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Sample records for acute radiation disease

  1. Acute radiation disease

    Features of clinical trends in acute period of radiation disease at personnel who suffered from Chernobyl accident are considered. The main attention is paid to the results of 10 year observation of organs, systems and metabolic processes in patients. Used therapeutic, rehabilitation and preventive actions in stationary, ambulatory and sanatorium - health resort stages are described

  2. Diagnosis of acute radiation disease by Enzyme Immune-Assay (EIA)

    Diagnosis of the acute radiation disease by the method of immune enzyme assay is a simple and efficient tool of evaluating and biological dosimetry and forecasting of development of the acute radiation defeats as at group of population so at individuals locating in the zone polluted by the radiation. We use as biological markers the group of essential radiotoxins - high molecular mass glycoprotein ( molecular mass - 200 - 250 kDa ) - radiation antigens (S.D.R. - specific radiation determinant ) accumulated in the lymphoid system, with epitopes specific to each form of radiation syndrome, after animals have been irradiated in doses inducing the development of the cerebral (1), toxic ( 2), gastrointestinal ( 3 ) and typical ( 4 ) forms of acute radiation sickness. These two phenomena allowed us to develop a technologies for diagnosis, prophylaxis and therapy of radiation disease - enzyme immune assay ( EIA ), anti radiation vaccine, anti radiation serum, method of immune - lymph - plasma-sorption. The important first step in effectiveness of therapy is an accurate assessment of severity of disease in early period after irradiation. The ideal markers for early and accurate assessment is high weight glycoprotein with specifics radiation induced features (S.D.R.) mentioned above. This biology active substance isolated from lymph can induct the symptoms of radiation syndrome without previously radiation when it is administrated intra-muscularly or intravenously to healthy animals. Enzyme immune assay (EIA) allowed researchers to indicate the significant levels of different forms of S.D.R. in peripheral blood of animals in first 24 hours after radiation. Indication of high level of S.D.R. -1 allowed to forecast a fast development of cerebral form of acute radiation disease. Determination of high levels of S.D.R.-2, S.D.R.-3 and S.D.R.-4 in peripheral blood allowed to recognize early periods of toxic, gastrointestinal and typical forms of acute radiation sickness

  3. Subacute radiation dermatitis: a histologic imitator of acute cutaneous graft-versus-host disease

    The histopathologic changes of radiation dermatitis have been classified either as early effects (necrotic keratinocytes, fibrin thrombi, and hemorrhage) or as late effects (vacuolar changes at the dermal-epidermal junction, atypical radiation fibroblasts, and fibrosis). Two patients, one exposed to radiation therapeutically and one accidentally, are described. Skin biopsy specimens showed an interface dermatitis characterized by numerous dyskeratotic epidermal cells with lymphocytes in close apposition (satellite cell necrosis); that is, the epidermal changes were similar to those in acute graft-versus-host disease. Because recipients of bone marrow transplants frequently receive total body irradiation as part of their preparatory regimen, the ability of radiation to cause persistent epidermal changes similar to those in acute graft-versus-host disease could complicate the interpretation of posttransplant skin biopsy specimens

  4. Acute Radiation Disease : Cutaneous Syndrome and Toxic properties of Radiomimetics -Radiation Neurotoxins and Hematotoxins.

    Popov, Dmitri; Maliev, Slava

    Cutaneous injury is an important complication of a general or local acute irradiation. A type of a skin and tissues lesions depends on a type, intensity, and period of irradiation. Also, the clinical picture, signs, and manifestations of the cutaneous syndrome depend on a type of the radiation toxins circulated in lymph and blood of irradiated mammals. Radiation Toxins were isolated from lymph of the mammals that were irradiated and developed different forms of the Acute Radiation Syndromes (ARS) -Cerebrovascular, Cardiovascular, Gastrointestinal, and Hematopoietic. Radiation Toxins can be divided into the two important types of toxins (Neu-rotoxins and Hematotoxins) or four groups. The effects of Radiation Neurotoxins include severe damages and cell death of brain, heart, gastrointestinal tissues and endothelial cells of blood and lymphatic vessels. The hematotoxicity of Hematotoxic Radiation Toxins includes lym-phopenia, leukopenia, thrombocytopenia, and anemia in the blood circulation and transitory lymphocytosis and leukocytosis in the Central Lymphatic System. In all cases, administration of the Radiomimetics (Radiation Toxins) intramuscularly or intravenously to healthy, radiation naive mammals had induced and developed the typical clinical manifestations of the ARS. In all cases, administration of Radiomimetics by subtoxic doses had demonstrated development of typical clinical signs of the cutaneous syndrome such as hair loss, erythema, swelling, desqua-mation, blistering and skin necrosis. In animal-toxic models, we have activated development of the local skin and tissue injury after injection of Radiation Toxins with cytoxic properties.

  5. Factors Influencing the Efficacy of Radiation Protection of the Thyroid Gland in Chernobyl Patients with Acute Radiation Disease

    Full text: Just after the Chernobyl accident there were three groups of factors which could influence on the incorporation of radioactive iodine into the victims at the Chernobyl nuclear power plant. The first group was related with the amount of radioactive iodine in the air, the second with radiation protection measures and the third with clinical condition of the victims. The purpose of this investigation was to study relationships among them. The subject of the research was 108 case histories of the victims after short-term external gamma-exposure from 0.5 to 12.7 Gy. 92 of them fell ill with acute radiation disease. Their thyroid glands were exposed to radiation iodine within 0.01-12 Gy. A multifactor analysis was used for studying the relationships among the radioactive iodine intake, development of prodromal radiation syndrome and taking in 0.125 g of potassium iodine to protect the thyroid gland. The investigation shows that the highest level of iodine incorporation was determined in the men stayed at the nuclear power plant for the first hour after the beginning of the accident. A protective effect of potassium iodine depended on the time of taking in. The vomiting was a reason for decreasing the effect due to the loss of some potassium iodine with vomiting materials during the prodromal period of acute radiation disease. The level of the radionuclide incorporation had no influence on the development of the acute radiation syndrome. (author)

