altered partitioning of carbon between the oxidized and reduced carbon sinks and that these changes occurred in response to elevated atmospheric CO_2 levels and coupled climate change. Both carbon isotope anomalies coincide with episodes of increased volcanic activity, which is regarded as the source of excess atmospheric carbon dioxide. The Aptian carbon isotope anomaly is preceded by a short-lived negative carbon isotope pulse of up to 2 ppm amplitude while a comparable pulse is not recognized at the base of the Valanginian carbon isotope excursion. This C- isotope event may record a climate-induced destabilisation of sedimentary gas hydrates and the sudden release of methane to oceans and atmosphere. Both, the Aptian and the Valanginian carbon isotope excursions are accompanied by biocalcification crises on carbonate platforms and in pelagic environments. The Valanginian carbonate platform drowning, the nannoconid crisis and the disappearance of calpionellids coincide with the beginning of the positive carbon isotope anomaly. The Aptian biocalcification crises on platforms and in pelagic environments started before the negative carbon isotope spike. Both crises in biocalcification may have been triggered by p CO_2-induced changes in surface water chemistry and/or by sudden changes in temperatures and/or by changes in nutrient levels. Available paleoclimate data and the bulk oxygen isotope records show no evidence for major low latitude ocean paleotemperature changes at the base of the Valanginian isotope anomaly. Partial choking of carbonate production during the Aptian occurred at a time of decreasing oxygen isotope values in pelagic bulk

  8. Functional and genetic characterization of clinical malignant hyperthermia crises: a multi-centre study

    PubMed Central

    2014-01-01

    Background Malignant hyperthermia (MH) is a rare pharmacogenetic disorder which is characterized by life-threatening metabolic crises during general anesthesia. Classical triggering substances are volatile anesthetics and succinylcholine (SCh). The molecular basis of MH is excessive release of Ca2+ in skeletal muscle principally by a mutated ryanodine receptor type 1 (RyR1). To identify factors explaining the variable phenotypic presentation and complex pathomechanism, we analyzed proven MH events in terms of clinical course, muscle contracture, genetic factors and pharmocological triggers. Methods In a multi-centre study including seven European MH units, patients with a history of a clinical MH episode confirmed by susceptible (MHS) or equivocal (MHE) in vitro contracture tests (IVCT) were investigated. A test result is considered to be MHE if the muscle specimens develop pathological contractures in response to only one of the two test substances, halothane or caffeine. Crises were evaluated using a clinical grading scale (CGS), results of IVCT and genetic screening. The effects of SCh and volatile anesthetics on Ca2+ release from sarcoplasmic reticulum (SR) were studied in vitro. Results A total of 200 patients met the inclusion criteria. Two MH crises (1%) were triggered by SCh (1 MHS, 1 MHE), 18% by volatile anesthetics and 81% by a combination of both. Patients were 70% male and 50% were younger than 12 years old. Overall, CGS was in accord with IVCT results. Crises triggered by enflurane had a significantly higher CGS compared to halothane, isoflurane and sevoflurane. Of the 200 patients, 103 carried RyR1 variants, of which 14 were novel. CGS varied depending on the location of the mutation within the RyR1 gene. In contrast to volatile anesthetics, SCh did not evoke Ca2+ release from isolated rat SR vesicles. Conclusions An MH event could depend on patient-related risk factors such as male gender, young age and causative RyR1 mutations as well as on the use

  9. Acute Bronchitis

    MedlinePlus

    ... can also cause acute bronchitis. To diagnose acute bronchitis, your health care provider will ask about your symptoms and listen to your breathing. You may also have other tests. Treatments include rest, fluids, and aspirin (for adults) or ...

  10. Perturbation of Aptian and Valanginian Carbon Cycle and Marine Biocalcification Crises

    NASA Astrophysics Data System (ADS)

    Weissert, H.; Burla, S.

    2005-12-01

    The mid-Cretaceous is known as a time of major perturbations of the global carbon cycle, which coincided with widespread biocalcification crises. Detailed Ccarbonate and Corganic carbon isotope records through the early Aptian show a prominent negative spike followed by a positive carbon isotope anomaly with amplitude of up to 3permil. Based on cyclostratigraphy, the negative C-isotope anomaly lasted up to a few hundred thousand years while the positive excursion had duration of up to millions of years. The negative spike coincides with low oxygen isotope values documented from the Pacific and Tethys Oceans. Tethyan carbon isotope data indicate that fractionation between marine organic matter and carbonate was largest during the time of most negative carbon isotope values. These data provide evidence that atmospheric carbon dioxide levels were highest during the time of the negative spike. The negative carbon isotope spike coincides with a major biocalcification crisis which is recorded in pelagic, neritic and coastal environments. New carbon and strontium isotope data from Aptian coastal successions in Portugal confirm that the most severe Aptian biocalcification crisis started before but culminated during negative carbon isotope anomaly. The widespread Aptian biocalcifcation crisis seems to have been triggered by elevated atmospheric CO2 values related to volcanic activity. Sudden methane release contributed to an amplification of greenhouse climate and it led to further weakening of marine calcification. Comparable calcification crises are recognized in the Valanginian. There, a negative carbon isotope anomaly recoding a methane pulse is not observed. Volcanic degassing alone seems to have triggered this calcification crisis. The positive carbon isotope excursions in the early Aptian and in the Valanginian following the biocalcification crises record the response of oceans and biota to greenhouse climate. Increased organic carbon burial and an accelerated

  11. A review of pharmaceutical policies in response to economic crises and sanctions.

    PubMed

    Kheirandish, Mehrnaz; Rashidian, Arash; Kebriaeezade, Abbas; Cheraghali, Abdol Majid; Soleymani, Fatemeh

    2015-01-01

    An economic crisis has been defined as a situation in which the scale of a country's economy becomes smaller in a period of time. Economic crises happen for various reasons, including economic sanctions. Economic crises in a country may affect national priorities for investment and expenditure and reduce available resources, and hence may affect the health care sector including access to medicines. We reviewed the pharmaceutical policies that the countries adopted in order to mitigate the potential negative effects on access to medicines. We reviewed published reports and articles after conducting a comprehensive search of the PubMed and the Google Scholar. After extracting relevant data from the identified articles, we used the World Health Organization (WHO) access to medicines framework as a guide for the categorization of the policies. We identified a total of 40 studies, of which 10 reported the national pharmaceutical policies adopted to reduce the negative impacts of economic crises on access to medicines in high-income and middle-income countries. We identified 89 policies adopted in the 11 countries and categorized them into 12 distinct policy directions. Most of the policies focused on financial aspects of the pharmaceutical sector. In some cases, countries adopted policies that potentially had negative effects on access to medicines. Only Italy had adopted policies encompassing all four accesses to medicine factors recommended by the WHO. While the countries have adopted many seemingly effective policies, little evidence exists on the effectiveness of these policies to improve access to medicines at a time of an economic crisis.

  12. Coordinating the Provision of Health Services in Humanitarian Crises: a Systematic Review of Suggested Models

    PubMed Central

    Lotfi, Tamara; Bou-Karroum, Lama; Darzi, Andrea; Hajjar, Rayan; El Rahyel, Ahmed; El Eid, Jamale; Itani, Mira; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; El-Jardali, Fadi; Akl, Elie

    2016-01-01

    Background: Our objective was to identify published models of coordination between entities funding or delivering health services in humanitarian crises, whether the coordination took place during or after the crises. Methods: We included reports describing models of coordination in sufficient detail to allow reproducibility. We also included reports describing implementation of identified models, as case studies. We searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library. We also searched websites of relevant organizations. We followed standard systematic review methodology. Results: Our search captured 14,309 citations. The screening process identified 34 eligible papers describing five models of coordination of delivering health services: the “Cluster Approach” (with 16 case studies), the 4Ws “Who is Where, When, doing What” mapping tool (with four case studies), the “Sphere Project” (with two case studies), the “5x5” model (with one case study), and the “model of information coordination” (with one case study). The 4Ws and the 5x5 focus on coordination of services for mental health, the remaining models do not focus on a specific health topic. The Cluster approach appears to be the most widely used. One case study was a mixed implementation of the Cluster approach and the Sphere model. We identified no model of coordination for funding of health service. Conclusion: This systematic review identified five proposed coordination models that have been implemented by entities funding or delivering health service in humanitarian crises. There is a need to compare the effect of these different models on outcomes such as availability of and access to health services. PMID:27617167

  13. A review of pharmaceutical policies in response to economic crises and sanctions

    PubMed Central

    Kheirandish, Mehrnaz; Rashidian, Arash; Kebriaeezade, Abbas; Cheraghali, Abdol Majid; Soleymani, Fatemeh

    2015-01-01

    An economic crisis has been defined as a situation in which the scale of a country's economy becomes smaller in a period of time. Economic crises happen for various reasons, including economic sanctions. Economic crises in a country may affect national priorities for investment and expenditure and reduce available resources, and hence may affect the health care sector including access to medicines. We reviewed the pharmaceutical policies that the countries adopted in order to mitigate the potential negative effects on access to medicines. We reviewed published reports and articles after conducting a comprehensive search of the PubMed and the Google Scholar. After extracting relevant data from the identified articles, we used the World Health Organization (WHO) access to medicines framework as a guide for the categorization of the policies. We identified a total of 40 studies, of which 10 reported the national pharmaceutical policies adopted to reduce the negative impacts of economic crises on access to medicines in high-income and middle-income countries. We identified 89 policies adopted in the 11 countries and categorized them into 12 distinct policy directions. Most of the policies focused on financial aspects of the pharmaceutical sector. In some cases, countries adopted policies that potentially had negative effects on access to medicines. Only Italy had adopted policies encompassing all four accesses to medicine factors recommended by the WHO. While the countries have adopted many seemingly effective policies, little evidence exists on the effectiveness of these policies to improve access to medicines at a time of an economic crisis. PMID:26312250

  14. The role of motivation, responsibility, and integrative complexity in crisis escalation: comparative studies of war and peace crises.

    PubMed

    Winter, David G

    2007-05-01

    Drawing on D. G. Winter's (1993) comparison of 1914 and the Cuban Missile Crisis, the author identified 8 paired crises (1 escalating to war, 1 peacefully resolved). Documents (diplomatic messages, speeches, official media commentary) from each crisis were scored for power, affiliation, and achievement motivation; text measures of responsibility and activity inhibition; and integrative complexity. Aggregated effect-size results show that war crises had significantly higher levels of power motivation and responsibility, whereas peace crises showed trends toward higher integrative complexity and achievement motivation. Follow-up analyses suggested that these results are robust with respect to both sides in a crisis, type of material scored, and historical time. The power motive results extend previous findings, but the responsibility results suggest that responsibility plays a paradoxical role in war. Future research directions are sketched, and the role of psychological content analysis in monitoring the danger of war is discussed.

  15. International crises and global health electives: lessons for faculty and institutions.

    PubMed

    Steiner, Beat D; Carlough, Martha; Dent, Georgette; Peña, Rodolfo; Morgan, Douglas R

    2010-10-01

    Student participation in global health electives and community service initiatives is associated with a number of favorable outcomes, and student interest in participating in such experiences is high. Increasingly, medical schools are facilitating and supervising global health opportunities. The inherent risks and uncertainties of global community service deserve careful consideration as schools engage more actively in this area. This article presents how one institution managed three crises in three electives in a single year. The H1N1 flu epidemic impacted a group of students bound for Mexico, a political upheaval affected a student group working in Honduras, and a hurricane threatened a student group in Nicaragua. This article outlines lessons learned from responding to these crises. Well-defined institutional travel policies, clear communication plans in the event of an emergency, a responsible administrative entity for global experiences, and formal predeparture training for students and faculty can help institutions better respond to unpredictable events. A comprehensive examination of these lessons and reflections on how to institutionalize the various components may help other institutions prepare for such events and lessen negative impact on student learning.

  16. Crises and Collective Socio-Economic Phenomena: Simple Models and Challenges

    NASA Astrophysics Data System (ADS)

    Bouchaud, Jean-Philippe

    2013-05-01

    Financial and economic history is strewn with bubbles and crashes, booms and busts, crises and upheavals of all sorts. Understanding the origin of these events is arguably one of the most important problems in economic theory. In this paper, we review recent efforts to include heterogeneities and interactions in models of decision. We argue that the so-called Random Field Ising model ( rfim) provides a unifying framework to account for many collective socio-economic phenomena that lead to sudden ruptures and crises. We discuss different models that can capture potentially destabilizing self-referential feedback loops, induced either by herding, i.e. reference to peers, or trending, i.e. reference to the past, and that account for some of the phenomenology missing in the standard models. We discuss some empirically testable predictions of these models, for example robust signatures of rfim-like herding effects, or the logarithmic decay of spatial correlations of voting patterns. One of the most striking result, inspired by statistical physics methods, is that Adam Smith's invisible hand can fail badly at solving simple coordination problems. We also insist on the issue of time-scales, that can be extremely long in some cases, and prevent socially optimal equilibria from being reached. As a theoretical challenge, the study of so-called "detailed-balance" violating decision rules is needed to decide whether conclusions based on current models (that all assume detailed-balance) are indeed robust and generic.

  17. Finite-time singularities in the dynamics of Mexican financial crises

    NASA Astrophysics Data System (ADS)

    Alvarez-Ramirez, Jose; Ibarra-Valdez, Carlos

    2004-01-01

    Historically, symptoms of Mexican financial crises have been strongly reflected in the dynamics of the Mexican peso to the dollar exchange currency market. Specifically, in the Mexican financial crises during 1990's, the peso suffered significant depreciation processes, which has important impacts in the macro- and micro-economical environment. In this paper, it is shown that the peso depreciation growth was greater than an exponential and that these growth rates are compatible with a spontaneous singularity occurring at a critical time, which signals an abrupt transition to new dynamical conditions. As in the major 1990's financial crisis in 1994-1995, some control actions (e.g., increasing the USA dollar supply) are commonly taken to decelerate the degree of abruptness of peso depreciation. Implications of these control actions on the crisis dynamics are discussed. Interestingly, by means of a simple model, it is demonstrated that the time at which the control actions begin to apply is critical to moderate the adverse effects of the financial crisis.

  18. A Numeric Scorecard Assessing the Mental Health Preparedness for Large-Scale Crises at College and University Campuses: A Delphi Study

    ERIC Educational Resources Information Center

    Burgin, Rick A.

    2012-01-01

    Large-scale crises continue to surprise, overwhelm, and shatter college and university campuses. While the devastation to physical plants and persons is often evident and is addressed with crisis management plans, the number of emotional casualties left in the wake of these large-scale crises may not be apparent and are often not addressed with…

  19. Managing an Infectious Disease Outbreak in a School. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 3

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an infectious disease incident, which resulted in the death of a student, closure of area schools and the operation of an on-site school vaccine clinic. The report highlights the critical need…

  20. Incorporating Chemical Hazards into an Emergency Management Plan. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 4

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on a chemical spill that went unreported for approximately seven years, setting off a series of responses from the school district's Environmental Health and Safety Department (EHS) and the state…

  1. Coping with Multiple Suicides among Middle School Students. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 2

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue addresses the experience of a school district where three middle school students hung themselves within a three-week timeframe. Although deaths were apparently unconnected, the school district is part of a…

  2. Educating Children in the Midst of Health Crises: A Phenomenological Study of Teachers in Children's Hospital Schools

    ERIC Educational Resources Information Center

    Burns, Johnna N.

    2013-01-01

    Purpose, Scope, and Method of Study: Hospital school teachers are a unique population of educators highly qualified and experienced in teaching students who are facing health crises. The purpose of this phenomenological study was to describe the lived experience of teaching seriously ill students in the hospital school setting. The study was…

  3. Improving Responses to Individual and Family Crises. Learning Guide 10. Project Connect. Linking Self-Family-Work.

    ERIC Educational Resources Information Center

    Emily Hall Tremaine Foundation, Inc., Hartford, CT.

    This learning guide on improving responses to individual and family crises is part of a series of learning guides developed for competency-based adult consumer and homemaking education programs in community colleges, adult education centers, community centers, and the workplace. Focus is on the connections among personal, family, and job…

  4. Acute Pancreatitis and Pregnancy

    MedlinePlus

    ... Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  5. Perioperative Anaesthetic Approach in a Homozygous Sickle Cell Anaemia Patient with Frequent Pain Crises.

    PubMed

    Tuzcu, Kasım; Karcıoğlu, Murat; Davarcı, Işıl; Hakimoğlu, Sedat; Akküçük, Seçkin

    2014-12-01

    Sickle cell disease (HbS) is a haemolytic anaemia characterized by the formation of abnormal haemoglobin. In patients with sickle cell disease, high rates of erythrocyte generation, degradation, and hyperbilirubinemia increase the risk for cholelithiasis. Previous studies have found that the incidence of cholelithiasis is 70% in adult patients. In sickle cell disease, decreased oxygen concentration leads to the sickling of erythrocytes by causing aggregation and polymerization. Sickle erythrocytes can have devastating effects on many vital organs by causing microvascular occlusion. In patients with sickle cell anaemia, anaesthetic technique, anaesthetic agents, and surgical trauma may cause additional risk. In this case report, we present a perioperative anaesthetic approach in the laparoscopic cholecystectomy of a patient with HbS, elevated liver function tests, and frequent pain crises.

  6. Architectures engender crises: The emergence of power laws in social networks

    NASA Astrophysics Data System (ADS)

    Tohmé, Fernando; Larrosa, Juan M. C.

    2016-05-01

    Recent financial crises posed a number of questions. The most salient were related to the cogency of derivatives and other sophisticated hedging instruments. One claim is that all those instruments rely heavily on the assumption that events in the world are guided by normal distributions while, instead, all the evidence shows that they actually follow fat-tailed power laws. Our conjecture is that it is the very financial architecture that engenders extreme events. Not on purpose but just because of its complexity. That is, the system has an internal connection structure that is able to propagate and enhance initially small disturbances. The final outcome ends up not being correlated with its triggering event. To support this claim, we appeal to the intuition drawn from the behavior of social networks. Most of the interesting cases constitute scale-free structures. In particular, we contend, those that arise from strategic decisions of the agents.

  7. Perioperative Anaesthetic Approach in a Homozygous Sickle Cell Anaemia Patient with Frequent Pain Crises

    PubMed Central

    Tuzcu, Kasım; Karcıoğlu, Murat; Davarcı, Işıl; Hakimoğlu, Sedat; Akküçük, Seçkin

    2014-01-01

    Sickle cell disease (HbS) is a haemolytic anaemia characterized by the formation of abnormal haemoglobin. In patients with sickle cell disease, high rates of erythrocyte generation, degradation, and hyperbilirubinemia increase the risk for cholelithiasis. Previous studies have found that the incidence of cholelithiasis is 70% in adult patients. In sickle cell disease, decreased oxygen concentration leads to the sickling of erythrocytes by causing aggregation and polymerization. Sickle erythrocytes can have devastating effects on many vital organs by causing microvascular occlusion. In patients with sickle cell anaemia, anaesthetic technique, anaesthetic agents, and surgical trauma may cause additional risk. In this case report, we present a perioperative anaesthetic approach in the laparoscopic cholecystectomy of a patient with HbS, elevated liver function tests, and frequent pain crises. PMID:27366449

  8. Energy security in the post-Cold War era: Identifying future courses for crises

    SciTech Connect

    Freund, M.T.; Wise, J.A.; Ulibarri, C.A.; Shaw, B.R.; Seely, H.E.; Roop, J.M.

    1994-11-01

    This paper addresses US energy security in the post-Cold War era for a conference on energy security jointly sponsored by the Department of Energy and the National Defense University. It examines the evolving nature of energy security based on analysis of past crisis-inducing events and-discusses potentially important geopolitical, environmental, regulatory, and economic developments during the next twenty-five years. The paper steps beyond the traditional economic focus of energy security issues to examine the interplay between fundamental economic and technical drivers on the one hand, and political, environmental, and perceptual phenomena, on the other hand, that can combine to create crises where none were expected. The paper expands on the premise that the recent demise of the Soviet Union and other changing world conditions have created a new set of energy dynamics, and that it is imperative that the United States revise its energy security perspective accordingly. It proceeds by reviewing key factors that comprise the concepts of ``energy security`` and ``energy crisis`` and how they may fit into the new world energy security equation. The study also presents a series of crisis scenarios that could develop during the next twenty-five years, paying particular attention to mechanisms and linked crisis causes and responses. It concludes with a discussion of factors that may serve to warn analysts and decision makers of impending future crises conditions. The crisis scenarios contained in this report should be viewed only as a representative sample of the types of situations that could occur. They serve to illustrate the variety of factors that can coalesce to produce a ``crisis.``

  9. [Acute pancreatitis].

    PubMed

    Hecker, M; Mayer, K; Askevold, I; Collet, P; Weigand, M A; Krombach, G A; Padberg, W; Hecker, A

    2014-03-01

    Acute pancreatitis is a potentially fatal disease with individually differing expression of systemic involvement. For this reason early diagnosis with subsequent risk stratification is essential in the clinical management of this frequent gastroenterological disorder. Severe forms of acute pancreatitis occur in approximately 20 % of cases often requiring intensive care monitoring and interdisciplinary therapeutic approaches. In the acute phase adequate fluid replacement and sufficient analgesic therapy is of major therapeutic importance. Concerning the administration of antibiotics and the nutritional support of patients with acute pancreatitis a change in paradigms could be observed in recent years. Furthermore, endoscopic, radiological or surgical interventions can be necessary depending on the severity of the disease and potential complications.

  10. Bronchitis - acute

    MedlinePlus

    ... to breathe. Other symptoms of bronchitis are a cough and coughing up mucus. Acute means the symptoms ... diagnosed with chronic bronchitis, you must have a cough with mucus on most days for at least ...

  11. Acute Bronchitis

    MedlinePlus

    ... bronchitis? Acute bronchitis is inflammation of your bronchial tree. The bronchial tree consists of tubes that carry air into your ... weeks or months. This happens because the bronchial tree takes a while to heal. A lasting cough ...

  12. Crisis Reliability Indicators Supporting Emergency Services (CRISES): A Framework for Developing Performance Measures for Behavioral Health Crisis and Psychiatric Emergency Programs.

    PubMed

    Balfour, Margaret E; Tanner, Kathleen; Jurica, Paul J; Rhoads, Richard; Carson, Chris A

    2016-01-01

    Crisis and emergency psychiatric services are an integral part of the healthcare system, yet there are no standardized measures for programs providing these services. We developed the Crisis Reliability Indicators Supporting Emergency Services (CRISES) framework to create measures that inform internal performance improvement initiatives and allow comparison across programs. The framework consists of two components-the CRISES domains (timely, safe, accessible, least-restrictive, effective, consumer/family centered, and partnership) and the measures supporting each domain. The CRISES framework provides a foundation for development of standardized measures for the crisis field. This will become increasingly important as pay-for-performance initiatives expand with healthcare reform.

  13. C3I for Crisis, Emergency and Consequence Management (C3I pour la gestion des crises, des urgences et de leurs consequences)

    DTIC Science & Technology

    2009-05-01

    May 2009 C3I for Crisis, Emergency and Consequence Management (C3I pour la gestion des crises , des urgences et de leurs conséquences) Research and...consequence management. ES - 2 RTO-MP-IST-086 C3I pour la gestion des crises , des urgences et de leurs conséquences (RTO-MP-IST-086...contre-terrorisme, de sécurité nationale/publique et de réponse collective face aux situations d’urgence (à la fois gestion des crises et gestion de leurs

  14. The Nature of Punctuational Crises and the Spenglerian Model of Civilization

    NASA Astrophysics Data System (ADS)

    Clube, S. V. M.

    acknowledged dispensers of prognosis and mitigation who endorsed the adverse implications of 'blazing stars' (astrologers, soothsayers etc.) were commonly impugned and censured. Nowadays, of course, we are able to recognise that the Earth's environment is not only one of essentially uniformitarian calm, as formerly assumed, but one that is also interrupted by 'punctuational crises', each crisis being the sequence of events which arises due to the fragmentation of an individual comet whose orbit intersects the Earth's. That even modest crises can arouse apprehension is known through the circumstances of the nineteenth century break-up of Comet Biela. Indeed it seems that these crises are rather frequently characterized by relatively violent (paradigm shifting) transmutations of human society such as were originally proposed by Spengler and Toynbee more than sixty years ago on the basis of historical analysis alone. It would appear, then, that the historical fear of comets which has been with us since the foundation of civilization, far from being the reflection of an astrological perception of the cosmos which was deranged and therefore abandoned, has a perfectly rational basis in occasional cometary fragmentation events. Such events recur and evidently have quite serious implications for society and government today. Thus when cosmic danger returns and there is growing awareness of the fact, we find that society is capable of becoming uncontrollably convulsed as 'enlightenment' spreads. A revival of millenarian expectations under these circumstances, for example, is not so much an underlying consequence but a deviant manifestation of the violent turmoil into which society falls, often to revolutionary effect.

  15. Acute vs. chronic stressors, multiple suicide attempts, and persistent suicide ideation in US soldiers.

    PubMed

    Bryan, Craig J; Clemans, Tracy A; Leeson, Bruce; Rudd, Michael David

    2015-01-01

    This study examined recent-onset (i.e., acute) and persistent (i.e., chronic) life stressors among 54 acutely suicidal US Army Soldiers and examined their relationship to persistence of suicidal crises over time. Soldiers with a history of multiple suicide attempts reported the most severe suicide ideation (F(2,51) = 4.18, p = 0.021) and the greatest number of chronic stressors (F(2,51) = 5.11, p = 0.009). Chronic but not acute stressors were correlated with severity of suicide ideation (r = 0.24, p = 0.026). Participants reporting low-to-average levels of chronic stress resolved suicide ideation during the 6-month follow-up, but participants reporting high levels of chronic stress did not (Wald χ(1) = 4.57, p = 0.032). Soldiers who are multiple attempters report a greater number of chronic stressors. Chronic, but not acute-onset, stressors are associated with more severe and longer-lasting suicidal crises.

  16. Being in two minds: the neural basis of experiencing action crises in personal long-term goals.

    PubMed

    Herrmann, Marcel; Baur, Volker; Brandstätter, Veronika; Hänggi, Jürgen; Jäncke, Lutz

    2014-01-01

    Although the successful pursuit of long-term goals constitutes an essential prerequisite to personal development, health, and well-being, little research has been devoted to the understanding of its underlying neural processes. A critical phase in the pursuit of long-term goals is defined as an action crisis, conceptualized as the intra-psychic conflict between further goal pursuit and disengagement from the goal. In the present research, we applied an interdisciplinary (cognitive and neural) approach to the analysis of processes underlying the experience of an action crisis. In Study 1, a longitudinal field study, action crises in personal goals gave rise to an increased and unbiased (re)evaluation of the costs and benefits (i.e., rewards) of the goal. Study 2 was a magnetic resonance imaging study examining resting-state functional connectivity. The extent of experienced action crises was associated with enhanced fronto-accumbal connectivity signifying increased reward-related impact on prefrontal action control. Action crises, furthermore, mediated the relationship between a dispositional measure of effective goal pursuit (action orientation) and fronto-accumbal connectivity. The converging and complementary results from two methodologically different approaches advance the understanding of the neurobiology of personal long-term goals, especially with respect to the role of rewards in the context of goal-related conflicts.

  17. Entropies of negative incomes, Pareto-distributed loss, and financial crises.

    PubMed

    Gao, Jianbo; Hu, Jing; Mao, Xiang; Zhou, Mi; Gurbaxani, Brian; Lin, Johnny

    2011-01-01

    Health monitoring of world economy is an important issue, especially in a time of profound economic difficulty world-wide. The most important aspect of health monitoring is to accurately predict economic downturns. To gain insights into how economic crises develop, we present two metrics, positive and negative income entropy and distribution analysis, to analyze the collective "spatial" and temporal dynamics of companies in nine sectors of the world economy over a 19 year period from 1990-2008. These metrics provide accurate predictive skill with a very low false-positive rate in predicting downturns. The new metrics also provide evidence of phase transition-like behavior prior to the onset of recessions. Such a transition occurs when negative pretax incomes prior to or during economic recessions transition from a thin-tailed exponential distribution to the higher entropy Pareto distribution, and develop even heavier tails than those of the positive pretax incomes. These features propagate from the crisis initiating sector of the economy to other sectors.

  18. Cross-border portfolio investment networks and indicators for financial crises.

    PubMed

    Joseph, Andreas C; Joseph, Stephan E; Chen, Guanrong

    2014-02-10

    Cross-border equity and long-term debt securities portfolio investment networks are analysed from 2002 to 2012, covering the 2008 global financial crisis. They serve as network-proxies for measuring the robustness of the global financial system and the interdependence of financial markets, respectively. Two early-warning indicators for financial crises are identified: First, the algebraic connectivity of the equity securities network, as a measure for structural robustness, drops close to zero already in 2005, while there is an over-representation of high-degree off-shore financial centres among the countries most-related to this observation, suggesting an investigation of such nodes with respect to the structural stability of the global financial system. Second, using a phenomenological model, the edge density of the debt securities network is found to describe, and even forecast, the proliferation of several over-the-counter-traded financial derivatives, most prominently credit default swaps, enabling one to detect potentially dangerous levels of market interdependence and systemic risk.

  19. Collaboration in crisis: Carer perspectives on police and mental health professional's responses to mental health crises.

    PubMed

    Brennan, Alice; Warren, Narelle; Peterson, Violeta; Hollander, Yitzchak; Boscarato, Kara; Lee, Stuart

    2016-10-01

    For many situations involving a mental health crisis, carers (e.g. family or friends) are present and either attempt to help the person overcome the crisis or request assistance from professional services (e.g. mental health or police). Comparatively, little research has explored how carers experience the crisis, the professional response and how the nature of the response, in turn, impacts carers. The current study was conducted to explore these issues during individual interviews with nine carers who had previous contact with police and mental health services during a crisis response. Collected data described the definition and perceived impact of a mental health crisis for carers, how carers had experienced a crisis response from police and mental health services, and how the professional response had impacted on carers. Of importance was the finding that carers were often themselves traumatized by witnessing or being involved in the crisis, however, were rarely offered direct education or support to help them cope or prevent future crises. A number of carers described a reluctance to request assistance from professional services due to previous poor experiences. This highlighted the importance of implementing strategies to deliver more timely, respectful, specialist and collaborative crisis responses to improve carer and consumer outcomes.

  20. Metahabilitation: Transforming Life Crises: A Story of Enhanced Recovery Involving Addiction and Dependency.

    PubMed

    2015-01-01

    Individuals experience crisis when their estimation of resources needed to successfully manage traumatic situations such as addiction and dependency is greater than their perception of resources available. Some recovery models are limited in their perspective on enhanced outcomes, failing to put the individual in a position of strength and on the path to a positive, more meaningful future. Rehabilitation can be too general, failing to incorporate personal experiences of trauma into the therapeutic plan. Recovery models must address these insufficiencies and promote an individual's biological, psychological, and spiritual abilities to transform and experience higher levels of functioning-actually brought about by traumas and personal life crises such as addictions and dependencies. These conditions become vehicles, providing opportunities to creatively restructure the self and find significant existential meaning. A heuristic study revealed insights into advanced recovery. The results identified limitations of current rehabilitative models and informed the development of the unique recovery concept and process: metahabilitation. A case study provides an overview and shows the model as it applies to addiction and dependency.

  1. The role of igneous and metamorphic processes in triggering mass extinctions and Earth crises

    NASA Astrophysics Data System (ADS)

    Svensen, Henrik; Planke, Sverre; Polozov, Alexander G.; Jerram, Dougal; Jones, Morgan T.

    2016-04-01

    Mass extinctions and transient climate events commonly coincide in time with the formation of Large igneous provinces (LIPs). The end-Permian event coincides with the Siberian Traps, the end-Triassic with the Central Atlantic Magmatic Event (CAMP), the Toarcian with the Karoo LIP, and the Paleocene-Eocene Thermal Maximum (PETM) with the North Atlantic Igneous Province. Although the temporal relationship between volcanism and the environmental crises has been known for decades, the geological processes linking LIPs to these environmental events are strongly debated: Explosive LIP volcanism should lead to short term cooling (not long term warming), mantle CO2 is too 13C-enriched to explain negative 13C carbon isotope excursions from sedimentary sequences, the LIP volcanism is poorly dated and apparently lasts much longer that the associated environmental events, large portions of the LIPs remain poorly explored, especially the sub-volcanic parts where sills and dikes are emplaced in sedimentary host rocks, and thus gas flux estimates from contact aureoles around sill intrusions are often poorly constrained. In this presentation, we discuss the status of LIP research with an emphasis on the sub volcanic processes. We show that potential for degassing of greenhouse gases, aerosols, and ozone destructive gases is substantial and can likely explain the triggering of both climatic events and mass extinctions.

  2. Long-range dependence in returns and volatility of global gold market amid financial crises

    NASA Astrophysics Data System (ADS)

    Omane-Adjepong, Maurice; Boako, Gideon

    2017-04-01

    Using sampled historical daily gold market data from 07-03-1985 to 06-01-2015, and building on a related work by Bentes (2016), this paper examines the presence of long-range dependence (LRD) in the world's gold market returns and volatility, accounting for structural breaks. The sampled gold market data was divided into subsamples based on four global crises: the September 1992 collapse of the European Exchange Rate Mechanism (ERM), the Asian financial crisis of mid-1997, the Subprime meltdown of 2007, and the recent European sovereign debt crisis, which hit the world's market with varying effects. LRD test was carried-out on the full-sample and subsample periods using three semiparametric methods-before and after adjusting for structural breaks. The results show insignificant evidence of LRD in gold returns. However, very diminutive evidence is found for periods characterized by financial/economic shocks, with no significant detections for post-shock periods. Collectively, this is indicative that the gold market is less speculative, and hence could be somehow less risky for hedging and portfolio diversification.

  3. Cross-border Portfolio Investment Networks and Indicators for Financial Crises

    NASA Astrophysics Data System (ADS)

    Joseph, Andreas C.; Joseph, Stephan E.; Chen, Guanrong

    2014-02-01

    Cross-border equity and long-term debt securities portfolio investment networks are analysed from 2002 to 2012, covering the 2008 global financial crisis. They serve as network-proxies for measuring the robustness of the global financial system and the interdependence of financial markets, respectively. Two early-warning indicators for financial crises are identified: First, the algebraic connectivity of the equity securities network, as a measure for structural robustness, drops close to zero already in 2005, while there is an over-representation of high-degree off-shore financial centres among the countries most-related to this observation, suggesting an investigation of such nodes with respect to the structural stability of the global financial system. Second, using a phenomenological model, the edge density of the debt securities network is found to describe, and even forecast, the proliferation of several over-the-counter-traded financial derivatives, most prominently credit default swaps, enabling one to detect potentially dangerous levels of market interdependence and systemic risk.

  4. From famine to food crisis: what history can teach us about local and global subsistence crises.

    PubMed

    Vanhaute, Eric

    2011-01-01

    The number of famine prone regions in the world has been shrinking for centuries. It is currently mainly limited to sub-Saharan Africa. Yet the impact of endemic hunger has not declined and the early twenty-first century seems to be faced with a new threat: global subsistence crises. In this essay I question the concepts of famine and food crisis from different analytical angles: historical and contemporary famine research, food regime theory, and peasant studies. I will argue that only a more integrated historical framework of analysis can surpass dualistic interpretations grounded in Eurocentric modernization paradigms. This article successively debates historical and contemporary famine research, the contemporary food regime and the new global food crisis, the lessons from Europe's 'grand escape' from hunger, and the peasantry and 'depeasantization' as central analytical concepts. Dualistic histories of food and famine have been dominating developmentalist stories for too long. This essay shows how a blending of historical and contemporary famine research, food regime theory and new peasant studies can foster a more integrated perspective.

  5. EDs credit drills, community engagement with helping them manage casualties from tornado crises.

    PubMed

    2011-07-01

    Emergency department leaders at DCH Regional Medical Center in Tuscaloosa, AL, and Cullman Regional Medical Center in Cullman, AL, credit their regular practice drills with helping them deal with unprecedented demand when deadly tornadoes swept through the South this past April. Both facilities used the hospital instant command structure (HICS) to mobilize the resources needed to care for the surge in patients, and say the approach worked well in helping them meet the needs of their communities. However, the crises also showcased opportunities for improvement. The ED at DCH Regional Medical Center saw more than 600 patients on the day of the storm, a three-fold increase in the hospital's typical volume. CRMC treated 99 patients in the seven hours immediately following the storm when it usually treats 114 patients per day. In addition to a big surge in patients, both hospitals dealt with power outages that limited access to some services such as radiology. Triage proved particularly challenging at DCH Regional Medical Center, as patients flowed into the hospital from numerous access points. The hospital plans to assign coordinators to each area of the hospital to better manage the influx in the future. When reviewing emergency operations plans, Joint Commission reviewers often find deficiencies in hazard vulnerability analyses as well as the processes used to determine the emergency credentials of licensed independent practitioners.

  6. Cross-border Portfolio Investment Networks and Indicators for Financial Crises

    PubMed Central

    Joseph, Andreas C.; Joseph, Stephan E.; Chen, Guanrong

    2014-01-01

    Cross-border equity and long-term debt securities portfolio investment networks are analysed from 2002 to 2012, covering the 2008 global financial crisis. They serve as network-proxies for measuring the robustness of the global financial system and the interdependence of financial markets, respectively. Two early-warning indicators for financial crises are identified: First, the algebraic connectivity of the equity securities network, as a measure for structural robustness, drops close to zero already in 2005, while there is an over-representation of high-degree off-shore financial centres among the countries most-related to this observation, suggesting an investigation of such nodes with respect to the structural stability of the global financial system. Second, using a phenomenological model, the edge density of the debt securities network is found to describe, and even forecast, the proliferation of several over-the-counter-traded financial derivatives, most prominently credit default swaps, enabling one to detect potentially dangerous levels of market interdependence and systemic risk. PMID:24510060

  7. Midlife Crises in Dwarf Galaxies in the NGC 5353/4 Group

    NASA Astrophysics Data System (ADS)

    Tully, R. Brent; Trentham, Neil

    2008-04-01

    This third paper in a series about the dwarf galaxy populations in groups within the Local Supercluster concerns the intermediate mass (2.1 × 1013 M sun) NGC 5353/4 Group with a core dominated by S0 systems and a periphery of mostly spiral systems. Dwarf galaxies are strongly concentrated toward the core. The mass-to-light ratio M/LR = 105 M sun/L sun is a factor of 3 lower than for the two groups studied earlier in the series. The properties of the group suggest it is much less dynamically evolved than those two groups of early-type galaxies. By comparison, the NGC 5353/4 Group lacks superluminous systems but has a large fraction of intermediate-luminosity galaxies; or equivalently, a luminosity function with a flatter faint-end slope. The luminosity function for the NGC 5353/4 Group should steepen as the intermediate-luminosity galaxies merge. Evidence for the ongoing collapse of the group is provided by the unusually large incidence of star-formation activity in small galaxies with early morphological types. The pattern in the distribution of galaxies with activity suggests a succession of infall events. Residual gas in dwarfs that enter the group is used up in sputtering events. The resolution of midlife crises is exhaustion.

  8. Acute Pancreatitis

    PubMed Central

    Geokas, Michael C.

    1972-01-01

    For many decades two types of acute pancreatitis have been recognized: the edematous or interstitial and the hemorrhagic or necrotic. In most cases acute pancreatitis is associated with alcoholism or biliary tract disease. Elevated serum or urinary α-amylase is the most important finding in diagnosis. The presence of methemalbumin in serum and in peritoneal or pleural fluid supports the diagnosis of the hemorrhagic form of the disease in patients with a history and enzyme studies suggestive of pancreatitis. There is no characteristic clinical picture in acute pancreatitis, and its complications are legion. Pancreatic pseudocyst is probably the most common and pancreatic abscess is the most serious complication. The pathogenetic principle is autodigestion, but the precise sequence of biochemical events is unclear, especially the mode of trypsinogen activation and the role of lysosomal hydrolases. A host of metabolic derangements have been identified in acute pancreatitis, involving lipid, glucose, calcium and magnesium metabolism and changes of the blood clotting mechanism, to name but a few. Medical treatment includes intestinal decompression, analgesics, correction of hypovolemia and other supportive and protective measures. Surgical exploration is advisable in selected cases, when the diagnosis is in doubt, and is considered imperative in the presence of certain complications, especially pancreatic abscess. PMID:4559467

  9. An update of clinical management of acute intermittent porphyria

    PubMed Central

    Pischik, Elena; Kauppinen, Raili

    2015-01-01

    Acute intermittent porphyria (AIP) is due to a deficiency of the third enzyme, the hydroxymethylbilane synthase, in heme biosynthesis. It manifests with occasional neuropsychiatric crises associated with overproduction of porphyrin precursors, aminolevulinic acid and porphobilinogen. The clinical criteria of an acute attack include the paroxysmal nature and various combinations of symptoms, such as abdominal pain, autonomic dysfunction, hyponatremia, muscle weakness, or mental symptoms, in the absence of other obvious causes. Intensive abdominal pain without peritoneal signs, acute peripheral neuropathy, and encephalopathy usually with seizures or psychosis are the key symptoms indicating possible acute porphyria. More than fivefold elevation of urinary porphobilinogen excretion together with typical symptoms of an acute attack is sufficient to start a treatment. Currently, the prognosis of the patients with AIP is good, but physicians should be aware of a potentially fatal outcome of the disease. Mutation screening and identification of type of acute porphyria can be done at the quiescent phase of the disease. The management of patients with AIP include following strategies: A, during an acute attack: 1) treatment with heme preparations, if an acute attack is severe or moderate; 2) symptomatic treatment of autonomic dysfunctions, polyneuropathy and encephalopathy; 3) exclusion of precipitating factors; and 4) adequate nutrition and fluid therapy. B, during remission: 1) exclusion of precipitating factors (education of patients and family doctors), 2) information about on-line drug lists, and 3) mutation screening for family members and education about precipitating factors in mutation-positive family members. C, management of patients with recurrent attacks: 1) evaluation of the lifestyle, 2) evaluation of hormonal therapy in women, 3) prophylactic heme therapy, and 4) liver transplantation in patients with severe recurrent attacks. D, follow-up of the AIP

  10. An update of clinical management of acute intermittent porphyria.

    PubMed

    Pischik, Elena; Kauppinen, Raili

    2015-01-01

    Acute intermittent porphyria (AIP) is due to a deficiency of the third enzyme, the hydroxymethylbilane synthase, in heme biosynthesis. It manifests with occasional neuropsychiatric crises associated with overproduction of porphyrin precursors, aminolevulinic acid and porphobilinogen. The clinical criteria of an acute attack include the paroxysmal nature and various combinations of symptoms, such as abdominal pain, autonomic dysfunction, hyponatremia, muscle weakness, or mental symptoms, in the absence of other obvious causes. Intensive abdominal pain without peritoneal signs, acute peripheral neuropathy, and encephalopathy usually with seizures or psychosis are the key symptoms indicating possible acute porphyria. More than fivefold elevation of urinary porphobilinogen excretion together with typical symptoms of an acute attack is sufficient to start a treatment. Currently, the prognosis of the patients with AIP is good, but physicians should be aware of a potentially fatal outcome of the disease. Mutation screening and identification of type of acute porphyria can be done at the quiescent phase of the disease. The management of patients with AIP include following strategies: A, during an acute attack: 1) treatment with heme preparations, if an acute attack is severe or moderate; 2) symptomatic treatment of autonomic dysfunctions, polyneuropathy and encephalopathy; 3) exclusion of precipitating factors; and 4) adequate nutrition and fluid therapy. B, during remission: 1) exclusion of precipitating factors (education of patients and family doctors), 2) information about on-line drug lists, and 3) mutation screening for family members and education about precipitating factors in mutation-positive family members. C, management of patients with recurrent attacks: 1) evaluation of the lifestyle, 2) evaluation of hormonal therapy in women, 3) prophylactic heme therapy, and 4) liver transplantation in patients with severe recurrent attacks. D, follow-up of the AIP

  11. Acute Vestibulopathy

    PubMed Central

    Cha, Yoon-Hee

    2011-01-01

    The presentation of acute vertigo may represent both a common benign disorder or a life threatening but rare one. Familiarity with the common peripheral vestibular disorders will allow the clinician to rapidly “rule-in” a benign disorder and recognize when further testing is required. Key features of vertigo required to make an accurate diagnosis are duration, chronicity, associated symptoms, and triggers. Bedside tests that are critical to the diagnosis of acute vertigo include the Dix-Hallpike maneuver and canalith repositioning manuever, occlusive ophthalmoscopy, and the head impulse test. The goal of this review is to provide the clinician with the clinical and pathophysiologic background of the most common disorders that present with vertigo to develop a logical differential diagnosis and management plan. PMID:23983835

  12. Acute Blindness.

    PubMed

    Meekins, Jessica M

    2015-09-01

    Sudden loss of vision is an ophthalmic emergency with numerous possible causes. Abnormalities may occur at any point within the complex vision pathway, from retina to optic nerve to the visual center in the occipital lobe. This article reviews specific prechiasm (retina and optic nerve) and cerebral cortical diseases that lead to acute blindness. Information regarding specific etiologies, pathophysiology, diagnosis, treatment, and prognosis for vision is discussed.

  13. Chaos and crises in a model for cooperative hunting: a symbolic dynamics approach.

    PubMed

    Duarte, Jorge; Januário, Cristina; Martins, Nuno; Sardanyés, Josep

    2009-12-01

    In this work we investigate the population dynamics of cooperative hunting extending the McCann and Yodzis model for a three-species food chain system with a predator, a prey, and a resource species. The new model considers that a given fraction sigma of predators cooperates in prey's hunting, while the rest of the population 1-sigma hunts without cooperation. We use the theory of symbolic dynamics to study the topological entropy and the parameter space ordering of the kneading sequences associated with one-dimensional maps that reproduce significant aspects of the dynamics of the species under several degrees of cooperative hunting. Our model also allows us to investigate the so-called deterministic extinction via chaotic crisis and transient chaos in the framework of cooperative hunting. The symbolic sequences allow us to identify a critical boundary in the parameter spaces (K,C(0)) and (K,sigma) which separates two scenarios: (i) all-species coexistence and (ii) predator's extinction via chaotic crisis. We show that the crisis value of the carrying capacity K(c) decreases at increasing sigma, indicating that predator's populations with high degree of cooperative hunting are more sensitive to the chaotic crises. We also show that the control method of Dhamala and Lai [Phys. Rev. E 59, 1646 (1999)] can sustain the chaotic behavior after the crisis for systems with cooperative hunting. We finally analyze and quantify the inner structure of the target regions obtained with this control method for wider parameter values beyond the crisis, showing a power law dependence of the extinction transients on such critical parameters.