  6. Dynamics of ceruloplasmin amd of some blood parameters in piglets suffering from acute radiation disease

    Changes in oxidase activity of ceruloplasmin (CP) were followed up after treatment with gamma rays of 60Co with a dose of 4 Ey (dose power 0.68 Ey/min) in the blood serum of male piglets of an average life weight of 18+-3 kg. CP level from 217 E/l raised to 376 E/l on the 16th hour after radiation and on the 16th day decreased to 296 e/l. Moreover, serum copper increased from 25 μmol/l to 42.3 μmol/l on the 16th hour following irradiation but on the 14th day its level dropped to 32.5 μmol/l. Erythrocyte and leucocyte count decreased from 5.83x1012/l and 19.94x1012/l to 2.47x1012/l and 2.0x109/l, respectively. Besides, serum albumin decreased, but α-and β-globulins increased. Examination of ailing piglets showed a paraclinical pattern of an inflammatory process by acute radiation disease. CP as an antioxidant participates in reactions with toxic radiacals on radiation. By the rising of its level on radiation it again was characterized as an acute-phase protein. Serum CP was determined according to the method of Ravin using as substrate P-phenylendiamine dihydrochloride; serum copper - by the test of Boehringer Mannheim; serum proteins were studied electrophoretically on agarose gels using veronal buffer, pH 8.6

  7. Diagnostic value of 18F-FDG uptake by spleen in acute radiation disease

    Shao-jie WU

    2015-07-01

    Full Text Available Objective To investigate whether 18F-FDG uptake can be applied in dosimetry to facilitate a rapid and accurate evaluation of individual radiation dosage after a nuclear accident. Methods Forty-eight Tibetan minipigs were randomly assigned into 6 groups, i.e., 0, 1, 2, 5, 8 and 11Gy groups. Animals in all except 0Gy group received total body irradiation (TBI with a 8MV X centrifugal linear accelerator, and 18F-FDG combined positron-emission tomography and computed tomography (PET/CT were carried out before TBI, and also at 6, 24 and 72h after receiving TBI in different doses ranging from 1 to 11Gy. Spleen tissues and blood samples were collected for histological examination, apoptosis, and routine blood analysis. Results Mean standardized uptake values (SUVs of the spleen showed significant differences between experimental groups and control group. The spleen SUVs at 6h post-irradiation showed significant correlation with radiation dose; Spearman's correlation coefficient was 0.95(P<0.01. Histopathological observations showed that the degree of splenic damage was proportional to the radiation dose. Moreover, flow cytometry revealed that apoptosis was one of the major forms of splenic lymphocyte death. Conclusion In the Tibetan minipig model, it was shown that radiation doses bear a close relationship with the 18F-FDG uptake of spleen. This finding suggests that 18F-FDG PET/CT may be useful for the rapid detection of individual radiation dosage after acute radiation disease (ARD. DOI: 10.11855/j.issn.0577-7402.2015.07.08

  8. Untraditional pharmacotherapeutic approaches to prevention and therapy of acute radiation disease

    Weiterová, Lenka; Hofer, Michal

    Praha : Ediční oddělení Institutu postgraduálního vzdělávání ve zdravotnictví, 1999. s. 120-121. [Days of Radiation Hygiene /22./. 16.11.1999-18.11.1999, Jáchymov] Institutional research plan: CEZ:A17/98:Z5-004-9-ii Subject RIV: BO - Biophysics

  9. Lung pathology in case of acute radiation injury

    Results of pathomorphological studies of 27 patients exposed to total external γ- and β-radiation resulted from the Chernobyl accident and lost due to the acute radiation disease in the first weeks following radiation exposure are discussed. Dose range is 3.7-13.7 Gy. Two groups of pathological changes in lungs are revealed, those are: infection (bacterial, viral and fungous) ones caused by acute radiation disease and signs of respiratory distress-syndrome in adults

  10. The acute radiation syndrome

    Symptoms and signs from medical aspects resulting from whole body exposure, or in the main part, to ionizing radiation are described. The dose-response relationship is studied and the exposure is divided in three parts: central nervous system syndrome, gastrointestinal syndrome and hematopoietic syndrome. Brief comments about the treatment are reported. (M.A.C.)

  11. Role of Vitamin C As A Potent Antioxidant in Acute Radiation Induced Liver Disease (RILD) Among Male Albino Rats

    Recent studies demonstrated the role of vitamin C as antioxidant in alleviating organ damage caused by gamma irradiation. The present study was conducted to find out the effect of vitamin C on liver biochemical functions such as serum ALT, AST, albumin and bilirubin after experimental liver damage induced by gamma irradiation. Rats irradiated with gamma radiation were used as a model of liver injury terminating with necro inflammatory activity and acute hepatitis. Forty male albino rats were classified into 6 groups (G0-G5). G0 included 8 male albino rats that were divided to 2 subgroups (4 rats/subgroup). Both subgroups were exposed to gamma irradiation with 6 Gy as a single dose. The first subgroup was left for 3 weeks then serum and liver samples were collected while in the second subgroup, 2 rats were died and the remaining 2 rats were left for 6 weeks then serum and liver samples were collected. G1 was the negative control while in the rest groups, the whole body of rats was exposed to gamma irradiation of dose 8 Gy divided to 2 doses (4 Gy/one dose) at one week interval in between. G2 included 12 albino rats divided into 3 subgroups (4 rats/subgroup). The whole body of albino rats of G2 was exposed to 8 Gy gamma irradiation that divided as mentioned before. Serum and liver samples were collected after one day, two days and four days after last dose of irradiation. G3 also included 8 rats that were divided into 2 subgroups (4 rats/subgroup) and whole body was exposed to 8 Gy gamma irradiation that were divided as mentioned before. Serum and liver samples were collected after one week for one subgroup and 2 weeks for other subgroup after last dose of irradiation. The rest 2 groups (4 rats/group) were exposed to 8Gy gamma irradiation divided as before, but the rats in one group were orally supplemented with low dose of vitamin C. G4 and the others were supplemented with high dose of vitamin C for 2 weeks starting after last dose of irradiation (G5) then serum

  12. Acute radiation syndrome in human

    The combination of the different types of irradiation dramatically changes the clinical course of acute radiation syndrome (ARS) in the case of short term exposure. The recent experience has been compared mostly with the data on the atomic bomb victims in Hiroshima and Nagasaki. The comparison of the injuries from different radiation exposures resulted in the possibility to receive summarized data and the actual basis of the observed difference. The situation with total relatively uniform irradiation is observed when human position is at long distance from powerful radiation sources or when he changes his position, as seen in atomic bomb survivors, the results of nuclear weapon tests and the patients in the Chernobyl accident. This is connected with the ARS of bone, marrow and intestine. The situation characterized by the clinical signs of the large area of skin and mucosa injuries was observed in nuclear weapon tests and the Chernobyl accident. In the case of the more localized and less severe beta injuries of skin and mucosa, the long term effects may be important. The majority of accidents in peaceful period are related to the uneven exposure from near sources, and the situation of the combination of external and internal irradiation is related to uneven irradiation and the predominance of internal exposure. (K.I.)

  13. Acute Myeloid Leukemia and Myelodysplastic Syndromes After Radiation Therapy Are Similar to De Novo Disease and Differ From Other Therapy-Related Myeloid Neoplasms

    Nardi, Valentina; Winkfield, Karen M.; Ok, Chi Young; Niemierko, Andrzej; Kluk, Michael J.; Attar, Eyal C.; Garcia-Manero, Guillermo; Wang, Sa A.; Hasserjian, Robert P.

    2012-01-01

    Purpose Therapy-related myeloid neoplasms (t-MN) represent a unique clinical syndrome occurring in patients treated with chemotherapy and/or external-beam radiation (XRT) and are characterized by poorer prognosis compared with de novo disease. XRT techniques have evolved in recent years and are associated with significantly reduced bone marrow exposure. The characteristics of post-XRT t-MN in the current era have not been studied. Patients and Methods We analyzed patients who developed acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) after XRT alone (47 patients) or cytotoxic chemotherapy/combined-modality therapy (C/CMT, 181 patients) and compared them with patients with de novo MDS or AML (222 patients). We estimated bone marrow exposure to radiation and compared the clinical, pathologic, and cytogenetic features and outcome of the XRT patients with the C/CMT patients and with patients with de novo MDS and AML. Results Patients with t-MN after XRT alone had superior overall survival (P = .006) and lower incidence of high-risk karyotypes (P = .01 for AML and karyotypes between the XRT and de novo groups. Conclusion AML and MDS diagnosed in the past decade in patients after receiving XRT alone differ from t-MN occurring after C/CMT and share genetic features and clinical behavior with de novo AML/MDS. Our results suggest that post-XRT MDS/AML may not represent a direct consequence of radiation toxicity and warrant a therapeutic approach similar to de novo disease. PMID:22585703

  14. Clinical features of subacute course of radiation disease

    Krasnyuk V.I.; Konchalovsky M.V.; Ustyugova A.A.

    2014-01-01

    Aim: to show the clinical features of subacute course of subacute course of radiation disease and how they differ from the typical manifestations of acute and chronic radiation syndrome. Material and methods. Materials of the Burnasyan Federal Medical and Biophysical Center Register of acute radiation disease (ARS) in the Former USSR and Russia and Materials of a Burnasyan Federal Medical and Biophysical Center database of workers "Mayak" with chronic radiation syndrome (CRS) were analyzed. T...

  15. Electronical recording and evaluation of acute radiation morbidity

    Background: Relatively uniform documentation systems are used for recording of acute side effects in oncology. Object of this work is to illustrate the applicability of electronic data bases for registration and evaluation of acute side effects in radiation therapy. Methods: Based on topographic documentation sheets, an electronic data base was developed for each major topographic site. Besides general patient related parameters (TNM, previous chemotherapy, surgical interventions, intercurrent diseases and more), the kind and the degree of acute radiation related side effects are documented for each week of radiation and for day 90 (RTOG) as the joint day between acute and subacute tissue reactions. Results: The temporal expenditure for the recording of the general patient related parameters of a patient is less than a minute. The weekly documentation can be performed during the daily routine work and needs approximately 5 minutes per week. The structure of the data base enables later analyses of acute radiation related morbidity. Conclusions: Electronic data bases enable a fast and systematic recording and evaluation of acute radiation related side effects. The development of particular registration entities for recording of acute side effects may be a possible application and demonstrates the needs of professional developments. (orig.)

  16. Acute radiation syndrome caused by accidental radiation exposure - therapeutic principles

    Dörr Harald; Meineke Viktor

    2011-01-01

    Abstract Fortunately radiation accidents are infrequent occurrences, but since they have the potential of large scale events like the nuclear accidents of Chernobyl and Fukushima, preparatory planning of the medical management of radiation accident victims is very important. Radiation accidents can result in different types of radiation exposure for which the diagnostic and therapeutic measures, as well as the outcomes, differ. The clinical course of acute radiation syndrome depends on the ab...

  17. Acute radiation syndrome, c.aused by single whole-body external irradiation

    The general characteristic of conceptions of the material substrate of various forms and types of radiation injuries from the moment of a wide use of radiation energy and radioactive substances up to the present time, the dependence of structural changes on the type of ionizing radiation, dose and forms of its effect, are presented. The pathological anatomy of particular manifestations of acute radiation disease in various systems of the organism is described. The attention is paid to the variant of radiation disease taking place during non-uniform general irradiation. Local and general morphological changes which develop in skin, hyperdermic fat and skeleton muscles simultaneously in the zone of massive local effect against the background of the general radiation injury, are described for the first time. Delayed alterations in blood vessels and interstitial tissue after the acute radiation disease are described as well as the pathomorphology and histochemistry of trophic disorders in the acute and delayed periods of acute radiation disease

  18. Acute Radiation Syndrome. Consequences and outcomes

    Okladnikova, N.D.; Pesternikova, V.S.; Sumina, M.V.; Azizova, T.V.; Yurkov, N.N. [Branch No 1 State Research Center of Russia, Ozyorsk (Russian Federation). Inst. of Biophysics