  14. [Health threats and health system crises. An approach to early warning and response. 2008 SESPAS Report].

    PubMed

    Simón Soria, Fernando; Guillén Enríquez, Francisco Javier

    2008-04-01

    The world is changing more and faster than ever before. New diseases are coming to light each year, controlled diseases are reemerging as potential threats, and natural or man-made disasters are increasingly affecting human health. The "International Health Regulations (2005)" reflect the changes in the response of public health to this new situation. Surveillance of specific diseases and predefined control measures have been replaced by surveillance of public health events of international concern and control measures adapted to each situation. The public health events of international interest are characterized by their seriousness, predictability, the risk of international spread and potential for travel or trade restrictions. The development of the European Early Warning and Response System in 1998 and the creation of the European Center for Disease Prevention and Control in 2005 demonstrate political commitment in Europe, with early detection of and response to public health threats. However, timely risk evaluation and response at a national level requires improved data digitalization and accessibility, automatic notification processes, data analysis and dissemination of information, the combination of information from multiple sources and adaptation of public health services. The autonomous regions in Spain are initiating this adaptation process, but interoperability between systems and the development of guidelines for a coordinated response should be steered by the National Interregional Health Council and coordinated by the Ministry of Health. Efficient early warning systems of health threats that allow for a timely response and reduce uncertainty about information would help to minimize the risk of public health crises. The profile of public health threats is nonspecific. Early detection of threats requires access to information from multiple sources and efficient risk assessment. Key factors for improving the response to public health threats are the

  15. On the dynamics of the world demographic transition and financial-economic crises forecasts

    NASA Astrophysics Data System (ADS)

    Akaev, A.; Sadovnichy, V.; Korotayev, A.

    2012-05-01

    The article considers dynamic processes involving non-linear power-law behavior in such apparently diverse spheres, as demographic dynamics and dynamics of prices of highly liquid commodities such as oil and gold. All the respective variables exhibit features of explosive growth containing precursors indicating approaching phase transitions/catastrophes/crises. The first part of the article analyzes mathematical models of demographic dynamics that describe various scenarios of demographic development in the post-phase-transition period, including a model that takes the limitedness of the Earth carrying capacity into account. This model points to a critical point in the early 2050s, when the world population, after reaching its maximum value may decrease afterward stabilizing then at a certain stationary level. The article presents an analysis of the influence of the demographic transition (directly connected with the hyperexponential growth of the world population) on the global socioeconomic and geopolitical development. The second part deals with the phenomenon of explosive growth of prices of such highly liquid commodities as oil and gold. It is demonstrated that at present the respective processes could be regarded as precursors of waves of the global financial-economic crisis that will demand the change of the current global economic and political system. It is also shown that the moments of the start of the first and second waves of the current global crisis could have been forecasted with a model of accelerating log-periodic fluctuations superimposed over a power-law trend with a finite singularity developed by Didier Sornette and collaborators. With respect to the oil prices, it is shown that it was possible to forecast the 2008 crisis with a precision up to a month already in 2007. The gold price dynamics was used to calculate the possible time of the start of the second wave of the global crisis (July-August 2011); note that this forecast has turned out

  16. Identifying the causes of water crises: A configurational frequency analysis of 22 basins world wide

    NASA Astrophysics Data System (ADS)

    Srinivasan, V.; Gorelick, S.; Lambin, E.; Rozelle, S.; Thompson, B.

    2010-12-01

    Freshwater "scarcity" has been identified as being a major problem world-wide, but it is surprisingly hard to assess if water is truly scarce at a global or even regional scale. Most empirical water research remains location specific. Characterizing water problems, transferring lessons across regions, to develop a synthesized global view of water issues remains a challenge. In this study we attempt a systematic understanding of water problems across regions. We compared case studies of basins across different regions of the world using configurational frequency analysis. Because water crises are multi-symptom and multi-causal, a major challenge was to categorize water problems so as to make comparisons across cases meaningful. In this study, we focused strictly on water unsustainability, viz. the inability to sustain current levels of the anthropogenic (drinking water, food, power, livelihood) and natural (aquatic species, wetlands) into the future. For each case, the causes of three outcome variables, groundwater declines, surface water declines and aquatic ecosystem declines, were classified and coded. We conducted a meta-analysis in which clusters of peer-reviewed papers by interdisciplinary teams were considered to ensure that the results were not biased towards factors privileged by any one discipline. Based on our final sample of 22 case study river basins, some clear patterns emerged. The meta-analysis suggests that water resources managers have long overemphasized the factors governing supply of water resources and while insufficient attention has been paid to the factors driving demand. Overall, uncontrolled increase in demand was twice as frequent as declines in availability due to climate change or decreased recharge. Moreover, groundwater and surface water declines showed distinct causal pathways. Uncontrolled increases in demand due to lack of credible enforcement were a key factor driving groundwater declines; while increased upstream abstractions

  17. Chaos and crises in a model for cooperative hunting: A symbolic dynamics approach

    NASA Astrophysics Data System (ADS)

    Duarte, Jorge; Januário, Cristina; Martins, Nuno; Sardanyés, Josep

    2009-12-01

    In this work we investigate the population dynamics of cooperative hunting extending the McCann and Yodzis model for a three-species food chain system with a predator, a prey, and a resource species. The new model considers that a given fraction σ of predators cooperates in prey's hunting, while the rest of the population 1-σ hunts without cooperation. We use the theory of symbolic dynamics to study the topological entropy and the parameter space ordering of the kneading sequences associated with one-dimensional maps that reproduce significant aspects of the dynamics of the species under several degrees of cooperative hunting. Our model also allows us to investigate the so-called deterministic extinction via chaotic crisis and transient chaos in the framework of cooperative hunting. The symbolic sequences allow us to identify a critical boundary in the parameter spaces (K ,C0) and (K ,σ) which separates two scenarios: (i) all-species coexistence and (ii) predator's extinction via chaotic crisis. We show that the crisis value of the carrying capacity Kc decreases at increasing σ, indicating that predator's populations with high degree of cooperative hunting are more sensitive to the chaotic crises. We also show that the control method of Dhamala and Lai [Phys. Rev. E 59, 1646 (1999)] can sustain the chaotic behavior after the crisis for systems with cooperative hunting. We finally analyze and quantify the inner structure of the target regions obtained with this control method for wider parameter values beyond the crisis, showing a power law dependence of the extinction transients on such critical parameters.

  18. Rig Side Online Drilling Support System for Prediction and Prevention of Upcoming Crises

    NASA Astrophysics Data System (ADS)

    Jandl, B.; Winter, M.; Fruhwirth, R.; Riedel, F.; Zeiner, H.

    2012-04-01

    Safety requirements play a central role in drilling operations worldwide. Especially, protecting the crew from injury, preventing damage to equipment and avoiding environmental pollution are of utmost importance. Prevailing drilling procedures already provide a high degree of safety; but uncertainties hinder efficient and accurate risk assessment. Uncertainties are primarily introduced due to the unknown structure of the rock formation and other unknowns in the drilling process. Insufficient insight into ongoing processes may therefore lead to unexpected and unwanted critical drilling situations. To support drilling engineers in the early detection and subsequently in the prevention of upcoming crises, we present a modular drilling support system for in-situ usage on rigs which improves insight into processes and current drilling operations. In our case, the system consists of a complete data processing chain including several modules for data acquisition from sensors on the drilling platform, feature generation, online learning and problem-specific visualization. While data acquisition modules collect data from sensors at the rig and produce a live data stream in an appropriate format, the data processing algorithms analyze the data streams in real time and classify the drilling operations, detect emerging potentially critical situations and give appropriate advice to the drilling crew, if possible. A (geo-)physically motivated extended feature generator produces additional features to improve the quality-performance (recognition rate) of the algorithms. Finally, all sensor data streams as well as the output of the extended feature generator, the results of several adaptive online learning algorithms and a set of sensor data quality indicators of the rig are visualized in a novel user interface to support drilling employees at the rig. As a result, the current drilling situation is presented in a comprehensive manner and in real time.

  19. Systematic review of the evidence on the effectiveness of sexual and reproductive health interventions in humanitarian crises

    PubMed Central

    Warren, Emily; Post, Nathan; Hossain, Mazeda; Blanchet, Karl; Roberts, Bayard

    2015-01-01

    Objectives This systematic review aims to evaluate evidence on the effectiveness of sexual and reproductive health (SRH) interventions delivered in humanitarian crises. Setting Crisis affected low-income or middle-income countries. Participants Crisis-affected populations in low-income or middle-income countries. Method Peer-reviewed and grey literature sources were systematically searched for relevant papers detailing interventions from 1 January 1980 until the search date on 30 April 2013. Data from included studies were then extracted, and the papers’ quality evaluated using criteria based on modified STROBE and CONSORT checklists. Primary and secondary outcome measures Primary outcomes include, but are not limited to, changes in morbidity, mortality, sexually transmitted infection (STI) diagnosis or gender-based violence. Secondary outcomes include, but are not limited to, reported condom use or skilled attendance at birth. Primary outputs include, but are not limited to, condoms distributed or education courses taught. Results Of 7149 returned citations, 15 studies met the inclusion criteria. Only one randomised controlled trial was identified. The remaining observational studies were of moderate quality, demonstrating limited use of controls and inadequate attempts to address bias. Evidence of effectiveness was available for the following interventions: impregnated bed nets for pregnant women, subsidised refugee healthcare, female community health workers, and tiered community reproductive health services. Conclusions The limited evidence base for SRH interventions highlights the need for improved research on the effectiveness of public health interventions in humanitarian crises. While interventions proven efficacious in stable settings are being used in humanitarian efforts, more evidence is required to demonstrate the effectiveness of delivering and scaling-up such interventions in humanitarian crises. PMID:26685020

  20. Evaluation of the return periods of water crises and evaporation in Monte Cotugno reservoir (Southern Italy)

    NASA Astrophysics Data System (ADS)

    Copertino, Vito; Lo Vecchio, Giuseppina; Marotta, Lucia; Pastore, Vittoria; Ponzio, Giuseppe; Scavone, Giuseppina; Telesca, Vito; Vita, Michele

    2010-05-01

    In the past water resources management has been dealt and solved increasing water availabilities; today such opportunities have been considerably reduced and the technical-scientific perspectives are addressed above all to improve water system effectiveness and to promote an use of water resources that holds account of the droughts frequency and based on a correct estimate of the hydrologic balance. In this work a study on the water stored in Monte Cotugno reservoir in Sinni river - Basilicata (Southern Italy) - is proposed, estimating water crises return periods and reservoir evaporation. For such purpose the runs method was applied, based on the comparison between the temporal series of the "water volume" hydrological variable and a threshold representative of the "normal" conditions regarding which the availability in excess or defect was estimated. This allowed to individualize the beginning and the end of a water crisis event and to characterize the droughts in terms of duration, sum deficit and intensity. Therefore the return period was evaluated by means of the methodology proposed by Shiau and Shen in 2001, turned out equal approximately to 6 years. Such value was then verified with a frequency analysis of the "water volume" random variable, using the Weibull's distribution. Subsequently, the Fourier's analysis in the last twenty years was carried out, obtaining the same result of the previous methods. Moreover, in proximity of the Monte Cotugno reservoir the weather station of Senise is located, managed by ALSIA (Agenzia Lucana di Sviluppo e Innovazione in Agricultura), that provides in continuous measurements of air temperature and humidity, wind speed and direction, and global solar radiation since 2000. Such parameters allowed to apply five methods for reservoir evaporation estimate selected from those proposed in the literature, of which the first three, the Jensen-Haise's method, Makkink's method and Stephens-Stewart's one are based on solar radiation

  1. A Distributed Architecture for Tsunami Early Warning and Collaborative Decision-support in Crises

    NASA Astrophysics Data System (ADS)

    Moßgraber, J.; Middleton, S.; Hammitzsch, M.; Poslad, S.

    2012-04-01

    The presentation will describe work on the system architecture that is being developed in the EU FP7 project TRIDEC on "Collaborative, Complex and Critical Decision-Support in Evolving Crises". The challenges for a Tsunami Early Warning System (TEWS) are manifold and the success of a system depends crucially on the system's architecture. A modern warning system following a system-of-systems approach has to integrate various components and sub-systems such as different information sources, services and simulation systems. Furthermore, it has to take into account the distributed and collaborative nature of warning systems. In order to create an architecture that supports the whole spectrum of a modern, distributed and collaborative warning system one must deal with multiple challenges. Obviously, one cannot expect to tackle these challenges adequately with a monolithic system or with a single technology. Therefore, a system architecture providing the blueprints to implement the system-of-systems approach has to combine multiple technologies and architectural styles. At the bottom layer it has to reliably integrate a large set of conventional sensors, such as seismic sensors and sensor networks, buoys and tide gauges, and also innovative and unconventional sensors, such as streams of messages from social media services. At the top layer it has to support collaboration on high-level decision processes and facilitates information sharing between organizations. In between, the system has to process all data and integrate information on a semantic level in a timely manner. This complex communication follows an event-driven mechanism allowing events to be published, detected and consumed by various applications within the architecture. Therefore, at the upper layer the event-driven architecture (EDA) aspects are combined with principles of service-oriented architectures (SOA) using standards for communication and data exchange. The most prominent challenges on this layer

  2. Socioeconomic status and length of hospital stay in children with vaso-occlusive crises of sickle cell disease.

    PubMed Central

    Ellison, Angela M.; Bauchner, Howard

    2007-01-01

    OBJECTIVE: To examine the association between socioeconomic status and length of hospital stay for vaso-occlusive crises in children with sickle cell disease. METHODS: 19,174 discharges (aged 1-20 years), with a primary diagnosis of sickle cell disease with crisis were analyzed from the Healthcare Cost and Utilization Project Kid Inpatient Database 2000. Socioeconomic status was assessed using an area-based measure, median household income by ZIP code and an individual-level measure, insurance status. We adjusted for age, gender, hospital location/teaching status, presence of pneumonia, number of diagnoses on record and number of procedures performed. Negative binomial regression models using generalized estimating equations (GEE) were used to assess length of stay. RESULTS: Socioeconomic status as measured by income was not associated with length of stay (incidence rate ratio (highest versus lowest category) = 1.04 (95% CI: 0.98, 1.11)). In contrast, socioeconomic status as measured by insurance was associated with length of stay [adjusted incidence rate ratio = 1.04 (95% CI: 1.01, 1.08)), although the magnitude of this difference is small and not likely to be clinically important. CONCLUSIONS: We found no evidence to suggest that socioeconomic status has any clinically important effect on length of hospital stay in children with vaso-occlusive crises in sickle cell disease. PMID:17393942

  3. The Impact of Economic Crises on Communicable Disease Transmission and Control: A Systematic Review of the Evidence

    PubMed Central

    Suhrcke, Marc; Stuckler, David; Suk, Jonathan E.; Desai, Monica; Senek, Michaela; McKee, Martin; Tsolova, Svetla; Basu, Sanjay; Abubakar, Ibrahim; Hunter, Paul; Rechel, Boika; Semenza, Jan C.

    2011-01-01

    There is concern among public health professionals that the current economic downturn, initiated by the financial crisis that started in 2007, could precipitate the transmission of infectious diseases while also limiting capacity for control. Although studies have reviewed the potential effects of economic downturns on overall health, to our knowledge such an analysis has yet to be done focusing on infectious diseases. We performed a systematic literature review of studies examining changes in infectious disease burden subsequent to periods of crisis. The review identified 230 studies of which 37 met our inclusion criteria. Of these, 30 found evidence of worse infectious disease outcomes during recession, often resulting from higher rates of infectious contact under poorer living circumstances, worsened access to therapy, or poorer retention in treatment. The remaining studies found either reductions in infectious disease or no significant effect. Using the paradigm of the “SIR” (susceptible-infected-recovered) model of infectious disease transmission, we examined the implications of these findings for infectious disease transmission and control. Key susceptible groups include infants and the elderly. We identified certain high-risk groups, including migrants, homeless persons, and prison populations, as particularly vulnerable conduits of epidemics during situations of economic duress. We also observed that the long-term impacts of crises on infectious disease are not inevitable: considerable evidence suggests that the magnitude of effect depends critically on budgetary responses by governments. Like other emergencies and natural disasters, preparedness for financial crises should include consideration of consequences for communicable disease control. PMID:21695209

  4. Acute laminitis.

    PubMed

    Baxter, G M

    1994-12-01

    Laminitis is an inflammation of the sensitive laminae along the dorsal aspect of the digit and is considered to be a secondary complication of several predisposing or primary factors. Affected horses are usually very lame, have increased digital pulses, are painful to hoof testers along the toe of the foot, and have evidence of downward rotation or distal displacement of the distal phalanx present on radiographs. Treatments for acute laminitis include anti-inflammatory drugs, anti-endotoxin therapy, vasodilators, antithrombotic therapy, corrective trimming and shoeing, and surgical procedures. Treatment regimens are very controversial and the true efficacy of these treatments is unknown. The quality of laminae damage that occurs with laminitis, however, probably has greater influence on the success of treatment and outcome of the horse than the treatment regimen itself.

  5. Management of natural crises with choreography and orchestration of federated warning-systems

    NASA Astrophysics Data System (ADS)

    Haener, Rainer; Waechter, Joachim; Hammitzsch, Martin

    2013-04-01

    The project Collaborative, Complex and Critical Decision-Support in Evolving Crises (TRIDEC), co-funded by the European Commission in its Seventh Framework Programme focuses on real-time intelligent information management in earth management. The addressed challenges include the design and implementation of a robust and scalable service infrastructure supporting the integration of existing resources, components and systems. Key challenge for TRIDEC is establishing a network of independent systems, cooperatively interacting as a collective in a system-of-systems (SoS). For this purpose TRIDEC adopts enhancements of service-oriented architecture (SOA) principles in terms of an event-driven architecture (EDA) design (SOA 2.0). In this way TRIDEC establishes large-scale concurrent and intelligent information management of a manifold of crisis types by focusing on the integration of autonomous, task-oriented and geographically distributed systems. To this end TRIDEC adapts both ways SOA 2.0 offers: orchestration and choreography. In orchestration, a central knowledge-based processing framework takes control over the involved services and coordinates their execution. Choreography on the other hand avoids central coordination. Rather, each system involved in the SoS follows a global scenario without a single point of control but specifically defined (enacted, agreed upon) trigger conditions. More than orchestration choreography allows collaborative business processes of various heterogeneous sub-systems (e.g. cooperative decision making) by concurrent Complex Event Processing (CEP) and asynchronous communication. These types of interaction adapt the concept of decoupled relationships between information producers (e.g. sensors and sensor systems) and information consumers (e.g. warning systems and warning dissemination systems). Asynchronous communication is useful if a participant wants to trigger specific actions by delegating the responsibility (separation of concerns

  6. Responding To Infectious Disease: Multiple Cases of Staph Infections in a Rural School District. Lessons Learned From School Crises and Emergencies, Volume 3, Issue 3, 2008

    ERIC Educational Resources Information Center

    US Department of Education, 2008

    2008-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an incident involving several cases of Methicillin-resistant Staphylococcus aureus (MRSA) at a rural high school. MRSA is a specific strain of Staphylococcus aureus bacteria (often called staph)…

  7. Communication and Collaboration During Natural Disasters: The Lessons Learned From Past Experience. Lessons Learned From School Crises and Emergencies, Volume 3, Issue 2, 2008

    ERIC Educational Resources Information Center

    US Department of Education, 2008

    2008-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on the response and recovery efforts to wildfires by the San Diego County Office of Education (SDCOE) and its school and community partners. Natural disasters such as floods,…

  8. Responding To and Recovering From an Active Shooter Incident That Turns Into a Hostage Situation. Lessons Learned From School Crises and Emergencies, Volume 2, Issue 6, 2007

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an active shooter situation that escalated to a hostage situation that required multiple law enforcement agencies and other first responders and agencies to coordinate response and recovery…

  9. Acute intermittent porphyria presenting as progressive muscular atrophy in a young black man.

    PubMed

    Albertyn, C H; Sonderup, M; Bryer, A; Corrigall, A; Meissner, P; Heckmann, J M

    2014-04-01

    Acute intermittent porphyria, the most common porphyria affecting the nervous system, typically presents with neurovisceral crises followed by a motor neuropathy. We describe a 23-year-old black South African man presenting with a progressive stuttering, lower motor neuron syndrome developing over months. He had not experienced pain or neuropsychiatric symptoms. One year after symptom onset he was bed-bound with a flaccid quadriparesis. There was marked amyotrophy, but without fasciculations. Sensation was intact apart from a hypo-aesthetic patch over the thigh. Electrophysiological investigations showed an active motor axonopathy. Urinary porphyrins, delta-aminolaevulinic acid and porphobilinogen were elevated. Mutation analysis revealed the c445C>T (R149X) mutation in the porphobilinogen deaminase gene. The patient responded dramatically to haem arginate and could walk with assistance 2 weeks later. We identified the first molecularly confirmed acute intermittent porphyria in a black South African. The clinical presentation mimicked a progressive lower motor neuron syndrome.

  10. Acute Illness Protocol for Organic Acidemias: Methylmalonic Acidemia and Propionic Acidemia.

    PubMed

    Aldubayan, Saud H; Rodan, Lance H; Berry, Gerard T; Levy, Harvey L

    2017-02-01

    Inborn errors of metabolism (IEM) are genetic disorders that disrupt enzyme activity, cellular transport, or energy production. They are individually rare, but collectively have an incidence of 1:1000. Most patients with IEMs are followed by a physician with expertise in Biochemical Genetics (Metabolism), but may present outside of this setting. Because IEMs can present acutely with life-threatening crises that require specific interventions, it is critical for the emergency medicine physicians, pediatricians, internists, and critical care physicians as well as biochemical geneticists to be familiar with the initial assessment and management of patients with these disorders. Appropriate early care can be lifesaving. This protocol is not designed to replace the expert consultation of a biochemical geneticist but rather to improve early care and increase the level of comfort of the acute care physician with initial management of organic acidemias until specialty consultation is obtained.

  11. Bi-allelic Truncating Mutations in TANGO2 Cause Infancy-Onset Recurrent Metabolic Crises with Encephalocardiomyopathy.

    PubMed

    Kremer, Laura S; Distelmaier, Felix; Alhaddad, Bader; Hempel, Maja; Iuso, Arcangela; Küpper, Clemens; Mühlhausen, Chris; Kovacs-Nagy, Reka; Satanovskij, Robin; Graf, Elisabeth; Berutti, Riccardo; Eckstein, Gertrud; Durbin, Richard; Sauer, Sascha; Hoffmann, Georg F; Strom, Tim M; Santer, René; Meitinger, Thomas; Klopstock, Thomas; Prokisch, Holger; Haack, Tobias B

    2016-02-04

    Molecular diagnosis of mitochondrial disorders is challenging because of extreme clinical and genetic heterogeneity. By exome sequencing, we identified three different bi-allelic truncating mutations in TANGO2 in three unrelated individuals with infancy-onset episodic metabolic crises characterized by encephalopathy, hypoglycemia, rhabdomyolysis, arrhythmias, and laboratory findings suggestive of a defect in mitochondrial fatty acid oxidation. Over the course of the disease, all individuals developed global brain atrophy with cognitive impairment and pyramidal signs. TANGO2 (transport and Golgi organization 2) encodes a protein with a putative function in redistribution of Golgi membranes into the endoplasmic reticulum in Drosophila and a mitochondrial localization has been confirmed in mice. Investigation of palmitate-dependent respiration in mutant fibroblasts showed evidence of a functional defect in mitochondrial β-oxidation. Our results establish TANGO2 deficiency as a clinically recognizable cause of pediatric disease with multi-organ involvement.

  12. Bi-allelic Truncating Mutations in TANGO2 Cause Infancy-Onset Recurrent Metabolic Crises with Encephalocardiomyopathy

    PubMed Central

    Kremer, Laura S.; Distelmaier, Felix; Alhaddad, Bader; Hempel, Maja; Iuso, Arcangela; Küpper, Clemens; Mühlhausen, Chris; Kovacs-Nagy, Reka; Satanovskij, Robin; Graf, Elisabeth; Berutti, Riccardo; Eckstein, Gertrud; Durbin, Richard; Sauer, Sascha; Hoffmann, Georg F.; Strom, Tim M.; Santer, René; Meitinger, Thomas; Klopstock, Thomas; Prokisch, Holger; Haack, Tobias B.

    2016-01-01

    Molecular diagnosis of mitochondrial disorders is challenging because of extreme clinical and genetic heterogeneity. By exome sequencing, we identified three different bi-allelic truncating mutations in TANGO2 in three unrelated individuals with infancy-onset episodic metabolic crises characterized by encephalopathy, hypoglycemia, rhabdomyolysis, arrhythmias, and laboratory findings suggestive of a defect in mitochondrial fatty acid oxidation. Over the course of the disease, all individuals developed global brain atrophy with cognitive impairment and pyramidal signs. TANGO2 (transport and Golgi organization 2) encodes a protein with a putative function in redistribution of Golgi membranes into the endoplasmic reticulum in Drosophila and a mitochondrial localization has been confirmed in mice. Investigation of palmitate-dependent respiration in mutant fibroblasts showed evidence of a functional defect in mitochondrial β-oxidation. Our results establish TANGO2 deficiency as a clinically recognizable cause of pediatric disease with multi-organ involvement. PMID:26805782

  13. Livelihoods, power, and food insecurity: adaptation of social capital portfolios in protracted crises--case study Burundi.

    PubMed

    Vervisch, Thomas G A; Vlassenroot, Koen; Braeckman, Johan

    2013-04-01

    The failure of food security and livelihood interventions to adapt to conflict settings remains a key challenge in humanitarian responses to protracted crises. This paper proposes a social capital analysis to address this policy gap, adding a political economy dimension on food security and conflict to the actor-based livelihood framework. A case study of three hillsides in north Burundi provides an ethnographic basis for this hypothesis. While relying on a theoretical framework in which different combinations of social capital (bonding, bridging, and linking) account for a diverse range of outcomes, the findings offer empirical insights into how social capital portfolios adapt to a protracted crisis. It is argued that these social capital adaptations have the effect of changing livelihood policies, institutions, and processes (PIPs), and clarify the impact of the distribution of power and powerlessness on food security issues. In addition, they represent a solid way of integrating political economy concerns into the livelihood framework.

  14. Pneumomédiastin compliquant une crise d’éclampsie: à propos d'un cas

    PubMed Central

    Doumiri, Mouhssine; Motiaa, Youssef; Oudghiri, Nezha; Saoud, Anas Tazi

    2014-01-01

    Le pneumomédiastin associé à l'emphysème sous cutané et le pneumothorax, sont des complications rares de la grossesse et surviennent au cours du travail obstétrical. Nous rapportons l'observation d'une parturiente de 25ans, sans antécédent pathologique particulier, admise pour une crise d’éclampsie à 36 semaines d'aménorrhées avec une mort fœtale et trouble de la conscience. L'examen clinique a montré un emphysème sous cutané étendu du visage jusqu’à l'abdomen sans notion de traumatisme et un score de Glasgow à 10. Après mise en condition, traitement de la crise d’éclampsie, stabilisation de la tension artérielle et retour à l’état de conscience, une TDM cervico-thoraco-abdominale a été demandée et a révélé la présence d'un pneumomédiastin important avec un discret pneumothorax droit postérieur et un pneumopéritoine important qui n'ont pas nécessité de drainage pleural. Deux jours après son admission, la patiente a expulsé un mort-né d'un poids de 1800 grammes avec forceps et sans efforts d'expulsions sous analgésie péridurale. Le contrôle radiologique à une semaine a noté une nette diminution de l'emphysème sous cutané et du pneumomédiastin. La patiente a quitté l'hôpital après dix jours. PMID:25838864

  15. Metabolic causes and prevention of ventricular fibrillation during acute coronary syndromes.

    PubMed

    Oliver, Michael F

    2002-03-01

    The mechanisms leading to ventricular fibrillation that occur during acute myocardial ischemia are ill understood. Whether primary ventricular fibrillation is due to a transient imbalance of electrolytes, an alteration of membrane permeability, electrical re-entry phenomena, or other factors, one overriding influence is the development of regional myocardial energy crises. Acute alteration in the balance of substrate supply may lead, during greatly reduced blood flow, to instability of myocardial electrical conduction with the development of re-entry circuits. An immediate response to the angor animi and initial symptoms of an acute coronary syndrome is a rapid and marked increase in catecholamine release, which leads to adipose tissue lipolysis with an acute increase in plasma free fatty acid concentrations, suppression of insulin activity, and a reduction in glucose uptake by the myocardium. The utilization of free fatty acids instead of glucose by the ischemic myocardium could precipitate regional oxygen or energy crises. Prevention therefore should focus on minimizing the catecholamine response and providing the myocardium with an optimum supply of energy substrates. Since catecholamines are inotropic, the aim should be to redress the imbalance of substrate availability by controlling adipose lipolysis with reduction of plasma free fatty acid concentrations, increasing the availability of glucose, or both. Other approaches include inhibition of acylcarnitine transport and manipulation of fatty acid intermediaries. To combat primary ventricular fibrillation, preventive treatment must be established within 6 to 10 hours of the onset of ischemia. There is already experimental and clinical evidence that antilipolytic drugs decrease the incidence of ventricular fibrillation, but their potential has not been explored extensively.

  16. Pentoxifylline Treatment in Acute Pancreatitis (AP)

    ClinicalTrials.gov

    2016-09-14

    Acute Pancreatitis (AP); Gallstone Pancreatitis; Alcoholic Pancreatitis; Post-ERCP/Post-procedural Pancreatitis; Trauma Acute Pancreatitis; Hypertriglyceridemia Acute Pancreatitis; Idiopathic (Unknown) Acute Pancreatitis; Medication Induced Acute Pancreatitis; Cancer Acute Pancreatitis; Miscellaneous (i.e. Acute on Chronic Pancreatitis)

  17. Acute bacterial parotitis following acute stroke.

    PubMed

    Lee, V K; Kimbrough, D J; Jarquin-Valdivia, A A

    2009-06-01

    Acute bacterial parotitis (ABP) is a relatively uncommon condition that tends to occur in debilitated older patients. We report a case of an older woman that presented with an acute intracerebral hemorrhage who developed ABP. This morbidity led to endotracheal intubation, mechanical ventilation, tracheostomy and gastrostomy, all of which were not initially needed. We discuss the proposed physiopathology and etiopathogenesis of ABP in adults.

  18. Acute Lymphocytic Leukemia

    MedlinePlus

    ... hard for blood to do its work. In acute lymphocytic leukemia (ALL), also called acute lymphoblastic leukemia, there are too ... of white blood cells called lymphocytes or lymphoblasts. ALL is the most common type of cancer in ...

  19. Acute arterial occlusion - kidney

    MedlinePlus

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidneys need a good blood supply. The main artery to the kidney is called the renal artery. ...

  20. Acute kidney failure

    MedlinePlus

    Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... There are many possible causes of kidney damage. They include: ... cholesterol (cholesterol emboli) Decreased blood flow due to very ...

  1. Acute phosphate nephropathy.

    PubMed

    Monfared, Ali; Habibzadeh, Seyed Mahmoud; Mesbah, Seyed Alireza

    2014-05-01

    We present acute phosphate nephropathy in a 28-year-old man, which was developed after a car accident due to rhabdomyolysis. Treatment of acute kidney injury was done with administration of sodium bicarbonate.

  2. Acute Pancreatitis and Pregnancy

    MedlinePlus

    ... and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as the sudden inflammation ... the incidence of recurrent attacks minimized. Timothy Gardner, MD is Director of Pancreatic Disorders at Dartmouth-Hitchcock ...

  3. Acute Appendicitis in Patients with Acute Leukemia

    PubMed Central

    Kim, Ki Up; Kim, Jin Kyeung; Won, Jong Ho; Hong, Dae Sik; Park, Hee Sook; Park, Kyeung Kyu

    1993-01-01

    The decision to operate for abdominal pain in patients with leukopenia can be exceedingly difficult. Surgical exploration may be the only effective way to differentiate acute appendicitis from other causes, but it involves considerable risk of infectious complications due to immunesuppression. Leukemic patients, who presented significant RLQ pain, had been indicated for operation, despite having advanced disease or having had received chemotherapy or steroids. Four adult leukemia patients, complicated by acute appendictis, were reviewed. Two patients were in induction chemotherapy, one receiving salvage chemotheapy due to relapse and the other was in conservative treatment. Two patients were acute myelocytic leukemia (AML), one had acute lymphocytic leukemia (ALL), and the other had aleukemic leukemia. All patients underwent appendectomy and recovered without complication. Our experience supports the theory that the surgical management of appendicitis in acute leukemia is the most effective way, in spite of leukopenia. PMID:8268146

  4. Liposomal daunorubicin, fludarabine, and cytarabine (FLAD) as bridge therapy to stem cell transplant in relapsed and refractory acute leukemia.

    PubMed

    De Astis, Enrico; Clavio, Marino; Raiola, Anna Maria; Ghiso, Anna; Guolo, Fabio; Minetto, Paola; Galaverna, Federica; Miglino, Maurizio; Di Grazia, Carmen; Ballerini, Filippo; Marani, Carlo; Pastori, Giordana; Mitscheunig, Laura; Cruciani, Fabio; Lovera, Davide; Varaldo, Riccardo; Ghiggi, Chiara; Lemoli, Roberto Massimo; Bacigalupo, Andrea; Gobbi, Marco

    2014-12-01

    Therapeutic options for patients with relapsed or refractory acute leukemia are still undefined and often unsatisfactory. We report the outcome of 79 patients with relapsed-refractory acute leukemia treated with fludarabine, cytarabine, and liposomal daunorubicin (FLAD regimen) followed by hematopoietic stem cell transplantation (HSCT), when clinically indicated, between May 2000 and January 2013. Forty-one patients had acute myeloid leukemia (AML), and 38 had acute lymphoblastic leukemia (ALL). Two patients with myeloid blast crises of CML and three with lymphoid blast crises were included in the AML and ALL subgroups, respectively. Median age was 48 years (range 13-77). FLAD was well tolerated with negligible, nonhematological toxicity. Six patients (7.5 %) died before response evaluation. Forty-seven patients achieved hematologic complete response (CR). Complete remission rate was 53 and 65 % among AML and ALL patients, respectively. No CR was recorded among 11 refractory AML patients. Twenty-four patients (30 %) underwent HSCT. Nine patients received stem cells from an HLA identical sibling, and 15 from an alternative donor (3 unrelated matched, 12 haploidentical sibling). Median overall survival in AML and ALL patients receiving FLAD therapy was 9 and 8 months, respectively. A 5-year projected OS for patients receiving the whole program (FLAD + HSCT) was 24 % for AML patients (median survival 43 months), 28 % for ALL patients treated in relapse (median survival 15 months), and 0 % for ALL patients treated for refractory disease. In this paper, we show that FLAD seems to be an effective bridge therapy to HSCT for a part of poor prognosis acute leukemia patients. However, prospective studies are needed to confirm our results.

  5. The Changing Face of Crises and Aid in the Asia-Pacific

    PubMed Central

    Burkle, Frederick M.; Hamon, David W.; Walker, Peter; Benjamin, Georges C.

    2014-01-01

    Both US foreign policy and global attention attest to the strategic, economic, and political importance of Asia. Yet, the region faces urgent challenges that must be addressed if it is to remain stable and prosperous. The densely populated countries of the Asia-Pacific are beleaguered by poverty, population displacement, decreasing access to potable water and adequate sanitation, and high rates of disease morbidity and mortality. New and reemerging diseases known to have originated in Asia over the past decades have spread globally by international trade, tourism, worker migration, and agricultural exportation. Unremitting naturally occurring and man-made disasters have strained Southeast Asia's already fragile disaster and public health response infrastructures and the essential services they provide (eg, surveillance, vaccination, maternal and child health, and mental health programs). Following disasters, governments often contract with the broader humanitarian community (eg, indigenous and international NGOs) and seek the assistance of militaries to provide essential services. Yet, their roles and capabilities in addressing acute and chronic health issues in the wake of complex disasters remain unclear. Current mechanisms of nation-state and outside organization interaction, including dissimilar operational platforms, may limit true partnership on behalf of the health security mission. Additionally, concerns regarding skill sets and the lack of standards-based training raise questions about the balance between developing internal response capabilities and professionalizing external, deployable resources. Both the mega-disasters that are forecast for the region and the global health security threats that are expected to emanate from them require an increased focus on improving the Asia-Pacific's emergency preparedness and response posture. PMID:25268048

  6. The changing face of crises and aid in the Asia-Pacific.

    PubMed

    Gursky, Elin A; Burkle, Frederick M; Hamon, David W; Walker, Peter; Benjamin, Georges C

    2014-01-01

    Both US foreign policy and global attention attest to the strategic, economic, and political importance of Asia. Yet, the region faces urgent challenges that must be addressed if it is to remain stable and prosperous. The densely populated countries of the Asia-Pacific are beleaguered by poverty, population displacement, decreasing access to potable water and adequate sanitation, and high rates of disease morbidity and mortality. New and reemerging diseases known to have originated in Asia over the past decades have spread globally by international trade, tourism, worker migration, and agricultural exportation. Unremitting naturally occurring and man-made disasters have strained Southeast Asia's already fragile disaster and public health response infrastructures and the essential services they provide (eg, surveillance, vaccination, maternal and child health, and mental health programs). Following disasters, governments often contract with the broader humanitarian community (eg, indigenous and international NGOs) and seek the assistance of militaries to provide essential services. Yet, their roles and capabilities in addressing acute and chronic health issues in the wake of complex disasters remain unclear. Current mechanisms of nation-state and outside organization interaction, including dissimilar operational platforms, may limit true partnership on behalf of the health security mission. Additionally, concerns regarding skill sets and the lack of standards-based training raise questions about the balance between developing internal response capabilities and professionalizing external, deployable resources. Both the mega-disasters that are forecast for the region and the global health security threats that are expected to emanate from them require an increased focus on improving the Asia-Pacific's emergency preparedness and response posture.

  7. Acute loss of consciousness.

    PubMed

    Tristán, Bekinschtein; Gleichgerrcht, Ezequiel; Manes, Facundo

    2015-01-01

    Acute loss of consciousness poses a fascinating scenario for theoretical and clinical research. This chapter introduces a simple yet powerful framework to investigate altered states of consciousness. We then explore the different disorders of consciousness that result from acute brain injury, and techniques used in the acute phase to predict clinical outcome in different patient populations in light of models of acute loss of consciousness. We further delve into post-traumatic amnesia as a model for predicting cognitive sequels following acute loss of consciousness. We approach the study of acute loss of consciousness from a theoretical and clinical perspective to conclude that clinicians in acute care centers must incorporate new measurements and techniques besides the classic coma scales in order to assess their patients with loss of consciousness.

  8. Institutional and relational determinants in high- and medium-extent food product crises: the inner perspective of a public health crisis.

    PubMed

    Charlebois, Sylvain; Horan, Hilary

    2010-08-01

    In 2008, Canada enacted its biggest-ever food recall in response to a Listeria crisis, stemming from a Maple Leaf Foods plant, that killed 22 Canadians. Afterwards, Maple Leaf's market share quickly returned to pre-crisis levels, but the long-term repercussions of the scare still reverberate in Maple Leaf's brand. In this case study, which offers an organizational perspective on the food recall, data was collected, through in-depth interviews of persons involved in the crisis response, and analyzed. The aim of this paper is to make transparent the ways in which Maple Leaf Foods organized their resources to manage the 2008 food recall. Results reveal that institutional and relational determinants are the most important factors in high- and medium-extent food product crises, whereas external and internal effects primarily influence an organization's capacity to cope with severe crises. Based on these findings, a conceptual framework is presented and managerial implications are discussed.

  9. Decitabine in Treating Children With Relapsed or Refractory Acute Myeloid Leukemia or Acute Lymphoblastic Leukemia

    ClinicalTrials.gov

    2013-01-22

    Childhood Acute Myeloblastic Leukemia With Maturation (M2); Childhood Acute Promyelocytic Leukemia (M3); Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia

  10. Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review

    PubMed Central

    Akl, Elie A.; El-Jardali, Fadi; Bou Karroum, Lama; El-Eid, Jamale; Brax, Hneine; Akik, Chaza; Osman, Mona; Hassan, Ghayda; Itani, Mira; Farha, Aida; Pottie, Kevin; Oliver, Sandy

    2015-01-01

    Background Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. Methods We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. Results Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. Conclusion This systematic review provides evidence of possible effectiveness of information coordination

  11. DNA polymorphisms at the BCL11A, HBS1L-MYB, and beta-globin loci associate with fetal hemoglobin levels and pain crises in sickle cell disease.

    PubMed

    Lettre, Guillaume; Sankaran, Vijay G; Bezerra, Marcos André C; Araújo, Aderson S; Uda, Manuela; Sanna, Serena; Cao, Antonio; Schlessinger, David; Costa, Fernando F; Hirschhorn, Joel N; Orkin, Stuart H

    2008-08-19

    Sickle cell disease (SCD) is a debilitating monogenic blood disorder with a highly variable phenotype characterized by severe pain crises, acute clinical events, and early mortality. Interindividual variation in fetal hemoglobin (HbF) expression is a known and potentially heritable modifier of SCD severity. High HbF levels are correlated with reduced morbidity and mortality. Common single nucleotide polymorphisms (SNPs) at the BCL11A and HBS1L-MYB loci have been implicated previously in HbF level variation in nonanemic European populations. We recently demonstrated an association between a BCL11A SNP and HbF levels in one SCD cohort [Uda M, et al. (2008) Proc Natl Acad Sci USA 105:1620-1625]. Here, we genotyped additional BCL11A SNPs, HBS1L-MYB SNPs, and an SNP upstream of (G)gamma-globin (HBG2; the XmnI polymorphism), in two independent SCD cohorts: the African American Cooperative Study of Sickle Cell Disease (CSSCD) and an SCD cohort from Brazil. We studied the effect of these SNPs on HbF levels and on a measure of SCD-related morbidity (pain crisis rate). We strongly replicated the association between these SNPs and HbF level variation (in the CSSCD, P values range from 0.04 to 2 x 10(-42)). Together, common SNPs at the BCL11A, HBS1L-MYB, and beta-globin (HBB) loci account for >20% of the variation in HbF levels in SCD patients. We also have shown that HbF-associated SNPs associate with pain crisis rate in SCD patients. These results provide a clear example of inherited common sequence variants modifying the severity of a monogenic disease.

  12. The Opportunities of Crises and Emergency Risk Communication in Activities of Serbian Public Health Workforce in Emergencies

    PubMed Central

    Radović, V; Ćurčić, L

    2012-01-01

    Background: The aim of the study was a recommendation and establishment the concept of the appropriate communication between public health, other competent services and population in emergency as the corner stone which guarantee that all goals which are important for community life will be achieved. Methods: We used methodology appropriate for social science: analyses of documents, historical approach and comparative analysis. Results: The finding shows the urgent need for accepting of crises and emergency risk communication principles, or some similar concepts, in Serbia, and implementing effective two way communication especially in multiethnic region. The pragmatic value of the paper lays in information about the recent improvement of health workforce and emergency services in emergencies using new concept of communication and as source of numerous useful documents published in USA and few recent Serbian examples. Conclusion: Health workforce has significant role in the process of protection of population in emergencies. Policy makers should work on finding a way to improve their coordination and communication, creating new academic programs, providing of adequate training, and financial means in order to give them different role in society and provide visibility. From other side health workforce should build back to the citizen trust in what they are doing for society welfare using all their skills and abilities. PMID:23308348

  13. The Crisis Intervention Team Model of Police Response to Mental Health Crises: A Primer for Mental Health Practitioners.

    PubMed

    Watson, Amy C; Fulambarker, Anjali J

    2012-12-01

    As persons with mental illnesses and law enforcement become increasingly entangled, the collaboration of police and mental health service providers has become critical to appropriately serving the needs of individuals experiencing mental health crises. This article introduces the Crisis Intervention Team (CIT) Model as a collaborative approach to safely and effectively address the needs of persons with mental illnesses, link them to appropriate services, and divert them from the criminal justice system if appropriate. We discuss the key elements of the CIT model, implementation and its related challenges, as well as variations of the model. While this model has not undergone enough research to be deemed an Evidence-Based Practice, it has been successfully utilized in many law enforcement agencies worldwide and is considered a "Best Practice" model in law enforcement. This primer for mental health practitioners serves as an introduction to a model that may already be utilized in their community or serve as a springboard for the development CIT programs where they do not currently exist.

  14. The Crisis Intervention Team Model of Police Response to Mental Health Crises: A Primer for Mental Health Practitioners

    PubMed Central

    Watson, Amy C.; Fulambarker, Anjali J.

    2013-01-01

    As persons with mental illnesses and law enforcement become increasingly entangled, the collaboration of police and mental health service providers has become critical to appropriately serving the needs of individuals experiencing mental health crises. This article introduces the Crisis Intervention Team (CIT) Model as a collaborative approach to safely and effectively address the needs of persons with mental illnesses, link them to appropriate services, and divert them from the criminal justice system if appropriate. We discuss the key elements of the CIT model, implementation and its related challenges, as well as variations of the model. While this model has not undergone enough research to be deemed an Evidence-Based Practice, it has been successfully utilized in many law enforcement agencies worldwide and is considered a “Best Practice” model in law enforcement. This primer for mental health practitioners serves as an introduction to a model that may already be utilized in their community or serve as a springboard for the development CIT programs where they do not currently exist. PMID:24039557

  15. The food, fuel, and financial crises affect the urban and rural poor disproportionately: a review of the evidence.

    PubMed

    Ruel, Marie T; Garrett, James L; Hawkes, Corinna; Cohen, Marc J

    2010-01-01

    The vulnerability of the urban poor to the recent food and fuel price crisis has been widely acknowledged. The unfolding global financial crisis, which brings higher unemployment and underemployment, is likely to further intensify this vulnerability. This paper reviews the evidence concerning the disproportionate vulnerability of the urban compared with the rural poor to these types of shocks. It reviews some of the unique characteristics of urban life that could make the urban poor particularly susceptible to price and financial shocks and summarizes the evidence regarding the disproportionate vulnerability of the urban poor. The focus is on impacts on poverty, food insecurity, and malnutrition. The review shows that although the urban poor are clearly one of the population groups most affected by the current (and previous) crises, the rural poor, landless, and net buyers are in no better position to confront the crisis without significant suffering. The poorest of the poor are the ones who will be most affected, irrespective of the continent, country, or urban or rural area where they live. The magnitude and severity of their suffering depends on their ability to adapt and on the specific nature, extent, and duration of the coping strategies they adopt. A better understanding of how these coping strategies are used and staggered is critical to help design triggers for action that can prevent households from moving to more desperate measures. Using these early coping strategies as early warning indicators could help prevent dramatic losses in welfare.