    2000-05-01

    The consequences and outcomes of an Acute Radiation Syndrome (ARS), induced by external gamma radiation for 59 persons (49 men and 10 women) have been estimated. All incidents have taken place more than 40 years ago in the yearly years of adjustment of an atomic industry (1950-1953-38 persons, 1954-1958-21 persons). According to the degree of severity ARS 5 groups are selected: the severest degree - 7 individuals (average dose in group 43.8{+-}12.8 Sv), severe - 4 individuals (9.3{+-}1.5 Sv), medium - 14 individuals (2.2{+-}0.8 Sv), a light degree - 15 individuals (0.93{+-}0.13 Sv), ''erased'' from - 19 individuals (0.85{+-}0.07 Sv). In all cases, except for lethal (the severest degree), the characteristics of morphological composition of the peripheral blood were restored in the first year after ARS and now correspond to physiological standard. In 2 cases the moderate hypoplasia of granulocytopoiesis was diagnosed. A marker of the acute exposure was the chromosome aberrations in lymphocytes of the peripheral blood. The frequency of chromosome aberrations correlates with severity degree of ARS (from 3-7 up to 35-50 stable aberrations per 100 cells). In cases of ARS with severe degree the early development of a cerebral atherosclerosis is detected. The radiation cataract was diagnosed in 5 patients (an exposure doses 4.0-9.8 Sv, a period of development 2-5 years). During the first years after ARS in 80% of cases the complete labour rehabilitation is reached. Of 53 patients with known vital status by 45 year of monitoring 19 persons (35.8%) have died, of these in 2 cases the causes of death are not determined. In remaining cases the causes of death were ARS of severest degree (7 persons), Ischemic Heart Disease (5 persons), malignant tumors (4 persons), accidents and traumas (2 persons). (author)

  19. Acute Radiation Syndrome. Consequences and outcomes

    The consequences and outcomes of an Acute Radiation Syndrome (ARS), induced by external gamma radiation for 59 persons (49 men and 10 women) have been estimated. All incidents have taken place more than 40 years ago in the yearly years of adjustment of an atomic industry (1950-1953-38 persons, 1954-1958-21 persons). According to the degree of severity ARS 5 groups are selected: the severest degree - 7 individuals (average dose in group 43.8±12.8 Sv), severe - 4 individuals (9.3±1.5 Sv), medium - 14 individuals (2.2±0.8 Sv), a light degree - 15 individuals (0.93±0.13 Sv), ''erased'' from - 19 individuals (0.85±0.07 Sv). In all cases, except for lethal (the severest degree), the characteristics of morphological composition of the peripheral blood were restored in the first year after ARS and now correspond to physiological standard. In 2 cases the moderate hypoplasia of granulocytopoiesis was diagnosed. A marker of the acute exposure was the chromosome aberrations in lymphocytes of the peripheral blood. The frequency of chromosome aberrations correlates with severity degree of ARS (from 3-7 up to 35-50 stable aberrations per 100 cells). In cases of ARS with severe degree the early development of a cerebral atherosclerosis is detected. The radiation cataract was diagnosed in 5 patients (an exposure doses 4.0-9.8 Sv, a period of development 2-5 years). During the first years after ARS in 80% of cases the complete labour rehabilitation is reached. Of 53 patients with known vital status by 45 year of monitoring 19 persons (35.8%) have died, of these in 2 cases the causes of death are not determined. In remaining cases the causes of death were ARS of severest degree (7 persons), Ischemic Heart Disease (5 persons), malignant tumors (4 persons), accidents and traumas (2 persons). (author)

  20. Ultrasound in Acute Kidney Disease.

    Meola, Mario; Nalesso, Federico; Petrucci, Ilaria; Samoni, Sara; Ronco, Claudio

    2016-01-01

    Kidneys' imaging provides useful information in acute kidney injury (AKI) diagnosis and management. Today, several imaging techniques give information on kidneys anatomy, urinary obstruction, differential diagnosis between AKI and chronic kidney disease (CKD), renal blood flow and glomerular filtration rate. Ultrasound is a safe, non-invasive and repeatable imaging technique so it is widely used in the first level work-up of AKI. The utility of contrast-enhanced computed tomography and magnetic resonance imaging in AKI or in AKI during CKD is limited because of renal toxicity associated with contrast agents used. PMID:27169556

  1. Acute Chagas Disease in a Returning Traveler

    Carter, Yvonne L.; Juliano, Jonathan J; Montgomery, Susan P.; Qvarnstrom, Yvonne

    2012-01-01

    Acute Chagas disease is rarely recognized, and the risk for acquiring the disease is undefined in travelers to Central America. We describe a case of acute Chagas disease in a traveler to Costa Rica and highlight the need for increased awareness of this infection in travelers to Chagas-endemic areas.

  2. Radiobiology of the acute radiation syndrome

    Acute radiation syndrome or acute radiation sickness is classically subdivided into three sub syndromes: the hematopoietic, gastrointestinal and neurovascular syndrome but many other tissues can be damaged. The time course and severity of clinical signs and symptoms are a function of the overall body volume irradiated, the inhomogeneity of dose exposure, the particle type, the absorbed dose and the dose rate. Classical pathophysiology explain the failure of each of these organs and the timing of appearance of their signs and symptoms due to radiation-induced cytocidal effects of a great number of parenchymal cells of hierarchically organized tissues. Contemporaneously, many other radiation-induced effects has been described and all of them may lead to tissue injury with their corresponding signs and symptoms that can be expressed after short or long period of time. Radiation-induced multi-organ involvement is thought to be due to radiation-induced systemic inflammatory response mediated by released pro-inflammatory cytokines. (authors)

  3. Cerebral hemodynamics in acute radiation disease in the victims of the accident of the Chernobylsk Nuclear Power Plant

    Cerebral hemodynamics was investigated on the basis of rheoencephalography findings in persons with ARD of various degrees of severity in the latent period and during rehabilatation. The data obtained showed correlation of cerebral hemodynamics and a degree of gravity of ARD and a period of development of disease. A decrease in pulse rate, a tendency to increased peripheral resistnce and vein tone and an increased rate of cerebral dystonia were marked at the time or rehybilitation of patients with ARD, 2-3 degree

  4. Focus on acute diarrhoeal disease

    Fabio Baldi; Maria Antonia Bianco; Gerardo Nardone; Alberto Pilotto; Emanuela Zamparo

    2009-01-01

    Diarrhoea is an alteration of normal bowel movement characterized by an increase in the water content,volume, or frequency of stools. Diarrhoea needs to be classified according to the trends over time (acute or chronic) and to the characteristics of the stools (watery, fatty, inflammatory). Secretory diarrhoeas,mostly acute and of viral aetiology in more than 70% of cases, are by far the most important subtype of diarrhoeas in terms of frequency, incidence and mortality (over 2.5 million deaths/year in developing countries). Natural and synthetic opiates such as morphine, codeine, and loperamide which react with endogenous opiates (enkephalins, beta-endorphins,dynorphins) mainly act on intestinal motility and slow down transit. An antidiarrhoeal drug developed in recent years, racecadotril, acts as an enkephalinase inhibitor.Clinical studies have shown that it is just as effective as loperamide in resolving acute diarrhoea but with greater reduction in pain and abdominal distension.Some studies have explored the prevalence of diarrhoea in old age. An epidemiological study carried out in Italy by 133 General Practitioners on 5515 elderly outpatients reported a prevalence of diarrhoea, defined according to the Rome criteria, of 9.1%. Infectious diseases (19%) and drug use (16%) were the most commoncauses of diarrhoea in old age. Regardless of the cause,the treatment of elderly patients with diarrhoea must include rehydration and nutritional support. Every year,more than 50 million tourists travel from industrialized countries to places where hygiene levels are poor. At least 75% of those travelling for short periods mention health problems, and in particular traveller's diarrhoea.

  5. Acute radiation syndrome caused by accidental radiation exposure - therapeutic principles

    Dörr Harald

    2011-11-01

    Full Text Available Abstract Fortunately radiation accidents are infrequent occurrences, but since they have the potential of large scale events like the nuclear accidents of Chernobyl and Fukushima, preparatory planning of the medical management of radiation accident victims is very important. Radiation accidents can result in different types of radiation exposure for which the diagnostic and therapeutic measures, as well as the outcomes, differ. The clinical course of acute radiation syndrome depends on the absorbed radiation dose and its distribution. Multi-organ-involvement and multi-organ-failure need be taken into account. The most vulnerable organ system to radiation exposure is the hematopoietic system. In addition to hematopoietic syndrome, radiation induced damage to the skin plays an important role in diagnostics and the treatment of radiation accident victims. The most important therapeutic principles with special reference to hematopoietic syndrome and cutaneous radiation syndrome are reviewed.

  6. Is acute recurrent pancreatitis a chronic disease?

    Mariani, Alberto; Testoni, Pier Alberto

    2008-01-01

    Whether acute recurrent pancreatitis is a chronic disease is still debated and a consensus is not still reached as demonstrated by differences in the classification of acute recurrent pancreatitis. There is major evidence for considering alcoholic pancreatitis as a chronic disease ab initio while chronic pancreatitis lesions detectable in biliary acute recurrent pancreatitis (ARP) seem a casual association. Cystic fibrosis transmembrane conductance regulator (CFTR) gene mutation, hereditary a...

  7. Obstructive lung disease in acute medical patients.

    Seemungal, T.; Harrinarine, R.; Rios, M.; Abiraj, V.; Ali, A.; Lacki, N.; Mahabir, N.; Ramoutar, V.; King, C. P.; Bhowmik, A.; Wedzicha, J A

    2008-01-01

    OBJECTIVES: To determine the proportion of adult medical patients who have chronic obstructive pulmonary disease (COPD), using the Global initiative for Chronic Obstructive Lung Disease guidelines (GOLD), and its relation to vascular disease. METHODS: This is a prospective cross-sectional study of adult patients admitted to acute medical wards. Interviewer administered questionnaire, anthropometric and spirometric measurements were done. RESULTS: Spirometry was performed in 720 acute admissio...

  8. Evaluation and management of acute radiation dermatitis

    Acute radiation dermatitis remains one of the most commonly observed side effect during radiation therapy leading to complication such as superinfection or treatment disruption. Its management is characterized by a great heterogeneity. Few strategies have demonstrated a benefit in preventing radiation dermatitis, which relies mostly on decreasing dose delivered to the skin and skin care practices. Simple emollients and use of topical steroids can be useful in early stages. The singularity of the skin toxicity seen with cetuximab and radiotherapy warrants a specific grading system and distinctive clinical treatment with use of antibiotics. (authors)

  9. Diarrheal Diseases - Acute and Chronic

    ... and drinking contaminated or raw foods and beverages. Screening/Diagnosis Most episodes of acute diarrhea resolve quickly without antibiotic therapy and with simple dietary modifications. See a ...

  10. Is acute recurrent pancreatitis a chronic disease?

    Alberto Mariani; Pier Alberto Testoni

    2008-01-01

    Whether acute recurrent pancreaUtis is a chronic disease is still debated and a consensus is not still reached as demonstrated by differences in the classification of acute recurrent pancreatitis.There is major evidence for considering alcoholic pancreatitis as a chronic disease ab initio while chronic pancreatitis lesions detectable in biliary acute recurrent pancreatitis (ARP) seem a casual association.Cystic fibrosis transmembrane con ductance regulator (CFTR) gene mutation,hereditary and obstructive pancreatitis seem an acute disease that progress to chronic pancreatitis,likely as a consequence of the activation and proliferation of pancreatic stellate cells that produce and activate collagen and therefore fibrosis.From the diagnostic point of view,in patients with acute recurrent pancreatitis Endoscopic ultrasound (EUS) seems the more reliable technique for an accurate evaluation and follow-up of some ductal and parenchymal abnormalities suspected for early chronic pancreatitis.