  16. Recurrent Muscle Weakness with Rhabdomyolysis, Metabolic Crises, and Cardiac Arrhythmia Due to Bi-allelic TANGO2 Mutations

    PubMed Central

    Lalani, Seema R.; Liu, Pengfei; Rosenfeld, Jill A.; Watkin, Levi B.; Chiang, Theodore; Leduc, Magalie S.; Zhu, Wenmiao; Ding, Yan; Pan, Shujuan; Vetrini, Francesco; Miyake, Christina Y.; Shinawi, Marwan; Gambin, Tomasz; Eldomery, Mohammad K.; Akdemir, Zeynep Hande Coban; Emrick, Lisa; Wilnai, Yael; Schelley, Susan; Koenig, Mary Kay; Memon, Nada; Farach, Laura S.; Coe, Bradley P.; Azamian, Mahshid; Hernandez, Patricia; Zapata, Gladys; Jhangiani, Shalini N.; Muzny, Donna M.; Lotze, Timothy; Clark, Gary; Wilfong, Angus; Northrup, Hope; Adesina, Adekunle; Bacino, Carlos A.; Scaglia, Fernando; Bonnen, Penelope E.; Crosson, Jane; Duis, Jessica; Maegawa, Gustavo H.B.; Coman, David; Inwood, Anita; McGill, Jim; Boerwinkle, Eric; Graham, Brett; Beaudet, Art; Eng, Christine M.; Hanchard, Neil A.; Xia, Fan; Orange, Jordan S.; Gibbs, Richard A.; Lupski, James R.; Yang, Yaping

    2016-01-01

    The underlying genetic etiology of rhabdomyolysis remains elusive in a significant fraction of individuals presenting with recurrent metabolic crises and muscle weakness. Using exome sequencing, we identified bi-allelic mutations in TANGO2 encoding transport and Golgi organization 2 homolog (Drosophila) in 12 subjects with episodic rhabdomyolysis, hypoglycemia, hyperammonemia, and susceptibility to life-threatening cardiac tachyarrhythmias. A recurrent homozygous c.460G>A (p.Gly154Arg) mutation was found in four unrelated individuals of Hispanic/Latino origin, and a homozygous ∼34 kb deletion affecting exons 3–9 was observed in two families of European ancestry. One individual of mixed Hispanic/European descent was found to be compound heterozygous for c.460G>A (p.Gly154Arg) and the deletion of exons 3–9. Additionally, a homozygous exons 4–6 deletion was identified in a consanguineous Middle Eastern Arab family. No homozygotes have been reported for these changes in control databases. Fibroblasts derived from a subject with the recurrent c.460G>A (p.Gly154Arg) mutation showed evidence of increased endoplasmic reticulum stress and a reduction in Golgi volume density in comparison to control. Our results show that the c.460G>A (p.Gly154Arg) mutation and the exons 3–9 heterozygous deletion in TANGO2 are recurrent pathogenic alleles present in the Latino/Hispanic and European populations, respectively, causing considerable morbidity in the homozygotes in these populations. PMID:26805781

  17. The impact of critical event checklists on medical management and teamwork during simulated crises in a surgical daycare facility.

    PubMed

    Everett, T C; Morgan, P J; Brydges, R; Kurrek, M; Tregunno, D; Cunningham, L; Chan, A; Forde, D; Tarshis, J

    2017-03-01

    Although the incidence of major adverse events in surgical daycare centres is low, these critical events may not be managed optimally due to the absence of resources that exist in larger hospitals. We aimed to study the impact of operating theatre critical event checklists on medical management and teamwork during whole-team operating theatre crisis simulations staged in a surgical daycare facility. We studied 56 simulation encounters (without and with a checklist available) divided between an initial session and then a retention session several months later. Medical management and teamwork were quantified via percentage adherence to key processes and the Team Emergency Assessment Measure, respectively. In the initial session, medical management was not improved by the presence of a checklist (56% without checklist vs. 62% with checklist; p = 0.50). In the retention session, teams performed significantly worse without the checklists (36% without checklist vs. 60% with checklist; p = 0.04). We did not observe a change in non-technical skills in the presence of a checklist in either the initial or retention sessions (68% without checklist vs. 69% with checklist (p = 0.94) and 69% without checklist vs. 65% with checklist (p = 0.36), respectively). Critical events checklists do not improve medical management or teamwork during simulated operating theatre crises in an ambulatory surgical daycare setting.

  18. Acute otitis media and acute bacterial sinusitis.

    PubMed

    Wald, Ellen R

    2011-05-01

    Acute otitis media and acute bacterial sinusitis are 2 of the most common indications for antimicrobial agents in children. Together, they are responsible for billions of dollars of health care expenditures. The pathogenesis of the 2 conditions is identical. In the majority of children with each condition, a preceding viral upper respiratory tract infection predisposes to the development of the acute bacterial complication. It has been shown that viral upper respiratory tract infection predisposes to the development of acute otitis media in 37% of cases. Currently, precise microbiologic diagnosis of acute otitis media and acute bacterial sinusitis requires performance of tympanocentesis in the former and sinus aspiration in the latter. The identification of a virus from the nasopharynx in either case does not obviate the need for antimicrobial therapy. Furthermore, nasal and nasopharyngeal swabs are not useful in predicting the results of culture of the middle ear or paranasal sinus. However, it is possible that a combination of information regarding nasopharyngeal colonization with bacteria and infection with specific viruses may inform treatment decisions in the future.

  19. Crise convulsive chez les abuseurs de Tramadol et caféine: à propos de 8 cas et revue de la littérature

    PubMed Central

    Maiga, Djibo Douma; Seyni, Houdou; Sidikou, Amadou; Azouma, Alfazazi

    2012-01-01

    Nous rapportons Huit cas de crises convulsives diagnostiquées comme maladie épileptique après ingestion de Tramadol et d'autres substances psychotropes dont la Caféine dans une région ou maladie épileptique et addiction au café sont fréquentes. L'objectif de ce travail était d'informer les praticiens sur le risque de convulsion lié à la consommation du Tramadol seul ou en association avec d'autres psychotropes en s'appuyant sur les données de la littérature. Il s'agissait d'une étude rétrospective et exhaustive de patients vus en consultation ambulatoire pour crise convulsive et consommation de Tramadol et de caféine de janvier à mai 2012. Les données collectées étaient les caractéristiques sociodémographiques et de la consommation de Tramadol. Le diagnostic de crise convulsive a été posé sur les renseignements obtenus à l'anamnèse. Tous les patients ont été soumis à un examen neurologique et aux critères de dépendance du Diagnostic and Statistical Manual of Mental Disorders (DSMIV)-R par rapport à leur consommation de Tramadol. Nous n'avons pas trouvé dans la littérature médicale de cas de consommation concomitante de Tramadol et de Caféine. Les données expérimentales suggèrent une action synergique du Tramadol et de la Caféine sur la douleur et le seuil épileptogène. Nos observations plaident également en faveur d'une synergie d'action de ces deux molécules dans la survenue des crises convulsives. La fréquence des crises convulsives suite à une intoxication par le Tramadol et la caféine est susceptible d'augmenter en Afrique en raison du mésusage croissant de ces substances. Une étude comparative usagers de Tramadol associé à la Caféine et usagers du Tramadol seul devrait permettre d’évaluer le risque. PMID:23308329

  20. Sickle cell anemia in Guadeloupean children: pattern and prevalence of acute clinical events.

    PubMed

    Tarer, Vanessa; Etienne-Julan, Maryse; Diara, Jean-Pierre; Belloy, Marie Sylvaine; Mukizi-Mukaza, Martin; Elion, Jacques; Romana, Marc

    2006-03-01

    We analyzed the records of 153 Guadeloupean children with sickle cell anemia (SCA), for whom clinical and laboratory data were prospectively collected (mean follow-up duration 8.4 +/- 4.6 yr). Prevalence and age-specific frequencies of acute clinical events were determined and correlations between complications, hematological parameters and potential modulating factors investigated. Painful crisis and acute chest syndrome (ACS) were the two most common complications, affecting 65.4% and 58.8% of the patients, respectively. The frequency of acute anemia was 49.7% (acute splenic sequestration 24.8%; acute aplastic anemia 15.0%). Prevalences of septicemia-meningitis and osteomyelitis were 15.7% and 16.3%, respectively. A higher incidence of infections, painful crises and acute anemia was detected in patients who developed ACS. The well-documented protective effect of HbF level on the overall disease expression was observed with higher HbF level in asymptomatic than in symptomatic patients (17.5% +/- 8% vs. 9.9% +/- 6.4%, P = 0.01) with similar ages and sex ratio. It was also confirmed on ACS and, for the first time, further extended to acute anemic events and septicemia. Besides its effect on hematological parameters, alpha-thalassemia seems to have little impact on the prevalence of complications, as do beta(S)-globin haplotypes. Comparison with other series suggests that the natural history of SCA in Guadeloupe is more similar to that in Jamaica with regard to those reported in Europe and the United States, suggesting a potential impact of environmental factors on the clinical course of the disease.

  1. Detection of Occult Acute Kidney Injury in Glucose-6-Phosphate Dehydrogenase Deficiency Anemia

    PubMed Central

    Abdel Hakeem, Gehan Lotfy; Abdel Naeem, Emad Allam; Swelam, Salwa Hussein; El Morsi Aboul Fotoh, Laila; El Mazary, Abdel Azeem Mohamed; Abdel Fadil, Ashraf Mohamed; Abdel Hafez, Asmaa Hosny

    2016-01-01

    Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency anemia is associated with intravascular hemolysis. The freely filtered hemoglobin can damage the kidney. We aimed to assess any subclinical renal injury in G6PD children. Methods Sixty children were included. Thirty G6PD deficiency anemia children were enrolled during the acute hemolytic crisis and after the hemolytic episode had elapsed. Another thirty healthy children were included as controls. Serum cystatin C, creatinine levels, and urinary albumin/creatinine (A/C) ratio were measured, and the glomerular filtration rate (GFR) was calculated. Results Significantly higher urinary A/C ratio (p=0.001,0.002 respectively) and lower GFR (p=0.001 for both) were found during hemolysis and after the hemolytic episode compared to the controls. Also, significant higher serum cystatin C (p=0.001), creatinine (p=0.05) and A/C (p= 0.001) ratio and insignificant lower GFR (p=0.3) during acute hemolytic crisis compared to the same children after the hemolytic episode subsided. Conclusions G6PD deficiency anemia is associated with a variable degree of acute renal injury during acute hemolytic episodes which may persist after elapsing of the hemolytic crises. PMID:27648201

  2. [Acute rheumatic fever].

    PubMed

    Maier, Alexander; Kommer, Vera

    2016-03-01

    We report on a young women with acute rheumatic fever. Acute rheumatic fever has become a rare disease in Germany, especially in adults. This carries the risk that it can be missed in the differential diagnostic considerations of acute rheumatic disorders and febrile status. If rheumatic fever is not diagnosed and treated correctly, there is a considerable risk for rheumatic valvular heart disease. In this article diagnosis, differential diagnosis and therapy of rheumatic fever are discussed extensively.

  3. Acute clinical events in 299 homozygous sickle cell patients living in France. French Study Group on Sickle Cell Disease.

    PubMed

    Neonato, M G; Guilloud-Bataille, M; Beauvais, P; Bégué, P; Belloy, M; Benkerrou, M; Ducrocq, R; Maier-Redelsperger, M; de Montalembert, M; Quinet, B; Elion, J; Feingold, J; Girot, R

    2000-09-01

    A subset of 299 patients with homozygous sickle cell anaemia, enrolled in the cohort of the French Study Group on sickle cell disease (SCD), was investigated in this study. The majority of patients were children (mean age 10.1 +/- 5.8 yr) of first generation immigrants from Western and Central Africa, the others originated from the French West Indies (20.2%). We report the frequency of the main clinical events (mean follow-up 4.2 +/- 2.2 yr). The prevalence of meningitis-septicaemia and osteomyelitis was, respectively, 11.4% and 12% acute chest syndrome was observed in 134 patients (44.8%). Twenty patients (6.7%) developed stroke with peak prevalence at 10-15 yr of age. One hundred and seventy-two patients (58%) suffered from one or more painful sickle cell crises, while the others (42.5%) never suffered from pain. The overall frequency of acute anaemic episodes was 50.5%, (acute aplastic anaemia 46%; acute splenic sequestration 26%). A group of 27 patients were asymptomatic (follow-up > 3 yr). Epistatic mechanisms influencing SCD were studied. Coinherited alpha-thalassemia strongly reduced the risk of stroke (p <0.001) and increased that of painful crises (p < 0.02). There was a low prevalence of Senegal and Bantu (CAR) betas-chromosomes in patients with meningitis (p <0.04) and osteomyelitis (p < 0.03). Prevalence of Senegal betas-chromosomes was lower in the asymptomatic group of 27 patients (p < 0.02). The patients come from a population of unmixed immigrants in whom the beta-globin gene haplotype strongly reflects the geographic origin and identifies subgroups with a homogenous genetic background. Thus the observed effects might result more from differences in as yet unidentified determinants in the genetic background than from the direct linkage with differences in the beta-globin gene locus.

  4. Acute phase reaction and acute phase proteins*

    PubMed Central

    Gruys, E.; Toussaint, M.J.M.; Niewold, T.A.; Koopmans, S.J.

    2005-01-01

    A review of the systemic acute phase reaction with major cytokines involved, and the hepatic metabolic changes, negative and positive acute phase proteins (APPs) with function and associated pathology is given. It appears that APPs represent appropriate analytes for assessment of animal health. Whereas they represent non-specific markers as biological effect reactants, they can be used for assessing nutritional deficits and reactive processes, especially when positive and negative acute phase variables are combined in an index. When such acute phase index is applied to separate healthy animals from animals with some disease, much better results are obtained than with single analytes and statistically acceptable results for culling individual animals may be reached. Unfortunately at present no cheap, comprehensive and easy to use system is available for assessing various acute phase proteins in serum or blood samples at the same time. Protein microarray or fluid phase microchip technology may satisfy this need; and permit simultaneous analysis of numerous analytes in the same small volume sample and enable integration of information derived from systemic reactivity and nutrition with disease specific variables. Applying such technology may help to solve health problems in various countries not only in animal husbandry but also in human populations. PMID:16252337

  5. Infant acute myocarditis mimicking acute myocardial infarction

    PubMed Central

    Tilouche, Samia; Masmoudi, Tasnim; Sahnoun, Maha; Chkirbène, Youssef; Mestiri, Sarra; Boughamoura, Lamia; Ben Dhiab, Mohamed; Souguir, Mohamed Kamel

    2016-01-01

    Myocarditis is an inflammatory disease of the myocardium with heterogeneous clinical manifestations and progression. In clinical practice, although there are many methods of diagnosis of acute myocarditis, the diagnosis remains an embarrassing dilemma for clinicians. The authors report the case of 9-month-old infant who was brought to the Pediatric Emergency Department with sudden onset dyspnea. Examination disclosed heart failure and resuscitation was undertaken. The electrocardiogram showed an ST segment elevation in the anterolateral leads with a mirror image. Cardiac enzyme tests revealed a significant elevation of troponin and creatine phosphokinase levels. A diagnosis of acute myocardial infarction was made, and heparin therapy was prescribed. The infant died on the third day after admission with cardiogenic shock. The autopsy showed dilatation of the ventricles and massive edema of the lungs. Histological examinations of myocardium samples revealed the presence of a marked lymphocytic infiltrate dissociating myocardiocytes. Death was attributed to acute myocarditis. The authors call attention to the difficulties of differential diagnosis between acute myocarditis and acute myocardial infarction especially in children, and to the important therapeutic implications of a correct diagnosis. PMID:28210569

  6. Adult Acute Leukaemia

    PubMed Central

    Atkinson, K.; Wells, D. G.; Clink, H. McD.; Kay, H. E. M.; Powles, R.; McElwain, T. J.

    1974-01-01

    Seventy-eight adult patients with acute leukaemia were classified cytologically into 3 categories: acute lymphoblastic leukaemia (ALL), acute myelogenous leukaemia (AML) or acute undifferentiated leukaemia (AUL). The periodic acid-Schiff stain was of little value in differentiating the 3 groups. The treatment response in each group was different: 94% of patients with ALL (16/17) achieved complete remission with prednisone, vincristine and other drugs in standard use in childhood ALL; 59% of patients with AML (27/46) achieved complete remission with cytosine arabinoside and daunorubicin (22 patients), or 6-thioguanine and cyclophosphamide (2 patients), 6-thioguanine, cyclophosphamide and Adriamycin (1 patient), and cytosine and Adriamycin (1 patient); only 2 out of 14 patients (14%) with acute undifferentiated leukaemia achieved complete remission using cytosine and daunorubicin after an initial trial of prednisone and vincristine had failed. Prednisone and vincristine would seem to be of no value in acute undifferentiated leukaemia. It would seem also that no benefit is obtained by classifying all patients with acute leukaemia over 20 years of age as “adult acute leukaemia” and treating them with the same polypharmaceutical regimen. The problems posed by each disease are different and such a policy serves only to obscure them. ImagesFig. 1Fig. 2Fig. 3 PMID:4141625

  7. Acute Disseminated Encephalomyelitis.

    PubMed

    Gray, Matthew Philip; Gorelick, Marc H

    2016-06-01

    Acute disseminated encephalomyelitis is a primarily pediatric, immune-mediated disease characterized by demyelination and polyfocal neurologic symptoms that typically occur after a preceding viral infection or recent immunization. This article presents the pathophysiology, diagnostic criteria, and magnetic resonance imaging characteristics of acute disseminated encephalomyelitis. We also present evaluation and management strategies.

  8. Acute kidney injury during pregnancy.

    PubMed

    Van Hook, James W

    2014-12-01

    Acute kidney injury complicates the care of a relatively small number of pregnant and postpartum women. Several pregnancy-related disorders such as preeclampsia and thrombotic microangiopathies may produce acute kidney injury. Prerenal azotemia is another common cause of acute kidney injury in pregnancy. This manuscript will review pregnancy-associated acute kidney injury from a renal functional perspective. Pathophysiology of acute kidney injury will be reviewed. Specific conditions causing acute kidney injury and treatments will be compared.

  9. [Chronic pancreatitis, acute pancreatitis].

    PubMed

    Mabuchi, T; Katada, N; Nishimura, D; Hoshino, H; Shimizu, F; Suzuki, R; Sano, H; Kato, K

    1998-11-01

    MRCP has been recognized as a safe and noninvasive diagnostic method. In the present study we evaluated the usefulness of MRCP in diagnosis of chronic and acute pancreatitis. Two-dimensional fast asymmetric spin-echo (FASE) MRCP was performed in 40 patients with chronic pancreatitis and 13 with acute pancreatitis. In 29 patients (72.5%) with chronic pancreatitis and 9 (66.7%) with acute pancreatitis, main pancreatic duct (MPD) was visualized entirely. MRCP could demonstrate the characteristic findings of chronic pancreatitis such as dilatation and irregularity of MPD in most cases. In acute pancreatitis, MRCP indicated that MPD was normal in diameter, but irregular in configuration compared with that of the control group. MRCP may facilitate the diagnosis of chronic and acute pancreatitis.

  10. Acute disseminated encephalomyelitis.

    PubMed

    Alper, Gulay

    2012-11-01

    Acute disseminated encephalomyelitis is an immune-mediated inflammatory and demyelinating disorder of the central nervous system, commonly preceded by an infection. It principally involves the white matter tracts of the cerebral hemispheres, brainstem, optic nerves, and spinal cord. Acute disseminated encephalomyelitis mainly affects children. Clinically, patients present with multifocal neurologic abnormalities reflecting the widespread involvement in central nervous system. Cerebrospinal fluid may be normal or may show a mild pleocytosis with or without elevated protein levels. Magnetic resonance image (MRI) shows multiple demyelinating lesions. The diagnosis of acute disseminated encephalomyelitis requires both multifocal involvement and encephalopathy by consensus criteria. Acute disseminated encephalomyelitis typically has a monophasic course with a favorable prognosis. Multiphasic forms have been reported, resulting in diagnostic difficulties in distinguishing these cases from multiple sclerosis. In addition, many inflammatory disorders may have a similar presentation with frequent occurrence of encephalopathy and should be considered in the differential diagnosis of acute disseminated encephalomyelitis.

  11. Acute kidney injury in children with sickle cell disease-compounding a chronic problem.

    PubMed

    Mammen, Cherry; Bissonnette, Mei Lin; Matsell, Douglas G

    2017-03-28

    In an article recently published in Pediatric Nephrology, Baddam and colleagues discuss the relatively underreported clinical problem of repeated episodes of acute kidney injury (AKI) in children with sickle cell disease (SCD). Their report is a cautionary note about the importance of repeated kidney injury on the background of underlying chronic kidney injury and its potential implications on long-term kidney outcome. In children and adults with SCD, this includes the effects of repeated vaso-occlusive crises and the management of these painful episodes with non-steroidal anti-inflammatory drugs. Here we review the scope of kidney involvement in SCD in children and discuss the potential short- and long-term consequences of AKI in children with SCD.

  12. Rare Case of Posterior Reversible Leukoencephalopathy Syndrome Secondary to Acute Chest Syndrome

    PubMed Central

    Klein, Daniel; El-Sherif, Yasir

    2016-01-01

    We present a case of 29/m with a history of sickle cell disease who presented to the emergency department with sudden onset of chest, trunk, extremity, and back pain, consistent in quality and severity with the patient's usual pain crises. Soon after admission to the medical unit for acute chest syndrome (ACS), the patient developed sudden onset of hypertension associated with left sided hemiplegia, lethargy, dysarthria, aphasia, and left sided facial droop. Neuroimaging revealed that on MRI Brain there was multifocal extensive signal abnormality and a small focal areas of hemorrhage compatible with posterior reversible leukoencephalopathy syndrome (PRES). Patient was treated with levetiracetam and phenytoin and improved soon afterwards, with resolution seen on follow-up MRI two months later. PMID:27957377

  13. MEK1/2 inhibitors reverse acute vascular occlusion in mouse models of sickle cell disease.

    PubMed

    Zhao, Yulin; Schwartz, Evan A; Palmer, Gregory M; Zennadi, Rahima

    2016-03-01

    In sickle cell disease (SCD), treatment of recurrent vasoocclusive episodes, leading to pain crises and organ damage, is still a therapeutic challenge. Vasoocclusion is caused primarily by adherence of homozygous for hemoglobin S (SS) red blood cells (SSRBCs) and leukocytes to the endothelium. We tested the therapeutic benefits of MEK1/2 inhibitors in reversing vasoocclusion in nude and humanized SCD mouse models of acute vasoocclusive episodes using intravital microscopy. Administration of 0.2, 0.3, 1, or 2 mg/kg MEK1/2 inhibitor to TNF-α-pretreated nude mice before human SSRBC infusion inhibited SSRBC adhesion in inflamed vessels, prevented the progression of vasoocclusion, and reduced SSRBC organ sequestration. By use of a more clinically relevant protocol, 0.3 or 1 mg/kg MEK1/2 inhibitor given to TNF-α-pretreated nude mice after human SSRBC infusion and onset of vasoocclusion reversed SSRBC adhesion and vasoocclusion and restored blood flow. In SCD mice, 0.025, 0.05, or 0.1 mg/kg MEK1/2 inhibitor also reversed leukocyte and erythrocyte adhesion after the inflammatory trigger of vasoocclusion and improved microcirculatory blood flow. Cell adhesion was reversed by shedding of endothelial E-selectin, P-selectin, and αvβ3 integrin, and leukocyte CD44 and β2 integrin. Thus, MEK1/2 inhibitors, by targeting the adhesive function of SSRBCs and leukocytes, could represent a valuable therapeutic intervention for acute sickle cell vasoocclusive crises.

  14. Forecasting of magnitude and duration of currency crises based on the analysis of distortions of fractal scaling in exchange rate fluctuations

    NASA Astrophysics Data System (ADS)

    Uritskaya, Olga Y.

    2005-05-01

    Results of fractal stability analysis of daily exchange rate fluctuations of more than 30 floating currencies for a 10-year period are presented. It is shown for the first time that small- and large-scale dynamical instabilities of national monetary systems correlate with deviations of the detrended fluctuation analysis (DFA) exponent from the value 1.5 predicted by the efficient market hypothesis. The observed dependence is used for classification of long-term stability of floating exchange rates as well as for revealing various forms of distortion of stable currency dynamics prior to large-scale crises. A normal range of DFA exponents consistent with crisis-free long-term exchange rate fluctuations is determined, and several typical scenarios of unstable currency dynamics with DFA exponents fluctuating beyond the normal range are identified. It is shown that monetary crashes are usually preceded by prolonged periods of abnormal (decreased or increased) DFA exponent, with the after-crash exponent tending to the value 1.5 indicating a more reliable exchange rate dynamics. Statistically significant regression relations (R=0.99, p<0.01) between duration and magnitude of currency crises and the degree of distortion of monofractal patterns of exchange rate dynamics are found. It is demonstrated that the parameters of these relations characterizing small- and large-scale crises are nearly equal, which implies a common instability mechanism underlying these events. The obtained dependences have been used as a basic ingredient of a forecasting technique which provided correct in-sample predictions of monetary crisis magnitude and duration over various time scales. The developed technique can be recommended for real-time monitoring of dynamical stability of floating exchange rate systems and creating advanced early-warning-system models for currency crisis prevention.

  15. What Is Acute Lymphocytic Leukemia (ALL)?

    MedlinePlus

    ... Adults About Acute Lymphocytic Leukemia (ALL) What Is Acute Lymphocytic Leukemia? Cancer starts when cells in the body begin ... Acute Lymphocytic Leukemia Research and Treatment? More In Acute Lymphocytic Leukemia About Acute Lymphocytic Leukemia Causes, Risk Factors, and ...

  16. Targeted Therapy for Acute Lymphocytic Leukemia

    MedlinePlus

    ... Adults Treating Acute Lymphocytic Leukemia Targeted Therapy for Acute Lymphocytic Leukemia In recent years, new drugs that target specific ... Typical Treatment of Acute Lymphocytic Leukemia More In Acute Lymphocytic Leukemia About Acute Lymphocytic Leukemia Causes, Risk Factors, and ...

  17. Treatment of Acute Promyelocytic (M3) Leukemia

    MedlinePlus

    ... Acute Myeloid Leukemia Treatment of Acute Promyelocytic (M3) Leukemia Early diagnosis and treatment of acute promyelocytic leukemia ( ... Comes Back After Treatment? More In Acute Myeloid Leukemia About Acute Myeloid Leukemia Causes, Risk Factors, and ...

  18. Acute Hepatic Porphyria

    PubMed Central

    Bissell, D. Montgomery; Wang, Bruce

    2015-01-01

    The porphyrias comprise a set of diseases, each representing an individual defect in one of the eight enzymes mediating the pathway of heme synthesis. The diseases are genetically distinct but have in common the overproduction of heme precursors. In the case of the acute (neurologic) porphyrias, the cause of symptoms appears to be overproduction of a neurotoxic precursor. For the cutaneous porphyrias, it is photosensitizing porphyrins. Some types have both acute and cutaneous manifestations. The clinical presentation of acute porphyria consists of abdominal pain, nausea, and occasionally seizures. Only a small minority of those who carry a mutation for acute porphyria have pain attacks. The triggers for an acute attack encompass certain medications and severely decreased caloric intake. The propensity of females to acute attacks has been linked to internal changes in ovarian physiology. Symptoms are accompanied by large increases in delta-aminolevulinic acid and porphobilinogen in plasma and urine. Treatment of an acute attack centers initially on pain relief and elimination of inducing factors such as medications; glucose is administered to reverse the fasting state. The only specific treatment is administration of intravenous hemin. An important goal of treatment is preventing progression of the symptoms to a neurological crisis. Patients who progress despite hemin administration have undergone liver transplantation with complete resolution of symptoms. A current issue is the unavailability of a rapid test for urine porphobilinogen in the urgent-care setting. PMID:26357631

  19. Acute renal failure.

    PubMed

    Bellomo, Rinaldo

    2011-10-01

    Acute renal failure (now acute kidney injury) is a common complication of critical illness affecting between 30 and 60% of critically ill patients. The development of a consensus definition (RIFLE--risk, injury, failure, loss, end-stage system) has allowed standardization of reporting and epidemiological work. Multicenter multinational epidemiological studies indicate that sepsis is now the most common cause of acute renal failure in the intensive care unit (ICU) followed by cardiac surgery-associated acute kidney injury. Unfortunately, our understanding of the pathogenesis of acute renal failure in these settings remains limited. Because of such limited understanding, no reproducibly effective therapies have been developed. In addition the diagnosis of acute renal failure still rests upon the detection of changes in serum creatinine, which only occur if more than 50% of glomerular filtration is lost and are often delayed by more than 24 hours. Such diagnostic delays make the implementation of early therapy nearly impossible. In response to these difficulties, there has been a concerted effort to use proteomics to identify novel early biomarkers of acute renal failure. The identification and study of neutrophil gelatinase- associated lipocalin has been an important step in this field. Another area of active interest and investigation relates to the role of intravenous fluid resuscitation and fluid balance. Data from large observational studies and randomized, controlled trials consistently indicate that a positive fluid balance in patients with acute renal failure represents a major independent risk factor for mortality and provides no protection of renal function. The pendulum is clearly swinging away from a fluid-liberal approach to a fluid-conservative approach in these patients. Finally, there is a growing appreciation that acute renal failure may identify patients who are at increased risk of subsequent chronic renal dysfunction and mortality, opening the way

  20. Acute pulmonary oedema.

    PubMed

    Powell, Jessica; Graham, David; O'Reilly, Sarah; Punton, Gillian

    2016-02-03

    Acute pulmonary oedema is a distressing and life-threatening illness that is associated with a sudden onset of symptoms. For the best possible patient outcomes, it is essential that nurses in all clinical areas are equipped to accurately recognise, assess and manage patients with acute pulmonary oedema. This article outlines the pathophysiology of acute cardiogenic and non-cardiogenic pulmonary oedema, and suggests a systematic approach to the recognition and management of its most serious manifestations. Long-term care and symptom recognition are discussed and suggestions for ongoing patient self-management are provided.

  1. Acute porphyric disorders.

    PubMed

    Moore, A W; Coke, J M

    2000-09-01

    Acute porphyrias are classified into 3 distinct groups of rare genetic disorders of metabolic enzyme biosynthesis. Acute porphyrias can significantly impact multiple organ systems, which often provides a challenge to the dentist presented with such a patient. A case of hereditary coproporphyria is reported in a patient with many of the classical signs and symptoms. The patient also had complex dental needs that required special medical and pharmacotherapeutic modifications. The acute porphyrias are reviewed by the authors with presentation of this challenging case. Recommendations for other dental health care professionals encountering these patients are then presented.

  2. Proposed recommendations for diagnosing and managing individuals with glutaric aciduria type I: second revision.

    PubMed

    Boy, Nikolas; Mühlhausen, Chris; Maier, Esther M; Heringer, Jana; Assmann, Birgit; Burgard, Peter; Dixon, Marjorie; Fleissner, Sandra; Greenberg, Cheryl R; Harting, Inga; Hoffmann, Georg F; Karall, Daniela; Koeller, David M; Krawinkel, Michael B; Okun, Jürgen G; Opladen, Thomas; Posset, Roland; Sahm, Katja; Zschocke, Johannes; Kölker, Stefan

    2017-01-01

    Glutaric aciduria type I (GA-I; synonym, glutaric acidemia type I) is a rare inherited metabolic disease caused by deficiency of glutaryl-CoA dehydrogenase located in the catabolic pathways of L-lysine, L-hydroxylysine, and L-tryptophan. The enzymatic defect results in elevated concentrations of glutaric acid, 3-hydroxyglutaric acid, glutaconic acid, and glutaryl carnitine in body tissues, which can be reliably detected by gas chromatography/mass spectrometry (organic acids) and tandem mass spectrometry (acylcarnitines). Most untreated individuals with GA-I experience acute encephalopathic crises during the first 6 years of life that are triggered by infectious diseases, febrile reaction to vaccinations, and surgery. These crises result in striatal injury and consequent dystonic movement disorder; thus, significant mortality and morbidity results. In some patients, neurologic disease may also develop without clinically apparent crises at any age. Neonatal screening for GA-I us being used in a growing number of countries worldwide and is cost effective. Metabolic treatment, consisting of low lysine diet, carnitine supplementation, and intensified emergency treatment during catabolism, is effective treatment and improves neurologic outcome in those individuals diagnosed early; treatment after symptom onset, however, is less effective. Dietary treatment is relaxed after age 6 years and should be supervised by specialized metabolic centers. The major aim of this second revision of proposed recommendations is to re-evaluate the previous recommendations (Kölker et al. J Inherit Metab Dis 30:5-22, 2007b; J Inherit Metab Dis 34:677-694, 2011) and add new research findings, relevant clinical aspects, and the perspective of affected individuals.

  3. Averting comfortable lifestyle crises.

    PubMed

    Bilton, Rod

    2013-01-01

    How have climate change and diet shaped the evolution of human energy metabolism, and responses to vitamin C, fructose and uric acid? Through the last three millennia observant physicians have noted the association of inappropriate diets with increased incidence of obesity, heart disease, diabetes and cancer, and over the past 300 years doctors in the UK observed that overeating increased the incidence of these diseases. Anthropological studies of the Inuit culture in the mid-nineteenth century revealed that humans can survive and thrive in the virtual absence of dietary carbohydrate. In the 1960s, Cahill revealed the flexibility of human metabolism in response to partial and total starvation and demonstrated that type 2 diabetics were better adapted than healthy subjects to conserving protein during fasting. The potential role for brown adipose tissue thermogenesis in temperature maintenance and dietary calorie control was suggested by Rothwell and Stock from their experiments with 'cafeteria fed rats' in the 1980s. Recent advances in gene array studies and PET scanning support a role for this process in humans. The industrialisation of food processing in the twentieth century has led to increases in palatability and digestibility with a parallel loss of quality leading to overconsumption and the current obesity epidemic. The switch from animal to vegetable fats at the beginning of the twentieth century, followed by the rapid increase in sugar and fructose consumption from 1979 is mirrored by a steep increase in obesity in the 1980s, in the UK and USA. Containment of the obesity epidemic is compounded by the addictive properties of sugar which involve the same dopamine receptors in the pleasure centres of the brain as for cocaine, nicotine and alcohol. Of the many other toxic effects of excessive sugar consumption, immunocompromisation, kidney damage, atherosclerosis, oxidative stress and cancer are highlighted. The WHO and guidelines on sugar consumption include: alternative non-sugar sweeteners; toxic side-effects of aspartame. Stevia and xylitol as healthy sugar replacements; the role of food processing in dietary health; and beneficial effects of resistant starch in natural and processed foods. The rise of maize and soya-based vegetable oils have led to omega-6 fat overload and imbalance in the dietary ratio of omega-3 to omega-6 fats. This has led to toxicity studies with industrial trans fats; investigations on health risks associated with stress and comfort eating; and abdominal obesity. Other factors to consider are: diet, cholesterol and oxidative stress, as well as the new approaches to the chronology of eating and the health benefits of intermittent fasting.

  4. Energy Crises in Perspective

    ERIC Educational Resources Information Center

    Fisher, John C.

    1973-01-01

    Discusses some long-range aspects of energy resources and consumption, including the history of current energy crisis, resource and reserve estimates, and future of the energy industry. Indicates that the United States of American has enough fossil and nuclear fuel to last, respectively, for 500 years and a million years. (CC)

  5. Forecasting Potential Crises.

    ERIC Educational Resources Information Center

    Neufeld, William P.

    1984-01-01

    By foreseeing the possibility of crisis, we can plan how to respond. Five potential crisis areas are identified and possible consequences discussed. The areas are the warming of the earth; water shortage; collapse of the physical infrastructure, e.g., decay of roads; global financial crisis; and the threat of nuclear war. (Author/RM)

  6. Weight Loss & Acute Porphyria

    MedlinePlus

    ... 2017 Apr 05, 2017 National Porphyria Awareness Week! Mar 23, 2017 National Porphyria Awareness Week is ONE ... 2017 National Porphyria Awareness Week (NPAW) 2017 date: Mar 1, 2017 FDA Meeting for Acute Porphyrias is ...

  7. [Acute radiation injury].

    PubMed

    Saito, Tsutomu

    2012-03-01

    Cell death due to DNA damage by ionizing radiation causes acute radiation injury of tissues and organs. Frequency and severity of the injuries increase according to dose increase, when the dose becomes more than threshold dose. The threshold dose of acute human radiation death is 1 Gy and LD50 of human is 4 Gy. Human dies due to the cerebrovascular syndrome, the gastrointestinal syndrome or the hematopoetic syndrome, when he received more than 20 Gy, 10-20 Gy or 3-8 Gy to his total body, respectively. Any tissue or organ, including embryo and fetus, does not show the acute injury, when it received less than 100 mSv. Acute injuries are usually reversible, and late injuries are sometimes irreversible.

  8. Acute Coronary Syndrome

    MedlinePlus

    ... angina? This content was last reviewed July 2015. Heart Attack • Home • About Heart Attacks Acute Coronary Syndrome (ACS) ... Recovery FAQs • Heart Attack Tools & Resources • Support Network Heart Attack Tools & Resources What Is a Heart Attack? How ...

  9. Acute genital ulcers

    PubMed Central

    Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora

    2014-01-01

    Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers. PMID:24473429

  10. [Acute Kidney Injury].

    PubMed

    Brix, Silke; Stahl, Rolf

    2017-02-01

    Acute kidney injury (AKI) is an important part of renal diseases and a common clinical problem. AKI is an acute decline in renal function. Due to a lack of therapeutic options, prevention and optimal management of patients with AKI are the most important strategies. Although seldom the sole cause of patients' death, AKI is associated with a significant increase in mortality. Our objective is to draw the attention towards the prevention of AKI of non-renal causes.

  11. Pathophysiology of acute pancreatitis.

    PubMed

    Bhatia, Madhav; Wong, Fei Ling; Cao, Yang; Lau, Hon Yen; Huang, Jiali; Puneet, Padmam; Chevali, Lakshmi

    2005-01-01

    Acute pancreatitis is a common clinical condition. It is a disease of variable severity in which some patients experience mild, self-limited attacks while others manifest a severe, highly morbid, and frequently lethal attack. The exact mechanisms by which diverse etiological factors induce an attack are still unclear. It is generally believed that the earliest events in acute pancreatitis occur within acinar cells. Acinar cell injury early in acute pancreatitis leads to a local inflammatory reaction. If this inflammatory reaction is marked, it leads to a systemic inflammatory response syndrome (SIRS). An excessive SIRS leads to distant organ damage and multiple organ dysfunction syndrome (MODS). MODS associated with acute pancreatitis is the primary cause of morbidity and mortality in this condition. Recent studies have established the role played by inflammatory mediators in the pathogenesis of acute pancreatitis and the resultant MODS. At the same time, recent research has demonstrated the importance of acinar cell death in the form of apoptosis and necrosis as a determinant of pancreatitis severity. In this review, we will discuss about our current understanding of the pathophysiology of acute pancreatitis.

  12. A GCH1 haplotype confers sex-specific susceptibility to pain crises and altered endothelial function in adults with sickle cell anemia.

    PubMed

    Belfer, Inna; Youngblood, Victoria; Darbari, Deepika S; Wang, Zhengyuan; Diaw, Lena; Freeman, Lita; Desai, Krupa; Dizon, Michael; Allen, Darlene; Cunnington, Colin; Channon, Keith M; Milton, Jacqueline; Hartley, Stephen W; Nolan, Vikki; Kato, Gregory J; Steinberg, Martin H; Goldman, David; Taylor, James G

    2014-02-01

    GTP cyclohydrolase (GCH1) is rate limiting for tetrahydrobiopterin (BH4) synthesis, where BH4 is a cofactor for nitric oxide (NO) synthases and aromatic hydroxylases. GCH1 polymorphisms are implicated in the pathophysiology of pain, but have not been investigated in African populations. We examined GCH1 and pain in sickle cell anemia where GCH1 rs8007267 was a risk factor for pain crises in discovery (n = 228; odds ratio [OR] 2.26; P = 0.009) and replication (n = 513; OR 2.23; P = 0.004) cohorts. In vitro, cells from sickle cell anemia subjects homozygous for the risk allele produced higher BH4. In vivo physiological studies of traits likely to be modulated by GCH1 showed rs8007267 is associated with altered endothelial dependent blood flow in females with SCA (8.42% of variation; P = 0.002). The GCH1 pain association is attributable to an African haplotype with where its sickle cell anemia pain association is limited to females (OR 2.69; 95% CI 1.21-5.94; P = 0.01) and has the opposite directional association described in Europeans independent of global admixture. The presence of a GCH1 haplotype with high BH4 in populations of African ancestry could explain the association of rs8007267 with sickle cell anemia pain crises. The vascular effects of GCH1 and BH4 may also have broader implications for cardiovascular disease in populations of African ancestry.

  13. Probabilistic approach to decision making under uncertainty during volcanic crises. Retrospective analysis of the 2011 eruption of El Hierro, in the Canary Islands

    NASA Astrophysics Data System (ADS)

    Sobradelo, Rosa; Martí, Joan; Kilburn, Christopher; López, Carmen

    2014-05-01

    Understanding the potential evolution of a volcanic crisis is crucial to improving the design of effective mitigation strategies. This is especially the case for volcanoes close to densely-populated regions, where inappropriate decisions may trigger widespread loss of life, economic disruption and public distress. An outstanding goal for improving the management of volcanic crises, therefore, is to develop objective, real-time methodologies for evaluating how an emergency will develop and how scientists communicate with decision makers. Here we present a new model BADEMO (Bayesian Decision Model) that applies a general and flexible, probabilistic approach to managing volcanic crises. The model combines the hazard and risk factors that decision makers need for a holistic analysis of a volcanic crisis. These factors include eruption scenarios and their probabilities of occurrence, the vulnerability of populations and their activities, and the costs of false alarms and failed forecasts. The model can be implemented before an emergency, to identify actions for reducing the vulnerability of a district; during an emergency, to identify the optimum mitigating actions and how these may change as new information is obtained; and after an emergency, to assess the effectiveness of a mitigating response and, from the results, to improve strategies before another crisis occurs. As illustrated by a retrospective analysis of the 2011 eruption of El Hierro, in the Canary Islands, BADEMO provides the basis for quantifying the uncertainty associated with each recommended action as an emergency evolves, and serves as a mechanism for improving communications between scientists and decision makers.

  14. Acute pancreatitis: Manifestation of acute HIV infection in an adolescent

    PubMed Central

    Bitar, Anas; Altaf, Muhammad; Sferra, Thomas J.

    2012-01-01

    Summary Background: Pancreatitis in the pediatric age group is not as common as in adults. Etiologies are various and differ from those in adults. Although infectious etiology accounts for a significant number of cases of pancreatitis, acute infection with Human Immunodeficiency Virus (HIV) was rarely reported as a possible etiology for acute pancreatitis in adults. Acute pancreatitis has never been reported as a presenting manifestation of acute HIV infection in children. Case Report: We describe a pediatric patient who presented with acute pancreatitis that revealed acute HIV infection. Conclusions: Acute pancreatitis as a primary manifestation of HIV infection is very rare. It may represent an uncommon aspect of primary HIV infection. We suggest that acute HIV infection should be considered in the differential diagnosis of acute pancreatitis at all ages. PMID:23569476

  15. Acute cerebellar ataxia, acute cerebellitis, and opsoclonus-myoclonus syndrome.

    PubMed

    Desai, Jay; Mitchell, Wendy G

    2012-11-01

    Acute cerebellar ataxia and acute cerebellitis represent a process characterized by parainfectious, postinfectious, or postvaccination cerebellar inflammation. There is considerable overlap between these entities. The mildest cases of acute cerebellar ataxia represent a benign condition that is characterized by acute truncal and gait ataxia, variably with appendicular ataxia, nystagmus, dysarthria, and hypotonia. It occurs mostly in young children, presents abruptly, and recovers over weeks. Neuroimaging is normal. Severe cases of cerebellitis represent the other end of the spectrum, presenting with acute cerebellar signs often overshadowed by alteration of consciousness, focal neurological deficits, raised intracranial pressure, hydrocephalus, and even herniation. Neuroimaging is abnormal and the prognosis is less favorable than in acute cerebellar ataxia. Acute disseminated encephalomyelitis may be confused with acute cerebellitis when the clinical findings are predominantly cerebellar, but lesions on neuroimaging are usually widespread. Paraneoplastic opsoclonus-myoclonus syndrome is often initially misdiagnosed as acute cerebellar ataxia, but has very specific features, course, and etiopathogensis.