  11. Thrombolysis in Acute Cerebrovascular Disease

    刘泽霖

    2003-01-01

    @@ Large-scale trials have shown that thrombolytic therapy reduces mortality and preserves left ventricular function in patients with acute myocardial infarction (AMI). That's a rationale for the use of thrombolytic agents in the management of ischemic stroke.

  12. Diagnosis of moderate acute radiation sickness

    Forty patients with malignant lymphoma were given 60Co TLI. 21 cases received 6 Gy and 19 received 8 Gy. It was estimated that a single TLI of 6 and 8 Gy would correspond to TBI of 3.55 Gy and 4.25 Gy (average values) by analysing peripheral blood cell chromosome aberrations and 1.85-2.37 Gy by measuring red bone marrow stem cells clinically. Moderate acute radiation sickness with digestive tract reaction and hemopoietic and immunologic depression was observed. WBC and platelets decreased rapidly. Lymphocytes showed quantitative and qualitative changes even at early stage. All these indexes are significant for diagnosis. Besides, the degree of labial stimulation response, levels of C-reactive protein, corticoid, and urinal nucleoside and alkaloid base presented great changes both pre-and post-irradiation. Early diagnosis of moderate acute radiation sickness could be made in cancer patients subjected to 6-8 Gy TLI

  13. Radiation treatment of benign diseases

    The report deals with an estimation of the volume of radiation treatment of benign diseases in Norway and gives a survey of the subjective opinion of patients regarding the result of the treatment. Reported subjective recovery after radiation treatment seems to be at the same level as recovery without treatment. For an indication of the objective effect of radiation treatment of benign diseases, the subjective effect of this treatment has to be compared with objective findings

  14. Clinical features of subacute course of radiation disease

    Krasnyuk V.I.

    2014-12-01

    Full Text Available Aim: to show the clinical features of subacute course of subacute course of radiation disease and how they differ from the typical manifestations of acute and chronic radiation syndrome. Material and methods. Materials of the Burnasyan Federal Medical and Biophysical Center Register of acute radiation disease (ARS in the Former USSR and Russia and Materials of a Burnasyan Federal Medical and Biophysical Center database of workers "Mayak" with chronic radiation syndrome (CRS were analyzed. There were selected 22 patients with radiation syndrome due to fractionated or prolonged accidental exposure (the main group of patients. There were formed two subgroups for comparison: patients with a typical marrowy syndrome of acute radiation disease and with chronic radiation syndrome. Statistical analysis of results was made by means of statistical software package Statistica v. 6.1 for Windows (StatSoft Inc., USA and Microsoft Excel 2010. Results. It was found that subacute course of radiation syndrome is possible under radiation exposure with medium dose rate in the range of 0.1-0.3 Gy/day Early symptoms of the disease as a primary reaction symptoms are completely absent. First complaints appeared in the earliest one month after the start of work in adverse conditions, on the average 6 months. In the period of formation there is a pancytopenia in the peripheral blood. Duration of the formation period was also determined. In this case radiation cataracts in patients are not observed. After the termination of radiation exposure hematopoietic recovery is slow, possibly incomplete with a high probability of hemoblastosis development. Conclusions. There has been described the subacute course of radiation disease by analyzing the clinical material of patients with radiation syndrome, there has been analyzed the clinical criteria that distinguish subacute radiation syndrome from acute and chronic.

  15. Macrophage expression in acute radiation colitis in rats

    Although radiation therapy is important in the treatment of tumors in pelvic and abdominal region, it may cause radiation injury as a side effect. But there is no effective way of preventing or curing the damages. The mechanism of acute radiation colitis has not been elucidated yet. Our previous reports have revealed that X-ray irradiation induce apoptosis of epithelial stem cells in colon. Then a hypothesis of the radiation colitis can be put forward, DNA damage by irradiation, apoptosis of mucosal epithelial stem cells and degeneration of epithelial gland structure, macrophages phagocyte the debris, being activated and secreting various inflammatory cytokines, infiltration of inflammatory cells. Several recent reports show that macrophages may play an important role in the process of inflammatory bowel diseases such ulcerative colitis or Crohn's disease. We studied radiation colitis using rat animal models. Male Wister rats were irradiated by a single fraction dose of 22.5 Gy X-ray at laparotomy, shielding except for an approximately 2.5 cm length of rectum. Histological changes and macrophage accumulation in the rectum mucosa were evaluated by immunohistochemistry and western blot method with the specimens which were taken on the 1, 2, 3, 4, 5, 6, 7, 10, and 14th day after irradiation. Severe macrophage accumulation in the lamina propria of the rectum was observed on the 5th day. At the same time, severe destruction of mucosal structure and inflammatory cells infiltration were also observed. Based on the potent pro-inflammatory cytokine producing effects of macrophage in rat and the increased expression in inflammatory bowel disease patients, speculate that intervention in the macrophage-cytokine network could form a future target for the treatment of acute radiation colitis. (author)

  16. Health Impacts from Acute Radiation Exposure

    Strom, Daniel J.

    2003-09-30

    Absorbed doses above1-2 Gy (100-200 rads) received over a period of a day or less lead to one or another of the acute radiation syndromes. These are the hematopoietic syndrome, the gastrointestinal (GI) syndrome, the cerebrovascular (CV) syndrome, the pulmonary syndrome, or the cutaneous syndrome. The dose that will kill about 50% of the exposed people within 60 days with minimal medical care, LD50-60, is around 4.5 Gy (450 rads) of low-LET radiation measured free in air. The GI syndrome may not be fatal with supportive medical care and growth factors below about 10 Gy (1000 rads), but above this is likely to be fatal. Pulmonary and cutaneous syndromes may or may not be fatal, depending on many factors. The CV syndrome is invariably fatal. Lower acute doses, or protracted doses delivered over days or weeks, may lead to many other health outcomes than death. These include loss of pregnancy, cataract, impaired fertility or temporary or permanent sterility, hair loss, skin ulceration, local tissue necrosis, developmental abnormalities including mental and growth retardation in persons irradiated as children or fetuses, radiation dermatitis, and other symptoms listed in Table 2 on page 12. Children of parents irradiated prior to conception may experience heritable ill-health, that is, genetic changes from their parents. These effects are less strongly expressed than previously thought. Populations irradiated to high doses at high dose rates have increased risk of cancer incidence and mortality, taken as about 10-20% incidence and perhaps 5-10% mortality per sievert of effective dose of any radiation or per gray of whole-body absorbed dose low-LET radiation. Cancer risks for non-uniform irradiation will be less.

  17. Occupational disease caused by ionizing radiation

    The study investigates the course of the disease of persons whose occupational exposure to radiation had resulted in impairment of their professional ability and entitled them to damages under the current regulations. 35 receivers of damages were found who by answering the question form and partly giving permission to study their file at the insurance institution under the conditions of data protection made is possible to carry through this investigation. 14 receivers of damages were occupied in the technical industry, 21 in the sector of medicine. The radiation disease acknowledged as professional concerned in 30 cases the skin, in two cases the lungs and in one case each the haematopoietic system, the eyes and the pelvic organs. In 8 indemnified, acute radiation exposure had caused the disease, in 25 the time of exposure had ranged from one year to several decades. The investigation describes when and under what professional circumstances the radiation exposure took place, the course of the disease, what kind of diagnostic and therapeutical measures were carried through and what personal and professional consequences the indemnified sustained. It gives suggestions to set up a future, more effective documentation system on the basis of the experience gathered on the occasion of this investigation with the currently valid registration system, which is unsuitable for further scientific studies, and with the currently practised methods of after-care. (orig./HP)

  18. An Acute Hemorrhagic Infectious Disease: Ebola Virus Disease

    Lei JIAO

    2014-09-01

    Full Text Available Ebola virus disease (EVD is an acute hemorrhagic infectious disease caused by ebola virus, with high infectivity and fatality rate. At present, it mainly occurs in areas of Central Africa and West Africa and no effective vaccine and antiviral drugs are available for the clinical treatment.

  19. Radiation treatment of testicular relapse in acute lymphoblastic leukemia

    Ten patients with testicular relapse among 128 cases of acute lymphoblastic leukemia are reported. At the time of the initial diagnosis of leukemia all patients with later testicular relapse showed one or more risk factors as predictive for leukemic infiltration of the testicles. All patients except one, who underwent orchiectomy and died 11 weeks after surgical intervention, received radiation therapy with doses ranging from 12 to 20 Gy and chemotherapy. The local control was excellent. Average survival time from testicular relapse to death was 68 weeks in 8 of 9 patients treated by irradiation and chemotherapy. One patient is still alive without signs of disease after 6 years. (orig.)

  20. Microcirculation in Acute and Chronic Kidney Diseases.

    Zafrani, Lara; Ince, Can

    2015-12-01

    The renal microvasculature is emerging as a key player in acute and chronic kidney diseases. Renal microvascular disease involves alterations in endothelial barrier permeability, exaggerated inflammation, impairment of endothelium-dependent vasorelaxation involving the nitric oxide system, increased oxidative stress, and loss of angiogenic factors. Moreover, evidence suggests that there is a microvascular component to the pathogenesis of renal scarring. New technology is being developed to explore renal microcirculation in vivo in experimental models and humans. This technology will provide a better understanding of the pathogenesis of kidney diseases and will help guide specific therapeutic strategies aimed at restoring the renal microcirculation. This article reviews the cellular and molecular mechanisms of renal microvascular dysfunction in acute and chronic kidney diseases and the potential diagnostic and therapeutic implications of these findings. Recent developments in the monitoring of renal microcirculation are described with respect to their advantages and limitations, and future directions are outlined. PMID:26231789

  1. Crohn's Disease and Acute Pancreatitis: A Review of Literature

    Sarfaraz Jasdanwala; Mark Babyatsky

    2015-01-01

    Crohn's disease, a transmural inflammatory bowel disease, has many well-known extra-intestinal manifestations and complications. Although acute pancreatitis has a higher incidence in patients with Crohn's disease as compared to the general population, acute pancreatitis is still relatively uncommon in patients with Crohn's disease. Patients with Crohn's disease are at an approximately fourfold higher risk than the general population to develop acute pancreatitis. The risk of developing acute ...

  2. Protective effects of gelsolin on acute radiation symptom

    This paper is to study the protective effect of gelsolin on acute radiation symptoms after total body irradiation. The concentration of plasma gelsolin was determined by a commercial ELISA Kit before and post-irradiation at different times by 137Cs γ rays with 4 Gy and 8 Gy. Levels of prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) were detected by an STAGO blood coagulation instrument at different times post-irradiation with 6 Gy γ ray. Otherwise the contents of the plasma malonaldehyde (MDA), superoxide dismutase (SOD) and whole blood glutathione (GSH) were examined at 2 d and 7 a respectively after radiation. We found that the plasma levels of gelsolin were rising at 24 h post-radiation and a persistent degression tendency of gelsolin concentration was found from 24 h to 72 h post-irradiation with 4 Gy and 8 Gy. This decreasing degree had a positive correlation with the exposure dose. On the day from 4 d to 7 d after radiation treatment, the gelsolin treatment group had significantly higher PT and APTT, but low FIB than those of irradiated control group. Within 14 d to 18 d post-radiation, APTT, PT and FIB in gelsolin treatment group were lower than those in irradiated control group, but only APTT and PT differences were prominent. Levels of GSH and SOD in gelsolin treatment group were conspicuously higher than those in irradiated control group; whereas MDA levels were significantly lower than the irradiated control group. Gelsolin may have some certain protective effects on acute radiation disease in improving radiation hemorrhagic injury and eliminating free radicals. (authors)