  16. Flavopiridol, Cytarabine, and Mitoxantrone in Treating Patients With Acute Leukemia

    ClinicalTrials.gov

    2013-10-07

    Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia; Untreated Adult Acute Lymphoblastic Leukemia; Untreated Adult Acute Myeloid Leukemia

  17. Tsunamis as geomorphic crises: Lessons from the December 26, 2004 tsunami in Lhok Nga, West Banda Aceh (Sumatra, Indonesia)

    NASA Astrophysics Data System (ADS)

    Paris, Raphaël; Wassmer, Patrick; Sartohadi, Junun; Lavigne, Franck; Barthomeuf, Benjamin; Desgages, Emilie; Grancher, Delphine; Baumert, Philippe; Vautier, Franck; Brunstein, Daniel; Gomez, Christopher

    2009-03-01

    Large tsunamis are major geomorphic crises, since they imply extensive erosion, sediment transport and deposition in a few minutes and over hundreds of kilometres of coast. Nevertheless, little is known about their geomorphologic imprints. The December 26, 2004 tsunami in Sumatra (Indonesia) was one of the largest and deadliest tsunamis in recorded human history. We present a description of the coastal erosion and boulder deposition induced by the 2004 tsunami in the Lhok Nga Bay, located to the West of Banda Aceh (northwest Sumatra). The geomorphological impact of the tsunami is evidenced by: beach erosion (some beaches have almost disappeared); destruction of sand barriers protecting the lagoons or at river mouths; numerous erosion escarpments typically in the order of 0.5-1.5 m when capped by soil and more than 2 m in dunes; bank erosion in the river beds (the retreat along the main river is in the order of 5-15 m, with local retreats exceeding 30 m); large scars typically 20-50 cm deep on slopes; dislodgement of blocks along fractures and structural ramps on cliffs. The upper limit of erosion appears as a continuous trimline at 20-30 m a.s.l., locally reaching 50 m. The erosional imprints of the tsunami extend to 500 m from the shoreline and exceed 2 km along riverbeds. The overall coastal retreat from Lampuuk to Leupung was 60 m (550,000 m 2) and locally exceeded 150 m. Over 276,000 m 3 of coastal sediments were eroded by the tsunami along the 9.2 km of sandy coast. The mean erosion rate of the beaches was ~ 30 m 3/m of coast and locally exceeded 80 m 3/m. The most eroded coasts were tangent to the tsunami wave train, which was coming from the southwest. The fringing reefs were not efficient in reducing the erosional impact of the tsunami. The 220 boulders measured range from 0.3 to 7.2 m large (typically 0.7-1.5 m), with weights from over 50 kg up to 85 t. We found one boulder, less than 1 m large, at 1 km from the coastline, but all the others were

  18. Sickle cell disease: acute clinical manifestations in early childhood and molecular characteristics in a group of children in Rio de Janeiro

    PubMed Central

    da Silva Filho, Isaac Lima; Ribeiro, Georgina Severo; Moura, Patrícia Gomes; Vechi, Monica Longo; Cavalcante, Andréa Cony; de Andrada-Serpa, Maria José

    2012-01-01

    Objectives To describe clinical events of sickle cell disease and the correlation with β-globin haplotypes and α-thalassemia in under 6-year-old children. Methods A retrospective study was conducted of under 6-year-old children from the neonatal screening program in Rio de Janeiro. Forty-eight male and 48 female children were enrolled in this study, 79 with sickle cell anemia and 17 with hemoglobin SC. The mean age was 29.9 (standard deviation = 20.9) months, 62 (16.2 ± 8.6) were aged between 0-3 years old and 34 (54.9 ± 11.3) were from 3-6 years old. Painful events, acute splenic sequestration, hemolytic crises, hand-foot and acute chest syndromes and infections were evaluated. Results The events were more frequent in under 3-year-old children, 94% of children had at least one episode. Infection was the most common event affecting 88.5% of children. Acute splenic sequestration took place earlier, while painful crises and acute chest syndromes in under 6-year-old children. Thal-α 3.7 was observed in 20.9% of cases. Bantu was the most frequent haplotype found, followed by Benin. No correlation was observed between clinical events and β-globin haplotypes. Children with sickle cell anemia and α-thalassemia have less infectious events. No correlation was found among these polymorphisms and clinical events, however, the majority of children with Bantu/Bantu and without α-thalassemia had more clinical events. PMID:23049419

  19. Acute Appendicitis Secondary to Acute Promyelocytic Leukemia

    PubMed Central

    Rodriguez, Eduardo A.; Lopez, Marvin A.; Valluri, Kartik; Wang, Danlu; Fischer, Andrew; Perdomo, Tatiana

    2015-01-01

    Patient: Female, 43 Final Diagnosis: Myeloid sarcoma appendicitis Symptoms: Abdominal pain • chills • fever Medication: — Clinical Procedure: Laparoscopic appendectomy, bone marrow biopsy Specialty: Gastroenterology and Hepatology Objective: Rare disease Background: The gastrointestinal tract is a rare site for extramedullary involvement in acute promyelocytic leukemia (APL). Case Report: A 43-year-old female with no past medical history presented complaining of mild abdominal pain, fever, and chills for the past day. On examination, she was tachycardic and febrile, with mild tenderness of her right lower quadrant and without signs of peritoneal irritation. Laboratory examination revealed pancytopenia and DIC, with a fibrinogen level of 290 mg/dL. CT of the abdomen showed a thickened and hyperemic appendix without perforation or abscess, compatible with acute appendicitis. The patient was given IV broad-spectrum antibiotics and was transfused with packed red blood cells and platelets. She underwent uncomplicated laparoscopic appendectomy and bone marrow biopsy, which revealed neo-plastic cells of 90% of the total bone marrow cellularity. Flow cytometry indicated presence of 92.4% of immature myeloid cells with t (15: 17) and q (22: 12) mutations, and FISH analysis for PML-RARA demonstrated a long-form fusion transcript, positive for APL. Appendix pathology described leukemic infiltration with co-expression of myeloperoxidase and CD68, consistent with myeloid sarcoma of the appendix. The patient completed a course of daunorubicin, cytarabine, and all trans-retinoic acid. Repeat bone marrow biopsy demonstrated complete remission. She will follow up with her primary care physician and hematologist/oncologist. Conclusions: Myeloid sarcoma of the appendix in the setting of APL is very rare and it might play a role in the development of acute appendicitis. Urgent management, including bone marrow biopsy for definitive diagnosis and urgent surgical intervention

  20. Acute viral myocarditis

    PubMed Central

    Dennert, Robert; Crijns, Harry J.; Heymans, Stephane

    2008-01-01

    Acute myocarditis is one of the most challenging diagnosis in cardiology. At present, no diagnostic gold standard is generally accepted, due to the insensitivity of traditional diagnostic tests. This leads to the need for new diagnostic approaches, which resulted in the emergence of new molecular tests and a more detailed immunohistochemical analysis of endomyocardial biopsies. Recent findings using these new diagnostic tests resulted in increased interest in inflammatory cardiomyopathies and a better understanding of its pathophysiology, the recognition in overlap of virus-mediated damage, inflammation, and autoimmune dysregulation. Novel results also pointed towards a broader spectrum of viral genomes responsible for acute myocarditis, indicating a shift of enterovirus and adenovirus to parvovirus B19 and human herpes virus 6. The present review proposes a general diagnostic approach, focuses on the viral aetiology and associated autoimmune processes, and reviews treatment options for patients with acute viral myocarditis. PMID:18617482

  1. Acute Decompensated Heart Failure

    PubMed Central

    Joseph, Susan M.; Cedars, Ari M.; Ewald, Gregory A.; Geltman, Edward M.; Mann, Douglas L.

    2009-01-01

    Hospitalizations for acute decompensated heart failure are increasing in the United States. Moreover, the prevalence of heart failure is increasing consequent to an increased number of older individuals, as well as to improvement in therapies for coronary artery disease and sudden cardiac death that have enabled patients to live longer with cardiovascular disease. The main treatment goals in the hospitalized patient with heart failure are to restore euvolemia and to minimize adverse events. Common in-hospital treatments include intravenous diuretics, vasodilators, and inotropic agents. Novel pharmaceutical agents have shown promise in the treatment of acute decompensated heart failure and may simplify the treatment and reduce the morbidity associated with the disease. This review summarizes the contemporary management of patients with acute decompensated heart failure. PMID:20069075

  2. Acute Treatment of Migraine

    PubMed Central

    ÖZTÜRK, Vesile

    2013-01-01

    Migraine is one of the most frequent disabling neurological conditions with a major impact on the patient’s quality of life. Migraine has been described as a chronic disorder that characterized with attacks. Attacks are characterized by moderate–severe, often unilateral, pulsating headache attacks, typically lasting 4 to 72 hours. Migraine remains underdiagnosed and undertreated despite advances in the understanding of its pathophysiology. This article reviews management of migraine acute pharmacological treatment. Currently, for the acute treatment of migraine attacks, non-steroidal anti-inflammatory drugs (NSAIDs) and triptans (serotonin 5HT1B/1D receptor agonists) are recommended. Before intake of NSAID and triptans, metoclopramide or domperidone is useful. In very severe attacks, subcutaneous sumatriptan is first choice. The patient should be treated early in the attack, use an adequate dose and formulation of a medication. Ideally, acute therapy should be restricted to no more than 2 to 3 days per week to avoid medication overuse.

  3. Acute abdominal pain.

    PubMed

    Stone, R

    1998-01-01

    Abdominal pain is among the most frequent ailments reported in the office setting and can account for up to 40% of ailments in the ambulatory practice. Also, it is in the top three symptoms of patients presenting to emergency departments (ED) and accounts for 5-10% of all ED primary presenting ailments. There are several common sources for acute abdominal pain and many for subacute and chronic abdominal pain. This article explores the history-taking, initial evaluation, and examination of the patient presenting with acute abdominal pain. The goal of this article is to help differentiate one source of pain from another. Discussion of acute cholecystitis, pancreatitis, appendicitis, ectopic pregnancy, diverticulitis, gastritis, and gastroenteritis are undertaken. Additionally, there is discussion of common laboratory studies, diagnostic studies, and treatment of the patient with the above entities.

  4. Low back pain (acute)

    PubMed Central

    2011-01-01

    Introduction Low back pain affects about 70% of people in resource-rich countries at some point in their lives. Acute low back pain can be self-limiting; however, 1 year after an initial episode, as many as 33% of people still have moderate-intensity pain and 15% have severe pain. Acute low back pain has a high recurrence rate; 75% of those with a first episode have a recurrence. Although acute episodes may resolve completely, they may increase in severity and duration over time. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of oral drug treatments for acute low back pain? What are the effects of local injections for acute low back pain? What are the effects of non-drug treatments for acute low back pain? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2009 (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 49 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: acupuncture, advice to stay active, analgesics (paracetamol, opioids), back exercises, back schools, bed rest, behavioural therapy, electromyographic biofeedback, epidural corticosteroid injections, lumbar supports, massage, multidisciplinary treatment programmes, muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDs), spinal manipulation, temperature treatments (short-wave diathermy, ultrasound, ice, heat), traction, and transcutaneous electrical nerve stimulation

  5. [Experimental models of acute pancreatitis].

    PubMed

    Ceranowicz, Piotr; Cieszkowski, Jakub; Warzecha, Zygmunt; Dembiński, Artur

    2015-02-21

    Acute pancreatitis is a severe disease with high mortality. Clinical studies can bring some data about etiology, pathogenesis and the course of acute pancreatitis. However, studies concerning early events of this disease and the new concepts of treatment cannot be performed on humans, due to ethical reasons. Animal models of acute pancreatitis have been developed to solve this problem. This review presents currently used experimental models of acute pancreatitis, their properties and clinical relevance. Experimental models of acute pancreatitis can be divided into in vivo (non-invasive and invasive) and ex vivo models. The onset, development, severity and extent of acute pancreatitis, as well as the mortality, vary considerably between these different models. Animal models reproducibly produce mild, moderate or severe acute pancreatitis. One of the most commonly used models of acute pancreatitis is created by administration of supramaximal doses of cerulein, an analog of cholecystokinin. This model produces acute mild edematous pancreatitis in rats, whereas administration of cerulein in mice leads to the development of acute necrotizing pancreatitis. Acute pancreatitis evoked by retrograde administration of sodium taurocholate into the pancreatic duct is the most often used model of acute severe necrotizing pancreatitis in rats. Ex vivo models allow to eliminate the influence of hormonal and nervous factors on the development of acute pancreatitis.

  6. Hypothyroid acute renal failure.

    PubMed

    Birewar, Sonali; Oppenheimer, Mark; Zawada, Edward T

    2004-03-01

    Muscular disorders and even hypothyroid myopathy with elevated muscle enzymes are commonly seen in hypothyroidism. In this paper, we report a case of acute renal failure in a 35-year old male patient with myalgia. His serum creatinine reached a level of 2.4 mg/dl. Later, his myalgia was found to be due to hypothyroidism with TSH of over 500 uiv/ml. With thyroid replacement therapy, myalgia and his serum creatinine stabilized and subsequently improved. Hypothyroidism, although rare, has been reported as a definite and authentic cause of rhabdomyolysis. As a result, hypothyroidism must be considered in patients presenting with acute renal failure and elevated muscle enzymes.

  7. Acute sinusitis in children.

    PubMed

    Brook, Itzhak

    2013-04-01

    Acute rhinosinusitis is a common illness in children. Viral upper respiratory tract infection is the most common presentation of rhinosinusitis. Most children resolve the infection spontaneously and only a small proportion develops a secondary bacterial infection. The proper choice of antibiotic therapy depends on the likely infecting pathogens, bacterial antibiotic resistance, and pharmacologic profiles of antibiotics. Amoxicillin-clavulanate is currently recommended as the empiric treatment in those requiring antimicrobial therapy. Isolation of the causative agents should be considered in those who failed the initial treatment. In addition to antibiotics, adjuvant therapies and surgery may be used in the management of acute bacterial rhinosinusitis.

  8. Recurrent acute pancreatitis.

    PubMed

    Khurana, Vishal; Ganguly, Ishita

    2014-09-28

    Recurrent acute pancreatitis (RAP) is commonly encountered, but less commonly understood clinical entity, especially idiopathic RAP, with propensity to lead to repeated attacks and may be chronic pancreatitis if attacks continue to recur. A great number of studies have been published on acute pancreatitis, but few have focused on RAP. Analysing the results of clinical studies focusing specifically on RAP is problematic in view due to lack of standard definitions, randomised clinical trials, standard evaluation protocol used and less post intervention follow-up duration. With the availability of newer investigation modalities less number of etiologies will remains undiagnosed. This review particularly is focused on the present knowledge in understanding of RAP.

  9. Acute Intraoperative Pulmonary Aspiration.

    PubMed

    Nason, Katie S

    2015-08-01

    Acute intraoperative aspiration is a potentially fatal complication with significant associated morbidity. Patients undergoing thoracic surgery are at increased risk for anesthesia-related aspiration, largely due to the predisposing conditions associated with this complication. Awareness of the risk factors, predisposing conditions, maneuvers to decrease risk, and immediate management options by the thoracic surgeon and the anesthesia team is imperative to reducing risk and optimizing patient outcomes associated with acute intraoperative pulmonary aspiration. Based on the root-cause analyses that many of the aspiration events can be traced back to provider factors, having an experienced anesthesiologist present for high-risk cases is also critical.

  10. [Acute pancreatitis due to lupus].

    PubMed

    Hani, Mohamed Aziz; Guesmi, Fethi; Ben Achour, Jamel; Zribi, Riadh; Bouasker, Ibtissem; Zoghlami, Ayoub; Najah, Nabil

    2004-02-01

    Among digestive clinical presentations of systemic lupus erythematosus, acute pancreatitis remains a serious affection with very poor prognosis. To date, pathogenesis is still unclear. We report two cases of fatal acute pancreatitis related to systemic lupus erythematosus.

  11. What Is Acute Myeloid Leukemia?

    MedlinePlus

    ... Acute Myeloid Leukemia (AML) What Is Acute Myeloid Leukemia? Cancer starts when cells in a part of ... the body from doing their jobs. Types of leukemia Not all leukemias are the same. There are ...

  12. Nutrition, Inflammation, and Acute Pancreatitis

    PubMed Central

    Petrov, Max

    2013-01-01

    Acute pancreatitis is acute inflammatory disease of the pancreas. Nutrition has a number of anti-inflammatory effects that could affect outcomes of patients with pancreatitis. Further, it is the most promising nonspecific treatment modality in acute pancreatitis to date. This paper summarizes the best available evidence regarding the use of nutrition with a view of optimising clinical management of patients with acute pancreatitis. PMID:24490104

  13. What Good Are Positive Emotions in Crises? A Prospective Study of Resilience and Emotions Following the Terrorist Attacks on the United States on September 11th, 2001

    PubMed Central

    Fredrickson, Barbara L.; Tugade, Michele M.; Waugh, Christian E.; Larkin, Gregory R.

    2009-01-01

    Extrapolating from B. L. Fredrickson's (1998, 2001) broaden-and-build theory of positive emotions, the authors hypothesized that positive emotions are active ingredients within trait resilience. U.S. college students (18 men and 28 women) were tested in early 2001 and again in the weeks following the September 11th terrorist attacks. Mediational analyses showed that positive emotions experienced in the wake of the attacks— gratitude, interest, love, and so forth—fully accounted for the relations between (a) precrisis resilience and later development of depressive symptoms and (b) precrisis resilience and postcrisis growth in psychological resources. Findings suggest that positive emotions in the aftermath of crises buffer resilient people against depression and fuel thriving, consistent with the broaden-and-build theory. Discussion touches on implications for coping. PMID:12585810

  14. What good are positive emotions in crises? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001.

    PubMed

    Fredrickson, Barbara L; Tugade, Michele M; Waugh, Christian E; Larkin, Gregory R

    2003-02-01

    Extrapolating from B. L. Fredrickson's (1998, 2001) broaden-and-build theory of positive emotions, the authors hypothesized that positive emotions are active ingredients within trait resilience. U.S. college students (18 men and 28 women) were tested in early 2001 and again in the weeks following the September 11th terrorist attacks. Mediational analyses showed that positive emotions experienced in the wake of the attacks--gratitude, interest, love, and so forth--fully accounted for the relations between (a) precrisis resilience and later development of depressive symptoms and (b) precrisis resilience and postcrisis growth in psychological resources. Findings suggest that positive emotions in the aftermath of crises buffer resilient people against depression and fuel thriving, consistent with the broaden-and-build theory. Discussion touches on implications for coping.

  15. Low back pain - acute

    MedlinePlus

    Backache; Low back pain; Lumbar pain; Pain - back; Acute back pain; Back pain - new; Back pain - short-term; Back strain - new ... lower back supports most of your body's weight. Low back pain is the number two reason that Americans see ...

  16. Acute septic arthritis.

    PubMed

    Shirtliff, Mark E; Mader, Jon T

    2002-10-01

    Acute septic arthritis may develop as a result of hematogenous seeding, direct introduction, or extension from a contiguous focus of infection. The pathogenesis of acute septic arthritis is multifactorial and depends on the interaction of the host immune response and the adherence factors, toxins, and immunoavoidance strategies of the invading pathogen. Neisseria gonorrhoeae and Staphylococcus aureus are used in discussing the host-pathogen interaction in the pathogenesis of acute septic arthritis. While diagnosis rests on isolation of the bacterial species from synovial fluid samples, patient history, clinical presentation, laboratory findings, and imaging studies are also important. Acute nongonococcal septic arthritis is a medical emergency that can lead to significant morbidity and mortality. Therefore, prompt recognition, rapid and aggressive antimicrobial therapy, and surgical treatment are critical to ensuring a good prognosis. Even with prompt diagnosis and treatment, high mortality and morbidity rates still occur. In contrast, gonococcal arthritis is often successfully treated with antimicrobial therapy alone and demonstrates a very low rate of complications and an excellent prognosis for full return of normal joint function. In the case of prosthetic joint infections, the hardware must be eventually removed by a two-stage revision in order to cure the infection.

  17. Acute coronary care 1986

    SciTech Connect

    Califf, R.M.; Wagner, G.S.

    1985-01-01

    This book contains 22 chapters. Some of the titles are: The measurement of acute myocardial infarct size by CT; Magnetic resonance imaging for evaluation of myocardial ischemia and infarction; Poistron imaging in the evaluation of ischemia and myocardial infarction; and New inotropic agents.

  18. [Acute plasma cell leukemia].

    PubMed

    Monsalbe, V; Domíngues, C; Roa, I; Busel, D; González, S

    1989-01-01

    Plasma Cell Leukemia is a very rare form of plasmocytic dyscrasia, whose clinical and pathological characteristics warrant its recognition as a distinct subentity. We report the case of a 60 years old man who presented a rapidly fatal acute plasma cell leukemia, with multiple osteolytic lesions, hipercalcemia, renal and cardiac failure.

  19. Acute radiation risk models

    NASA Astrophysics Data System (ADS)

    Smirnova, Olga

    Biologically motivated mathematical models, which describe the dynamics of the major hematopoietic lineages (the thrombocytopoietic, lymphocytopoietic, granulocytopoietic, and erythropoietic systems) in acutely/chronically irradiated humans are developed. These models are implemented as systems of nonlinear differential equations, which variables and constant parameters have clear biological meaning. It is shown that the developed models are capable of reproducing clinical data on the dynamics of these systems in humans exposed to acute radiation in the result of incidents and accidents, as well as in humans exposed to low-level chronic radiation. Moreover, the averaged value of the "lethal" dose rates of chronic irradiation evaluated within models of these four major hematopoietic lineages coincides with the real minimal dose rate of lethal chronic irradiation. The demonstrated ability of the models of the human thrombocytopoietic, lymphocytopoietic, granulocytopoietic, and erythropoietic systems to predict the dynamical response of these systems to acute/chronic irradiation in wide ranges of doses and dose rates implies that these mathematical models form an universal tool for the investigation and prediction of the dynamics of the major human hematopoietic lineages for a vast pattern of irradiation scenarios. In particular, these models could be applied for the radiation risk assessment for health of astronauts exposed to space radiation during long-term space missions, such as voyages to Mars or Lunar colonies, as well as for health of people exposed to acute/chronic irradiation due to environmental radiological events.

  20. What Evidence Exists for Initiatives to Reduce Risk and Incidence of Sexual Violence in Armed Conflict and Other Humanitarian Crises? A Systematic Review

    PubMed Central

    Spangaro, Jo; Adogu, Chinelo; Ranmuthugala, Geetha; Powell Davies, Gawaine; Steinacker, Léa; Zwi, Anthony

    2013-01-01

    Sexual violence is highly prevalent in armed conflict and other humanitarian crises and attracting increasing policy and practice attention. This systematic review aimed to canvas the extent and impact of initiatives to reduce incidence, risk and harm from sexual violence in conflict, post-conflict and other humanitarian crises, in low and middle income countries. Twenty three bibliographic databases and 26 websites were searched, covering publications from 1990 to September 2011 using database-specific keywords for sexual violence and conflict or humanitarian crisis. The 40 included studies reported on seven strategy types: i) survivor care; ii) livelihood initiatives; iii) community mobilisation; iv) personnel initiatives; v) systems and security responses; vi) legal interventions and vii) multiple component interventions. Conducted in 26 countries, the majority of interventions were offered in African countries. Despite the extensive literature on sexual violence by combatants, most interventions addressed opportunistic forms of sexual violence committed in post-conflict settings. Only one study specifically addressed the disaster setting. Actual implementation of initiatives appeared to be limited as was the quality of outcome studies. No studies prospectively measured incidence of sexual violence, although three studies provided some evidence of reductions in association with firewood distribution to reduce women's exposure, as did one program to prevent sexual exploitation and abuse by peacekeeping forces. Apparent increases to risk resulted from lack of protection, stigma and retaliation associated with interventions. Multiple-component interventions and sensitive community engagement appeared to contribute to positive outcomes. Significant obstacles prevent women seeking help following sexual violence, pointing to the need to protect anonymity and preventive strategies. This review contributes a conceptual framework for understanding the forms, settings

  1. What evidence exists for initiatives to reduce risk and incidence of sexual violence in armed conflict and other humanitarian crises? A systematic review.

    PubMed

    Spangaro, Jo; Adogu, Chinelo; Ranmuthugala, Geetha; Powell Davies, Gawaine; Steinacker, Léa; Zwi, Anthony

    2013-01-01

    Sexual violence is highly prevalent in armed conflict and other humanitarian crises and attracting increasing policy and practice attention. This systematic review aimed to canvas the extent and impact of initiatives to reduce incidence, risk and harm from sexual violence in conflict, post-conflict and other humanitarian crises, in low and middle income countries. Twenty three bibliographic databases and 26 websites were searched, covering publications from 1990 to September 2011 using database-specific keywords for sexual violence and conflict or humanitarian crisis. The 40 included studies reported on seven strategy types: i) survivor care; ii) livelihood initiatives; iii) community mobilisation; iv) personnel initiatives; v) systems and security responses; vi) legal interventions and vii) multiple component interventions. Conducted in 26 countries, the majority of interventions were offered in African countries. Despite the extensive literature on sexual violence by combatants, most interventions addressed opportunistic forms of sexual violence committed in post-conflict settings. Only one study specifically addressed the disaster setting. Actual implementation of initiatives appeared to be limited as was the quality of outcome studies. No studies prospectively measured incidence of sexual violence, although three studies provided some evidence of reductions in association with firewood distribution to reduce women's exposure, as did one program to prevent sexual exploitation and abuse by peacekeeping forces. Apparent increases to risk resulted from lack of protection, stigma and retaliation associated with interventions. Multiple-component interventions and sensitive community engagement appeared to contribute to positive outcomes. Significant obstacles prevent women seeking help following sexual violence, pointing to the need to protect anonymity and preventive strategies. This review contributes a conceptual framework for understanding the forms, settings

  2. Acute stroke initiative involving an acute care team.

    PubMed

    Roth, Sean M; Keyser, Gabrielle; Winfield, Michelle; McNeil, Julie; Simko, Leslie; Price, Karen; Moffa, Donald; Hussain, Muhammad Shazam; Peacock, W Frank; Katzan, Irene L

    2012-06-01

    The Acute Care Team Educational Initiative (ACTEI) was developed as a quality improvement initiative for the recognition and initial management of time-sensitive medical conditions. For our first time-sensitive disease process, we focused on acute stroke [acute stroke initiative (ASI)]. As part of the larger ACTEI, the ASI included creating an ACT that responds to all suspected emergency department stroke patients. In this article, we describe the planning, process, and development of the ACTEI/ASI as well as how we created an acute response team for the diagnosis and management of suspected acute stroke.

  3. Acute organophosphorus poisoning.

    PubMed

    Chowdhary, Sheemona; Bhattacharyya, Rajasri; Banerjee, Dibyajyoti

    2014-04-20

    Acute organophosphorus poisoning continues to be a detrimental problem and a potential cause of mortality especially in developing countries. Inhibition of acetylcholinesterase enzyme is the main mechanism of toxicity of such pesticides and measurement of acetylcholinesterase activity is the commonly used laboratory diagnosis approved for the purpose. It is now proved beyond any doubt that early intervention is beneficial for cases of acute organophosphorus poisoning and, therefore, considerable current interest has been generated for development of point of care testing tool for screening of the same. However, to the best of our knowledge so far the matter is not reviewed from the view of point of care testing tool development. In this paper, this subject is reviewed highlighting the methodological aspects and point of care testing tool development in the context of organophosphorus poisoning.

  4. [Acute respiratory distress syndrome].

    PubMed

    Hecker, M; Weigand, M A; Mayer, K

    2012-05-01

    Acute respiratory distress syndrome (ARDS) is the clinical manifestation of an acute lung injury caused by a variety of direct and indirect injuries to the lung. The cardinal clinical feature of ARDS, refractory arterial hypoxemia, is the result of protein-rich alveolar edema with impaired surfactant function, due to vascular leakage and dysfunction with consequently impaired matching of ventilation to perfusion. Better understanding of the pathophysiology of ARDS has led to the development of novel therapies, pharmacological strategies, and advances in mechanical ventilation. However, protective ventilation is the only confirmed option in ARDS management improving survival, and few other therapies have translated into improved oxygenation or reduced ventilation time. The development of innovative therapy options, such as extracorporeal membrane oxygenation, have the potential to further improve survival of this devastating disease.

  5. [Schistosomiasis and acute appendicitis].

    PubMed

    Figueiredo, Jacinta; Santos, Ângela; Clemente, Horácio; Lourenço, Augusto; Costa, Sandra; Grácio, Maria Amélia; Belo, Silvana

    2014-01-01

    Acute appendicitis associated to Schistosoma haematobium and S. mansoni infection has been found in patients submitted to urgent appendectomy at the Hospital Américo Boavida in Luanda. Due to the high prevalence and morbidity caused by schistosomiasis (or bilharziasis) in the country, we suspect that the involvement of Schistosoma infection on appendicular pathology could be very frequent, in particular for those individuals more exposed to the parasite transmission. We report two clinical cases of acute appendicitis whose surgical specimens of the appendix revealed S. haematobium and S. mansoni eggs in histological samples. The reported patients live in endemic areas and have been exposed to schistosome during childhood, which may explain the infection's chronicity. Information of these clinical cases could be relevant, particularly for surgery specialists and clinical pathologists, due to the possibility of finding more patients with concurrent appendicitis and schistosomiasis.

  6. Diarrhoea in adults (acute)

    PubMed Central

    2011-01-01

    Introduction An estimated 4.6 billion cases of diarrhoea occurred worldwide in 2004, resulting in 2.2 million deaths. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for acute diarrhoea in adults living in resource-rich countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults from resource-rich countries travelling to resource-poor countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults living in resource-poor countries? What are the effects of treatments for acute severe diarrhoea in adults living in resource-poor countries? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 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 72 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: antibiotics, antimotility agents, antisecretory agents, bismuth subsalicylate, diet, intravenous rehydration, nasogastric tube rehydration, oral rehydration solutions (amino acid oral rehydration solution, bicarbonate oral rehydration solution, reduced osmolarity oral rehydration solution, rice-based oral rehydration solution, standard oral rehydration solution), vitamin A supplementation, and zinc supplementation. PMID:21718555

  7. Myopathy in acute hypothyroidism.

    PubMed Central

    Kung, A. W.; Ma, J. T.; Yu, Y. L.; Wang, C. C.; Woo, E. K.; Lam, K. S.; Huang, C. Y.; Yeung, R. T.

    1987-01-01

    Hypothyroid myopathy has so far been reported in long standing cases of hypothyroidism. We describe two adult patients with myopathy associated with acute transient hypothyroidism. Both presented with severe muscle aches and cramps, stiffness and spasms. Muscle enzymes were markedly elevated and electromyography in one patient showed myopathic features. Histological changes were absent in muscle biopsy, probably because of the short duration of metabolic disturbance. The myopathy subsided promptly when the hypothyroid state was reversed. PMID:3422868

  8. Atrial fibrillation (acute onset)

    PubMed Central

    2014-01-01

    Introduction Acute atrial fibrillation is rapid, irregular, and chaotic atrial activity of recent onset. Various definitions of acute atrial fibrillation have been used in the literature, but for the purposes of this review we have included studies where atrial fibrillation may have occurred up to 7 days previously. Risk factors for acute atrial fibrillation include increasing age, cardiovascular disease, alcohol, diabetes, and lung disease. Acute atrial fibrillation increases the risk of stroke and heart failure. The condition resolves spontaneously within 24 to 48 hours in more than 50% of people; however, many people will require interventions to control heart rate or restore sinus rhythm. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent embolism, for conversion to sinus rhythm, and to control heart rate in people with recent-onset atrial fibrillation (within 7 days) who are haemodynamically stable? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2014 (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 26 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: amiodarone, antithrombotic treatment before cardioversion, atenolol, bisoprolol, carvedilol, digoxin, diltiazem, direct current cardioversion, flecainide, metoprolol, nebivolol, propafenone, sotalol, timolol, and verapamil. PMID:25430048

  9. Acupuncture for acute hordeolum

    PubMed Central

    Cheng, Ke; Wang, Xue; Guo, Menghu; Wieland, L. Susan; Shen, Xueyong; Lao, Lixing

    2014-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: The objective of this review is to determine the effects and, when possible, the safety of acupuncture for the treatment of acute hordeola, in comparison to no specific treatment (e.g., observation), sham acupuncture, or other active treatments. Acupuncture as an adjuvant to another treatment also will be compared to that treatment alone. PMID:25214814

  10. Acute toxicity of arsenobetaine

    SciTech Connect

    Kaise, T.; Watanabe, S.; Itoh, K.

    1985-01-01

    The acute toxicity of arsenobetaine was studied in male mice. No deaths were observed with oral administration of 10 g/kg of arsenobetaine. Therefore the LD/sub 50/ value was higher than 10 g/kg. This compound was found in urine in the non-metabolized form. No particular toxic symptoms were observed following administration. These suggest that arsenobetaine has low toxicity and is not metabolized in mice.

  11. IMMUNOTHERAPY IN ACUTE LEUKEMIA

    PubMed Central

    Leung, Wing

    2010-01-01

    Recent advances in immunotherapy of cancer may represent a successful example in translational research, in which progress in knowledge and technology in immunology has lead to new strategies of immunotherapy, and even past failure in many clinical trials have led to a better understanding of basic cancer immunobiology. This article reviews the latest concepts in antitumor immunology and its application in the treatment of cancer, with particular focus on acute leukemia. PMID:19100371

  12. Acute pancreatitis and acute renal failure complicating doxylamine succinate intoxication.

    PubMed

    Lee, Yang Deok; Lee, Soo Teik

    2002-06-01

    Doxylamine succinate is an antihistaminic drugwith additional hypnotic, anticholinergic and local anesthetic effects first described in 1948. In Korea and many other countries, it is a common-over-the counter medication frequently involved in overdoses. Clinical symtomatology of doxylamine succinate overdose includes somnolence, coma, seizures, mydriasis, tachycardia, psychosis, and rhabdomyolysis. A serious complication may be rhabdomyolysis with subsequent impairment of renal function and acute renal failure. We report a case of acute renal failure and acute pancreatitis complicating a doxylamine succinate intoxication.

  13. Life-Threatening Bleeding from Peristomal Varices after Cystoprostatectomy: Multimodal Approach in a Cirrhotic, Encephalopathic Patient with Severe Portal Hypertension

    PubMed Central

    Staubli, Sergej E. L.; Gramann, Tobias; Schwab, Christoph; Semela, David; Hechelhammer, Lukas; Engeler, Daniel S.; Abt, Dominik; Mordasini, Livio

    2015-01-01

    The bleeding of peristomal varices due to a portosystemic shunt is rare but potentially life-threatening in cirrhotic patients with portal hypertension. The scarce case reports in the literature recommend transjugular intrahepatic portosystemic shunt (TIPS) to prevent further bleeding. We report on a 72-year-old man who was referred to our hospital because of life-threatening bleeding from peristomal varices, three years after radical cystoprostatectomy for invasive bladder cancer. CT imaging showed liver cirrhosis with a prominent portosystemic shunt leading to massively enlarged peristomal varices. TIPS was taken into consideration, but not possible due to hepatic encephalopathy (HE). Medical therapy with lactulose and the nonselective beta-blocker carvedilol was initiated to treat HE and portal hypertension. In a second step, the portosystemic shunt was percutaneously embolized. Here, we present a multimodal approach to treat intractable bleeding from peristomal varices in a patient with ileal conduit urinary diversion, not suitable for TIPS. PMID:25709851

  14. [Acute pulmonary edema secondary to acute upper airway obstruction].

    PubMed

    Sánchez-Ortega, J L; Carpintero-Moreno, F; Olivares-López, A; Borrás-Rubio, E; Alvarez-López, M J; García-Izquierdo, A

    1992-01-01

    We report a 72 years old woman with mild arterial hypertension and no other pathological history who presented an acute pulmonary edema due to acute obstruction of the upper airway secondary to vocal chord paralysis developing during the immediate postoperative phase of thyroidectomy. The acute pulmonary edema resolved after application of tracheal reintubation, mechanical ventilation controlled with end expiratory positive pressure, diuretics, morphine, and liquid restriction. We discuss the possible etiopathogenic possibilities of this infrequent clinical picture and we suggest that all patients who suffered and acute obstruction of the upper airways require a careful clinical surveillance in order to prevent the development of the pulmonary syndrome.

  15. Acute psychotic disorder and hypoglycemia.

    PubMed

    Singh, S K; Agrawal, J K; Srivastava, A S; Bhardwaj, V K; Bose, B S

    1994-04-01

    A variable array of neuroglycopenic symptoms are frequently encountered in the hypoglycemic stage, but acute psychotic disorders are quite rare. A fifty five year old female presented with an acute psychosis following oral sulfonylurea induced hypoglycemia without preceding features of adrenomedullary stimulation. This case report suggests that an acute and transient psychotic disorder may be an important neuroglycopenic feature and its early recognition protects the patient from severe hypoglycemic brain damage in a state of hypoglycemia unawareness.

  16. Acute exacerbation of COPD.

    PubMed

    Ko, Fanny W; Chan, Ka Pang; Hui, David S; Goddard, John R; Shaw, Janet G; Reid, David W; Yang, Ian A

    2016-10-01

    The literature of acute exacerbation of chronic obstructive pulmonary disease (COPD) is fast expanding. This review focuses on several aspects of acute exacerbation of COPD (AECOPD) including epidemiology, diagnosis and management. COPD poses a major health and economic burden in the Asia-Pacific region, as it does worldwide. Triggering factors of AECOPD include infectious (bacteria and viruses) and environmental (air pollution and meteorological effect) factors. Disruption in the dynamic balance between the 'pathogens' (viral and bacterial) and the normal bacterial communities that constitute the lung microbiome likely contributes to the risk of exacerbations. The diagnostic approach to AECOPD varies based on the clinical setting and severity of the exacerbation. After history and examination, a number of investigations may be useful, including oximetry, sputum culture, chest X-ray and blood tests for inflammatory markers. Arterial blood gases should be considered in severe exacerbations, to characterize respiratory failure. Depending on the severity, the acute management of AECOPD involves use of bronchodilators, steroids, antibiotics, oxygen and noninvasive ventilation. Hospitalization may be required, for severe exacerbations. Nonpharmacological interventions including disease-specific self-management, pulmonary rehabilitation, early medical follow-up, home visits by respiratory health workers, integrated programmes and telehealth-assisted hospital at home have been studied during hospitalization and shortly after discharge in patients who have had a recent AECOPD. Pharmacological approaches to reducing risk of future exacerbations include long-acting bronchodilators, inhaled steroids, mucolytics, vaccinations and long-term macrolides. Further studies are needed to assess the cost-effectiveness of these interventions in preventing COPD exacerbations.

  17. Acute brain trauma

    PubMed Central

    Martin, GT

    2016-01-01

    In the 20th century, the complications of head injuries were controlled but not eliminated. The wars of the 21st century turned attention to blast, the instant of impact and the primary injury of concussion. Computer calculations have established that in the first 5 milliseconds after the impact, four independent injuries on the brain are inflicted: 1) impact and its shockwave, 2) deceleration, 3) rotation and 4) skull deformity with vibration (or resonance). The recovery, pathology and symptoms after acute brain trauma have always been something of a puzzle. The variability of these four modes of injury, along with a variable reserve of neurones, explains some of this problem. PMID:26688392

  18. Acute brain trauma.

    PubMed

    Martin, G T

    2016-01-01

    In the 20th century, the complications of head injuries were controlled but not eliminated. The wars of the 21st century turned attention to blast, the instant of impact and the primary injury of concussion. Computer calculations have established that in the first 5 milliseconds after the impact, four independent injuries on the brain are inflicted: 1) impact and its shockwave, 2) deceleration, 3) rotation and 4) skull deformity with vibration (or resonance). The recovery, pathology and symptoms after acute brain trauma have always been something of a puzzle. The variability of these four modes of injury, along with a variable reserve of neurones, explains some of this problem.

  19. Acute otitis media.

    PubMed

    Dickson, Gretchen

    2014-03-01

    One in 4 children will have at least 1 episode of acute otitis media (AOM) by age 10 years. AOM results from infection of fluid that has become trapped in the middle ear. The bacteria that most often cause AOM are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Differentiating AOM from otitis media with effusion (OME) is a critical skill for physicians, as accurate diagnosis will guide appropriate treatment of these conditions. Although fluid is present in the middle ear in both conditions, the fluid is not infected in OME as is seen in AOM patients.

  20. Acute respiratory distress syndrome.

    PubMed

    Gibbons, Cynthia

    2015-01-01

    Acute respiratory distress syndrome (ARDS) is a life-threatening condition with multiple causes and a high mortality rate. Approximately 150,000 cases are reported in the United States annually, making ARDS a public health concern. Management of the condition is complex because of its severity, and medical imaging is essential for both the diagnosis and management of ARDS. This article introduces common signs, symptoms, risk factors, and causes of ARDS. Diagnostic criteria, histopathology, treatment strategies, and prognostic information also are discussed. The article explains the value of medical imaging studies of ARDS, especially radiography, computed tomography, and ultrasonography.

  1. Acute ischemic stroke update.

    PubMed

    Baldwin, Kathleen; Orr, Sean; Briand, Mary; Piazza, Carolyn; Veydt, Annita; McCoy, Stacey

    2010-05-01

    Stroke is the third most common cause of death in the United States and is the number one cause of long-term disability. Legislative mandates, largely the result of the American Heart Association, American Stroke Association, and Brain Attack Coalition working cooperatively, have resulted in nationwide standardization of care for patients who experience a stroke. Transport to a skilled facility that can provide optimal care, including immediate treatment to halt or reverse the damage caused by stroke, must occur swiftly. Admission to a certified stroke center is recommended for improving outcomes. Most strokes are ischemic in nature. Acute ischemic stroke is a heterogeneous group of vascular diseases, which makes targeted treatment challenging. To provide a thorough review of the literature since the 2007 acute ischemic stroke guidelines were developed, we performed a search of the MEDLINE database (January 1, 2004-July 1, 2009) for relevant English-language studies. Results (through July 1, 2009) from clinical trials included in the Internet Stroke Center registry were also accessed. Results from several pivotal studies have contributed to our knowledge of stroke. Additional data support the efficacy and safety of intravenous alteplase, the standard of care for acute ischemic stroke since 1995. Due to these study results, the American Stroke Association changed its recommendation to extend the time window for administration of intravenous alteplase from within 3 hours to 4.5 hours of symptom onset; this recommendation enables many more patients to receive the drug. Other findings included clinically useful biomarkers, the role of inflammation and infection, an expanded role for placement of intracranial stents, a reduced role for urgent carotid endarterectomy, alternative treatments for large-vessel disease, identification of nontraditional risk factors, including risk factors for women, and newly published pediatric stroke guidelines. In addition, new devices for

  2. [Treatment of acute leukemias].

    PubMed

    Gross, R; Gerecke, D

    1982-11-12

    The effective treatment of acute (myeloblastic and lymphoblastic) leukaemias depends on the induction of remissions as well as on the maintenance of these remissions. Whereas the use of anthracyclines and of cytosine arabinoside in different combinations notably increased the rate of induction of remissions, their maintenance was less successful until now. We present a scheme using, beside MTX and 6-MP, modified COAP regimes periodically every 3 months. The follow-up of 26 patients treated in this way is encouraging since nearly one third remained in full haematological remission after 3 years of observation.

  3. Acute abdomen. Outcomes.

    PubMed

    Madonna, M B; Boswell, W C; Arensman, R M

    1997-05-01

    The outcome for children with common surgical conditions that cause an acute abdomen is discussed. These conditions include appendicitis, intussusception, malrotation, inflammatory bowel disease, intestinal obstructions, and nonorganic pain. Emphasis is placed on surgical intervention and disease processes that significantly affect outcome. The outcome of many of the diseases discussed is strongly influenced by the timing of diagnosis and treatment. These children should have prompt care and intervention to prevent morbidity and mortality. In addition, many children who present with common pediatric surgical emergencies have other medical conditions and are best treated in an environment that has a multidisciplinary team to handle their care and decrease the long-term complications.

  4. Acute emphysematous cholecystitis.

    PubMed

    Abengowe, C U; McManamon, P J

    1974-11-16

    Acute emphysematous cholecystitis is an uncommon condition caused by gas-forming organisms and characterized by the presence of gas in the wall and lumen of the gallbladder. Its incidence is higher among male diabetics. AEC in an elderly North American diabetic man with Indian ancestry is reported with a brief review of the world literature. The diagnosis was made preoperatively with the aid of plain radiographic films of the abdomen. A gangrenous distended gallbladder was removed at operation. Clostridium perfringens was cultured from the gallbladder contents and wall. If AEC is suspected, intensive antimicrobial therapy and fluid and electrolyte replacement should be given prior to early surgical intervention.

  5. Acute disseminated encephalomyelitis associated with acute Toxoplasma gondii Infection.

    PubMed

    Aksoy, Ayse; Tanir, Gonul; Ozkan, Mehpare; Oguz, Melek; Yıldız, Yasemin Tasci

    2013-03-01

    Acute disseminated encephalomyelitis is an acute demyelinating disorder of the central nervous system, which principally affects the brain and spinal cord. It usually follows a benign infection or vaccination in children. Although a number of infectious agents have been implicated in acute disseminated encephalomyelitis, Toxoplasma gondii infection has not been described previously in children. Acquired T. gondii infection presents with lymphadenopathy and fever and usually spontaneously resolves in immunocompetent patients. We describe a previously healthy 10-year-old boy with acute disseminated encephalomyelitis associated with acute acquired Toxoplasma gondii infection, the symptoms of which initially began with nuchal stiffness, difficulty in walking, and urinary and stool incontinence; he later had development of motor and sensory impairment in both lower extremities and classical magnetic resonance imaging lesions suggestive of the disease. The patient recovered completely after the specific therapy for acquired T. gondii infection and pulse prednisolone. Although acute acquired Toxoplasma gondii infection has not been reported previously in association with acute disseminated encephalomyelitis, clinicians should keep in mind this uncommon cause of a common disease when evaluating a patient with acute disseminated encephalomyelitis.

  6. [Acute respiratory distress syndrome].

    PubMed

    Matĕjovic, M; Novák, I; Srámek, V; Rokyta, R; Hora, P; Nalos, M

    1999-04-26

    Acute respiratory distress syndrome (ARDS) is the general term used for severe acute respiratory failure of diverse aetiology. It is associated with a high morbidity, mortality (50-70%), and financial costs. Regardless of aetiology, the basic pathogenesis of ARDS is a systemic inflammatory response leading to a diffuse inflammatory process that involves both lungs, thus causing diffuse alveolar and endothelial damage with increased pulmonary capillary permeability and excessive extravascular lung water accumulation. ARDS is commonly associated with sepsis and multiple organ failure. The clinical picture involves progressive hypoxaemia, radiographic evidence of pulmonary oedema, decreased lung compliance and pulmonary hypertension. Despite the scientific and technological progress in critical care medicine, there is no specific ARDS therapy available at the moment and its management remains supportive. Therapeutic goals include resolution of underlying conditions, maintenance of acceptable gas exchange and tissue oxygenation and prevention of iatrogenic lung injury. Many new specific therapeutic strategies have been developed, however, most of them require further scientific evaluation. The paper reviews definition, basic pathogenesis and pathophysiology of ARDS and discusses current concepts of therapeutic possibilities of ARDS.

  7. [Acute coronary syndrome -- 2012].

    PubMed

    Becker, Dávid; Merkely, Béla

    2012-12-23

    The acute coronary syndrome is the most severe form of coronary artery disease. It is an immediate threat of life and the mortality rate can be high without proper therapy and patient management. Based on the first ECG, two different forms can be distinguished: acute coronary syndrome with and without ST elevation. Besides adequate medication, management of these patients is an essential part of treatment. In case of ST elevation, coronarography and percutaneous coronary intervention is needed in general, within 24 hours from the onset of symptoms. When ST elevation is not detected on the ECG, individual ischemic risk factors and predictable mortality of the patient may define the necessity and the date of the invasive examination. The Hungarian hemodynamic laboratory network covers almost the whole country and, therefore, practically each patient may receive a state-of-the-art therapy. Although indicators of cardiovascular diseases are still prominent, the mortality rate of myocardial Infarction is decreasing in Hungary due to the well-organized invasive care.

  8. Acute unilateral isolated ptosis

    PubMed Central

    Court, Jennifer Helen; Janicek, David

    2015-01-01

    A 64-year-old man presented with a 2-day history of acute onset painless left ptosis. He had no other symptoms; importantly pupils were equal and reactive and eye movements were full. There was no palpable mass or swelling. He was systemically well with no headache, other focal neurological signs, or symptoms of fatigue. CT imaging showed swelling of the levator palpebrae superioris suggestive of myositis. After showing no improvement over 5 days the patient started oral prednisolone 30 mg reducing over 12 weeks. The ptosis resolved quickly and the patient remains symptom free at 6 months follow-up. Acute ptosis may indicate serious pathology. Differential diagnoses include a posterior communicating artery aneurysm causing a partial or complete third nerve palsy, Horner’s syndrome, and myasthenia gravis. A careful history and examination must be taken. Orbital myositis typically involves the extraocular muscles causing pain and diplopia. Isolated levator myositis is rare. PMID:25564592

  9. [An acute monoclonal gammopathy?].

    PubMed

    Presle, Alexandra; Bertocchio, Jean-Philippe; Schneider, Nathalie; Maquart, François-Xavier; Ramont, Laurent; Oudart, Jean-Baptiste

    2015-01-01

    Serum protein electrophoresis is commonly used in case of acute or chronic renal failure. It can lead to the etiologic diagnosis by detecting monoclonal gammopathies which are frequently complicated by renal failure, such as cast nephropathy, Randall's disease or amyloidosis, or to explore an associated inflammatory syndrome. We report the occurrence of two monoclonal components in a patient without any monoclonal component 10 days earlier. The sudden appearance of these two monoclonal components associated to the context of sepsis of urinary origin suggested the diagnosis of transient monoclonal gammopathy. This hypothesis was confirmed by monitoring serum protein electrophoresis that showed a gradual decrease of these two monoclonal components few weeks after the resolution of the infectious disease. The main etiological factors of transient monoclonal gammopathies are infectious or autoimmune diseases. In this context, it is important to delay the achievement of serum protein electrophoresis after the acute episode, in order to avoid to falsely conclude to hematologic malignancy diagnosis. This can prevent costly biological examinations of these transient monoclonal gammopathies and invasive procedures like bone marrow examination.

  10. Acute Kidney Injury

    PubMed Central

    Zuk, Anna; Bonventre, Joseph V.

    2016-01-01

    Acute kidney injury (AKI) is a global public health concern associated with high morbidity, mortality, and healthcare costs. Other than dialysis, no therapeutic interventions reliably improve survival, limit injury, or speed recovery. Despite recognized shortcomings of in vivo animal models, the underlying pathophysiology of AKI and its consequence, chronic kidney disease (CKD), is rich with biological targets. We review recent findings relating to the renal vasculature and cellular stress responses, primarily the intersection of the unfolded protein response, mitochondrial dysfunction, autophagy, and the innate immune response. Maladaptive repair mechanisms that persist following the acute phase promote inflammation and fibrosis in the chronic phase. Here macrophages, growth-arrested tubular epithelial cells, the endothelium, and surrounding pericytes are key players in the progression to chronic disease. Better understanding of these complex interacting pathophysiological mechanisms, their relative importance in humans, and the utility of biomarkers will lead to therapeutic strategies to prevent and treat AKI or impede progression to CKD or end-stage renal disease (ESRD). PMID:26768243

  11. [Insanity, life crises and longing for a "real life". On the discussion of deviant behavior and mental disorders in psychiatry of the 19th and 20th century].

    PubMed

    Kanis-Seyfried, Uta

    On insanity, life crises and the longing for a "right life". A contribution to the discussion on the deviant behavior and mental disorders in the psychiatry of the 19th and 20th centuries using the example of patient stories. History of psychiatry, understood as social and cultural history, provides the framework for this micro-historical article. Using the example of three patients treated in Wuerttemberg or Baden psychiatric asylums between 1875 and 1912, the article focuses on the critical analysis of types of asylums, their practices of admissions, therapies and power relations between patients and staff. Ways of thinking and acting, subjective experiences and emotions are exemplified by patient records, personal testimonials and contemporary publications again by patients and staff. The article examines options of patients to influence the institutional daily asylum routine against the background of its complexity and dynamics. Borders, manipulations, malingering and querulous paranoia are at stake here. Furthermore, the article reflects various forms of social interaction with the power regulating therapeutic and disciplinary aspects against the backdrop of the "canons of rules" of the asylum as well as the contemporary political and legal framework.

  12. Formulation and in vitro evaluation of a fast-disintegrating/sustained dual release bucoadhesive bilayer tablet of captopril for treatment of hypertension crises

    PubMed Central

    Abbasi, Sahar; Yousefi, Gholamhossein; Ansari, Ali Asghar; Mohammadi-Samani, Soliman

    2016-01-01

    Hypertension crisis is one of the main health problems and its effective treatment is of high importance. For this purpose, fast-disintegrating and sustained release formulations of captopril, as a drug of choice, were prepared using conventional mucoadhesive polymers hydroxypropyl methylcellulose (HPMC), sodium carboxymethyl cellulose (Na-CMC), hydroxypropyl cellulose (HPC), Carbopol 934 (CP934) and sodium alginate (Na-alg). The optimum sustained release formulations were selected based on mean dissolution time (MDT). The swellability and mucoadhesive properties of selected formulations were assessed and compared. A direct relationship between swelling and release rates/adhesiveness of sustained release formulations was observed. The results showed that formulations containing combination of CP934 and cellulose-based polymers had the highest swellability, sustainability and adhesion strength. These formulations prolonged drug release up to 8 h showing good fitness to Korsemeyer-Peppas model. Moreover, the adopted fast-disintegrating tablet could release up to 100% of drug within 3 min in oral pH. Finally, a dual fast-disintegrating/sustained release bucoadhesive bilayer tablet consisting of optimized formulations was prepared releasing 30% of the drug initially within 15 min and the remaining up to 8 h which could be considered as an appropriate formulation for the treatment of hypertension crises. PMID:27651807

  13. Hypertensive crises in quadriplegic patients. Changes in cardiac output, blood volume, serum dopamine-beta-hydroxylase activity, and arterial prostaglandin PGE2.

    PubMed

    Naftchi, N E; Demeny, M; Lowman, E W; Tuckman, J

    1978-02-01

    The syndrome of autonomic dysreflexia often occurs in quadriplegic subjects and is characterized by paroxysmal hypertension, headache, vasoconstriction below and flushing of the skin above the level of transection, and bradycardia. These attacks may cause hypertnesive encephalopathy, cerebral vascular accidents, and death. In five patients during crises, the mean arterial pressure changed from 95 to 154 mm Hg, heart rate 72 to 45 beats/min, cardiac output 4.76 to 4.70 L/min, and peripheral resistance 1650 to 2660 dynes.sec.cm-5. In eight subjects the control plasma, red cell, and total blood volumes were 19.1, 10.5, and 29.6 ml/cm body height, respectively, and when hypertensive, the plasma protein concentration increased by 9.9% and the hematocrit by 9.5%. Plasma volume was only reduced by an estimated 10-15%. At that time, arterial dopamine-beta-hydroxylase (DbetaH) activity increased 65% and prostaglandin E2 concentration by 68%. Thus, the augmented DbetaH activity presented primarily an elevated sympathetic tone and not hemoconcentration of that protein. The rise in prostaglandin may contribute to the severe headaches during hypertensive episodes.

  14. CHESS: a computer-based system for providing information, referrals, decision support and social support to people facing medical and other health-related crises.

    PubMed

    Gustafson, D H; Bosworth, K; Hawkins, R P; Boberg, E W; Bricker, E

    1992-01-01

    CHESS (the Comprehensive Health Enhancement Support System) is an interactive, computer-based system to support people facing health-related crises or concerns. CHESS provides information, referral to service providers, support in making tough decisions and networking to experts and others facing the same concerns. CHESS will improve access to health and human services for people who would otherwise face psychological, social, economic or geographic barriers to receiving services. CHESS has developed programs in five specific topic areas: Academic Crisis, Adult Children of Alcoholics, AIDS/HIV Infection, Breast Cancer and Sexual Assault. The lessons learned, and the structures developed, will serve as a model for future implementation of CHESS programs in a broad range of other topic areas. CHESS is designed around three major desired outcomes: 1) improving the emotional health status of users; 2) increasing the cost-effective use of health and human services; and 3) reducing the incidence of risk-taking behaviors that can lead to injury or illness. Pilot-testing and initial analysis of controlled evaluation data has shown that CHESS is extensively used, is useful and easy-to-use, and produces positive emotional outcomes. Further evaluation in continuing.

  15. Low-molecular-weight heparins for managing vasoocclusive crises in people with sickle cell disease: a summary of a cochrane systematic review.

    PubMed

    van Zuuren, Esther J; Fedorowicz, Zbys

    2014-01-01

    We summarize a Cochrane systematic review that was conducted to assess the effects of low-molecular-weight heparins (LMWH) for managing vasoocclusive crises (VOC) in people with sickle cell disease. Sickle cell disease is one of the most common and severe genetic disorders in the world. It can be divided into three broadly distinct clinical phenotypes characterized by either hemolysis, pain syndromes or organ damage. Pain is the most prominent symptom of vasoocclusion, and hypercoagulability is a well-established pathogenic phenomenon in people with sickle cell disease. Searches included the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register, abstract books of conference proceedings and several online trials registries (December 2012). One study (with an overall unclear to high risk of bias) comprising 253 participants was included. This study provided limited data, but concluded that tinzaparin resulted in a more rapid resolution of pain, and in a statistically significant lower number of hospitalization days compared to a placebo. Two minor bleeding events were reported as adverse events in the tinzaparin group. Based on the results from this single study, there is incomplete evidence to either support or refute the effectiveness of LMWH in people with sickle cell disease.

  16. Which side of the balance determines the frequency of vaso-occlusive crises in children with sickle cell anemia: Blood viscosity or microvascular dysfunction?

    PubMed

    Charlot, Keyne; Romana, Marc; Moeckesch, Berenike; Jumet, Stéphane; Waltz, Xavier; Divialle-Doumdo, Lydia; Hardy-Dessources, Marie-Dominique; Petras, Marie; Tressières, Benoît; Tarer, Vanessa; Hue, Olivier; Etienne-Julan, Maryse; Antoine-Jonville, Sophie; Connes, Philippe

    2016-01-01

    Vascular resistance and tissue perfusion may be both affected by impaired vascular function and increased blood viscosity. Little is known about the effects of vascular function on the occurrence of painful vaso-occlusive crises (VOC) in children with sickle cell anemia (SCA). The aim of the present study was to determine which side of the balance (blood viscosity or vascular function) is the most deleterious in SCA and increases the risk for frequent hospitalized VOC. Microvascular function, microcirculatory oxygenation and blood viscosity were determined in a group of 22 SCA children/adolescents at steady state and a group of 13 healthy children/adolescents. Univariate analyses demonstrated blunted microvascular reactivity during local thermal heating test and decreased microcirculatory oxygenation in SCA children compared to controls. Multivariate analysis revealed that increased blood viscosity and decreased microcirculatory oxygenation were independent risk factors of frequent VOC in SCA. In contrast, the level of microvascular dysfunction does not predict VOC rate. In conclusion, increased blood viscosity is usually well supported in healthy individuals where vascular function is not impaired. However, in the context of SCA, microvascular function is impaired and any increase of blood viscosity or decrease in microcirculatory oxygenation would increase the risks for frequent VOC.

  17. Managing Community Resilience to Climate Extremes, Rapid Unsustainable Urbanization, Emergencies of Scarcity, and Biodiversity Crises by Use of a Disaster Risk Reduction Bank.

    PubMed

    Canyon, Deon V; Burkle, Frederick M; Speare, Rick

    2015-12-01

    Earth's climate is changing and national and international decision-makers are recognizing that global health security requires urgent attention and a significant investment to protect the future. In most locations, current data are inadequate to conduct a full assessment of the direct and indirect health impacts of climate change. All states require this information to evaluate community-level resilience to climate extremes and climate change. A model that is being used successfully in the United Kingdom, Australia, and New Zealand is recommended to generate rapid information to assist decision-makers in the event of a disaster. The model overcomes barriers to success inherent in the traditional ''top-down'' approach to managing crises and recognizes the capacity of capable citizens and community organizers to facilitate response and recovery if provided the opportunity and resources. Local information is a prerequisite for strategic and tactical statewide planning. Time and resources are required to analyze risks within each community and what is required to prevent (mitigate), prepare, respond, recover (rehabilitate), anticipate, and assess any threatening events. Specific requirements at all levels from state to community must emphasize community roles by focusing on how best to maintain, respond, and recover public health protections and the infrastructure necessary for health security.

  18. Can Acute Myeloid Leukemia Be Prevented?

    MedlinePlus

    ... Causes, Risk Factors, and Prevention Can Acute Myeloid Leukemia Be Prevented? It’s not clear what causes most ... Myeloid Leukemia Be Prevented? More In Acute Myeloid Leukemia About Acute Myeloid Leukemia Causes, Risk Factors, and ...

  19. Canagliflozin-Associated Acute Pancreatitis.

    PubMed

    Verma, Rajanshu

    2016-01-01

    Canagliflozin is a new drug in class of sodium-glucose cotransporter 2 inhibitors used for treatment of type 2 diabetes mellitus. We describe a patient who developed moderately severe acute pancreatitis as an untoward consequence after being initiated on this drug. To the best of our knowledge, this is the first reported case of canagliflozin-associated acute pancreatitis in clinical literature.

  20. Acute care surgery in evolution.

    PubMed

    Davis, Kimberly A; Rozycki, Grace S

    2010-09-01

    At the center of the development of acute care surgery is the growing difficulty in caring for patients with acute surgical conditions. Care demands continue to grow in the face of an escalating crisis in emergency care access and the decreasing availability of surgeons to cover emergency calls. To compound this problem, there is an ever-growing shortage of general surgeons as technological advances have encouraged subspecialization. Developed by the leadership of the American Association for the Surgery of Trauma, the specialty of acute care surgery offers a training model that would produce a new breed of specialist with expertise in trauma surgery, surgical critical care, and elective and emergency general surgery. This article highlights the evolution of the specialty in hope that these acute care surgeons, along with practicing general surgeons, will bring us closer to providing superb and timely care for patients with acute surgical conditions.

  1. Gemtuzumab Ozogamicin in Treating Patients With Relapsed or Refractory Acute Myeloid Leukemia or Acute Promyelocytic Leukemia

    ClinicalTrials.gov

    2017-02-20

    Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Acute Promyelocytic Leukemia (M3); Childhood Acute Promyelocytic Leukemia (M3); Recurrent Adult Acute Myeloid Leukemia; Recurrent Childhood Acute Myeloid Leukemia

  2. [Acute postpartum psychoses].

    PubMed

    Tabbane, K; Charfi, F; Dellagi, L; Guizani, L; Boukadida, L

    1999-11-01

    The post-partum is a high risk period for the development of acute psychotic disorders. The frequence of post-partum psychoses is evaluated at 1 to 2 per 1,000 births. Post-partum psychosis include major affective disorders which is the most frequent diagnosis. The clinical pictures have specific characteristics: rapid change of symptomatology, liability of mood, and frequent confusional signs. The short-term prognosis is generally good but the risk of recurrence of the mental disorder, in or outside puerperal context, is high. At clinical, evolutive and genetic levels, the studies do not provide arguments for nosological autonomy of post-partum psychosis. At therapeutic level, the ECT is particularly efficient in this indication.

  3. Acute otitis media.

    PubMed

    Atkinson, Helen; Wallis, Sebastian; Coatesworth, Andrew P

    2015-05-01

    Acute otitis media (AOM) is a common problem facing general practitioners, paediatricians and otolaryngologists. This article reviews the aetiopathogenesis, epidemiology, presentation, natural history, complications and management of AOM. The literature was reviewed by using the PubMed search engine and entering a combination of terms including 'AOM', 'epidemiology' and 'management'. Relevant articles were identified and examined for content. What is the take-home message? AOM is a very common problem affecting the majority of children at least once and places a large burden on health care systems throughout the world. Although symptomatic relief is often enough for most children, more severe and protracted cases require treatment with antibiotics, especially in younger children.

  4. Acute Inhalation Injury

    PubMed Central

    Gorguner, Metin; Akgun, Metin

    2010-01-01

    Inhaled substances may cause injury in pulmonary epithelium at various levels of respiratory tract, leading from simple symptoms to severe disease. Acute inhalation injury (AII) is not uncommon condition. There are certain high risk groups but AII may occur at various places including home or workplace. Environmental exposure is also possible. In addition to individual susceptibility, the characteristics of inhaled substances such as water solubility, size of substances and chemical properties may affect disease severity as well as its location. Although AII cases may recover in a few days but AII may cause long-term complications, even death. We aimed to discuss the effects of short-term exposures (minutes to hours) to toxic substances on the lungs. PMID:25610115

  5. Acute lymphoblastic leukaemia

    PubMed Central

    Inaba, Hiroto; Greaves, Mel; Mullighan, Charles G.

    2013-01-01

    Summary Acute lymphoblastic leukaemia (ALL) is seen in both children and adults, but its incidence peaks between ages 2 and 5 years. The causation of ALL is considered to be multi-factorial, including exogenous or endogenous exposures, genetic susceptibility, and chance. The survival rate of paediatric ALL has improved to approximately 90% in recent trials with risk stratification by biologic features of leukaemic cells and response to therapy, therapy modification based on patient pharmacodynamics and pharmacogenomics, and improved supportive care. However, innovative approaches are needed to further improve survival while reducing adverse effects. While most children can be cured, the prognosis of infants and adults with ALL remains poor. Recent genome-wide profiling of germline and leukaemic cell DNA has identified novel submicroscopic structural genetic alterations and sequence mutations that contribute to leukaemogenesis, define new ALL subtypes, influence responsiveness to treatment, and may provide novel prognostic markers and therapeutic targets for personalized medicine. PMID:23523389

  6. Acute subarachnoid hemorrhage

    PubMed Central

    Hassan, Ali; Ahmad, Bakhtiar; Ahmed, Zahoor; Al-Quliti, Khalid W.

    2015-01-01

    Ruptured cerebral aneurysm is the most common cause of spontaneous subarachnoid hemorrhage (SAH). Rarely cerebral venous sinus thrombosis (CVST) may present initially as acute SAH, and clinically mimics aneurysmal bleed. We report 2 cases of CVST who presented with severe headache associated with neck pain and focal seizures. Non-contrast brain CT showed SAH, involving the sulci of the convexity of hemisphere (cSAH) without involving the basal cisterns. Both patients received treatment with anticoagulants and improved. Awareness of this unusual presentation of CVST is important for early diagnosis and treatment. The purpose of this paper is to emphasize the inclusion of vascular neuroimaging like MRI with venography or CT venography in the diagnostic workup of SAH, especially in a patient with strong clinical suspicion of CVST or in a patient where neuroimaging showed cSAH. PMID:25630784

  7. Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction

    PubMed Central

    Kumar, Andreas; Bagur, Rodrigo; Béliveau, Patrick; Potvin, Jean-Michel; Levesque, Pierre; Fillion, Nancy; Tremblay, Benoit; Larose, Éric; Gaudreault, Valérie

    2014-01-01

    A 24-year-old healthy man consulted to our center because of typical on-and-off chest-pain and an electrocardiogram showing ST-segment elevation in inferior leads. An urgent coronary angiography showed angiographically normal coronary arteries. Cardiovascular magnetic resonance imaging confirmed acute myocarditis. Although acute myocarditis triggering coronary spasm is an uncommon association, it is important to recognize it, particularly for the management for those patients presenting with ST-segment elevation and suspect myocardial infarction and angiographically normal coronary arteries. The present report highlights the role of cardiovascular magnetic resonance imaging to identify acute myocarditis as the underlying cause. PMID:25276306

  8. Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction.

    PubMed

    Kumar, Andreas; Bagur, Rodrigo; Béliveau, Patrick; Potvin, Jean-Michel; Levesque, Pierre; Fillion, Nancy; Tremblay, Benoit; Larose, Eric; Gaudreault, Valérie

    2014-09-26

    A 24-year-old healthy man consulted to our center because of typical on-and-off chest-pain and an electrocardiogram showing ST-segment elevation in inferior leads. An urgent coronary angiography showed angiographically normal coronary arteries. Cardiovascular magnetic resonance imaging confirmed acute myocarditis. Although acute myocarditis triggering coronary spasm is an uncommon association, it is important to recognize it, particularly for the management for those patients presenting with ST-segment elevation and suspect myocardial infarction and angiographically normal coronary arteries. The present report highlights the role of cardiovascular magnetic resonance imaging to identify acute myocarditis as the underlying cause.

  9. What Are the Key Statistics about Acute Lymphocytic Leukemia?

    MedlinePlus

    ... Leukemia (ALL) What Are the Key Statistics About Acute Lymphocytic Leukemia? The American Cancer Society’s estimates for acute lymphocytic ... Acute Lymphocytic Leukemia Research and Treatment? More In Acute Lymphocytic Leukemia About Acute Lymphocytic Leukemia Causes, Risk Factors, and ...

  10. [Latest advances in acute pancreatitis].

    PubMed

    de-Madaria, Enrique

    2015-09-01

    The present article analyses the main presentations on acute pancreatitis at Digestive Disease Week 2015. Arterial pseudoaneurysm is an uncommon complication of acute pancreatitis (incidence 0.7%) and mortality from this cause is currently anecdotal. Diabetes mellitus has little impact on the clinical course of acute pancreatitis, unlike cirrhosis, which doubles the risk of mortality. Intake of unsaturated fat could be associated with an increased severity of acute pancreatitis and is a confounding factor in studies evaluating the relationship between obesity and morbidity and mortality. PET-CT (positron emission tomography-computed tomography) could be a non-invasive tool to detect infection of collections in acute pancreatitis. Peripancreatic fat necrosis is less frequent than pancreatic fat necrosis and is associated with a better clinical course. If the clinical course is poor, increasing the calibre of the percutaneous drains used in the treatment of infected necrosis can avoid surgery in 20% of patients. The use of low molecular-weight heparin in moderate or severe pancreatitis could be associated with a better clinical course, specifically with a lower incidence of necrosis. In acute recurrent pancreatitis, simvastatin is a promising drug for prophylaxis of new episodes of acute pancreatitis. Nutritional support through a nasogastric tube does not improve clinical course compared with oral nutrition.

  11. Acute service delivery in a police-mental health program for children exposed to violence and trauma.

    PubMed

    Murphy, Robert A; Rosenheck, Robert A; Berkowitz, Steven J; Marans, Steven R

    2005-01-01

    The Child Development Community Policing Program represents a national model of community-based collaboration between police and mental health professionals for violence-exposed and traumatized children. Administrative data from clinical records of a 24-hour consultation service were examined through stepwise multivariate logistic regression to identify child and event characteristics associated with a direct, in-person response at the time of police contact. Of 2361 children, 809 (34.3%) received a direct, in-person response. Relative to Caucasian children, Hispanic youth were more likely to receive this form of response (OR = 1.36). An acute clinical response was more likely for incidents of gang involvement (OR = 8.12), accidents (OR = 5.21), felony assaults (OR = 2.97), property crimes (OR = 2.30), family violence (OR = 1.53) and psychiatric crises (OR = 1.29). Acute response was less likely when juvenile conduct problems (OR = 0.61), fires (OR = 0.59), child maltreatment (OR = 0.57), and domestic violence (OR = 0.44) were involved. Incidents that were more severe or involved a primary mental health component were related to utilization of intensive CDCP resources.

  12. Acute abdomen caused by both acute appendicitis and epididymitis.

    PubMed

    Nakatani, Hajime; Hamada, Shinichi; Okanoue, Toyotake; Kawamura, Akihiro; Inoue, Yuichiro; Yamamoto, Shinya; Chikai, Takashi; Hiroi, Makoto; Hanazaki, Kazuhiro

    2011-08-01

    Acute appendicitis often presents as right lower quadrant (RLQ) pain, severe tenderness at the point of McBurny or Lanz, and Blumberg's sign. Scrotal events with appendicitis are very rare. In our case, a 63-year-old Japanese man presented with severe RLQ pain and high fever. Physical examination revealed severe tenderness (including both points of McBurny and Lanz) and Blumberg's sign. The scrotum was slightly swollen and showed local heat with severe testicular pain. Abdominal computed tomography revealed ascites in a pelvic space and the right side of the spermatic cord was swollen. Emergency operation was performed and the final diagnosis was catarrhal appendicitis and acute epididymitis. This is the first report of acute appendicitis concomitant with acute epididymitis.

  13. [Cerebrolysin for acute ischemic stroke].

    PubMed

    iganshina, L E; Abakumova, T R

    2013-01-01

    The review discusses existing evidence of benefits and risks of cerebrolysin--a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue with proposed neuroprotective and neurotrophic properties, for acute ischemic stroke. The review presents results of systematic search and analysis of randomised clinical trials comparing cerebrolysin with placebo in patients with acute ischemic stroke. Only one trial was selected as meeting quality criteria. No difference in death and adverse events between cerebrolysin and placebo was established. The authors conclude about insufficiency of evidence to evaluate the effect of cerebrolysin on survival and dependency in people with acute ischemic stroke.

  14. [Laparoscopic cholecystectomy in acute cholecystitis].

    PubMed

    Neufeld, D; Sivak, G; Jessel, J; Freund, U

    1996-04-01

    We performed 417 laparoscopic cholecystectomies, including 58 for acute cholecystitis, between September 1991 and April 1995,. All operations were successful, with no mortality or complications. In about 10%, the laparoscopic approach failed and we converted to open cholecystectomy. Average post-operative hospitalization was 24 hours. We also performed primary open cholecystectomies in 55 patients with acute cholecystitis, because of limitations of operating room and staff availability for unscheduled laparoscopic surgery. In these patients, hospital stay was longer and rate of complications higher. In our opinion laparoscopic cholecystectomy is safe and the preferred approach in acute cholecystitis.

  15. The Campi Flegrei caldera: historical revision and new data on seismic crises, bradyseisms, the Monte Nuovo eruption and ensuing earthquakes (twelfth century 1582 uc(ad))

    NASA Astrophysics Data System (ADS)

    Guidoboni, Emanuela; Ciuccarelli, Cecilia

    2010-12-01

    This paper presents the results of a systematic historical study of the seismic, bradyseismic and eruptive activity of the Campi Flegrei caldera. The aim is to make a revised historical data available for accurate volcanological interpretation, supplying additional data and highlighting spurious previous data. The analysis begins with the supposed 1198 eruption, which did not actually take place. No information is available for the thirteenth and fourteenth centuries. As far as the fifteenth and sixteenth centuries are concerned, only direct sources were examined for this paper, and they include many different types of evidence. The chronological breadth of the analysis has also provided information about the seismic crises and bradyseisms prior to the eruption of 1538. The exceptional nature of this 1538 eruption attracted the attention of intellectuals, diplomats and natural philosophers, who left valuable accounts, which we have analysed, and which include many that are still available in their original manuscript form. The previous studies concerning the 1538 eruption were based on 23 (variously used) sources. We have examined 35 additional sources bringing the overall corpus of sources analysed to 58. The results provide a more precise scenario of events preceding the 1538 eruption, including bradyseismic activity starting from the end of the fifteenth century. The chronology of the phenomena described comprises the core result of this study, and has been constructed so as to clarify the time, location and impact of each event. For the 1538 eruption, a countdown is included which may also have a predictive value. For the last 36 hours before eruption began, the countdown is hour-by-hour. The effects of the eruption and earthquakes on people, structures and society are also described for Pozzuoli, Agnano and Naples. The areas where heavy materials and ash fell are likewise indicated, as well are the earth tremors felt by the population from the eruptive crisis

  16. The Campi Flegrei caldera: historical revision and new data on seismic crises, bradyseisms, the Monte Nuovo eruption and ensuing earthquakes (twelfth century 1582 AD)

    NASA Astrophysics Data System (ADS)

    Guidoboni, Emanuela; Ciuccarelli, Cecilia

    2011-08-01

    This paper presents the results of a systematic historical study of the seismic, bradyseismic and eruptive activity of the Campi Flegrei caldera. The aim is to make a revised historical data available for accurate volcanological interpretation, supplying additional data and highlighting spurious previous data. The analysis begins with the supposed 1198 eruption, which did not actually take place. No information is available for the thirteenth and fourteenth centuries. As far as the fifteenth and sixteenth centuries are concerned, only direct sources were examined for this paper, and they include many different types of evidence. The chronological breadth of the analysis has also provided information about the seismic crises and bradyseisms prior to the eruption of 1538. The exceptional nature of this 1538 eruption attracted the attention of intellectuals, diplomats and natural philosophers, who left valuable accounts, which we have analysed, and which include many that are still available in their original manuscript form. The previous studies concerning the 1538 eruption were based on 23 (variously used) sources. We have examined 35 additional sources bringing the overall corpus of sources analysed to 58. The results provide a more precise scenario of events preceding the 1538 eruption, including bradyseismic activity starting from the end of the fifteenth century. The chronology of the phenomena described comprises the core result of this study, and has been constructed so as to clarify the time, location and impact of each event. For the 1538 eruption, a countdown is included which may also have a predictive value. For the last 36?| hours before eruption began, the countdown is hour-by-hour. The effects of the eruption and earthquakes on people, structures and society are also described for Pozzuoli, Agnano and Naples. The areas where heavy materials and ash fell are likewise indicated, as well are the earth tremors felt by the population from the eruptive

  17. [Acute heart failure: acute cardiogenic pulmonary edema and cardiogenic shock].

    PubMed

    Sánchez Marteles, Marta; Urrutia, Agustín

    2014-03-01

    Acute cardiogenic pulmonary edema and cardiogenic shock are two of the main forms of presentation of acute heart failure. Both entities are serious, with high mortality, and require early diagnosis and prompt and aggressive management. Acute pulmonary edema is due to the passage of fluid through the alveolarcapillary membrane and is usually the result of an acute cardiac episode. Correct evaluation and clinical identification of the process is essential in the management of acute pulmonary edema. The initial aim of treatment is to ensure hemodynamic stability and to correct hypoxemia. Other measures that can be used are vasodilators such as nitroglycerin, loop diuretics and, in specific instances, opioids. Cardiogenic shock is characterized by sustained hypoperfusion, pulmonary wedge pressure > 18 mmHg and a cardiac index < 2.2l/min/m(2). The process typically presents with hypotension (systolic blood pressure < 90 mmHg or a decrease in mean arterial pressure > 30 mmHg) and absent or reduced diuresis (< 0.5 ml/kg/h). The most common cause is left ventricular failure due to acute myocardial infarction. Treatment consists of general measures to reverse acidosis and hypoxemia, as well as the use of vasopressors and inotropic drugs. Early coronary revascularization has been demonstrated to improve survival in shock associated with ischaemic heart disease.

  18. Toxic Megacolon and Acute Ischemia of the Colon due to Sigmoid Stenosis Related to Diverticulitis

    PubMed Central

    Antonopoulos, P.; Almyroudi, M.; Kolonia, V.; Kouris, S.; Troumpoukis, N.; Economou, N.

    2013-01-01

    We present a rare case of toxic megacolon accompanied by necrosis of the colon due to chronic dilation caused by stenosis of the sigmoid colon as a complication of diverticulitis. The patient presented at the emergency department with diffuse abdominal pain, fever (38.8°C) and tachycardia (120 beats/min). Physical examination revealed distension and tenderness on deep palpation on the left lower quadrant without peritoneal signs. Abdominal computed tomography showed located stenosis in the sigmoid colon and marked dilation of the descending (12 cm diameter) and transverse (7.5 cm diameter) colon. A few hours later, the patient developed severe septic shock with electrolyte abnormalities. He had a history of two prior admissions to our hospital due to crises of acute diverticulitis. Based on Jalan's criteria the diagnosis was compatible with toxic megacolon. The patient's condition deteriorated suddenly and an emergency colectomy was performed. The operative findings revealed a necrotic colon. Histology examination confirmed the diagnosis of ischemia of the colon. To our knowledge this is the first published report in the literature which refers to a rare complication of diverticulitis, namely chronic stenosis which complicated to colonic ischemia and toxic megacolon. PMID:24163654

  19. Biomarkers in acute lung injury.

    PubMed

    Mokra, Daniela; Kosutova, Petra

    2015-04-01

    Acute respiratory distress syndrome (ARDS) and its milder form acute lung injury (ALI) may result from various diseases and situations including sepsis, pneumonia, trauma, acute pancreatitis, aspiration of gastric contents, near-drowning etc. ALI/ARDS is characterized by diffuse alveolar injury, lung edema formation, neutrophil-derived inflammation, and surfactant dysfunction. Clinically, ALI/ARDS is manifested by decreased lung compliance, severe hypoxemia, and bilateral pulmonary infiltrates. Severity and further characteristics of ALI/ARDS may be detected by biomarkers in the plasma and bronchoalveolar lavage fluid (or tracheal aspirate) of patients. Changed concentrations of individual markers may suggest injury or activation of the specific types of lung cells-epithelial or endothelial cells, neutrophils, macrophages, etc.), and thereby help in diagnostics and in evaluation of the patient's clinical status and the treatment efficacy. This chapter reviews various biomarkers of acute lung injury and evaluates their usefulness in diagnostics and prognostication of ALI/ARDS.

  20. Causes of acute bronchitis (image)

    MedlinePlus

    ... of the bronchial tubes, the part of the respiratory system that leads into the lungs. Acute bronchitis has a sudden onset and usually appears after a respiratory infection, such as a cold, and can be ...

  1. [Acute muscle weakness: differential diagnoses].

    PubMed

    Antoniuk, Sérgio A

    2013-09-06

    Acute muscle weakness, a common disorder in pediatrics, can occur from impairment of any part of the motor unit, including the upper motor neuron, lower motor neuron, peripheral nerve, neuromuscular junction or muscle. It usually manifests itself as an acute or hyperacute motor disorder of progressive or rapidly progressive course. Acute muscle weakness is a neuromuscular emergency, especially if it affects the respiratory or oropharyngeal musculature. The location of the motor weakness and associated neurological signs and symptoms usually indicate the location of the lesion. The onset, speed and clinical evolution, as well as other data from the patient's history, suggest the pathophysiological differential diagnosis. Successful treatment depends on the immediate and correct differential diagnosis. This paper presents the main differential diagnosis of main neuromuscular diseases that cause acute muscle weakness in children.

  2. Acute Pancreatitis after Kidney Transplantation

    PubMed Central

    Tabakovic, Mithat; Salkic, Nermin N.; Bosnjic, Jasmina; Alibegovic, Ervin

    2012-01-01

    Acute pancreatitis is a rare but life-threatening complication in patients with transplanted kidney. The incidence of acute pancreatitis after kidney transplantation ranges from 2% to 7%, with mortality rate between 50 and 100%. We report a case of a female patient aged 46 years, developing an interstitial acute pancreatitis 8 years following a renal transplantation. The specific aethiological factor was not clearly established, although possibility of biliary pancreatitis with spontaneous stone elimination and/or medication-induced pancreatitis remains the strongest. Every patient after renal transplantation with an acute onset of abdominal pain should be promptly evaluated for presence of pancreatitis with a careful application of the most appropriate diagnostic procedure for each individual patient. PMID:23259142

  3. Acute pancreatitis, acute hepatitis and acute renal failure favourably resolved in two renal transplant recipients.

    PubMed

    Voiculescu, Mihai; Ionescu, Camelia; Ismail, Gener; Mandache, Eugen; Hortopan, Monica; Constantinescu, Ileana; Iliescu, Olguta

    2003-03-01

    Renal transplantation is often associated with severe complications. Except for acute rejection, infections and toxicity of immunosuppressive treatment are the most frequent problems observed after transplantation. Infections with hepatic viruses (HBV, HDV, HCV, HGV) and cytomegalic virus (CMV) are the main infectious complications after renal transplantation. Cyclosporine toxicity is not unusual for a patient with renal transplantation and is even more frequent for patients with hepatic impairment due to viral infections. The subjects of this report are two renal transplant recipients with acute pancreatitis, severe hepatitis and acute renal failure on graft, receiving immunosuppressive therapy for maintaining renal graft function

  4. Acute Myeloid Leukaemia

    PubMed Central

    Villela, Luis; Bolaños-Meade, Javier

    2013-01-01

    The current treatment of patients with acute myeloid leukaemia yields poor results, with expected cure rates in the order of 30–40% depending on the biological characteristics of the leukaemic clone. Therefore, new agents and schemas are intensively studied in order to improve patients’ outcomes. This review summarizes some of these new paradigms, including new questions such as which anthracycline is most effective and at what dose. High doses of daunorubicin have shown better responses in young patients and are well tolerated in elderly patients. Monoclonal antibodies are promising agents in good risk patients. Drugs blocking signalling pathways could be used in combination with chemotherapy or in maintenance with promising results. Epigenetic therapies, particularly after stem cell transplantation, are also discussed. New drugs such as clofarabine and flavopiridol are reviewed and the results of their use discussed. It is clear that many new approaches are under study and hopefully will be able to improve on the outcomes of the commonly used ‘7+3’ regimen of an anthracycline plus cytarabine with daunorubicin, which is clearly an ineffective therapy in the majority of patients. PMID:21861539

  5. Neonatal Acute Kidney Injury.

    PubMed

    Selewski, David T; Charlton, Jennifer R; Jetton, Jennifer G; Guillet, Ronnie; Mhanna, Maroun J; Askenazi, David J; Kent, Alison L

    2015-08-01

    In recent years, there have been significant advancements in our understanding of acute kidney injury (AKI) and its impact on outcomes across medicine. Research based on single-center cohorts suggests that neonatal AKI is very common and associated with poor outcomes. In this state-of-the-art review on neonatal AKI, we highlight the unique aspects of neonatal renal physiology, definition, risk factors, epidemiology, outcomes, evaluation, and management of AKI in neonates. The changes in renal function with gestational and chronologic age are described. We put forth and describe the neonatal modified Kidney Diseases: Improving Global Outcomes AKI criteria and provide the rationale for its use as the standardized definition of neonatal AKI. We discuss risk factors for neonatal AKI and suggest which patient populations may warrant closer surveillance, including neonates <1500 g, infants who experience perinatal asphyxia, near term/ term infants with low Apgar scores, those treated with extracorporeal membrane oxygenation, and those requiring cardiac surgery. We provide recommendations for the evaluation and treatment of these patients, including medications and renal replacement therapies. We discuss the need for long-term follow-up of neonates with AKI to identify those children who will go on to develop chronic kidney disease. This review highlights the deficits in our understanding of neonatal AKI that require further investigation. In an effort to begin to address these needs, the Neonatal Kidney Collaborative was formed in 2014 with the goal of better understanding neonatal AKI, beginning to answer critical questions, and improving outcomes in these vulnerable populations.

  6. Acute asthma: under attack.

    PubMed

    Kissoon, Niranjan

    2002-06-01

    The burden of asthma (death, disability, and an increasing prevalence) makes it a major public health problem worldwide. In an effort to decrease this burden, investigators are studying many aspects of this disease. The role of race, ethnicity, infections, and pollutants as triggers, as well as the risk factors are now being defined. Research into methods to decrease acute exacerbations and improve emergency and in-hospital management, using standardized protocols and incentives for follow-up care, has yielded valuable information but has met with limited success. Adherence to the national guidelines has been poor and to some extent can be attributed to the lack of a practical method of measuring the degree of lung inflammation and cumbersome treatment protocols. Exhaled nitric oxide is a noninvasive marker of inflammation and may provide a rational method to titrate corticosteroid and leukotriene receptor antagonist therapy. The best route and dosing regimen for corticosteroid administration (oral vs intramuscular vs nebulized) are the subject of several studies, with no clear-cut winner. The burden of asthma in developing countries with limited financial resources has also triggered a search for simpler, cheaper, and practical methods for beta-agonist delivery using indigenous spacers. Recent research in asthma has unveiled our incomplete knowledge of the disease but has also provided a sense of where efforts should be expended. Research into the genetics and pharmacogenetics of asthma and into the societal factors limiting the delivery of optimal care is likely to yield useful and practical information.

  7. [Acute zincteral oral poisoning].

    PubMed

    Kamenczak, A; Pokorska, M; Wołek, E; Kobyłecka, K

    Zinc vapour poisoning by inhalation in the form of zinc fever is more frequent than oral zinc product poisoning, the product used in therapy. The main aim of the study was the evaluation of clinical manifestation present after Zincteral ingestion as well as attempt to find the relationship between the presence and aggravation of the clinical manifestation and zinc level in the blood. The course of acute clinical suicidal poisoning by ingestion of Zincteral 50 tablets (10.0 g) and 100 tablets (20.0 g) is presented. The clinical picture revealed the following symptoms and signs: tachycardia, changes of arterial BP, vascular shock; dyspeptic nausea, vomiting cramps in abdominal region, diarrhoea. Damage of the parenchymatous organs, mainly liver was evident. In pregnant woman (9-week-pregnancy) on the 12-th day of her stay in the Clinic complete miscarriage took place accompanied by haemorrhage from reproductive organs. The kind and exacerbation of the clinical manifestations in relation to the zinc level in body fluid were analysed.

  8. Acute liver failure.

    PubMed

    Blackmore, Laura; Bernal, William

    2015-10-01

    Acute liver failure (ALF) is a rare critical illness with high mortality whose successful management requires early recognition and effective initial management. Though it may result from a wide variety of causes, in the UK and much of the developed world most cases result from paracetamol-induced hepatotoxicity, and administration of antidotal N-acetyl cysteine at first recognition is key. Involvement of local critical care services should occur at an early stage for stabilisation, monitoring and supportive care with parallel discussion with specialist liver centres to identify those patients who may benefit from transfer. Prognostic criteria are applied to identify patients for emergency liver transplantation, and candidates for surgery are prioritised on waitlisting schemes. Outcomes now approach that of elective surgery. However, the majority of cases, and particularly those with paracetamol-induced disease, recover with supportive medical care alone. Overall outcomes for patients with ALF have improved dramatically over the last three decades, but mortality remains unacceptable and further advances in care are required.

  9. Acute generalised exanthematous pustulosis.

    PubMed

    Fernando, Suran L

    2012-05-01

    Acute generalised exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction and is caused by drugs in >90% of cases. It is rare, with an incidence of 1-5 patients per million per year. The clinical manifestations are characterised by fever and the rapid appearance of disseminated sterile pustules 3-5 days after the commencement of treatment. It is accompanied by marked neutrophilia. Mucous membranes are not typically involved. The drugs conferring the highest risk of AGEP according to the EuroSCAR study are aminopenicillins, pristinamycin, hydroxychloroquine, antibacterial sulphonamides, terbinafine and diltiazem. The pathogenesis of AGEP involves the initial influx of CD8 cytotoxic T-cells resulting in the apoptosis of keratinocytes and formation of vesicles. Then CXCL-8-producing and granulocyte macrophage-colony stimulating factor-producing CD4 cells enter the epidermis, resulting in neutrophil mediated inflammation and the formation of pustules. As a result, the histology reveals intraepidermal, usually subcorneal, pustules and an accompanying neutrophilic and lymphocytic infiltrate. Epicutaneous patch testing may also support the diagnosis by causing a localised pustular reaction 48-96 h after the offending drug is applied. The condition usually resolves by 15 days after the causative drug is withdrawn but oral corticosteroid therapy may be necessary in some individuals. The mortality rate is up to 5% and mostly occurs in elderly people who have significant comorbidities.

  10. Autophagy in Acute Kidney Injury

    PubMed Central

    Livingston, Man J.; Dong, Zheng

    2014-01-01

    Acute kidney injury is a major kidney disease associated with poor clinical outcomes. The pathogenesis of acute kidney injury is multifactorial and is characterized by tubular cell injury and death. Recent studies have demonstrated autophagy induction in proximal tubular cells during acute kidney injury. The regulatory mechanisms of tubular cell autophagy are poorly understood; however, some recent findings have set up a foundation for further investigation. Although autophagy may promote cell death under certain experimental conditions, pharmacological and autophagy-related gene knockout studies have established a renoprotective role for autophagy in acute kidney injury. The mechanisms by which autophagy protects cells from injury and how, possibly, its pro-survival role switches to pro-death under certain conditions are discussed. Further research is expected to help us understand the regulatory network of tubular cell autophagy, define its precise roles in specific context of acute kidney injury, and identify autophagy-targeting strategies for the prevention and treatment of acute kidney injury. PMID:24485026

  11. [Correlation between hyperamylasemia and acute pancreatitis].

    PubMed

    Monaco, R; Durante, E; Pampolini, M; Tioli, P

    1981-05-31

    It is often difficult to differentiate acute pancreatitis (A.P.) from some other acute abdominal diseases, when there is an elevated serum amylase. In contrast, the renal clearance of amylase, expressed as a percentage of creatinine clearance, can separate patients with A.P. from patients with acute colecistitis, common duct stone without pancreatitis, hyperamylasemia after biliary surgery, acute peptic ulcer and acute salivary diseases.

  12. Acute injuries in orienteerers.

    PubMed

    Kujala, U M; Nylund, T; Taimela, S

    1995-02-01

    The aim of this study was to characterize the type and severeity of acute injuries occurring in Finnish orienteerers in 1987 to 1991. The study is based on the orienteering license insurance records accounting for 2189 orienteering injuries during 69268 person-years of exposure in active orienteerers. Of these orienteerers, 73.0% were male; 73.5% (N = 1608) of all injuries occurred in males, so the injury rate was similar in males and females. The rate was highest in orienteerers 20 to 24 years of age and lowest in children. Injuries occurred most commonly during May to September (78.9% or all injuries), the months which include the orienteering competition season, and were more common during competitions (59.8%) than during training. A high number of the injuries occurred during weekends (58.9% of injuries) including 68.1% of all competition injuries and 44.9% of all training injuries. The lower limbs were involved in 1611 (73.6%) of cases, the ankle (28.7%) and the knee (23.2%) being the two most common injury locations. Sprains, strains and contusions were the most common injuries. Wounds were proportionally more common in males than in females while ankle sprains were more common in females. Fractures, seven open and 94 closed, accounted for 4.6% of injuries; they were most common in the hand/wrist/forearm (N = 44) and ankle (N = 16), and were more frequent during competition (62.3%) than during training. The most important areas for preventive measures seem to be the ankle and the knee.

  13. Acute Diarrheal Syndromic Surveillance

    PubMed Central

    Kam, H.J.; Choi, S.; Cho, J.P.; Min, Y.G.; Park, R.W.

    2010-01-01

    Objective In an effort to identify and characterize the environmental factors that affect the number of patients with acute diarrheal (AD) syndrome, we developed and tested two regional surveillance models including holiday and weather information in addition to visitor records, at emergency medical facilities in the Seoul metropolitan area of Korea. Methods With 1,328,686 emergency department visitor records from the National Emergency Department Information system (NEDIS) and the holiday and weather information, two seasonal ARIMA models were constructed: (1) The simple model (only with total patient number), (2) the environmental factor-added model. The stationary R-squared was utilized as an in-sample model goodness-of-fit statistic for the constructed models, and the cumulative mean of the Mean Absolute Percentage Error (MAPE) was used to measure post-sample forecast accuracy over the next 1 month. Results The (1,0,1)(0,1,1)7 ARIMA model resulted in an adequate model fit for the daily number of AD patient visits over 12 months for both cases. Among various features, the total number of patient visits was selected as a commonly influential independent variable. Additionally, for the environmental factor-added model, holidays and daily precipitation were selected as features that statistically significantly affected model fitting. Stationary R-squared values were changed in a range of 0.651-0.828 (simple), and 0.805-0.844 (environmental factor-added) with p<0.05. In terms of prediction, the MAPE values changed within 0.090-0.120 and 0.089-0.114, respectively. Conclusion The environmental factor-added model yielded better MAPE values. Holiday and weather information appear to be crucial for the construction of an accurate syndromic surveillance model for AD, in addition to the visitor and assessment records. PMID:23616829

  14. Hyperoxic Acute Lung Injury

    PubMed Central

    Kallet, Richard H; Matthay, Michael A

    2013-01-01

    Prolonged breathing of very high FIO2 (FIO2 ≥ 0.9) uniformly causes severe hyperoxic acute lung injury (HALI) and, without a reduction of FIO2, is usually fatal. The severity of HALI is directly proportional to PO2 (particularly above 450 mm Hg, or an FIO2 of 0.6) and exposure duration. Hyperoxia produces extraordinary amounts of reactive O2 species that overwhelms natural antioxidant defenses and destroys cellular structures through several pathways. Genetic predisposition has been shown to play an important role in HALI among animals, and some genetics-based epidemiologic research suggests that this may be true for humans as well. Clinically, the risk of HALI likely occurs when FIO2exceeds 0.7, and may become problematic when FIO2 exceeds 0.8 for an extended period of time. Both high-stretch mechanical ventilation and hyperoxia potentiate lung injury and may promote pulmonary infection. During the 1960s, confusion regarding the incidence and relevance of HALI largely reflected such issues as the primitive control of FIO2, the absence of PEEP, and the fact that at the time both ALI and ventilator-induced lung injury were unknown. The advent of PEEP and precise control over FIO2, as well as lung-protective ventilation, and other adjunctive therapies for severe hypoxemia, has greatly reduced the risk of HALI for the vast majority of patients requiring mechanical ventilation in the 21st century. However, a subset of patients with very severe ARDS requiring hyperoxic therapy is at substantial risk for developing HALI, therefore justifying the use of such adjunctive therapies. PMID:23271823

  15. Pancreatic pseudocyst after acute organophosphate poisoning.

    PubMed

    Kawabe, Ken; Ito, Tetsuhide; Arita, Yoshiyuki; Sadamoto, Yojiro; Harada, Naohiko; Yamaguchi, Koji; Tanaka, Masao; Nakano, Itsuro; Nawata, Hajime; Takayanagi, Ryoichi

    2006-04-01

    Acute organophosphate poisoning (OP) shows several severe clinical symptoms due to its strong blocking effect on cholinesterase. Acute pancreatitis is one of the complications associated with acute OP, but this association still may not be widely recognized. We report here the case of a 73-year-old man who had repeated abdominal pain during and after the treatment of acute OP. Hyperamylasemia and a 7-cm pseudocyst in the pancreatic tail were noted on investigations. We diagnosed pancreatic pseudocyst that likely was secondary to an episode of acute pancreatitis following acute OP. He was initially treated with a long-term intravenous hyperalimentation, protease inhibitors and octerotide, but eventually required surgical intervention, a cystgastrostomy. Acute pancreatitis and hyperamylasemia are known to be possible complications of acute OP. It is necessary to examine and assess pancreatic damage in patients with acute OP.

  16. Cenozoic evolution of the Pamir plateau recorded in surrounding basins, implications on Asian climate, land-sea distribution and biotic crises

    NASA Astrophysics Data System (ADS)

    Dupont Nivet, G.; Yang, W.; Blayney, T.; Bougeois, L.; Manceau, C.; Najman, Y.; Proust, J. N.; Guo, Z.; Grothe, A.; Mandic, O.; Fioroni, C.

    2014-12-01

    The Cenozoic Pamir orogen formed in response to the India-Asia collision. Existing datasets shows that the range grew since ca. 25 Ma, however the early Cenozoic history remains unconstrained. In that period, global climate changed from greenhouse to icehouse, the proto-Paratethys sea retreated out of Asia and continental aridification as well as monsoons established over Asia. These environmental changes are held responsible for major floral and faunal crises. However, the causal relationships between these events remains to be established because of the lack of accurate age constraints on their geological records. Here, we provide well-dated stratigraphic records using magneto- and bio-stratigraphy from the basins surrounding the Pamir. Southeast of the Pamir, along the Kunlun Shan into the southwestern Tarim Basin, Eocene marine deposits are continuously overlain by 41 to 15 Ma continental redbeds themselves overlain by conglomerates in a classic foreland sequence with upward increasing grain-size, accumulation rates and provenance proximity. However, North of the Pamir along the southwestern Tian Shan and West of the Pamir into the Afghan-Tadjik Basin, the entire Oligocene period appears to be missing from the record between the last marine and the first continental sediments dated to the Early Miocene. This supports a simple model in response to initial Eocene Pamir indentation with foreland basin activation in the Southeast related to the Kunlun Shan northward thrusting, followed much later by early Miocene activation of the northern foreland basin related to the southwestern Tian Shan overthrusting. The coeval activation of a lithospheric right-lateral strike-slip system along the Pamir/Tarim boundary may have enabled to transfer deformation from the India-Asia collision to the Tian Shan and possibly the Talas Fergana fault. This simple model suggests the following two-stage paleoenvironmental evolution: (1) Late Eocene sea retreat linked to the onset of

  17. Acute pancreatitis: The stress factor

    PubMed Central

    Binker, Marcelo G; Cosen-Binker, Laura I

    2014-01-01

    Acute pancreatitis is an inflammatory disorder of the pancreas that may cause life-threatening complications. Etiologies of pancreatitis vary, with gallstones accounting for the majority of all cases, followed by alcohol. Other causes of pancreatitis include trauma, ischemia, mechanical obstruction, infections, autoimmune, hereditary, and drugs. The main events occurring in the pancreatic acinar cell that initiate and propagate acute pancreatitis include inhibition of secretion, intracellular activation of proteases, and generation of inflammatory mediators. Small cytokines known as chemokines are released from damaged pancreatic cells and attract inflammatory cells, whose systemic action ultimately determined the severity of the disease. Indeed, severe forms of pancreatitis may result in systemic inflammatory response syndrome and multiorgan dysfunction syndrome, characterized by a progressive physiologic failure of several interdependent organ systems. Stress occurs when homeostasis is threatened, and stressors can include physical or mental forces, or combinations of both. Depending on the timing and duration, stress can result in beneficial or harmful consequences. While it is well established that a previous acute-short-term stress decreases the severity of experimentally-induced pancreatitis, the worsening effects of chronic stress on the exocrine pancreas have received relatively little attention. This review will focus on the influence of both prior acute-short-term and chronic stress in acute pancreatitis. PMID:24914340

  18. Acute liver failure due to acute fatty liver of pregnancy.

    PubMed

    Wand, S; Waeschle, R M; Von Ahsen, N; Hawighorst, T; Bräuer, A; Quintel, M

    2012-04-01

    Acute fatty liver of pregnancy (AFLP) is a rare but serious liver disease and typically occurs during the third trimester. It carries the risk for significant perinatal and maternal mortality. Therefore an early diagnosis and delivery, followed by close monitoring and optimized management of the impaired liver function with all associated problems are necessary to prevent maternal and foetal death. This case report focuses on the management of acute liver failure due to AFLP in a 31 year old women treated in our intensive care unit (ICU) after an emergency C-section.

  19. Triangulating Information from Recurrent Crises

    ERIC Educational Resources Information Center

    Verte, Lotte; De Moor, Gerrit

    2013-01-01

    Life Space Crisis Intervention (LSCI) is a therapeutic, verbal strategy for intervention with students in crisis. It explores a student's reactions to stressful events to gain insight into thinking, feelings, and behavior in order to strengthen resilience and self-esteem (Long, Wood, & Fecser, 2001). By exploring timelines of challenging…

  20. Psychosocial Crises of Older Men.

    ERIC Educational Resources Information Center

    Solomon, Kenneth

    Retirement is a major issue facing the older American man. Not only must he give up his work, a source of identity and self-esteem, the retiree must also face new relationships with his spouse, children, and peers; and he must learn to use leisure time appropriately. Widowerhood is a second major issue. Aside from deep emotional loss, the widower…

  1. Teacher Socialization through Career Crises.

    ERIC Educational Resources Information Center

    Gehrke, Nathalie J.; Taylor, Helen K.

    This study examined the nature of teacher layoffs and their effects on the role enactment and coping strategies of teachers. Fourteen high school teachers, who were employed in a large urban school district plagued by declining enrollment, were interviewed. Each teacher had been "riffed" (reduction in force) and recalled at least once in the…

  2. A Tale of Two Crises.

    ERIC Educational Resources Information Center

    Frymier, Jack

    1990-01-01

    According to these scenarios, the heart attack victim has a better chance of surviving than the child facing grade retention. Despite parental objections and research studies showing that children held back are three time as likely to drop out of school than children who are promoted, the antiquated practice of grade repetition continues. (MLH)

  3. Responding to School Health Crises

    ERIC Educational Resources Information Center

    Gomes, Patricia; Smith, Mary

    2007-01-01

    Today's school administrators face an increasing array of duties. Potentially one of the most serious responsibilities is student health services. It is estimated that 20% to 30% of all school-aged children in the U.S. have a health condition that may require monitoring. A survey of 60 new teachers in a medium-sized school district in California…

  4. Hyperdopaminergic crises in familial dysautonomia

    PubMed Central

    Norcliffe-Kaufmann, Lucy; Martinez, Jose; Axelrod, Felicia

    2013-01-01

    Objective: The purpose of this study was to determine whether carbidopa (Lodosyn), an inhibitor of dopa-decarboxylase that blocks the synthesis of dopamine outside the brain, is an effective antiemetic in patients with familial dysautonomia (FD) and hyperdopaminergic nausea/retching/vomiting attacks. Methods: We enrolled 12 patients with FD in an open-label titration and treatment study to assess the safety of carbidopa. We then conducted a randomized, double-blind, placebo-controlled, crossover study to evaluate its antiemetic efficacy. Results: Previous fundoplication surgery in each patient studied prevented vomiting, but all of the subjects experienced severe cyclical nausea and uncontrollable retching that was refractory to standard treatments. Carbidopa at an average daily dose of 480 mg (range 325–600 mg/day) was well tolerated. In the double-blind phase, patients experienced significantly less nausea and retching while on carbidopa than on placebo (p < 0.03 and p < 0.02, respectively). Twenty-four-hour urinary dopamine excretion was significantly lower while on carbidopa (147 ± 32 µg/gCr) than while on placebo (222 ± 41µg/gCr, p < 0.05). Conclusions: Carbidopa is a safe and effective antiemetic in patients with FD, likely by reducing the formation of dopamine outside the brain. Classification of evidence: This study provides Class II evidence that carbidopa is effective in reducing nausea/retching/vomiting in patients with FD. PMID:23553478

  5. Acute Stroke Imaging Research Roadmap

    PubMed Central

    Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.; Hacke, Werner; Kidwell, Chelsea S.; Kloska, Stephan P.; Köhrmann, Martin; Koroshetz, Walter; Lee, Ting-Yim; Lees, Kennedy R.; Lev, Michael H.; Liebeskind, David S.; Ostergaard, Leif; Powers, William J.; Provenzale, James; Schellinger, Peter; Silbergleit, Robert; Sorensen, Alma Gregory; Wardlaw, Joanna; Wu, Ona; Warach, Steven

    2009-01-01

    The recent “Advanced Neuroimaging for Acute Stroke Treatment” meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Biomedical Imaging and Bioengineering (NIBIB), industry representatives, and members of the US Food and Drug Administration (FDA) to discuss the role of advanced neuroimaging in acute stroke treatment. The goals of the meeting were to assess state-of-the-art practice in terms of acute stroke imaging research and to propose specific recommendations regarding: (1) the standardization of perfusion and penumbral imaging techniques, (2) the validation of the accuracy and clinical utility of imaging markers of the ischemic penumbra, (3) the validation of imaging biomarkers relevant to clinical outcomes, and (4) the creation of a central repository to achieve these goals. The present article summarizes these recommendations and examines practical steps to achieve them. PMID:18477656

  6. Acute hepatitis after amiodarone infusion.

    PubMed

    Fonseca, Paulo; Dias, Adelaide; Gonçalves, Helena; Albuquerque, Aníbal; Gama, Vasco

    2015-10-16

    Acute hepatitis is a very rare, but potentially fatal, adverse effect of intravenous amiodarone. We present a case of an 88-year-old man with history of ischemic dilated cardiomyopathy and severely depressed left ventricular function that was admitted to our coronary care unit with diagnosis of decompensated heart failure and non-sustained ventricular tachycardia. A few hours after the beginning of intravenous amiodarone he developed an acute hepatitis. There was a completely recovery within the next days after amiodarone withdrawn and other causes of acute hepatitis have been ruled out. This case highlights the need for close monitoring of hepatic function during amiodarone infusion in order to identify any potential hepatotoxicity and prevent a fatal outcome. Oral amiodarone is, apparently, a safe option in these patients.

  7. Therapy for acute retinal necrosis.

    PubMed

    Kawaguchi, Tatsushi; Spencer, Doran B; Mochizuki, Manabu

    2008-01-01

    Acute retinal necrosis is a progressive necrotizing retinopathy caused by herpes simplex virus (HSV) or varicella zoster virus (VZV). The mainstay of its treatment is antiviral therapy against these pathogenic organisms, such as intravenous acyclovir or oral valacyclovir. Systemic and topical corticosteroids together with antiviral therapy are used as an anti-inflammatory treatment to minimize damages to the optic nerve and retinal blood vessels. Because the majority of severe cases of the disease show occlusive retinal vasculitis, a low dosage of aspirin is used as anti-thrombotic treatment. Vitreo-retinal surgery is useful to repair rhegmatogenous retinal detachment, one of the main late-stage complications. Moreover, recent articles have reported some encouraging results of prophylactic vitrectomy before rhegmatogenous retinal detachment occurs. The efficacy of laser photocoagulation to prevent the development or extension of rhegmatogenous retinal detachment is controversial. Despite these treatments, the visual prognosis of acute retinal necrosis is still poor, in particular VZV-induced acute retinal necrosis.

  8. Appendicular sarcoidosis mimicking acute appendicitis

    PubMed Central

    Hunjan, Tia; Chaudery, Muzzafer; Zaidi, Ahsan; Beggs, Andrew D

    2012-01-01

    Appendicular sarcoidosis is a very rare cause of acute abdominal pain, with only seven cases reported previously in the literature. A 45-year-old woman, known to have sarcoidosis, presented to the emergency department with a 1-week history of epigastric and right iliac fossa abdominal pain. At diagnostic laparoscopy, an acutely inflamed appendix was found and removed as well as an omental mass which was biopsied. Subsequent histopathological examination of the appendix demonstrated appendicular sarcoidosis without acute appendicitis and chronic inflammatory changes in the omental biopsy. The patients’ symptoms completely resolved postoperatively. It is important to undertake urgent operative intervention in patients with sarcoidosis who present with right iliac fossa pain, owing to the high risk of perforation. PMID:23162022

  9. Study of chronic hemolytic anaemia patients in Rio de Janeiro: prevalence of anti-human parvovirus B19 IgG antibodies and the development aplastic crises.

    PubMed

    Sant'Anna, Anadayr L M; Garcia, Rita de Cássia N Cubel; Marzoche, Mônica; da Rocha, Heloisa Helena A Gallo; Paula, Maria Tereza M; Lobo, Clarisse C; Nascimento, Jussara P

    2002-01-01

    The prevalence of anti-human parvovirus B19 IgG antibodies was determined in sera from 165 chronic hemolytic anemia patients, receiving medical care at Instituto Estadual de Hematologia (IEHE), Rio de Janeiro, during the year of 1994. This sample represents around 10% of the chronic hemolytic anemia patients attending at IEHE. Most of these patients (140) have sickle cell disease. Anti-B19 IgG antibodies were detected in 32.1% of patients. No statistically significant difference (p > 0.05) was seen between IgG antibody prevalence in male (27.8%) and female (35.5%) patients. Anti-B19 IgG antibodies were more frequent in older (37.6%) than younger (28.2%) than 20 years old patients, although this difference had no statistical significance (p > 0.05). Anti-B19 IgG antibody prevalence showed that 67.9% of patients enrolled in the study were susceptible to B19 acute infection. With the aim to detect acute B19 infection, patients follow up continued until February 1996. During this period four patients presented transient aplastic crisis due to human parvovirus B19 as confirmed by the detection of specific IgM antibodies. All four patients were younger than 20 years old, and 3 were younger than 10 years old. Three of them were sickle cell disease patients. Three of the four acute B19 infection occurred during 1994 springtime.

  10. [Microbiology in acute otitis media].

    PubMed

    Bingen, E

    1998-04-15

    Acute otitis media is the most common bacterial infection in the child under 5 years of age and the leading reason for antibiotic prescriptions in Western countries. The choice of optimal antibiotic treatment is based essentially on microbiologic epidemiologic studies. The bacteria most often responsible for otitis belong to the commensal flora of the nasopharynx. French studies using paracentesis show that the main bacteria responsible for acute otitis media are H. influenzae, S. pneumoniae and M. catarrhalis. The epidemiology of resistance to antibiotics has recently changed, with the appearance of pneumococcal strains having reduced sensitivity to penicillin, and which have played a major role in treatment failures.

  11. Sympathetic crashing acute pulmonary edema

    PubMed Central

    Agrawal, Naman; Kumar, Akshay; Aggarwal, Praveen; Jamshed, Nayer

    2016-01-01

    Sympathetic crashing acute pulmonary edema (SCAPE) is the extreme end of the spectrum of acute pulmonary edema. It is important to understand this disease as it is relatively common in the emergency department (ED) and has better outcomes when managed appropriately. The patients have an abrupt redistribution of fluid in the lungs, and when treated promptly and effectively, these patients will rapidly recover. Noninvasive ventilation and intravenous nitrates are the mainstay of treatment which should be started within minutes of the patient's arrival to the ED. Use of morphine and intravenous loop diuretics, although popular, has poor scientific evidence. PMID:28149030

  12. Sympathetic crashing acute pulmonary edema.

    PubMed

    Agrawal, Naman; Kumar, Akshay; Aggarwal, Praveen; Jamshed, Nayer

    2016-12-01

    Sympathetic crashing acute pulmonary edema (SCAPE) is the extreme end of the spectrum of acute pulmonary edema. It is important to understand this disease as it is relatively common in the emergency department (ED) and has better outcomes when managed appropriately. The patients have an abrupt redistribution of fluid in the lungs, and when treated promptly and effectively, these patients will rapidly recover. Noninvasive ventilation and intravenous nitrates are the mainstay of treatment which should be started within minutes of the patient's arrival to the ED. Use of morphine and intravenous loop diuretics, although popular, has poor scientific evidence.

  13. [Acute vertigo of neurological origin].

    PubMed

    Bruun, Marie; Højgaard, Joan L Sunnleyg; Kondziella, Daniel

    2013-11-04

    Acute vertigo of neurological origin may be caused by haemorrhages and tumours in the posterior fossa and, most frequently, by ischaemic infarction in the vertebrobasilar circulation. Urgent diagnosis is necessary to avoid further ischaemic episodes, herniation due to cerebellar oedema and/or fatal brainstem infarction. The history should focus on accompanying neurological symptoms. However, vertigo with cerebellar lesions may be monosymptomatic and then bedside evaluation of oculomotor function is the key to correct diagnosis. This paper discusses the pathophysiology, symptomatology and clinical evaluation of acute vertigo of neurological origin.

  14. [Intravascular lymphoma causing acute abdomen].

    PubMed

    Kröber, S M

    2007-02-01

    A 65-year old man presented with acute abdominal pain and fever. The initial diagnosis was small bowel gangrene. Pathology revealed small to large abdominal vessels obliterated by cells of intravascular B-cell-lymphoma (IVL). Visceral IVL involvement is common at autopsy but rarely reported in patients with acute abdomen. The subtype of diffuse large B-cell lymphoma is a rare and aggressive malignancy, which in typical cases is characterized by cephalic or cutaneous manifestation. Few cases showed involvement of large vessels which in combination to fibrin thrombi may lead to infarction of the organ involved. Thus IVL should be considered in cases of ischemic diseases with fever of unknown origin.

  15. Acute silicosis with bilateral pneumothorax.

    PubMed

    Srivastava, G N; Prasad, Rajniti; Meena, Manoj; Hussain, Moosa

    2014-05-26

    We present a case of acute silicosis with bilateral pneumothorax of a 28-year-old man working at a stone crusher factory for 1 year. He presented to the emergency department with cough, respiratory distress and diffuse chest pain. The patient was managed with bilateral intercostal tube drainage under water seal, oxygen inhalation and conservative therapy. On follow-up he showed improvement of resting dyspnoea and was doing well. This case is being reported because of the rare complications of acute silicosis as bilateral pneumothorax.

  16. Amoebiasis Presenting as Acute Appendicitis.

    PubMed

    Ichikawa, Hitoshi; Imai, Jin; Mizukami, Hajime; Uda, Shuji; Yamamoto, Soichiro; Nomura, Eiji; Tajiri, Takuma; Watanabe, Norihito; Makuuchi, Hiroyasu

    2016-12-20

    We report a case of amoebic appendicitis without colitis symptoms. Acute appendicitis is commonly encountered by gastroenterologists in their daily practice. The number of cases of amoebiasis increases annually in Japan, and is thought to be associated with an increase in sexually transmitted disease or travel to endemic areas. However, acute amoebic appendicitis is rare and the prognosis is very poor compared to nonamoebic appendicitis. In our case, appendectomy was performed immediately after onset, and the patient was discharged without complications. It is difficult to differentiate between amoebic and nonamoebic appendicitis preoperatively, and the possibility of amoebic appendicitis should be kept in mind.

  17. Acute oesophageal necrosis (black oesophagus).

    PubMed

    Galtés, Ignasi; Gallego, María Ángeles; Esgueva, Raquel; Martin-Fumadó, Carles

    2016-03-01

    A 54-year-old man was admitted to hospital after being found unconscious in his home. He had a history of alcoholism, multiple drug addictions, and type I diabetes mellitus. At admission, he had hyperglycaemia (550 mg/dL) with glucosuria and ketone bodies in the urine, along with septic shock refractory to bilateral alveolar infiltrates and severe respiratory failure. The patient died 24 hours post admission due to multiple organ failure, with diabetic ketoacidosis decompensated by possible respiratory infection in a patient with polytoxicomania. The autopsy confirmed the presence of acute bilateral bronchopneumonia, chronic pancreatitis, severe hepatic steatosis, and generalized congestive changes. At the oesophagus, acute oesophageal necrosis was evident.

  18. How Is Acute Myeloid Leukemia Diagnosed?

    MedlinePlus

    ... Detection, Diagnosis, and Types How Is Acute Myeloid Leukemia Diagnosed? Certain signs and symptoms might suggest that ... of samples used to test for acute myeloid leukemia If signs and symptoms and/or the results ...

  19. Acute Myeloid Leukemia (AML) (For Parents)

    MedlinePlus

    ... Your 1- to 2-Year-Old Acute Myeloid Leukemia (AML) KidsHealth > For Parents > Acute Myeloid Leukemia (AML) ... Treatment Coping en español Leucemia mieloide aguda About Leukemia Leukemia is a type of cancer that affects ...

  20. Acute kidney injury after pediatric cardiac surgery

    PubMed Central

    Singh, Sarvesh Pal

    2016-01-01

    Acute kidney injury is a common complication after pediatric cardiac surgery. The definition, staging, risk factors, biomarkers and management of acute kidney injury in children is detailed in the following review article. PMID:27052074

  1. Genetics Home Reference: acute promyelocytic leukemia

    MedlinePlus

    ... acute myeloid leukemia, a cancer of the blood-forming tissue ( bone marrow ). In normal bone marrow, hematopoietic ... 7186-203. Review. Citation on PubMed de Thé H, Chen Z. Acute promyelocytic leukaemia: novel insights into ...

  2. What Should You Ask Your Doctor about Acute Lymphocytic Leukemia?

    MedlinePlus

    ... Types What Should You Ask Your Doctor About Acute Lymphocytic Leukemia? It is important to have frank, honest discussions ... Your Doctor About Acute Lymphocytic Leukemia? More In Acute Lymphocytic Leukemia About Acute Lymphocytic Leukemia Causes, Risk Factors, and ...

  3. Optical diagnosis of acute scrotum in children

    NASA Astrophysics Data System (ADS)

    Shadgan, Babak; Macnab, Andrew; Stothers, Lynn; Nigro, Mark; Afshar, Kourosh; Kajbafzadeh, A. M.

    2015-03-01

    Acute scrotum is a urologic condition defined by scrotal pain, swelling, and redness of acute onset. Prompt diagnosis and treatment are necessary to preserve testicular viability. The history and clinical symptoms reported are key to diagnosis and proper treatment, but are not always readily obtained in children, in whom common causes of acute scrotum include testicular torsion, torsion of the appendix testis, and epididymitis. These acute conditions have different causal pathology that mandate specific treatment, hence the importance of early and accurate diagnosis.

  4. Obstructive Uropathy Secondary to Missed Acute Appendicitis

    PubMed Central

    2016-01-01

    Hydronephrosis is a rare complication of acute appendicitis. We present a case of missed appendicitis in a 52-year-old female which presented as a right-sided hydronephrosis. 2 days after admission to the Department of Urology CT revealed acute appendicitis for what open appendectomy was performed. Acute appendicitis can lead to obstructive uropathy by periappendiceal inflammation due to adjacency. Urologists, surgeons, and emergency physicians should be aware of this rare complication of atypical acute appendicitis. PMID:27818827

  5. Decitabine in Treating Patients With Previously Untreated Acute Myeloid Leukemia

    ClinicalTrials.gov

    2016-05-18

    Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Secondary Acute Myeloid Leukemia; Untreated Adult Acute Myeloid Leukemia

  6. Dirofilariasis Mimicking an Acute Scrotum.

    PubMed

    Bertozzi, Mirko; Rinaldi, Victoria Elisa; Prestipino, Marco; Giovenali, Paolo; Appignani, Antonino

    2015-10-01

    Human infections caused by Dirofilaria repens have been reported in many areas of the world. We describe a case of a 3-year-old child with an intrascrotal mass caused by D repens mimicking an acute scrotum. This represents the first case of scrotal dirofilariasis described in pediatric age with such an unusual presentation.

  7. Redox signaling in acute pancreatitis

    PubMed Central

    Pérez, Salvador; Pereda, Javier; Sabater, Luis; Sastre, Juan

    2015-01-01

    Acute pancreatitis is an inflammatory process of the pancreatic gland that eventually may lead to a severe systemic inflammatory response. A key event in pancreatic damage is the intracellular activation of NF-κB and zymogens, involving also calcium, cathepsins, pH disorders, autophagy, and cell death, particularly necrosis. This review focuses on the new role of redox signaling in acute pancreatitis. Oxidative stress and redox status are involved in the onset of acute pancreatitis and also in the development of the systemic inflammatory response, being glutathione depletion, xanthine oxidase activation, and thiol oxidation in proteins critical features of the disease in the pancreas. On the other hand, the release of extracellular hemoglobin into the circulation from the ascitic fluid in severe necrotizing pancreatitis enhances lipid peroxidation in plasma and the inflammatory infiltrate into the lung and up-regulates the HIF–VEGF pathway, contributing to the systemic inflammatory response. Therefore, redox signaling and oxidative stress contribute to the local and systemic inflammatory response during acute pancreatitis. PMID:25778551

  8. Redox signaling in acute pancreatitis.

    PubMed

    Pérez, Salvador; Pereda, Javier; Sabater, Luis; Sastre, Juan

    2015-08-01

    Acute pancreatitis is an inflammatory process of the pancreatic gland that eventually may lead to a severe systemic inflammatory response. A key event in pancreatic damage is the intracellular activation of NF-κB and zymogens, involving also calcium, cathepsins, pH disorders, autophagy, and cell death, particularly necrosis. This review focuses on the new role of redox signaling in acute pancreatitis. Oxidative stress and redox status are involved in the onset of acute pancreatitis and also in the development of the systemic inflammatory response, being glutathione depletion, xanthine oxidase activation, and thiol oxidation in proteins critical features of the disease in the pancreas. On the other hand, the release of extracellular hemoglobin into the circulation from the ascitic fluid in severe necrotizing pancreatitis enhances lipid peroxidation in plasma and the inflammatory infiltrate into the lung and up-regulates the HIF-VEGF pathway, contributing to the systemic inflammatory response. Therefore, redox signaling and oxidative stress contribute to the local and systemic inflammatory response during acute pancreatitis.

  9. The Acute Care Theater Conference.

    ERIC Educational Resources Information Center

    Horwitz, Rany J.; And Others

    1991-01-01

    The University of Illinois' medical school has a third-year program of weekly role-playing exercises focusing on management of acute medical problems. Students are responsible for creating the cases, complete with scenarios and treatment teams, simulating them, and successfully treating or reaching an impasse. Little teacher preparation time is…

  10. Acute calcium pyrophosphate deposition arthropathy.

    PubMed

    Rosen, Thomas; Furman, Janet

    2016-06-01

    Acute calcium pyrophosphate deposition (CPPD) arthropathy, also called pseudogout, is common, and becomes more prevalent as patients age. The presenting symptoms are similar to both gout and septic arthritis but may be treated differently. This article describes a typical patient presentation and management from an emergency medicine and orthopedic surgery standpoint.

  11. Acute Lymphoblastic Leukemia (ALL) (For Parents)

    MedlinePlus

    ... 1- to 2-Year-Old Acute Lymphoblastic Leukemia (ALL) KidsHealth > For Parents > Acute Lymphoblastic Leukemia (ALL) Print A A A What's in this article? ... child will develop acute lymphoblastic, or lymphoid, leukemia (ALL). This is the most common type of childhood ...

  12. Acute Lymphoblastic Leukemia (ALL) (For Parents)

    MedlinePlus

    ... 1- to 2-Year-Old Acute Lymphoblastic Leukemia (ALL) KidsHealth > For Parents > Acute Lymphoblastic Leukemia (ALL) A A A What's in this article? About ... child will develop acute lymphoblastic, or lymphoid, leukemia (ALL). This is the most common type of childhood ...

  13. Acute coronary care: Principles and practice

    SciTech Connect

    Califf, R.M.; Wagner, G.S.

    1985-01-01

    This book contains 58 chapters. Some of the chapter titles are: Radionuclide Techniques for Diagnosing and Sizing of Myocardial Infarction; The Use of Serial Radionuclide Angiography for Monitoring Function during Acute Myocardial Infarction; Hemodynamic Monitoring in Acute Myocardial Infarction; and The Valve of Radionuclide Angiography for Risk Assessment of Patients following Acute Myocardial Infarction.

  14. The treatment of acute vertigo.

    PubMed

    Cesarani, A; Alpini, D; Monti, B; Raponi, G

    2004-03-01

    Vertigo and dizziness are very common symptoms in the general population. The aim of this paper is to describe the physical and pharmacological treatment of symptoms characterized by sudden onset of rotatory vertigo. Acute vertigo can be subdivided into two main groups: (1) spontaneous vertigo and (2) provoked vertigo, usually by postural changes, generally called paroxysmal positional vertigo (PPV). Sudden onset of acute vertigo is usually due to acute spontaneous unilateral vestibular failure. It can be also fluctuant as, e.g., in recurrent attacks of Ménière's disease. Pharmacotherapy of acute spontaneous vertigo includes Levo-sulpiride i.v., 50 mg in 250 physiologic solution, once or twice a day, methoclopramide i.m., 10 mg once or twice a day, or triethilperazine rectally, once or twice a day, to reduce neurovegetative symptoms; diazepam i.m., 10 mg once or twice a day, to decrease internuclear inhibition, sulfate magnesium i.v., two ampoules in 500 cc physiological solution, twice a day, or piracetam i.v., one ampoule in 500 cc physiological solution, twice a day, to decrease vestibular damage. At the onset of the acute symptoms, patients must lie on their healthy side with the head and trunk raised 20 degrees. The room must be quiet but not darkened. If the patient is able to swallow without vomiting, it is important to reduce nystagmus and stabilize the visual field with gabapentine, per os, 300 mg twice or three times a day. The first step of the physical therapy of acute vertigo is vestibular electrical stimulation, that is to say, a superficial paravertebral electrical stimulation of neck muscles, aimed to reduce antigravitary failure and to increase proprioceptive cervical sensory substitution. PPV is a common complaint and represents one of the most common entities in peripheral vestibular pathology. While the clinical picture is well known and widely described, the etiopathogenesis of PPV is still a matter of debate. Despite the different

  15. Acute toxicity of ingested fluoride.

    PubMed

    Whitford, Gary Milton

    2011-01-01

    This chapter discusses the characteristics and treatment of acute fluoride toxicity as well as the most common sources of overexposure, the doses that cause acute toxicity, and factors that can influence the clinical outcome. Cases of serious systemic toxicity and fatalities due to acute exposures are now rare, but overexposures causing toxic signs and symptoms are not. The clinical course of systemic toxicity from ingested fluoride begins with gastric signs and symptoms, and can develop with alarming rapidity. Treatment involves minimizing absorption by administering a solution containing calcium, monitoring and managing plasma calcium and potassium concentrations, acid-base status, and supporting vital functions. Approximately 30,000 calls to US poison control centers concerning acute exposures in children are made each year, most of which involve temporary gastrointestinal effects, but others require medical treatment. The most common sources of acute overexposures today are dental products - particularly dentifrices because of their relatively high fluoride concentrations, pleasant flavors, and their presence in non-secure locations in most homes. For example, ingestion of only 1.8 ounces of a standard fluoridated dentifrice (900-1,100 mg/kg) by a 10-kg child delivers enough fluoride to reach the 'probably toxic dose' (5 mg/kg body weight). Factors that may influence the clinical course of an overexposure include the chemical compound (e.g. NaF, MFP, etc.), the age and acid-base status of the individual, and the elapsed time between exposure and the initiation of treatment. While fluoride has well-established beneficial dental effects and cases of serious toxicity are now rare, the potential for toxicity requires that fluoride-containing materials be handled and stored with the respect they deserve.

  16. Towards Prevention of Acute Syndromes

    PubMed Central

    Ahmed, A.; Thongprayoon, C.; Pickering, B.W.; Akhoundi, A.; Wilson, G.; Pieczkiewicz, D.; Herasevich, V.

    2014-01-01

    Summary Background Identifying patients at risk for acute respiratory distress syndrome (ARDS) before their admission to intensive care is crucial to prevention and treatment. The objective of this study is to determine the performance of an automated algorithm for identifying selected ARDS predisposing conditions at the time of hospital admission. Methods This secondary analysis of a prospective cohort study included 3,005 patients admitted to hospital between January 1 and December 31, 2010. The automated algorithm for five ARDS predisposing conditions (sepsis, pneumonia, aspiration, acute pancreatitis, and shock) was developed through a series of queries applied to institutional electronic medical record databases. The automated algorithm was derived and refined in a derivation cohort of 1,562 patients and subsequently validated in an independent cohort of 1,443 patients. The sensitivity, specificity, and positive and negative predictive values of an automated algorithm to identify ARDS risk factors were compared with another two independent data extraction strategies, including manual data extraction and ICD-9 code search. The reference standard was defined as the agreement between the ICD-9 code, automated and manual data extraction. Results Compared to the reference standard, the automated algorithm had higher sensitivity than manual data extraction for identifying a case of sepsis (95% vs. 56%), aspiration (63% vs. 42%), acute pancreatitis (100% vs. 70%), pneumonia (93% vs. 62%) and shock (77% vs. 41%) with similar specificity except for sepsis and pneumonia (90% vs. 98% for sepsis and 95% vs. 99% for pneumonia). The PPV for identifying these five acute conditions using the automated algorithm ranged from 65% for pneumonia to 91 % for acute pancreatitis, whereas the NPV for the automated algorithm ranged from 99% to 100%. Conclusion A rule-based electronic data extraction can reliably and accurately identify patients at risk of ARDS at the time of hospital

  17. Lenalidomide in Treating Older Patients With Acute Myeloid Leukemia

    ClinicalTrials.gov

    2014-07-25

    Adult Acute Basophilic Leukemia; Adult Acute Eosinophilic Leukemia; Adult Acute Megakaryoblastic Leukemia (M7); Adult Acute Minimally Differentiated Myeloid Leukemia (M0); Adult Acute Monoblastic Leukemia (M5a); Adult Acute Monocytic Leukemia (M5b); Adult Acute Myeloblastic Leukemia With Maturation (M2); Adult Acute Myeloblastic Leukemia Without Maturation (M1); Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Acute Myelomonocytic Leukemia (M4); Adult Erythroleukemia (M6a); Adult Pure Erythroid Leukemia (M6b); Secondary Acute Myeloid Leukemia; Untreated Adult Acute Myeloid Leukemia

  18. Anaphylaxis: acute treatment and management.

    PubMed

    Ring, Johannes; Grosber, Martine; Möhrenschlager, Matthias; Brockow, Knut

    2010-01-01

    Anaphylaxis is the maximal variant of an acute life-threatening immediate-type allergy. Due to its often dramatic onset and clinical course, practical knowledge in the management of these reactions is mandatory both for physicians and patients. It has to be distinguished between acute treatment modalities and general recommendations for management of patients who have suffered from an anaphylactic reaction. Acute treatment comprises general procedures like positioning, applying an intravenous catheter, call for help, comfort of the patient as well as the application of medication. The acute treatment modalities are selected depending upon the intensity of the clinical symptomatology as they are categorized in 'severity grades'. First of all it is important to diagnose anaphylaxis early and consider several differential diagnoses. This diagnosis is purely clinical and laboratory tests are of no help in the acute situation. Epinephrine is the essential antianaphylactic drug in the pharmacologic treatment. It should be first applied intramuscularly, only in very severe cases or under conditions of surgical interventions intravenous application can be tried. Furthermore, glucocorticosteroids are given in order to prevent protracted or biphasic courses of anaphylaxis; they are of little help in the acute treatment. Epinephrine autoinjectors can be used by the patient him/herself. Histamine H(1)-antagonists are valuable in mild anaphylactic reactions; they should be given intravenously if possible. The replacement of volume is crucial in antianaphylactic treatment. Crystalloids can be used in the beginning, in severe shock colloid volume substitutes have to be applied. Patients suffering from an anaphylactic episode should be observed over a period of 4-10 h according to the severity of the symptomatology. It is crucial to be aware or recognize risk patients as for example patients with severe uncontrolled asthma, or under beta-adrenergic blockade. When bronchial

  19. [Acute hemolytic crisis followed by fulminant hepatic failure with fatal outcome, as a first clinical manifestation of Wilson's disease].

    PubMed

    de Andrade Júnior, D R; Fujita Neto, F G; Vieira, G S; Tibério, I F; Warth, M P; Calich, I

    1994-01-01

    We describe in this work a clinical case of a female patient aged 21 years, bearer of Wilson's disease, a first clinical manifestation of the disease occurred as an acute hemolytic crisis followed by fulminant hepatic failure evolving to death after 26 days' internment. The definitive diagnosis was obtained only as a quantitative measurement of hepatic copper from the necropsy material. The search for Kayser-Fleischer ring was negative and the serum ceruloplasmin level was 9 mg/dl (15 to 60). No involvement of the central nervous system was noted from the pathologic analysis. The patient presented two Coombs negative hemolytic crises during the internment; the first on being admitted to hospital and the second after a transjugular hepatic biopsy carried out on the 16th day after internment. The last hemolytic crisis was accompanied by an increase of serum and urinary copper levels. On this occasion the patient evolved to a progressive hepatic failure with severe jaundice and hepatic encephalopathy. We are presenting the clinical-biochemical evolution of the patient and we shall discuss the existent hypotheses to the pathophysiology of this rare form for manifestation of the Wilson's disease as well the diagnostic difficulties.

  20. The HAWK Federation and the Development of Black Adolescent Males: Toward a Solution to the Crises of America's Young Black Men. Testimony before the Select Committee on Children, Youth and Families. Congressional Hearings on America's Young Black Men: Isolated and in Trouble (Washington, D.C., July 25, 1989).

    ERIC Educational Resources Information Center

    Nobles, Wade W.

    Sources of the crises faced by young black men lie not in the young men, but in society which portrays them as stereotypes. Social conditions are at the root of the following problems of black males: (1) lowered life expectancy; (2) risk of criminality; (3) poor economic conditions; (4) inadequate education; (5) drugs and gang violence; and (6)…

  1. [Loperamide for acute infectious diarrhoea].

    PubMed

    Douma, Joeri A J; Smulders, Yvo M

    2015-01-01

    Many physicians are resistant to the idea of prescribing loperamide for acute infectious traveller's diarrhoea and community-acquired diarrhoea because of the fear of possible adverse effects. Large randomized trials with loperamide, either alone or as an adjunct to antibiotic treatment, have in fact revealed positive rather than negative effects. International guidelines now often support the use of loperamide for the treatment of infectious diarrhoea without dysentery. There seems to be no reason to systematically avoid loperamide in patients with dysentery, but caution is advised. Loperamide can be used as monotherapy or as an adjunct to antibiotic treatment in immunocompetent adults with acute infectious traveller's diarrhoea or community-acquired diarrhoea without severe comorbidities. This can reduce both the frequency of diarrhoea and the time until the diarrhoea stops without the risk of severe complications.

  2. Fluid resuscitation in acute pancreatitis

    PubMed Central

    Aggarwal, Aakash; Manrai, Manish; Kochhar, Rakesh

    2014-01-01

    Acute pancreatitis remains a clinical challenge, despite an exponential increase in our knowledge of its complex pathophysiological changes. Early fluid therapy is the cornerstone of treatment and is universally recommended; however, there is a lack of consensus regarding the type, rate, amount and end points of fluid replacement. Further confusion is added with the newer studies reporting better results with controlled fluid therapy. This review focuses on the pathophysiology of fluid depletion in acute pancreatitis, as well as the rationale for fluid replacement, the type, optimal amount, rate of infusion and monitoring of such patients. The basic goal of fluid epletion should be to prevent or minimize the systemic response to inflammatory markers. For this review, various studies and reviews were critically evaluated, along with authors’ recommendations, for predicted severe or severe pancreatitis based on the available evidence. PMID:25561779

  3. Scintiscan for acute intrascrotal conditions.

    PubMed

    Dunn, E K; Macchia, R J; Chauhan, P S; Laungani, G B; Solomon, N A

    1986-06-01

    The efficacy and merit of testicular imaging, utilizing Tc-99m pertechnetate, were studied prospectively in a group of patients who presented with acute onset of scrotal pain. Consecutive admissions were studied. All were managed according to the likelihood of the problem being testicular torsion, which was determined from the clinical history, physical examination and the routine laboratory data. The final diagnostic outcome, whether by surgical exploration or clinical progress with conservative treatment, is collated with the preoperative scintigraphic interpretations, made with respect to predefined criteria. Analysis of the pretreatment images obtained in 57 patients shows that the radionuclide study is highly reliable in cases of testicular torsion and epididymo-orchitis. It appears to be much less dependable, however, in the other acute scrotal conditions. Torsions that are intermittent in nature or corrected manually apparently can have variable presentations. Certain difficulties and potential pitfalls encountered in interpreting the scintigraphic studies are discussed.

  4. Acute onset of postoperative syringohydromyelia

    PubMed Central

    Rao, K. Santosh Mohan; Balasubramaniam, Chidambaram; Subramaniam, K.

    2015-01-01

    Syringohydromyelia is a frequent finding in cases of tethered cord syndrome. The classical teaching is that the development and progression of a syrinx is a chronic process. We present a case report of an acute onset syringomyelia in an infant, who underwent an excision of a lumbosacral transitional lipoma and detethering of the cord. Immediately after recovery, the infant was found to have flaccid paraplegia. An emergency magnetic resonance imaging revealed a large acute onset syringomyelia for which he underwent an emergency midline myelotomy and release of fluid from the syrinx. Though the eventual recovery was good, this made us re-visit our understanding of the concept of syringohydromyelia. The case details and a plausible hypothesis for the rapid development of the syrinx are presented. PMID:26557165

  5. Acute Hemorrhagic Edema of Infancy.

    PubMed

    Serra E Moura Garcia, C; Sokolova, A; Torre, M L; Amaro, C

    2016-01-01

    Acute Hemorrhagic Edema of Infancy is a small vessel leucocytoclastic vasculitis affecting young infants. It is characterized by large, target-like, macular to purpuric plaques predominantly affecting the face, ear lobes and extremities. Non-pitting edema of the distal extremities and low-grade fever may also be present. Extra-cutaneous involvement is very rare. Although the lesions have a dramatic onset in a twenty-four to forty-eight hour period, usually the child has a non-toxic appearance. In most cases there are no changes in laboratory parameters. The cutaneous biopsy reveals an inflammatory perivascular infiltrate. It is a benign and auto-limited disease, with complete resolution within two to three weeks leaving no sequelae in the majority of cases. No recurrences are described. We report a case of a 42-day old girl admitted at our hospital with Acute Hemorrhagic Edema of Infancy.

  6. [Diabetes mellitus in acute pancreatitis].

    PubMed

    Díaz-Rubio, José Luis; Torre-Delgadillo, Aldo; Robles-Díaz, Guillermo

    2002-01-01

    Exocrine and endocrine components of pancreas are interrelated anatomically and functionally. Exocrine pancreatic dysfunction often accompanies endocrine pancreatic impairment and vice versa. Diabetes mellitus resulting from alterations of exocrine pancreas, such as acute or chronic pancreatitis, is known as pancreatic diabetes. Hyperglycemia during acute pancreatitis (AP) can be due to abnormalities in insulin secretion, increase in counterregulatory hormones release, or decrease in glucose utilization by peripheral tissues. Causal association is suggested between diabetic ketoacidosis and AP and is attributed to alternation in metabolism of triglycerides. High blood glucose levels are associated with severe AP and constitute factor of worst prognosis. Some patients are discharged with diabetes after AP episode, while others develop diabetes during first year of follow-up. Origin and frequency of glycemic abnormalities associated with AP have not been settled yet accurately. Also, predictive factors for diabetes development and persistence after AP have not been recognized to date.

  7. Tachyarrhythmias in acute myocardial infarction.

    PubMed

    McLean, K H; Bett, J N; Saltups, A

    1975-02-01

    In 1505 patients with acute myocardial infarction (MI) serious ventricular arrhythmias were commoner in those with transmural ECG changes, and were associated with an increase in mortality and in the incidence of left ventricular failure (LVF) as well as higher peak serum lactic dehydrogenase (LDH) levels. Atrial fibrillation (AF) occurred more often in older patients and in those with LVF and clinical evidence of pericarditis.

  8. PROGRESS IN ACUTE MYELOID LEUKEMIA

    PubMed Central

    Kadia, Tapan M.; Ravandi, Farhad; O’Brien, Susan; Cortes, Jorge; Kantarjian, Hagop M.

    2014-01-01

    Significant progress has been made in the treatment of acute myeloid leukemia (AML). Steady gains in clinical research and a renaissance of genomics in leukemia have led to improved outcomes. The recognition of tremendous heterogeneity in AML has allowed individualized treatments of specific disease entities within the context of patient age, cytogenetics, and mutational analysis. The following is a comprehensive review of the current state of AML therapy and a roadmap of our approach to these distinct disease entities. PMID:25441110

  9. Acute hand injuries in athletes.

    PubMed

    Rosenbaum, Yoseph A; Awan, Hisham M

    2017-03-22

    Hand and wrist injuries in athletes are common, representing between 3 and 25% of all sports injuries. As many as a quarter of all sports injuries involve the hand or wrist. We review the recent literature regarding acute hand injuries in athletes based on the structures involved - bone, muscle/tendon, ligament, and neurovascular - including diagnosis and pathophysiology of these injuries, focusing on athlete-specific facets of treatment, and when available, opinions on return to play.

  10. Tipifarnib in Treating Older Patients With Acute Myeloid Leukemia

    ClinicalTrials.gov

    2015-03-19

    Adult Acute Megakaryoblastic Leukemia; Adult Acute Monoblastic Leukemia; Adult Acute Monocytic Leukemia; Adult Acute Myeloid Leukemia With Inv(16)(p13.1q22); CBFB-MYH11; Adult Acute Myeloid Leukemia With Maturation; Adult Acute Myeloid Leukemia With Minimal Differentiation; Adult Acute Myeloid Leukemia With t(16;16)(p13.1;q22); CBFB-MYH11; Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); RUNX1-RUNX1T1; Adult Acute Myeloid Leukemia With t(9;11)(p22;q23); MLLT3-MLL; Adult Acute Myeloid Leukemia Without Maturation; Adult Acute Myelomonocytic Leukemia; Adult Erythroleukemia; Adult Pure Erythroid Leukemia; Alkylating Agent-Related Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia; Untreated Adult Acute Myeloid Leukemia

  11. Imaging following acute knee trauma.

    PubMed

    Kijowski, R; Roemer, F; Englund, M; Tiderius, C J; Swärd, P; Frobell, R B

    2014-10-01

    Joint injury has been recognized as a potent risk factor for the onset of osteoarthritis. The vast majority of studies using imaging technology for longitudinal assessment of patients following joint injury have focused on the injured knee joint, specifically in patients with anterior cruciate ligament injury and meniscus tears where a high risk for rapid onset of post-traumatic osteoarthritis is well known. Although there are many imaging modalities under constant development, magnetic resonance (MR) imaging is the most important instrument for longitudinal monitoring after joint injury. MR imaging is sensitive for detecting early cartilage degeneration and can evaluate other joint structures including the menisci, bone marrow, tendons, and ligaments which can be sources of pain following acute injury. In this review, focusing on imaging following acute knee trauma, several studies were identified with promising short-term results of osseous and soft tissue changes after joint injury. However, studies connecting these promising short-term results to the development of osteoarthritis were limited which is likely due to the long follow-up periods needed to document the radiographic and clinical onset of the disease. Thus, it is recommended that additional high quality longitudinal studies with extended follow-up periods be performed to further investigate the long-term consequences of the early osseous and soft tissue changes identified on MR imaging after acute knee trauma.

  12. Therapeutic interventions in acute stroke.

    PubMed Central

    Lees, K R

    1992-01-01

    1. Potential therapies for ischaemic stroke include agents to reduce oedema, to improve cerebral perfusion, to reduce excitotoxic damage, to minimise free-radical induced injury and to reduce complications such as deep venous thrombosis. 2. Of the anti-oedema drugs, steroids are ineffective and possibly dangerous; intravenous glycerol is unproven. 3. Haemodilution to reduce whole blood viscosity and improve perfusion is ineffective. Thrombolytic drugs have not been adequately tested but several randomised multicentre trials are now commencing. Early treatment and CT scanning are essential. 4. Anticoagulants and antiplatelet drugs may have wide applicability but have not been tested in the acute phase of stroke. A multi-centre trial will address this issue. 5. Neuronal cytoprotection offers exciting prospects for acute stroke treatment. Antagonists of glutamate at the NMDA receptor, calcium and sodium channel blocking agents and free radical scavenging drugs have potent effects experimentally. Several agents are now reaching clinical trials. The calcium antagonist nimodipine has been disappointing in large scale trials but some studies were flawed by late treatment. 6. Successful treatment of acute stroke is likely to combine several approaches. 7. Therapeutic trials in stroke must include CT scanning, early treatment and a multicentre approach to achieve large numbers of patients. PMID:1493080

  13. Is acute appendicitis still misdiagnosed?

    PubMed Central

    Danys, Donatas; Poskus, Tomas; Mikalauskas, Saulius; Poskus, Eligijus; Jotautas, Valdemaras; Beisa, Virgilijus; Strupas, Kestutis

    2016-01-01

    Abstract Objective The optimal diagnostics and treatment of acute appendicitis continues to be a challenge. A false positive diagnosis of appendicitis may lead to an unnecessary operation, which has been appropriately termed negative appendectomy. The aim of our study was to identify the effectiveness of preoperative investigations in preventing negative appendectomy. Methods A retrospective study was performed on adult patients who underwent operation for suspected acute appendicitis from 2008 to 2013 at Vilnius University Hospital Santariskiu Klinikos. Patients were divided into two groups: group A underwent an operation, where appendix was found to be normal (non-inflamed); group B underwent an appendectomy for inflamed appendix. Groups were compared for preoperative data, investigations, treatment results and pathology findings. Results 554 patients were included in the study. Preoperative laboratory tests results of hemoglobin, hematocrit concentrations and white blood cell count were significantly higher in group B (p<0.001). Ultrasonography was performed for 78 % of patients in group A and 74 % in group B and did not provide any statistically significant results. Comparing Alvarado score results, there were more patients with Alvarado score less than 7 in group A than in group B. In our large series we could find only four independent risk factors, and they could only account for 24 % of cases. Conclusions In summary, acute appendicitis is still often misdiagnosed and the ratio of negative appendectomies remains rather high. Additional investigations such as observation and computed tomography should be used to prevent this.

  14. Risk-Based Classification System of Patients With Newly Diagnosed Acute Lymphoblastic Leukemia

    ClinicalTrials.gov

    2017-02-13

    Adult B Acute Lymphoblastic Leukemia; Adult T Acute Lymphoblastic Leukemia; Childhood B Acute Lymphoblastic Leukemia; Childhood T Acute Lymphoblastic Leukemia; Untreated Adult Acute Lymphoblastic Leukemia; Untreated Childhood Acute Lymphoblastic Leukemia

  15. A rare disease in the differential diagnosis of acute pancreatitis: acute brucellosis.

    PubMed

    Berber, Ilhami; Erkurt, Mehmet Ali; Yetkin, Funda; Unlu, Serkan; Yilmaz, Sami; Bentli, Recep; Bazna, Sezai

    2014-01-01

    Some infectious organisms may give rise to acute pancreatitis; brucellosis, however, extremely rarely leads to acute pancreatitis. A 40-year-old man was diagnosed with acute pancreatitis, the etiology of which was determined to be acute brucellosis. The patient was discharged without complications approximately 15 days after the initiation of trimethoprim-sulfamethoxazole and doxycycline treatment. Brucella infections may rarely be complicated by acute pancreatitis. Thus, brucellosis should be remembered in the etiology of acute pancreatitis in regions such as Turkey, where Brucella infections are endemic.

  16. Glutaric acid moderately compromises energy metabolism in rat brain.

    PubMed

    da C Ferreira, Gustavo; Viegas, Carolina M; Schuck, Patrícia F; Latini, Alexandra; Dutra-Filho, Carlos S; Wyse, Angela T S; Wannmacher, Clóvis M D; Vargas, Carmen R; Wajner, Moacir

    2005-12-01

    Glutaric acidemia type I is an inherited metabolic disorder biochemically characterized by tissue accumulation of predominantly glutaric acid (GA). Affected patients present frontotemporal hypotrophy, as well as caudate and putamen injury following acute encephalopathic crises. Considering that the underlying mechanisms of basal ganglia damage in this disorder are poorly known, in the present study we tested the effects of glutaric acid (0.2-5mM) on critical enzyme activities of energy metabolism, namely the respiratory chain complexes I-IV, succinate dehydrogenase and creatine kinase in midbrain of developing rats. Glutaric acid significantly inhibited creatine kinase activity (up to 26%) even at the lowest dose used in the assays (0.2mM). We also observed that CK inhibition was prevented by pre-incubation of the homogenates with reduced glutathione, suggesting that the inhibitory effect of GA was possibly mediated by oxidation of essential thiol groups of the enzyme. In addition, the activities of the respiratory chain complex I-III and of succinate dehydrogenase were also significantly inhibited by 20 and 30%, respectively, at the highest glutaric acid concentration tested (5mM). In contrast, complexes II-III and IV activities of the electron transport chain were not affected by the acid. The effect of glutaric acid on the rate of oxygen consumption in intact mitochondria from the rat cerebrum was also investigated. Glutaric acid (1mM) significantly lowered the respiratory control ratio (state III/state IV) up to 40% in the presence of the respiratory substrates glutamate/malate or succinate. Moreover, state IV respiration linked to NAD and FAD substrates was significantly increased in GA-treated mitochondria while state III was significantly diminished. The results indicate that the major metabolite accumulating in glutaric acidemia type I moderately compromises brain energy metabolism in vitro.

  17. Biomarkers in Bone Marrow Samples From Pediatric Patients With High-Risk Acute Myeloid Leukemia

    ClinicalTrials.gov

    2016-05-17

    Childhood Acute Basophilic Leukemia; Childhood Acute Eosinophilic Leukemia; Childhood Acute Erythroleukemia (M6); Childhood Acute Megakaryocytic Leukemia (M7); Childhood Acute Minimally Differentiated Myeloid Leukemia (M0); Childhood Acute Monoblastic Leukemia (M5a); Childhood Acute Monocytic Leukemia (M5b); Childhood Acute Myeloblastic Leukemia With Maturation (M2); Childhood Acute Myeloblastic Leukemia Without Maturation (M1); Childhood Acute Myelomonocytic Leukemia (M4); Recurrent Childhood Acute Myeloid Leukemia; Untreated Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies

  18. [Three sporadic cases of acute hepatitis E].

    PubMed

    Kim, Dong Han; Park, Hyeuk; Moon, Seung Won; Jeong, Jong Hyuk; Yang, Hyuk Seung; Kim, Do Hyun; Kim, Ho Dong

    2007-08-01

    Acute hepatitis E is an endemic disease, commonly reported in Indian subcontinent, China, Africa, Central America, and so forth. It is a self-limiting disease like other acute hepatitis except in pregnant patient. Although sporadic hepatitis E is noted all over the world, most of them are associated with travel history to HEV-endemic area. In Korea, Hepatitis E is rarely reported. Moreover, sporadic acute hepatitis E without travel history to HEV-endemic area is very rare. We experienced three sporadic cases of acute hepatitis E, without travel history. All of them presented acute hepatitis symptoms, elevated aminotransferase, and positive IgM HEV Ab. Symptoms and aminotransferase levels were normalized during hospitalization and IgM HEV Ab converted negative after 4-8 months. We report three sporadic cases of onset-acute hepatitis E without travel history to HEV-endemic area.

  19. Acute pancreatitis as a model of SIRS.

    PubMed

    Bhatia, Madhav

    2009-01-01

    Acute pancreatitis is a common clinical condition. Excessive systemic inflammatory response syndrome (SIRS) in acute pancreatitis leads to distant organ damage and multiple organ dysfunction syndrome (MODS), which is the primary cause of morbidity and mortality in this condition. Development of in vivo experimental models of acute pancreatitis and associated systemic organ damage has enabled us to study the role played by inflammatory mediators in the pathogenesis of acute pancreatitis and associated systemic organ damage. Using these models, recent studies by us and other investigators have established the critical role played by inflammatory mediators such as TNF-a, IL-1b, IL-6, PAF, IL-10, CD40L, C5a, ICAM-1, chemokines, substance P and hydrogen sulfide in acute pancreatitis and the resultant MODS. This chapter intends to present an overview of different experimental animal models of acute pancreatitis and associated MODS and the role of inflammatory mediators in the pathogenesis of this condition.

  20. Acute Exacerbations of Idiopathic Pulmonary Fibrosis

    PubMed Central

    Collard, Harold R.; Moore, Bethany B.; Flaherty, Kevin R.; Brown, Kevin K.; Kaner, Robert J.; King, Talmadge E.; Lasky, Joseph A.; Loyd, James E.; Noth, Imre; Olman, Mitchell A.; Raghu, Ganesh; Roman, Jesse; Ryu, Jay H.; Zisman, David A.; Hunninghake, Gary W.; Colby, Thomas V.; Egan, Jim J.; Hansell, David M.; Johkoh, Takeshi; Kaminski, Naftali; Kim, Dong Soon; Kondoh, Yasuhiro; Lynch, David A.; Müller-Quernheim, Joachim; Myers, Jeffrey L.; Nicholson, Andrew G.; Selman, Moisés; Toews, Galen B.; Wells, Athol U.; Martinez, Fernando J.

    2007-01-01

    The natural history of idiopathic pulmonary fibrosis (IPF) has been characterized as a steady, predictable decline in lung function over time. Recent evidence suggests that some patients may experience a more precipitous course, with periods of relative stability followed by acute deteriorations in respiratory status. Many of these acute deteriorations are of unknown etiology and have been termed acute exacerbations of IPF. This perspective is the result of an international effort to summarize the current state of knowledge regarding acute exacerbations of IPF. Acute exacerbations of IPF are defined as acute, clinically significant deteriorations of unidentifiable cause in patients with underlying IPF. Proposed diagnostic criteria include subjective worsening over 30 days or less, new bilateral radiographic opacities, and the absence of infection or another identifiable etiology. The potential pathobiological roles of infection, disordered cell biology, coagulation, and genetics are discussed, and future research directions are proposed. PMID:17585107

  1. 8-Chloro-Adenosine in Treating Patients With Relapsed or Refractory Acute Myeloid Leukemia

    ClinicalTrials.gov

    2016-11-08

    Recurrent Adult Acute Myeloid Leukemia; Relapsed Adult Acute Myeloid Leukemia; Acute Myeloid Leukemia Arising From Previous Myelodysplastic Syndrome; Acute Myeloid Leukemia Arising From Previous Myeloproliferative Disorder

  2. Stenting in Acute Lower Limb Arterial Occlusions

    SciTech Connect

    Raja, Jowad; Munneke, Graham; Morgan, Robert; Belli, Anna-Maria

    2008-07-15

    Management of critical limb ischemia of acute onset includes surgical embolectomy, bypass grafting, aspiration thrombectomy, thrombolysis, and mechanical thrombectomy followed by treatment of the underlying cause. We present our experience with the use of stents to treat acute embolic/thrombotic occlusions in one iliac and three femoropopliteal arteries. Although this is a small case series, excellent immediate and midterm results suggest that stenting of acute occlusions of the iliac, superficial femoral, and popliteal arteries is a safe and effective treatment option.

  3. Acute suppurative thyroiditis caused by Eikenella corrodens.

    PubMed

    Queen, J S; Clegg, H W; Council, J C; Morton, D

    1988-04-01

    Eikenella corrodens is a slow-growing facultative anaerobe present in the normal oral flora. Two children have been described with acute suppurative thyroiditis with E corrodens as the major pathogen. Staphylococci are the most frequently identified pathogens in acute suppurative thyroiditis. Penicillin or ampicillin are the drugs of choice for infections caused by E corrodens. Anatomic defects should be searched for in children with acute suppurative thyroiditis.

  4. [Surgical tactics in acute epididymitis in children].

    PubMed

    Pavlov, A Iu; Nechaeva, T N; Shchedrov, D N

    2010-01-01

    Differentiated surgical policy was applied in the treatment of 147 children aged under 18 years with acute epididymitis. Basing on laboratory, clinical and ultrasound characteristics, three treatment methods were used: conservative treatment, puncture of the scrotum, revision of the scrotum. Puncture treatment of acute epididymitis appeared effective in accurate diagnosis of indications for this therapy and due performance. Ultrasound potential is shown in differential diagnosis in acute scrotum syndrome.

  5. Scrub typhus presenting as an acute abdomen.

    PubMed

    Kundavaram, Abhilash Pp; Das, Sohini; George, Varghese M

    2014-01-01

    Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi, which presents as an acute febrile illness with headache, myalgia, breathlessness, and an eschar, a pathognomonic sign, in a varying proportion of patients. However, this illness can present unusually with fever and severe abdominal pain mimicking acute abdomen. A careful search for an eschar in all patients with an acute febrile illness would provide a valuable diagnostic clue and avoid unnecessary investigations and surgical exploration.

  6. Acute epididymitis: a work-related injury?

    PubMed Central

    Sawyer, E. K.; Anderson, J. R.

    1996-01-01

    Occupational medicine physicians frequently are presented with requests by employers to determine the work-relatedness of medical illnesses or injuries. Occasionally, this involves a sudden onset of acute epididymitis in the male employee after strenuous activity in the workplace. Because the vast majority of acute epididymitis cases have an underlying sexually transmitted disease component, this poses a real dilemma for the consulting physician. This article discusses the etiology and pathogenesis of acute epididymitis along with its epidemiologic significance and reviews workers' compensation and its possible legal interpretation when acute epididymitis occurs at the worksite. PMID:8691501

  7. Acute Submandibular Sialadenitis—A Case Report

    PubMed Central

    Chandak, Rakhi; Degwekar, Shirish; Chandak, Manoj; Rawlani, Shivlal

    2012-01-01

    Many conditions affect the salivary glands. Acute sialadenitis is infectious or inflammatory disorders of the salivary glands. The exact frequency of submandibular sialadenitis is unclear. The acute conditions more typically involve the parotid and submandibular glands. During an acute inflammatory process, there is swelling of the affected gland, overlying pain, gland tenderness, fever, and on occasion difficulty in opening the mouth. Initial treatment should include rehydration oral antistaphylococcal antibiotic should be started while awaiting culture results. Hygiene and repeated massaging of the gland when tenderness had subsided. The present report describes a case of acute submandibular sialadenitis in a 70-year-old female. PMID:22888457

  8. Acute and subacute idiopathic interstitial pneumonias.

    PubMed

    Taniguchi, Hiroyuki; Kondoh, Yasuhiro

    2016-07-01

    Idiopathic interstitial pneumonias (IIPs) may have an acute or subacute presentation, or acute exacerbation may occur in a previously subclinical or unrecognized chronic IIP. Acute or subacute IIPs include acute interstitial pneumonia (AIP), cryptogenic organizing pneumonia (COP), nonspecific interstitial pneumonia (NSIP), acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) and AE-NSIP. Interstitial lung diseases (ILDs) including connective tissue disease (CTD) associated ILD, hypersensitivity pneumonitis, acute eosinophilic pneumonia, drug-induced lung disease and diffuse alveolar haemorrhage need to be differentiated from acute and subacute IIPs. Despite the severe lack of randomized controlled trials for the treatment of acute and subacute IIPs, the mainstream treatment remains corticosteroid therapy. Other potential therapies reported in the literature include corticosteroids and immunosuppression, antibiotics, anticoagulants, neutrophil elastase inhibitor, autoantibody-targeted treatment, antifibrotics and hemoperfusion therapy. With regard to mechanical ventilation, patients in recent studies with acute and subacute IIPs have shown better survival than those in previous studies. Therefore, a careful value-laden decision about the indications for endotracheal intubation should be made for each patient. Noninvasive ventilation may be beneficial to reduce ventilator associated pneumonia.

  9. Acute aortic dissection at two extreme ages.

    PubMed

    Ramzisham, A R M; Arief, H; Ngoo, K S; Zamrin, D M; Joanna, O S M

    2011-01-01

    Acute aortic dissection is a life-threatening condition, warranting prompt diagnosis and treatment. Management of which incorporates multidisciplinary expertise from the medical, surgical and intensive care. If left untreated, the mortality rate of acute aortic disease exceeds 50% within 48 hours and 80% within two weeks, with a 5-year survival rate of 19%. The most common cause of death in untreated acute aortic dissection, regardless of aetiology, is aortic rupture. We would like to share our successful experience of cases at the two extreme ages of acute aortic dissection. Literature review with their pathogenesis are discussed.

  10. Finasteride use and acute pancreatitis in Taiwan.

    PubMed

    Lai, Shih-Wei; Lai, Hsueh-Chou; Lin, Cheng-Li; Liao, Kuan-Fu

    2015-06-01

    The aim of this study was to examine whether there is an association between finasteride use and the risk of acute pancreatitis. This population-based case-control study used the database of the Taiwan National Health Insurance Program. There were 2,530 male subjects aged 40-84 years with a first-attack of acute pancreatitis during the period of 1998-2011 as the case group and 10,119 randomly selected subjects without acute pancreatitis as the control group. Both groups were matched by age and index year of diagnosing acute pancreatitis. Subjects who never had finasteride prescription were defined as "never use." Subjects who at least received 1 prescription for finasteride before the date of diagnosing acute pancreatitis were defined as "ever use." The association of acute pancreatitis with finasteride use was examined by the odds ratio (OR) and 95% confidence interval (CI) using the multivariable unconditional logistic regression model. The crude OR of acute pancreatitis was 1.78 (95%CI 1.33, 2.39) for subjects with ever use of finasteride, when compared with subjects with never use of finasteride. After adjusting for potential confounders, the adjusted OR of acute pancreatitis decreased to 1.25 (95%CI 0.90, 1.73) for subjects with ever use of finasteride, but no statistical significance was seen. No association can be detected between finasteride use and the risk of acute pancreatitis.

  11. Managing acute and chronic pancreatitis.

    PubMed

    Skipworth, James R A; Shankar, Arjun; Pereira, Stephen P

    2010-10-01

    Pancreatitis may be acute or chronic. Although both can be caused by similar aetiologies, they tend to follow distinct natural histories. Around 80% of acute pancreatitis (AP) diagnoses occur secondary to gallstone disease and alcohol misuse. AP is commonly associated with sudden onset of upper abdominal pain radiating to the back that is usually severe enough to warrant the patient seeking urgent medical attention. Onset of pain may be related to a recent alcohol binge or rich, fatty meal. The patient may appear unwell, be tachycardic and have exquisite tenderness in the upper abdomen. Overall, 10-25% of AP episodes are classified as severe, leading to an associated mortality rate of 7.5%. Disease severity is best predicted from a number of clinical scoring systems which can be applied at diagnosis in association with repeated clinical assessment, measurement of acute inflammatory markers, and CT. All patients with suspected AP should be referred urgently. Chronic pancreatitis (CP) follows continued, repetitive or sustained injury to the pancreas and 70% of diagnoses occur secondary to alcohol abuse. The characteristic presenting feature of CP is insidious progression of chronic, severe, upper abdominal pain, radiating to the back, caused by a combination of progressive pancreatic destruction, inflammation and duct obstruction. Signs and symptoms include weight loss and steatorrhoea and later on diabetes. CP patients may also present with recurrent episodes mimicking AP, both symptomatically and metabolically. Diagnosis of CP should be based on symptom profile, imaging and assessment of exocrine and endocrine pancreatic function. CT should be the first-line imaging investigation.

  12. Geriatric nursing in acute settings.

    PubMed

    Fulmer, T; Ashley, J; Reilly, C

    1986-01-01

    In conclusion, it is important to reiterate the interdependent nature of the functional health patterns as they relate to the geriatric patient in the acute care setting. Further, the combination of the primary nursing model with the functional health pattern approach that leads to subsequent nursing diagnoses provides a comprehensive care approach, which is so important for the elderly patient. As elders live longer, become frailer, and are subject to increasingly frequent hospitalizations, it will become more and more important to provide care in a manner that decreases fragmentation, increases individualization, and makes provisions for comprehensive and wholistic continuing care.

  13. Barometer. Acute trusts February 2005.

    PubMed

    2005-03-17

    Almost two thirds of acute trusts rate the quality of commissioning from their PCTs at three out of 10 or less, according to the latest HSJ Barometer survey. This is the lowest score since we began the survey a year ago. Confidence in their performance against the 98 per cent four-hour A&E target fell sharply from a December high to an average of 6.87. The survey also found that fewer than one in seven trusts were confident of winning foundation status by the end of 2006-07.

  14. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  15. Asparaginase in acute lymphoblastic leukemia.

    PubMed

    Kawedia, Jitesh D; Rytting, Michael E

    2014-09-01

    Cure rates in pediatric acute lymphoblastic leukemia have significantly improved over the past decades. Now, almost 90% of children will survive the disease. The cure rates in adolescents, young adults, and adults have not kept pace with the improvements in younger patients, even though almost an equal proportion of adult patients achieve complete remission as their pediatric counterparts. Differences in treatment regimens might be important. Intensive use of asparaginase has been a key component of successful pediatric therapy. In this review, we focus on the use of asparaginase and the potential of optimizing asparaginase use via monitoring to minimize adverse drug events and improve efficacy of the drug.

  16. Haemodilution for acute ischaemic stroke

    PubMed Central

    Chang, Timothy S; Jensen, Matthew B

    2014-01-01

    Background Ischaemic stroke interrupts the flow of blood to part of the brain. Haemodilution is thought to improve the flow of blood to the affected areas of the brain and thus reduce infarct size. Objectives To assess the effects of haemodilution in acute ischaemic stroke. Search methods We searched the Cochrane Stroke Group Trials Register (February 2014), the Cochrane Central Register of Controlled Trials (Issue 1, 2014), MEDLINE (January 2008 to October 2013) and EMBASE (January 2008 to October 2013). We also searched trials registers, scanned reference lists and contacted authors. For the previous version of the review, the authors contacted manufacturers and investigators in the field. Selection criteria Randomised trials of haemodilution treatment in people with acute ischaemic stroke. We included only trials in which treatment was started within 72 hours of stroke onset. Data collection and analysis Two review authors assessed trial quality and one review author extracted the data. Main results We included 21 trials involving 4174 participants. Nine trials used a combination of venesection and plasma volume expander. Twelve trials used plasma volume expander alone. The plasma volume expander was plasma alone in one trial, dextran 40 in 12 trials, hydroxyethyl starch (HES) in five trials and albumin in three trials. Two trials tested haemodilution in combination with another therapy. Evaluation was blinded in 14 trials. Five trials probably included some participants with intracerebral haemorrhage. Haemodilution did not significantly reduce deaths within the first four weeks (risk ratio (RR) 1.10; 95% confidence interval (CI) 0.90 to 1.34). Similarly, haemodilution did not influence deaths within three to six months (RR 1.05; 95% CI 0.93 to 1.20), or death and dependency or institutionalisation (RR 0.96; 95% CI 0.85 to 1.07). The results were similar in confounded and unconfounded trials, and in trials of isovolaemic and hypervolaemic haemodilution. No

  17. Acute megakaryoblastic leukemia (acute 'malignant' myelofibrosis): An unusual cause of osteosclerosis

    SciTech Connect

    Karasick, S.; Karasick, D.; Schilling, J.

    1982-11-01

    Acute megakaryoblastic leukemia or acute 'malignant' myelosclerosis is an acute and rapidly progressive myeloproliferative syndrome characterized by minimal or absent splenomegaly, pancytopenia, diffuse marrow fibrosis, and circulating blasts of megakaryocytic origin. The disease must be differentiated from other hematologic malignancies especially myelofibrosis with myeloid metaplasia. The radiographic changes of osteosclerosis in our patient have not been previously reported in the literature.

  18. High Throughput Drug Sensitivity Assay and Genomics- Guided Treatment of Patients With Relapsed or Refractory Acute Leukemia

    ClinicalTrials.gov

    2016-11-14

    Acute Leukemia of Ambiguous Lineage; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Refractory Adult Acute Lymphoblastic Leukemia; Refractory Childhood Acute Lymphoblastic Leukemia

  19. Bortezomib and Combination Chemotherapy in Treating Younger Patients With Recurrent, Refractory, or Secondary Acute Myeloid Leukemia

    ClinicalTrials.gov

    2014-05-13

    Adult Acute Monoblastic Leukemia (M5a); Adult Acute Monocytic Leukemia (M5b); Adult Acute Myeloblastic Leukemia With Maturation (M2); Adult Acute Myeloblastic Leukemia Without Maturation (M1); Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myelomonocytic Leukemia (M4); Childhood Acute Basophilic Leukemia; Childhood Acute Eosinophilic Leukemia; Childhood Acute Erythroleukemia (M6); Childhood Acute Megakaryocytic Leukemia (M7); Childhood Acute Minimally Differentiated Myeloid Leukemia (M0); Childhood Acute Monoblastic Leukemia (M5a); Childhood Acute Monocytic Leukemia (M5b); Childhood Acute Myeloblastic Leukemia With Maturation (M2); Childhood Acute Myeloblastic Leukemia Without Maturation (M1); Childhood Acute Myelomonocytic Leukemia (M4); Recurrent Adult Acute Myeloid Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia

  20. Idarubicin and Cytarabine With or Without Bevacizumab in Treating Patients With Newly Diagnosed Acute Myeloid Leukemia

    ClinicalTrials.gov

    2013-01-23

    Adult Acute Basophilic Leukemia; Adult Acute Eosinophilic Leukemia; Adult Acute Megakaryoblastic Leukemia (M7); Adult Acute Minimally Differentiated Myeloid Leukemia (M0); Adult Acute Monoblastic Leukemia (M5a); Adult Acute Monocytic Leukemia (M5b); Adult Acute Myeloblastic Leukemia With Maturation (M2); Adult Acute Myeloblastic Leukemia Without Maturation (M1); Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myelomonocytic Leukemia (M4); Adult Erythroleukemia (M6a); Adult Pure Erythroid Leukemia (M6b); Childhood Acute Basophilic Leukemia; Childhood Acute Eosinophilic Leukemia; Childhood Acute Erythroleukemia (M6); Childhood Acute Megakaryocytic Leukemia (M7); Childhood Acute Monoblastic Leukemia (M5a); Childhood Acute Monocytic Leukemia (M5b); Childhood Acute Myeloblastic Leukemia With Maturation (M2); Childhood Acute Myeloblastic Leukemia Without Maturation (M1); Childhood Acute Myelomonocytic Leukemia (M4); Secondary Acute Myeloid Leukemia; Untreated Adult Acute Myeloid Leukemia; Untreated Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies

  1. Homeland security planning: what victory gardens and Fidel Castro can teach us in preparing for food crises in the United States.

    PubMed

    Endres, A Bryan; Endres, Jody M

    2009-01-01

    Two historical examples provide important insight into how federal government policies can integrate regional and local food systems to achieve food security during a time of acute crisis. During World War II, American home gardeners, through the federal government's Victory Garden program, supplied 40 percent of the nation's fresh produce, while simultaneously maintaining pre-war commodity production policies favoring large agricultural interests. The recent food crisis in Cuba, precipitated by the collapse of Soviet-bloc trade in the early 1990s, is another historical example that could inform U.S. policymakers on how to achieve food self-sufficiency through reemphasis on small farmers using sustainable practices supplemented with urban gardening. This article aims to ignite government action to strengthen and integrate regional and local food systems into federal food security planning so that citizens can be best prepared for a food emergency. The article first examines laws, regulations and policies put in place during World War II that employed regional and local food networks to satisfy a significant amount of civilian food supply needs. The article also looks at more recent Cuban efforts to achieve forced food self-reliance when, after the end of the Cold War, Soviet subsidies and preferential trading of energy and food supplies ceased almost overnight.

  2. [Latest advances in acute pancreatitis].

    PubMed

    de-Madaria, Enrique

    2013-10-01

    The present article analyzes the main presentations on acute pancreatitis (AP) in Digestive Disease Week 2013. Perfusion computed tomography allows early diagnosis of pancreatic necrosis. Neutrophil gelatinase-associated lipocalin predicts the development of acute renal failure, severe AP and death. Factors associated with greater fluid sequestration in AP are alcoholic etiology, an elevated hematocrit, and the presence of criteria of systemic inflammatory response syndrome; fluid sequestration is associated with a worse outcome. True pseudocysts (fluid collections without necrosis for more than 4 weeks) are a highly infrequent complication in AP. Patients with necrotic collections have a poor prognosis, especially if associated with infection. A meta-analysis on fluid therapy suggests that early aggressive fluid administration is associated with higher mortality and more frequent respiratory complications. According to a meta-analysis, enteral nutrition initiated within 24 hours of admission improves the outcome of AP compared with later initiation of enteral nutrition. Pentoxifylline could be a promising alternative in AP; a double-blind randomized study showed that this drug reduced the length of hospital and intensive care unit stay, as well as the need for intensive care unit admission. The association of octreotide and celecoxib seems to reduce the frequency of organ damage compared with octreotide alone. Mild AP can be managed in the ambulatory setting through hospital-at-home units after a short, 24-hour admission.

  3. [Acute asthmatic crisis in children].

    PubMed

    Dubus, J C; Bodiou, A C; Buttin, C; Jouglet, T; Stremler, N; Mély, L

    2000-03-01

    Acute asthma attack in children is an attack responsible for life-threatening acute respiratory distress with partial or no response to bronchodilator drugs. The severity of the episode needs to be quickly evaluated. This presupposes a perfect knowledge of the clinical signs of severity. Treatment is urgent and first based on the administration of high doses of inhaled short-acting beta 2-agonists. In the more obstructed children, anti-cholinergic drugs can be added to nebulized beta 2-agonists. Because of their delayed effect, systemic steroids require an early prescription. Symptomatic treatments are: urgent hospitalization, oxygen if needed, proper hydratation. Continuous nebulization or intravenous perfusion of beta 2-agonists are prescribed with cardiac monitoring when no objective improvement is noted. Admission into the pediatric intensive care unit when bronchial obstruction continues will permit the association of bronchodilator drugs and the proposal of mechanical ventilation if needed. When the episode is resolved, a prophylactic treatment using inhaled corticosteroids must be prescribed. Clinical and spirometric follow-up has to be organized, and the patient and his/her family have to be educated.

  4. Acute and chronic arsenic toxicity

    PubMed Central

    Ratnaike, R

    2003-01-01

    Arsenic toxicity is a global health problem affecting many millions of people. Contamination is caused by arsenic from natural geological sources leaching into aquifers, contaminating drinking water and may also occur from mining and other industrial processes. Arsenic is present as a contaminant in many traditional remedies. Arsenic trioxide is now used to treat acute promyelocytic leukaemia. Absorption occurs predominantly from ingestion from the small intestine, though minimal absorption occurs from skin contact and inhalation. Arsenic exerts its toxicity by inactivating up to 200 enzymes, especially those involved in cellular energy pathways and DNA synthesis and repair. Acute arsenic poisoning is associated initially with nausea, vomiting, abdominal pain, and severe diarrhoea. Encephalopathy and peripheral neuropathy are reported. Chronic arsenic toxicity results in multisystem disease. Arsenic is a well documented human carcinogen affecting numerous organs. There are no evidence based treatment regimens to treat chronic arsenic poisoning but antioxidants have been advocated, though benefit is not proven. The focus of management is to reduce arsenic ingestion from drinking water and there is increasing emphasis on using alternative supplies of water. PMID:12897217

  5. [Acute quadriplegia after diabetic ketoacidosis].

    PubMed

    Mihalik, Zoltán; Arányi, Zsuzsanna; Siska, Eva; Nyulasi, Tibor; Pénzes, István

    2003-11-02

    A 36-year-old female was admitted to the intensive care unit after resuscitation diagnosed with diabetic ketoacidotic coma, which was the first manifestation of her diabetes mellitus. It may have been provoked by pulmonary or gastrointestinal coinfection. Five days following admission the patient regained consciousness and homeostasis returned to normal. One week after the stabilization of her cardiopulmonary state, weaning from the respirator turned out to be unsuccessful: flaccid tetraparesis developed with rapid muscle atrophy and absence of deep tendon reflexes. The sensory system and cranial nerves remained intact. Electrophysiological studies and muscle biopsy showed serious acute illness myopathy with mild demyelination owing probably to the latent diabetes. The course of acute quadriplegia was fluctuating and correlated mainly with the activity of the systemic inflammatory response syndrome mechanisms. Myopathy might have been aggravated by using high-dose glucocorticoid therapy. The patient's general condition improved quickly as a result of full recovery from sepsis, discontinuation of glucocorticoids and normoglicaemia maintained by subcutan insulin substitution. Eight months after admission almost full neuromuscular restitution was achieved showing the reversibility of this grave illness.

  6. Acute pain management in children

    PubMed Central

    Verghese, Susan T; Hannallah, Raafat S

    2010-01-01

    The greatest advance in pediatric pain medicine is the recognition that untreated pain is a significant cause of morbidity and even mortality after surgical trauma. Accurate assessment of pain in different age groups and the effective treatment of postoperative pain is constantly being refined; with newer drugs being used alone or in combination with other drugs continues to be explored. Several advances in developmental neurobiology and pharmacology, knowledge of new analgesics and newer applications of old analgesics in the last two decades have helped the pediatric anesthesiologist in managing pain in children more efficiently. The latter include administering opioids via the skin and nasal mucosa and their addition into the neuraxial local anesthetics. Systemic opioids, nonsteroidal anti-inflammatory agents and regional analgesics alone or combined with additives are currently used to provide effective postoperative analgesia. These modalities are best utilized when combined as a multimodal approach to treat acute pain in the perioperative setting. The development of receptor specific drugs that can produce pain relief without the untoward side effects of respiratory depression will hasten the recovery and discharge of children after surgery. This review focuses on the overview of acute pain management in children, with an emphasis on pharmacological and regional anesthesia in achieving this goal. PMID:21197314

  7. Acute pain management in children.

    PubMed

    Verghese, Susan T; Hannallah, Raafat S

    2010-07-15

    The greatest advance in pediatric pain medicine is the recognition that untreated pain is a significant cause of morbidity and even mortality after surgical trauma. Accurate assessment of pain in different age groups and the effective treatment of postoperative pain is constantly being refined; with newer drugs being used alone or in combination with other drugs continues to be explored. Several advances in developmental neurobiology and pharmacology, knowledge of new analgesics and newer applications of old analgesics in the last two decades have helped the pediatric anesthesiologist in managing pain in children more efficiently. The latter include administering opioids via the skin and nasal mucosa and their addition into the neuraxial local anesthetics. Systemic opioids, nonsteroidal anti-inflammatory agents and regional analgesics alone or combined with additives are currently used to provide effective postoperative analgesia. These modalities are best utilized when combined as a multimodal approach to treat acute pain in the perioperative setting. The development of receptor specific drugs that can produce pain relief without the untoward side effects of respiratory depression will hasten the recovery and discharge of children after surgery. This review focuses on the overview of acute pain management in children, with an emphasis on pharmacological and regional anesthesia in achieving this goal.

  8. Sepsis and Acute Kidney Injury.

    PubMed

    Bilgili, Beliz; Haliloğlu, Murat; Cinel, İsmail

    2014-12-01

    Acute kindney injury (AKI) is a clinical syndrome which is generally defined as an abrupt decline in glomerular filtration rate, causing accumulation of nitrogenous products and rapid development of fluid, electrolyte and acid base disorders. In intensive care unit sepsis and septic shock are leading causes of AKI. Sepsis-induced AKI literally acts as a biologic indicator of clinical deterioration. AKI triggers variety of immune, inflammatory, metabolic and humoral patways; ultimately leading distant organ dysfunction and increases morbidity and mortality. Serial mesurements of creatinine and urine volume do not make it possible to diagnose AKI at early stages. Serum creatinine influenced by age, weight, hydration status and become apparent only when the kidneys have lost 50% of their function. For that reason we need new markers, and many biomarkers in the diagnosis of early AKI activity is assessed. Historically "Risk-Injury-Failure-Loss-Endstage" (RIFLE), "Acute Kidney Injury Netwok" (AKIN) and "The Kidney Disease/ Improving Global Outcomes" (KDIGO) classification systems are used for diagnosing easily in clinical practice and research and grading disease. Classifications including diagnostic criteria are formed for the identification of AKI. Neutrophil gelatinase associated lipocalin (NGAL), cystatin-C (Cys-C), kidney injury molecule-1 (KIM-1) and also "cell cycle arrest" molecules has been concerned for clinical use. In this review the pathophysiology of AKI, with the relationship of sepsis and the importance of early diagnosis of AKI is evaluated.

  9. Sepsis and Acute Kidney Injury

    PubMed Central

    Bilgili, Beliz; Haliloğlu, Murat; Cinel, İsmail

    2014-01-01

    Acute kindney injury (AKI) is a clinical syndrome which is generally defined as an abrupt decline in glomerular filtration rate, causing accumulation of nitrogenous products and rapid development of fluid, electrolyte and acid base disorders. In intensive care unit sepsis and septic shock are leading causes of AKI. Sepsis-induced AKI literally acts as a biologic indicator of clinical deterioration. AKI triggers variety of immune, inflammatory, metabolic and humoral patways; ultimately leading distant organ dysfunction and increases morbidity and mortality. Serial mesurements of creatinine and urine volume do not make it possible to diagnose AKI at early stages. Serum creatinine influenced by age, weight, hydration status and become apparent only when the kidneys have lost 50% of their function. For that reason we need new markers, and many biomarkers in the diagnosis of early AKI activity is assessed. Historically “Risk-Injury-Failure-Loss-Endstage” (RIFLE), “Acute Kidney Injury Netwok” (AKIN) and “The Kidney Disease/ Improving Global Outcomes” (KDIGO) classification systems are used for diagnosing easily in clinical practice and research and grading disease. Classifications including diagnostic criteria are formed for the identification of AKI. Neutrophil gelatinase associated lipocalin (NGAL), cystatin-C (Cys-C), kidney injury molecule-1 (KIM-1) and also “cell cycle arrest” molecules has been concerned for clinical use. In this review the pathophysiology of AKI, with the relationship of sepsis and the importance of early diagnosis of AKI is evaluated. PMID:27366441

  10. Acute fatty liver of pregnancy.

    PubMed

    Papafragkakis, Haris; Singhal, Shashideep; Anand, Sury

    2013-10-01

    Acute fatty liver of pregnancy is a rare but serious and potentially fatal complication of pregnancy. It typically presents in the third trimester with microvesicular fatty infiltration of the liver and can lead to multiorgan failure and death. Differentiation from hemolysis-elevated liver enzymes-low platelets syndrome can guide management. A high index of suspicion is necessary in the appropriate clinical setting to identify clinical manifestations and complications and manage them appropriately. In severe cases, prompt delivery can be lifesaving for the mother and fetus. Liver transplantation remains controversial and must be considered individually. Defects in fatty acid oxidation secondary to various enzymatic deficiencies have been associated with acute fatty liver of pregnancy. Women or couples with known defects in fatty acid oxidation and women with a history of previous liver disease during pregnancy or sudden death of a child within the first 2 years of life should be assessed for a defect in fatty acid oxidation and monitored carefully. Our review summarizes the current knowledge in pathophysiology, diagnostic approach and management of this disorder.

  11. Acute methanol toxicity in minipigs

    SciTech Connect

    Dorman, D.C.; Dye, J.A.; Nassise, M.P.; Ekuta, J.; Bolon, B.

    1993-01-01

    The pig has been proposed as a potential animal model for methanol-induced neuro-ocular toxicosis in humans because of its low liver tetrahydrofolate levels and slower rate of formate metabolism compared to those of humans. To examine the validity of this animal model, 12 4-month-old female minipigs (minipig YU) were given a single oral dose of water or methanol at 1.0, 2.5, or 5.0 g/kg body wt by gavage (n = 3 pigs/dose). Dose-dependent signs of acute methanol intoxication, which included mild CNS depression, tremors, ataxia, and recumbency, developed within 0.5 to 2.0 hr, and resolved by 52 hr. Methanol- and formate-dosed pigs did not develop optic nerve lesions, toxicologically significant formate accumulation, or metabolic acidosis. Based on results following a single dose, female minipigs do not appear to be overtly sensitive to methanol and thus may not be a suitable animal model for acute methanol-induced neuroocular toxicosis.

  12. Acute Monoarthritis: Diagnosis in Adults.

    PubMed

    Becker, Jonathan A; Daily, Jennifer P; Pohlgeers, Katherine M

    2016-11-15

    Acute monoarthritis can be the initial manifestation of many joint disorders. The most common diagnoses in the primary care setting are osteoarthritis, gout, and trauma. It is important to understand the prevalence of specific etiologies and to use the appropriate diagnostic modalities. A delay in diagnosis and treatment, particularly in septic arthritis, can have catastrophic results including sepsis, bacteremia, joint destruction, or death. The history and physical examination can help guide the use of laboratory and imaging studies. The presence of focal bone pain or recent trauma requires radiography of the affected joint to rule out metabolic bone disease, tumor, or fracture. If there is a joint effusion in the absence of trauma or recent surgery, and signs of infection (e.g., fever, erythema, warmth) are present, subsequent arthrocentesis should be performed. Inflammatory synovial fluid containing monosodium urate crystals indicates a high probability of gout. Noninflammatory synovial fluid suggests osteoarthritis or internal derangement. Pitfalls in the diagnosis and early treatment of acute monoarthritis include failure to perform arthrocentesis, administering antibiotics before aspirating the joint when septic arthritis is suspected (or failing to start antibiotics after aspiration), and starting treatment based solely on laboratory data, such as an elevated uric acid level.

  13. Epidemiology of acute lymphoblastic leukemia

    SciTech Connect

    Pendergrass, T.W.

    1985-06-01

    Although the etiology of acute leukemia is largely unknown, some facets of the puzzle are becoming clarified. Recognition of important patterns in age-specific mortality rates has suggested that events early in life, perhaps even prenatally, may have an influence on developing leukemia in childhood. The racial differences evident in mortality, incidence, and immunologic subtype of ALL suggest either differences in exposures to certain factors or differences in responses to those factors by white children. Hereditary factors appear to play a role. Familial and hereditary conditions exist that have high incidences of acute leukemia. Chromosomal anomalies are common in these conditions. Viral infections may play a role by contributing to alteration in genetic material through incorporation of the viral genome. How that virus is dealt with after primary infection seems important. The presence of immunodeficiency may allow wider dissemination or enhanced replication of such viruses, thereby increasing the likelihood of cellular transformation to an abnormal cell. Proliferation of that malignant cell to a clone may depend on other cofactors. Perhaps prolonged exposure to substances like benzene or alkylating agents may enhance these interactions between virus and genetic material. Does this change DNA repair mechanisms. Are viral infections handled differently. Is viral genomic information more easily integrated into host cells. Ionizing radiation has multiple effects. Alteration in genetic material occurs both at the molecular and chromosomal levels. DNA may be altered, lost, or added in the cell's attempt to recover from the injury.

  14. What Are the Key Statistics about Acute Myeloid Leukemia?

    MedlinePlus

    ... What Are the Key Statistics About Acute Myeloid Leukemia? The American Cancer Society’s estimates for leukemia in ... Leukemia Research and Treatment? More In Acute Myeloid Leukemia About Acute Myeloid Leukemia Causes, Risk Factors, and ...

  15. Acute pancreatitis in children and adolescents

    PubMed Central

    Suzuki, Mitsuyoshi; Sai, Jin Kan; Shimizu, Toshiaki

    2014-01-01

    In this Topic Highlight, the causes, diagnosis, and treatment of acute pancreatitis in children are discussed. Acute pancreatitis should be considered during the differential diagnosis of abdominal pain in children and requires prompt treatment because it may become life-threatening. The etiology, clinical manifestations, and course of acute pancreatitis in children are often different than in adults. Therefore, the specific features of acute pancreatitis in children must be considered. The etiology of acute pancreatitis in children is often drugs, infections, trauma, or anatomic abnormalities. Diagnosis is based on clinical symptoms (such as abdominal pain and vomiting), serum pancreatic enzyme levels, and imaging studies. Several scoring systems have been proposed for the assessment of severity, which is useful for selecting treatments and predicting prognosis. The basic pathogenesis of acute pancreatitis does not greatly differ between adults and children, and the treatments for adults and children are similar. In large part, our understanding of the pathology, optimal treatment, assessment of severity, and outcome of acute pancreatitis in children is taken from the adult literature. However, we often find that the common management of adult pancreatitis is difficult to apply to children. With advances in diagnostic techniques and treatment methods, severe acute pancreatitis in children is becoming better understood and more controllable. PMID:25400985

  16. Somatostatin therapy of acute experimental pancreatitis.

    PubMed Central

    Lankisch, P G; Koop, H; Winckler, K; Fölsch, U R; Creutzfeldt, W

    1977-01-01

    Because somatostatin (SRIF) reduces exocrine pancreatic secretion, its effect on acute pancreatitis was investigated in rats. Linear SRIF reduced serum amylase and lipase but had no effect on pancreatic necrosis, oedema, leucocyte infiltration, and enzyme content. The mortality rate was not reduced. These results do not recommend the use of SRIF in the treatment of acute pancreatitis. PMID:604191

  17. [Therapeutic attitude in acute necrotizing pancreatitis].

    PubMed

    Leşe, Mihaela; Pop, C; Naghi, Ildiko; Mureşan, Lavinia

    2002-01-01

    The necrosectomy, celiostomy and pancreatic drainage represent the surgical treatment of choice in necrotizing pancreatitis. We present the clinical observation of a patient 59 years old operated in surgical service of Baia Mare for acute necrotizing pancreatitis, discussing the moment of operation, tips of operations, postoperative complications as well as our experience in acute grave pancreatitis treatment.

  18. ACUTE TO CHRONIC ESTIMATION SOFTWARE FOR WINDOWS

    EPA Science Inventory

    Chronic No-Observed Effect Concentrations (NOEC) are commonly determined by either using acute-to-chronic ratios or by performing an ANOVA on chronic test data; both require lengthy and expensive chronic test results. Acute-to-Chronic Estimation (ACE) software was developed to p...

  19. Acute scurvy during treatment with interleukin-2.

    PubMed

    Alexandrescu, D T; Dasanu, C A; Kauffman, C L

    2009-10-01

    The association of vitamin C deficiency with nutritional factors is commonly recognized. However, an acute form of scurvy can occur in patients with an acute systemic inflammatory response, which is produced by sepsis, medications, cancer or acute inflammation. The frequency of acute hypovitaminosis C in hospitalized patients is higher than previously recognized. We report the occurrence of acute signs and symptoms of scurvy (perifollicular petechiae, erythema, gingivitis and bleeding) in a patient hospitalized for treatment of metastatic renal-cell carcinoma with high-dose interleukin-2. Concomitantly, serum vitamin C levels decreased to below normal. Better diets and longer lifespan may result a lower frequency of acute scurvy and a higher frequency of scurvy associated with systemic inflammatory responses. Therefore, increased awareness of this condition can lead to early recognition of the cutaneous signs of acute scurvy in hospitalized patients with acute illnesses or in receipt of biological agents, and prevent subsequent morbidity such as bleeding, anaemia, impaired immune defences, oedema or neurological symptoms.

  20. NSAIDs and Acute Pancreatitis: A Systematic Review

    PubMed Central

    Pezzilli, Raffaele; Morselli-Labate, Antonio Maria; Corinaldesi, Roberto

    2010-01-01

    The resulting pain is the main symptom of acute pancreatitis and it should be alleviated as soon as possible. NSAIDs are the first line therapy for pain and they are generally administered to acute pancreatitis patients upon admission to the hospital. In addition, these drugs have also been used to prevent post-endoscopic cholangiopancreatography (ERCP) acute pancreatitis. On the other hand, there are several reports indicating that NSAIDs may be the actual cause of acute pancreatitis. We carried out a literature search on PubMed/MEDLINE; all full text papers published in from January 1966 to November 2009 on the use of NSAIDs in acute pancreatitis were collected; the literature search was also supplemented by a review of the bibliographies of the papers evaluated. Thus, in this article, we will systematically review the current literature in order to better illustrate the role of NSAIDs in acute pancreatitis, in particular: i) NSAIDs as a cause of acute pancreatitis; ii) their use to prevent post-retrograde ERCP pancreatitis and iii) their efficacy for pain relief in the acute illness of the pancreas. PMID:27713268

  1. Fenmetozole in acute alcholol intoxication in man.

    PubMed

    McNamee, H B; Mendelson, J H; Korn, J

    1975-06-01

    Forty healthy adult male volunteers were studied to determine the efficacy of fenmetozole to antagonize the effects of acute alcholol intoxication. Twenty subjects receive placebo and 20 fenmetozole in dosage of 100 mg and 200 mg in a double-blind paradigm. Pretreatment with fenmetozole failed to antogonize or attenuate cognitive, perceptual, motor and affective changes associated with acute alchol intoxication.

  2. Acute Pancreatitis Secondary to Gestational Hypertriglyceridaemia

    PubMed Central

    Cahalane, Alexis M.; Smith, Myles J.; Ryan, James; Maguire, Donal

    2012-01-01

    Gestational hypertriglyceridaemia is a rare cause of acute pancreatitis. Its pathophysiology is incompletely understood. Severity scoring and effective management remain challenging. We report a case of acute pancreatitis secondary to gestational hypertriglyceridaemia. We describe the use of computed tomography to provide an alternative determination of severity, as well as plasmapheresis as a means of treating the condition. PMID:22844296

  3. Acute neurotoxicity after trichloroethylene ingestion. Case report.

    PubMed

    Perticoni, G F; Bondi, L

    1988-04-01

    Trichloroethylene (TCE), a solvent widely used in the chemical industry, in dry cleaning because of its degreasing action and as a household grease remover, is known to have a toxic action, especially on the nervous system. Cases of intoxication, acute and chronic, due to inhalation, are reported. We report a case, certainly an unusual one, of acute oral intoxication.

  4. Acute vascular abdomen. General outlook and algorithms.

    PubMed

    Miani, S; Boneschi, M; La Penna, A; Erba, M; De Monti, M; Giordanengo, F

    1999-09-01

    Acute vascular abdomen is a severe and life-threatening pathology due to arterial degeneration, leading to hemorrhage or arterial occlusion leading to ischemia. Differential diagnosis of patients with severe abdominal pain and/or shock include several vascular and traumatic diseases, the most common being rupture of abdominal aortic aneurysm (AAA), or less frequently rupture of visceral artery aneurysm. Also acute aortic dissection, iatrogenic injury and acute mesenteric ischemia may lead to acute vascular abdomen. Clinical evaluation of the haemodynamic status of the patient may be very difficult, and may require airway maintenance and ventilation with a rapid treatment of hemorrhagic shock. In the stable patient with an uncertain diagnosis, CT scan, NMR and selective angiography may be helpful in diagnosis before vascular repair. On the contrary, the unstable patient, after hemodynamic resuscitation, must be operated on expeditiously. We present our vascular algorithms, to assess timing of diagnosis and treatment of this severe acute disease.

  5. Practical management of acute asthma in adults.

    PubMed

    Hallstrand, Teal S; Fahy, John V

    2002-02-01

    All asthma patients are at risk for acute asthma exacerbations. Moderate to severe exacerbations account for many emergency department visits and subsequent hospitalizations each year. Recent studies have advanced our understanding of the pathogenesis and treatment of acute asthma. The purpose of this review is to provide practical guidance in the assessment and treatment of adults with acute asthma in the hospital setting. Managing patients with acute asthma involves assessing the severity of the exacerbation, implementing measures to rapidly reverse airflow limitation, and instituting therapies that limit the progression of airway inflammation. Some patients may benefit from other supportive measures such as heliox and noninvasive ventilation. If the patient continues to deteriorate and requires mechanical ventilation, then ventilator settings that minimize the risk of hyperinflation should be chosen. After an episode of acute asthma, long-term preventive medications, especially inhaled corticosteroids, should be prescribed and education should be provided to prevent future episodes.

  6. Acute intermittent porphyria: a diagnostic challenge.

    PubMed

    Anyaegbu, Elizabeth; Goodman, Michael; Ahn, Sun-Young; Thangarajh, Mathula; Wong, Michael; Shinawi, Marwan

    2012-07-01

    Acute intermittent porphyria is a metabolic disorder rarely seen in prepubertal children. A delay in diagnosis of acute intermittent porphyria is common because of variable and nonspecific symptoms. We report an 8-year-old boy with right hemimegalencephaly and intractable seizures, who presented with dark-colored urine, hypertension, increasing lethargy, fluctuating seizures, and poor oral intake. He subsequently developed hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion. His urinalysis was negative for red blood cells, and a random urine porphobilinogen level was elevated. Further biochemical and molecular testing confirmed the diagnosis of acute intermittent porphyria. His antiepileptic medications were discontinued and hemin administered, with dramatic clinical improvement. The diagnosis of acute intermittent porphyria was challenging because of his underlying neurologic condition. This case highlights the variable presentation of acute intermittent porphyria and emphasizes the importance of considering the diagnosis even in young patients with underlying neurologic conditions when they present with nonspecific neurovisceral symptoms or with unexplained neurologic deterioration.

  7. [Acute intermittent porphyria presenting as spontaneous hemothorax].

    PubMed

    Buitrago, Juliana; Santa, Sandra Viviana

    2009-09-01

    The porphyrias are inherited disorders of the heme biosynthetic pathway. They are relatively rare and often misdiagnosed; however, acute episodes can be curtailed by early administration of heme arginate. Acute intermittent porphyria is the commonest of acute forms of porphyria. Here, a case is presented of a 23-year-old male with acute intermittent porphyria who came to the emergency clinic with an unexplained abdominal pain. In addition, he exhibited spontaneous hemothorax (two liters of blood accumulated in the chest) as an unusual manifestation of the disease. The most relevant aspects of acute intermittent porphyria are discussed, along with its epidemiology, diagnosis, clinical presentation and treatment. Complexities and diagnostic requirements in making a diagnosis of porphyria are described.

  8. Hemorrhagic Colloid Cyst Presenting with Acute Hydrocephaly

    PubMed Central

    Akhavan, Reza; Zandi, Behrouz; Pezeshki-Rad, Masoud; Farrokh, Donya

    2017-01-01

    Colloid cysts are benign slow-growing cystic lesions located on the roof of the third ventricle that usually present with symptoms related to gradual rise of intracranial pressure. They mostly remain asymptomatic and sometimes grow progressively and cause diverse symptoms associated with increased intracranial pressure such as headache, diplopia, and sixth cranial nerve palsy. Here we report a 47-year-old female who presented to the emergency department with acute severe headache and nausea/vomiting. On MRI examination acute hydrocephaly due to hemorrhagic colloid cyst was detected. Acute hemorrhage in colloid cysts is extremely rare and may present with symptoms of acute increase in the intracranial pressure. Intracystic hemorrhage is very rarely reported as a complication of colloid cyst presenting with paroxysmal symptoms of acute hydrocephaly. PMID:28210514

  9. Treatment of acute septic arthritis.

    PubMed

    Pääkkönen, Markus; Peltola, Heikki

    2013-06-01

    Acute septic arthritis is a rare, but potentially devastating disease. The treatment is initiated intravenously, but can be safely switched to oral after 2-4 days providing large doses of a well-absorbing antibiotic and, for time-dependent antibiotics, 4 times-a-day administration are used. Empiric treatment should always cover Staphylococcus aureus and common respiratory pathogens, whereas Kingella kingae and Salmonella are important only regionally. Studies conducted by our group have shown that a total course of 10 days may suffice for previously healthy children in a Western setting. Treatment of neonates, patients with immunodeficiency or cases caused by methicillin-resistant S. aureus, may deserve a different approach.

  10. Recovery Potential After Acute Stroke

    PubMed Central

    Seitz, Rüdiger J.; Donnan, Geoffrey A.

    2015-01-01

    In acute stroke, the major factor for recovery is the early use of thrombolysis aimed at arterial recanalization and reperfusion of ischemic brain tissue. Subsequently, neurorehabilitative training critically improves clinical recovery due to augmention of postlesional plasticity. Neuroimaging and electrophysiology studies have revealed that the location and volume of the stroke lesion, the affection of nerve fiber tracts, as well as functional and structural changes in the perilesional tissue and in large-scale bihemispheric networks are relevant biomarkers of post-stroke recovery. However, associated disorders, such as mood disorders, epilepsy, and neurodegenerative diseases, may induce secondary cerebral changes or aggravate the functional deficits and, thereby, compromise the potential for recovery. PMID:26617568

  11. Acute inpatient presentation of scurvy.

    PubMed

    Swanson, Allison M; Hughey, Lauren C

    2010-10-01

    Scurvy is a well-known disease of vitamin C deficiency that still occurs in industrialized countries. The clinical manifestations of follicular hyperkeratosis, perifollicular petechiae, corkscrew hairs, and easy bruising are due to defective collagen synthesis and can be mistaken for small vessel vasculitis. Populations at risk for development of scurvy include elderly patients, alcohol and drug users, individuals who follow restrictive diets or have eating disorders, patients with malabsorption, and individuals with mental illness. We report an acute case of scurvy presenting in the inpatient/hospital setting with clinical findings initially thought to represent vasculitis. A high index of suspicion for scurvy must be kept in the appropriate clinical context, and a thorough medical history and physical examination are vital to make the diagnosis.

  12. Acute Respiratory Infections in Children

    PubMed Central

    Laxdal, Oliver E.; Robertson, H. E.; Braaten, Virgil; Walker, W. Alan

    1963-01-01

    During a seven-month period from November 1960 to May 1961, 181 infants and children, hospitalized because of acute respiratory infections, were studied intensively to determine the responsible etiologic agents. Forty-two per cent of the illnesses in this group appeared to be caused by bacterial agents, either primary or secondary to virus. Parainfluenza viruses were identified as causes of laryngotracheobronchitis in nearly 50% of the cases. Adenoviruses were also found to be important pathogens, particularly as causes of pneumonia in infants. The over-all infection rate attributed to adenoviruses was 11.6%. An epidemic due to Influenza B virus affected approximately 40% of children in this city just following the hospital study. This study was conducted as the first step in a long-term project undertaken at the Regina General Hospital to determine the effectiveness of vaccines in the prevention and treatment of respiratory infections in children. PMID:20327546

  13. Severe acute malnutrition and infection

    PubMed Central

    Jones, Kelsey D J; Berkley, James A

    2014-01-01

    Severe acute malnutrition (SAM) is associated with increased severity of common infectious diseases, and death amongst children with SAM is almost always as a result of infection. The diagnosis and management of infection are often different in malnourished versus well-nourished children. The objectives of this brief are to outline the evidence underpinning important practical questions relating to the management of infectious diseases in children with SAM and to highlight research gaps. Overall, the evidence base for many aspects covered in this brief is very poor. The brief addresses antimicrobials; antipyretics; tuberculosis; HIV; malaria; pneumonia; diarrhoea; sepsis; measles; urinary tract infection; nosocomial Infections; soil transmitted helminths; skin infections and pharmacology in the context of SAM. The brief is structured into sets of clinical questions, which we hope will maximise the relevance to contemporary practice. PMID:25475887

  14. Severe acute malnutrition and infection.

    PubMed

    Jones, Kelsey D J; Berkley, James A

    2014-12-01

    Severe acute malnutrition (SAM) is associated with increased severity of common infectious diseases, and death amongst children with SAM is almost always as a result of infection. The diagnosis and management of infection are often different in malnourished versus well-nourished children. The objectives of this brief are to outline the evidence underpinning important practical questions relating to the management of infectious diseases in children with SAM and to highlight research gaps. Overall, the evidence base for many aspects covered in this brief is very poor. The brief addresses antimicrobials; antipyretics; tuberculosis; HIV; malaria; pneumonia; diarrhoea; sepsis; measles; urinary tract infection; nosocomial Infections; soil transmitted helminths; skin infections and pharmacology in the context of SAM. The brief is structured into sets of clinical questions, which we hope will maximise the relevance to contemporary practice.

  15. Contraceptive pills and acute pancreatitis.

    PubMed

    Mehrotra, T N; Mital, H S; Gupta, S K

    1981-06-01

    This article reports a case of acute pancreatitis in a patient taking the oral contraceptive pill. A 32 year old mother had been on combined contraceptive pills since 1975. In 1978 she started having upper abdominal and retrosternal pain. She became critically ill with peripheral circulatory collapse, dyspnoea and cyanosis. A superficial thrombophlebitis was noted on the medial aspect of the right thigh. The diagnosis of pancreatitis was considered with history of recurrent abdominal pain. After several tests and supportive therapy (intravenous fluids, antibiotics, steriods), the woman started showing improvements in 48 hours and recovered in 10 days. This case differs from previously described cases in that the cholesterol and triglyceride levels were normal. The hypoglycemia has not been described previously.

  16. Phentermine induced acute interstitial nephritis.

    PubMed

    Shao, Emily Ximin; Wilson, Gregory John; Ranganathan, Dwarakanathan

    2017-03-09

    Acute interstitial nephritis (AIN) has a number of medication-related aetiologies. Antibiotics, proton pump inhibitors and non-steroidal anti-inflammatory drugs are common causes; however, any medication has the potential to cause drug-induced AIN. We report the first case of phentermine-induced AIN. A Caucasian woman aged 43 years presented with a 5-week history of lethargy, left-sided lower abdominal pain, nausea and vomiting. She had been taking phentermine for weight loss for 9 months and had recently ceased the medication. The patient underwent a renal biopsy that showed a predominantly lymphohistiocytic interstitial infiltrate with a moderate number of eosinophils consistent with AIN. Phentermine is increasingly used for weight loss in obese patients. This is the first case implicating phentermine as the causative agent for drug-induced AIN. While rare, phentermine-induced AIN is a possible adverse reaction of phentermine. Physicians and patients need to be aware of this risk.

  17. Acute fatty liver of pregnancy.

    PubMed Central

    Korula, J.; Malatjalian, D. A.; Badley, B. W.

    1982-01-01

    Acute fatty liver of pregnancy (AFLP) is rare and is peculiar to the latter half of pregnancy. Despite the high rates of death among affected mothers and their fetuses, early recognition of the disease and immediate delivery of the infant may improve the chances of survival. This paper describes a case of AFLP, characterized by a rapid decrease in the size of the liver, a greatly prolonged prothrombin time and minimal increases in the serum transaminase levels, in which an immediate cesarean section followed by vigorous supportive care led to survival of both mother and infant. It is clear that guidelines on treatment are necessary if the management of such cases is to be successful. Images FIG. 2 PMID:6751513

  18. Acute corneal hydrops in keratoconus

    PubMed Central

    Maharana, Prafulla K; Sharma, Namrata; Vajpayee, Rasik B

    2013-01-01

    Acute corneal hydrops is a condition characterized by stromal edema due to leakage of aqueous through a tear in descemet membrane. The patient presents with sudden onset decrease in vision, photophobia, and pain. Corneal thinning and ectasias combined with trivial trauma to the eye mostly by eye rubbing is considered as the underlying cause. With conservative approach self-resolution takes around 2 to 3 months. Surgical intervention is required in cases of non-resolution of corneal edema to avoid complications and for early visual rehabilitation. Intracameral injection of air or gas such as perflouropropane is the most common surgical procedure done. Recent investigative modality such as anterior segment optical coherence tomography is an extremely useful tool for diagnosis, surgical planning, and postoperative follow up. Resolution of hydrops may improve the contact lens tolerance and visual acuity but most cases require keratoplasty for visual rehabilitation. PMID:23925338

  19. UNDESCENDED TESTICLE COMPLICATING ACUTE APPENDICITIS*

    PubMed Central

    Herzig, Maximilian L.

    1924-01-01

    1. Symptoms referable to compression of the spermatic cord and incarceration of right testicle, obscure the underlying pathologic changes occurring in the vermiform appendix. 2. Testicular underdevelopment and resulting subnormal cerebration. 3. Operative technique: (a) Pre-operative diagnosis: Incarceration of right testicle and possible perforative appendicitis. (b) Descent of right incarcerated testicle. Bassini closure. (c) Exploratory laparotomy: Intramuscular gridiron incision. 4. Operative findings: (a) Strangulation and incarceration of undescended right testicle and spermatic cord in inguinal canal. (b) Copious pus, free in peritoneal cavity. An adherent, sloughing, perforative, retrocecal appendix identified, left undisturbed and free drainage established. 5. Progress: (a) Eventful recovery from acute suppurative appendicitis following drainage of appendical focus. (b) Marked development following the operative descent of an incarcerated testicle in a backward boy, age twelve, who had a bilateral cryptorchism. PMID:18739377

  20. Acute otitis externa in children

    PubMed Central

    McWilliams, Colin J.; Smith, Christine H.; Goldman, Ran D.

    2012-01-01

    Abstract Question In the summer months I see many children with uncomplicated acute otitis externa (AOE). I am aware of the multiple ototopical preparations. Which is the best first-line agent to treat AOE, and is there a role for an oral antibiotic? Answer There are no specific Canadian guidelines for the management of AOE. However, current American guidelines promote initial ototopical therapy without systemic antibiotics for uncomplicated AOE; suggest there is little difference between the various ototopical preparations; and recommend the choice of treatment be based on the specific clinical situation. In practice, this often results in prescribing an antibiotic-steroid formulation for 7 to 10 days. This ototopical treatment option is supported by a recent Cochrane review that has documented the superiority of an antibiotic-steroid combination when compared with placebo or acetic acid in providing clinical resolution of AOE. PMID:23152458

  1. [Fluid therapy in acute pancreatitis].

    PubMed

    de-Madaria, Enrique

    2013-12-01

    Severe acute pancreatitis (AP) is associated with an increased need for fluids due to fluid sequestration and, in the most severe cases, with decreased peripheral vascular tone. For several decades, clinical practice guidelines have recommended aggressive fluid therapy to improve the prognosis of AP. This recommendation is based on theoretical models, animal studies, and retrospective studies in humans. Recent studies suggest that aggressive fluid administration in all patients with AP could have a neutral or harmful effect. Fluid therapy based on Ringer's lactate could improve the course of the disease, although further studies are needed to confirm this possibility. Most patients with AP do not require invasive monitoring of hemodynamic parameters to guide fluid therapy administration. Moreover, the ability of these parameters to improve prognosis has not been demonstrated.

  2. Blood tests for acute pancreatitis

    PubMed Central

    Basnayake, Chamara; Ratnam, Dilip

    2015-01-01

    Summary The diagnosis of acute pancreatitis requires the presence of at least two of the three diagnostic criteria – characteristic abdominal pain, elevated serum amylase or lipase, and radiological evidence of pancreatitis. Serum concentrations of amylase and lipase rise within hours of the pancreatic injury. A threshold concentration 2–4 times the upper limit of normal is recommended for diagnosis. Serum lipase is now the preferred test due to its improved sensitivity, particularly in alcohol-induced pancreatitis. Its prolonged elevation creates a wider diagnostic window than amylase. Neither enzyme is useful in monitoring or predicting the severity of an episode of pancreatitis in adults. New biomarkers including trypsinogen and elastase have no significant advantage over amylase or lipase. PMID:26648641

  3. ACUTE RETINAL ARTERIAL OCCLUSIVE DISORDERS

    PubMed Central

    Hayreh, Sohan Singh

    2011-01-01

    The initial section deals with basic sciences; among the various topics briefly discussed are the anatomical features of ophthalmic, central retinal and cilioretinal arteries which may play a role in acute retinal arterial ischemic disorders. Crucial information required in the management of central retinal artery occlusion (CRAO) is the length of time the retina can survive following that. An experimental study shows that CRAO for 97 minutes produces no detectable permanent retinal damage but there is a progressive ischemic damage thereafter, and by 4 hours the retina has suffered irreversible damage. In the clinical section, I discuss at length various controversies on acute retinal arterial ischemic disorders. Classification of acute retinal arterial ischemic disorders These are of 4 types: CRAO, branch retinal artery occlusion (BRAO), cotton wools spots and amaurosis fugax. Both CRAO and BRAO further comprise multiple clinical entities. Contrary to the universal belief, pathogenetically, clinically and for management, CRAO is not one clinical entity but 4 distinct clinical entities – non-arteritic CRAO, non-arteritic CRAO with cilioretinal artery sparing, arteritic CRAO associated with giant cell arteritis (GCA) and transient non-arteritic CRAO. Similarly, BRAO comprises permanent BRAO, transient BRAO and cilioretinal artery occlusion (CLRAO), and the latter further consists of 3 distinct clinical entities - non-arteritic CLRAO alone, non-arteritic CLRAO associated with central retinal vein occlusion and arteritic CLRAO associated with GCA. Understanding these classifications is essential to comprehend fully various aspects of these disorders. Central retinal artery occlusion The pathogeneses, clinical features and management of the various types of CRAO are discussed in detail. Contrary to the prevalent belief, spontaneous improvement in both visual acuity and visual fields does occur, mainly during the first 7 days. The incidence of spontaneous visual

  4. Combination Chemotherapy With or Without Donor Stem Cell Transplant in Treating Patients With Acute Lymphoblastic Leukemia

    ClinicalTrials.gov

    2016-09-09

    Adult Acute Lymphoblastic Leukemia in Remission; Adult B Acute Lymphoblastic Leukemia; Adult B Acute Lymphoblastic Leukemia With t(9;22)(q34;q11.2); BCR-ABL1; Adult L1 Acute Lymphoblastic Leukemia; Adult L2 Acute Lymphoblastic Leukemia; Adult T Acute Lymphoblastic Leukemia; Recurrent Adult Acute Lymphoblastic Leukemia; Untreated Adult Acute Lymphoblastic Leukemia

  5. The dynamics of acute inflammation

    NASA Astrophysics Data System (ADS)

    Kumar, Rukmini

    The acute inflammatory response is the non-specific and immediate reaction of the body to pathogenic organisms, tissue trauma and unregulated cell growth. An imbalance in this response could lead to a condition commonly known as "shock" or "sepsis". This thesis is an attempt to elucidate the dynamics of acute inflammatory response to infection and contribute to its systemic understanding through mathematical modeling and analysis. The models of immunity discussed use Ordinary Differential Equations (ODEs) to model the variation of concentration in time of the various interacting species. Chapter 2 discusses three such models of increasing complexity. Sections 2.1 and 2.2 discuss smaller models that capture the core features of inflammation and offer general predictions concerning the design of the system. Phase-space and bifurcation analyses have been used to examine the behavior at various parameter regimes. Section 2.3 discusses a global physiological model that includes several equations modeling the concentration (or numbers) of cells, cytokines and other mediators. The conclusions drawn from the reduced and detailed models about the qualitative effects of the parameters are very similar and these similarities have also been discussed. In Chapter 3, the specific applications of the biologically detailed model are discussed in greater detail. These include a simulation of anthrax infection and an in silico simulation of a clinical trial. Such simulations are very useful to biologists and could prove to be invaluable tools in drug design. Finally, Chapter 4 discusses the general problem of extinction of populations modeled as continuous variables in ODES is discussed. The average time to extinction and threshold are estimated based on analyzing the equivalent stochastic processes.

  6. Acute neurobehavioural effects of toluene.

    PubMed Central

    Echeverria, D; Fine, L; Langolf, G; Schork, A; Sampaio, C

    1989-01-01

    An acute inhalation chamber study of 42 college students was performed to investigate the relation between exposure to 0, 75, and 150 ppm of toluene and changes in central nervous system function and symptoms. Paid subjects were exposed for seven hours over three days. Verbal and visual short term memory (Sternberg, digit span, Benton, pattern memory); perception (pattern recognition); psychomotor skill (simple reaction time, continuous performance, digit symbol, hand-eye coordination, finger tapping, and critical tracking); manual dexterity (one hole); mood (profile of mood scales (POMS]; fatigue (fatigue checklist); and verbal ability were evaluated at 0800, 1200, and 1600 hours. Voluntary symptoms and observations of sleep were collected daily. An analysis of variance and test for trend was performed on the difference and score for each concentration reflecting an eight hour workday where each subject was their own control. A 3 x 3 Latin square study design evaluated toluene effects simultaneously, controlling for learning across the three days and the solvent order. Intersubject variation in solvent uptake was monitored in breath and urine. A 5-10% decrement in performance was considered significant if it was consistent with a linear trend at p less than 0.05. Adverse performance at 150 ppm toluene was found at 6.0% for digit span, 12.1% for pattern recognition (latency), 5.0% for pattern memory (number correct), 6.5% for one hole, and 3.0% for critical tracking. The number of headaches and eye irritation also increased in a dose response manner. The greatest effect was found for an increasing number of observations of sleep. Overall, no clear pattern of neurobehavioural effects was found consistent with the type 1 central nervous system as classified by the World Health Organisation. Subtle acute effects, however, were found just below and above the ACGIH TLV of 100 ppm toluene, supporting the position that the guideline be lowered since the biological

  7. Alemtuzumab and Combination Chemotherapy in Treating Patients With Untreated Acute Lymphoblastic Leukemia

    ClinicalTrials.gov

    2014-03-20

    Acute Undifferentiated Leukemia; B-cell Adult Acute Lymphoblastic Leukemia; B-cell Childhood Acute Lymphoblastic Leukemia; L1 Adult Acute Lymphoblastic Leukemia; L1 Childhood Acute Lymphoblastic Leukemia; L2 Adult Acute Lymphoblastic Leukemia; L2 Childhood Acute Lymphoblastic Leukemia; Philadelphia Chromosome Negative Adult Precursor Acute Lymphoblastic Leukemia; Philadelphia Chromosome Positive Adult Precursor Acute Lymphoblastic Leukemia; Philadelphia Chromosome Positive Childhood Precursor Acute Lymphoblastic Leukemia; T-cell Adult Acute Lymphoblastic Leukemia; T-cell Childhood Acute Lymphoblastic Leukemia; Untreated Adult Acute Lymphoblastic Leukemia; Untreated Childhood Acute Lymphoblastic Leukemia

  8. Vosaroxin and Infusional Cytarabine in Treating Patients With Untreated Acute Myeloid Leukemia

    ClinicalTrials.gov

    2017-04-05

    Acute Myeloid Leukemia; Acute Myeloid Leukemia Arising From Previous Myelodysplastic Syndrome; Acute Myeloid Leukemia With Multilineage Dysplasia; Myeloid Sarcoma; Secondary Acute Myeloid Leukemia; Therapy-Related Acute Myeloid Leukemia; Therapy-Related Myelodysplastic Syndrome

  9. Tipifarnib in Treating Older Patients With Previously Untreated Acute Myeloid Leukemia

    ClinicalTrials.gov

    2013-03-22

    Acute Myeloid Leukemia With Multilineage Dysplasia Following Myelodysplastic Syndrome; Adult Acute Basophilic Leukemia; Adult Acute Eosinophilic Leukemia; Adult Acute Erythroid Leukemia (M6); Adult Acute Megakaryoblastic Leukemia (M7); Adult Acute Minimally Differentiated Myeloid Leukemia (M0); Adult Acute Monoblastic Leukemia (M5a); Adult Acute Monoblastic Leukemia and Acute Monocytic Leukemia (M5); Adult Acute Monocytic Leukemia (M5b); Adult Acute Myeloblastic Leukemia With Maturation (M2); Adult Acute Myeloblastic Leukemia Without Maturation (M1); Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Acute Myelomonocytic Leukemia (M4); Adult Erythroleukemia (M6a); Adult Pure Erythroid Leukemia (M6b); Cellular Diagnosis, Adult Acute Myeloid Leukemia; Untreated Adult Acute Myeloid Leukemia

  10. Nivolumab and Dasatinib in Treating Patients With Relapsed or Refractory Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia

    ClinicalTrials.gov

    2016-08-25

    B Acute Lymphoblastic Leukemia With t(9;22)(q34;q11.2); BCR-ABL1; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Lymphoblastic Leukemia; Refractory Adult Acute Lymphoblastic Leukemia; Refractory Childhood Acute Lymphoblastic Leukemia

  11. Studying Biomarkers in Samples From Younger Patients With Acute Myeloid Leukemia

    ClinicalTrials.gov

    2016-05-17

    Childhood Acute Monoblastic Leukemia (M5a); Childhood Acute Monocytic Leukemia (M5b); Childhood Acute Myeloblastic Leukemia Without Maturation (M1); Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies; Childhood Acute Myelomonocytic Leukemia (M4)

  12. Alternative acute oral toxicity assessment under REACH based on sub-acute toxicity values.

    PubMed

    Gissi, Andrea; Louekari, Kimmo; Hoffstadt, Laurence; Bornatowicz, Norbert; Aparicio, Alberto Martin

    2016-11-08

    The REACH Regulation requires information on acute oral toxicity for substances produced or imported in quantities greater than one tonne per year. When registering, animal testing should be used as last resort. The standard acute oral toxicity test requires use of animals. Therefore, the European Chemicals Agency examined whether alternative ways exist to generate information on acute oral toxicity. The starting hypothesis was that low acute oral toxicity can be predicted from the results of low toxicity in oral sub-acute toxicity studies. Proving this hypothesis would allow avoiding acute toxicity oral testing whenever a sub-acute oral toxicity study is required or available and indicates low toxicity. ECHA conducted an analysis of the REACH database and found suitable studies on both acute oral and sub-acute oral toxicities for 1,256 substances. 415 of these substances had low toxicity in the sub-acute toxicity study (i.e. NO(A)EL at or above the classification threshold of 1,000 mg/kg). For 98% of these substances, low acute oral toxicity was also reported (i.e. LD₅₀ above the classification threshold of 2,000 mg/kg). On the other hand, no correlation was found between lower NO(A)ELs and LD₅₀. According to the REACH regulation, this approach for predicting acute oral toxicity needs to be considered as part of a weight of evidence analysis. Therefore, additional sources of information to support this approach are presented. Ahead of the last REACH registration deadline in 2018, ECHA estimates that registrants of about 550 substances can omit the in vivo acute oral study by using this adaptation.

  13. Cholescintigraphy in acute and chronic cholecystitis

    SciTech Connect

    Freitas, J.E.

    1982-01-01

    Since the introduction of /sup 99m/Tc-labeled cholescintigraphic agents in the mid-1970s, there has been extensive investigation of their role in the evaluation of biliary tract disorders. These agents accurately assess the patency of the cystic and common bile ducts, and to date, their greatest impact has been on the diagnostic evaluation of suspected acute cholecystitis. This article reviews the use of /sup 99m/Tc-iminodiacetic acid (IDA) derivatives in acute and chronic cholecystitis. Since acute cholecystitis is characterized by cystic duct obstruction, failure of the gallbladder to visualize following /sup 99m/Tc-IDA administration is indicative of cystic duct obstruction and acute cholecystitis. Using this approach, cholescintigraphy has been shown to be highly sensitive, specific, and efficacious in the diagnosis of acute cholecystitis. Cholescintigraphy is now the procedure of choice for the detection of acute cholecystitis. Unlike its successful applications in acute cholecystitis, cholescintigraphy appears of limited value in chronic cholecystitis. Certain circumstances where cholescintigraphy is of value in chronic cholecystitis are discussed. Whether or not cholescintigraphy may play a greater role in the future in elucidating the pathogenesis of chronic cholecystitis by assessment of biliary kinetics remains unanswered.

  14. Emergency Surgery for Acute Complicated Diverticulitis

    PubMed Central

    Köckerling, Ferdinand

    2015-01-01

    Background The optimal treatment of acute complicated diverticulitis is a matter of debate and has undergone significant changes. Currently, the main focus of surgical treatment concepts is on controlling the emergency situation triggered by acute complicated sigmoid diverticulitis through interventional and minimally invasive measures. Methods This article presents the current data and recommendations on differentiated treatment of acute complicated sigmoid diverticulitis, which are also summarized in a decision tree. Results In general, resection of the diverticular sigmoid is needed to treat acute complicated sigmoid diverticulitis, because without resection the recurrence rate is too high at 40%. Since the morbidity and mortality rates associated with emergency resection are extremely high, resulting in the creation of a stoma, efforts are made to control the acute situation through interventional and laparoscopic measures. Therefore, pericolic and pelvic abscesses (Hinchey stages I, II) are eliminated through percutaneous or laparoscopic drainage. Likewise, laparoscopic lavage and drainage are performed for purulent and feculent peritonitis (Hinchey stages III, IV). After elimination of the acute septic situation, interval elective sigmoid resection is conducted. If emergency resection cannot be avoided, it is performed, while taking account of the patient's overall condition, with primary anastomosis and a protective stoma or as discontinuity resection using Hartmann's procedure. Conclusion Thanks to the progress made in interventional and laparoscopic treatment, differentiated concepts are now used to treat acute complicated sigmoid diverticulitis. PMID:26989380

  15. Diagnostic criteria of acute rheumatic fever.

    PubMed

    Burke, Rebecca J; Chang, Christopher

    2014-01-01

    Acute rheumatic fever is an inflammatory sequela of Group A Streptococcal pharyngitis that affects multiple organ systems. The incidence of acute rheumatic fever has been declining even before the use of antibiotics became widespread, however the disease remains a significant cause of morbidity and mortality in children, particularly in developing countries and has been estimated to affect 19 per 100,000 children worldwide. Acute rheumatic fever is a clinical diagnosis, and therefore subject to the judgment of the clinician. Because of the variable presentation, the Jones criteria were first developed in 1944 to aid clinicians in the diagnosis of acute rheumatic fever. The Jones criteria have been modified throughout the years, most recently in 1992 to aid clinicians in the diagnosis of initial attacks of acute rheumatic fever and to minimize overdiagnosis of the disease. Diagnosis of acute rheumatic fever is based on the presence of documented preceding Group A Streptococcal infection, in addition to the presence of two major manifestations or one major and two minor manifestations of the Jones criteria. Without documentation of antecedent Group A Streptococcal infection, the diagnosis is much less likely except in a few rare scenarios. Carditis, polyarthritis and Sydenham's chorea are the most common major manifestations of acute rheumatic fever. However, despite the predominance of these major manifestations of acute rheumatic fever, there can be significant overlap with other disorders such as Lyme disease, serum sickness, drug reactions, and post-Streptococcal reactive arthritis. This overlap between disease processes has led to continued investigation of the pathophysiology as well as development of new biomarkers and laboratory studies to aid in the diagnosis of acute rheumatic fever and distinction from other disease processes.

  16. [Diagnostic imaging and acute abdominal pain].

    PubMed

    Liljekvist, Mads Svane; Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-19

    Acute abdominal pain is a common clinical condition. Clinical signs and symptoms can be difficult to interpret, and diagnostic imaging may help to identify intra-abdominal disease. Conventional X-ray, ultrasound (US) and computed tomography (CT) of the abdomen vary in usability between common surgical causes of acute abdominal pain. Overall, conventional X-ray cannot confidently diagnose or rule out disease. US and CT are equally trustworthy for most diseases. US with subsequent CT may enhance diagnostic precision. Magnetic resonance seems promising for future use in acute abdominal imaging.

  17. Acute Disseminated Intravascular Coagulation in Neuroendocrine Carcinoma

    PubMed Central

    Teh, Ru-Wen; Tsoi, Daphne T.

    2012-01-01

    Malignancy is a common cause of disseminated intravascular coagulation and usually presents as a chronic disorder in solid organ tumours. We present a rare case of recurrent acute disseminated intravascular coagulation in neuroendocrine carcinoma after manipulation, firstly, by core biopsy and, later, by cytotoxic therapy causing a release of procoagulants and cytokines from lysed tumour cells. This is reminiscent of tumour lysis syndrome where massive quantities of intracellular electrolytes and nucleic acid are released, causing acute metabolic imbalance and renal failure. This case highlights the potential complication of acute disseminated intravascular coagulation after trauma to malignant cells. PMID:23139666

  18. The pathophysiology of developmental and acute laminitis.

    PubMed

    Hood, D M

    1999-08-01

    This review implies that although we know more regarding the enigma of developmental and acute laminitis today than previously, there is still more to investigate. As these investigations are conducted and interpreted, new and more effective preventive and therapeutic regimens are likely to be developed, tested, and made available. As this occurs, the impact of laminitis should undoubtedly decrease. Unfortunately, due to the lack of clinical symptoms in the developmental phase and the shortness of the acute phase, it is also evident that the two sequelae of acute laminitis, subacute and chronic laminitis, are likely to continue to pose a major problem for some time.

  19. The neurologic manifestations of the acute porphyrias.

    PubMed

    Simon, Neil G; Herkes, Geoffrey K

    2011-09-01

    The porphyrias are diseases characterised by accumulation of porphyrins and porphyrin precursors owing to enzymatic deficiencies of the haem synthetic pathway. In the acute hepatic porphyrias accumulation of porphyrin precursors, in particular delta-aminolaevulinic acid (ALA), cause dysfunction of the central, peripheral and autonomic nervous systems. This leads to the characteristic clinical findings of abdominal pain, neuropsychiatric symptoms and neuropathy. The exact pathogenic mechanism is not clear but evidence to date suggests both direct toxic effects of ALA and intracellular metabolic derangement contribute to the neurologic disorders. This review explores the mechanisms of neural dysfunction in the acute porphyrias and the resultant clinical features of an acute attack.

  20. Small Bowel Obstruction Secondary to Acute Pancreatitis

    PubMed Central

    Sunkara, Tagore; Etienne, Denzil; Caughey, Megan E.; Gaduputi, Vinaya

    2017-01-01

    While an uncommon occurrence, it is possible for patients diagnosed with acute pancreatitis to develop colonic ileus, obstruction, or perforation. By extension, it is also possible to develop a small bowel obstruction following an episode of acute pancreatitis. Here, we present the case of a 44-year-old male, who after repeated attacks of acute pancreatitis, came to the emergency department with continuous, non-bloody vomiting. This patient also complained of both left upper quadrant and epigastric pain, and was subsequently diagnosed with a small bowel obstruction involving the proximal jejunum. PMID:28270876