  3. Strain Echocardiography in Acute Cardiovascular Diseases.

    Favot, Mark; Courage, Cheryl; Ehrman, Robert; Khait, Lyudmila; Levy, Phillip

    2016-01-01

    Echocardiography has become a critical tool in the evaluation of patients presenting to the emergency department (ED) with acute cardiovascular diseases and undifferentiated cardiopulmonary symptoms. New technological advances allow clinicians to accurately measure left ventricular (LV) strain, a superior marker of LV systolic function compared to traditional measures such as ejection fraction, but most emergency physicians (EPs) are unfamiliar with this method of echocardiographic assessment. This article discusses the application of LV longitudinal strain in the ED and reviews how it has been used in various disease states including acute heart failure, acute coronary syndromes (ACS) and pulmonary embolism. It is important for EPs to understand the utility of technological and software advances in ultrasound and how new methods can build on traditional two-dimensional and Doppler techniques of standard echocardiography. The next step in competency development for EP-performed focused echocardiography is to adopt novel approaches such as strain using speckle-tracking software in the management of patients with acute cardiovascular disease. With the advent of speckle tracking, strain image acquisition and interpretation has become semi-automated making it something that could be routinely added to the sonographic evaluation of patients presenting to the ED with cardiovascular disease. Once strain imaging is adopted by skilled EPs, focused echocardiography can be expanded and more direct, phenotype-driven care may be achievable for ED patients with a variety of conditions including heart failure, ACS and shock. PMID:26823931

  4. Minimal Residual Disease in Acute Myeloid Leukemia

    Ommen, Hans Beier; Nederby, Line; Toft-Petersen, Marie;

    2014-01-01

    This chapter discusses how minimal residual disease (MRD) is detected and managed in acute myeloid leukemia (AML) patients. The most commonly used techniques to detect residual leukemia in patients in complete remission (CR) are quantitative PCR (qPCR) and multicolor flow cytometry (MFC). While q...

  5. Acute dysautonomia associated with Hodgkin's disease.

    van Lieshout, J. J.; Wieling, W.; van Montfrans, G A; Settels, J J; Speelman, J D; Endert, E.; Karemaker, J. M.

    1986-01-01

    A patient is described with acute dysautonomia associated with Hodgkin's disease. Testing of cardiovascular reflex control showed that this patient had a rare manifestation of autonomic cardiovascular neuropathy, namely intact parasympathetic heart rate control in combination with a sympathetic postganglionic lesion affecting the control of the vascular tree.

  6. Diagnostic criterions of the postradiation encephalopathy in remote period of the acute radiation syndrome

    Development of post-radiation encephalopathy diagnostic criteria on the base of neuro psychic, neuro- and psychofisiological research in patients who suffered with acute radiation disease after Chernobyl catastrophe was the aim of this work. 110 persons of 20-75 years age were investigated. 55 refs., 6 tab., 6 figs

  7. Ionizing radiation and cardiovascular disease.

    Hoel, David G

    2006-09-01

    For more than 15 years the A-bomb survivor studies have shown increased noncancer mortality due to radiation exposures. The most prominent cause of this increase is circulatory disease mortality. Although the estimated relative risk is less than for solid cancers (1.2 versus 1.6 per Sv), there are measurable increases in cardiovascular disease mortality at doses greater than 0.5 Sv. The evidence for circulatory diseases in mortality studies of occupational cohorts exposed to external radiation is less compelling. It is generally accepted that atherosclerosis is an inflammatory disease of the arteries and a risk factor for myocardial infarction. Immunological markers for inflammatory disease have been shown to be dose related in A-bomb survivors. Evidence from animal studies reveals increased cardiovascular mortality and arterial endothelial damage from both neutron and, to a lesser extent, gamma exposures. PMID:17119211

  8. Radiation exposure and occupational disease

    The knowledge about ionising radiation and the compensation of occupational diseases were both improved during the past 50 years. Now, the adverse effects of the radiation can be compensated by two ways: the disease of a claimant is automatically recognised as an occupational disease if all the criteria of the 'sixth table' are fulfilled. When all the previous criteria are not fulfilled, the 'Comites regionaux de reconnaissance en maladie professionnelle' have to estimate the relationship between the usual exposure and the disease. The decisions of the Comites are implicitly based on the probability of causation., However, the non specificity of the diseases, the influence of non occupational factors and the role of low doses lead to uncertainty of risk estimates and probability of causation. The compensation system has to be improved and has to remain consistent whatever the occupational exposure. (author)

  9. MRI assessment of local acute radiation syndrome

    Weber-Donat, G.; Potet, J.; Baccialone, J.; Teriitehau, C. [Military Hospital Percy, Radiology Department, Clamart (France); Amabile, J.C.; Laroche, P. [Military Hospital Percy, Army Institute of Radioprotection, Clamart (France); Lahutte-Auboin, M. [Military Hospital Val-de-Grace, Radiology Department, Paris (France); Bey, E. [Military Hospital Percy, Plastic and Reconstructive Surgery Department, Clamart (France)

    2012-12-15

    To describe local acute radiation syndrome and its radiological imaging characteristics. We performed a retrospective study of patients who had suffered skin and deeper radiation damage who were investigated by magnetic resonance imaging (MRI). We compared the clinical findings, C-reactive protein (CRP) levels and MRI results. A total of 22 MRI examinations were performed between 2005 and 2010 in 7 patients; 6 patients had increased CRP levels and MRI abnormalities. They were treated by surgery and local cellular therapy. One patient had no CRP or MRI abnormalities, and had a spontaneous good outcome. Eighteen abnormal MR examinations demonstrated high STIR signal and/or abnormal enhancement in the dermis and muscle tissues. Three MRI examinations demonstrated skeletal abnormalities, consistent with radionecrosis. The four normal MRI examinations were associated only with minor clinical manifestations such as pain and pigmentation disorders. MRI seems to be a useful and promising imaging investigation in radiation burns management i.e. initial lesion evaluation, treatment evaluation and complication diagnosis. MRI findings correlated perfectly with clinical stage and no false negative examinations were obtained. In particular, the association between normal MRI and low CRP level seems to be related to good outcome without specific treatment. (orig.)

  10. MRI assessment of local acute radiation syndrome

    To describe local acute radiation syndrome and its radiological imaging characteristics. We performed a retrospective study of patients who had suffered skin and deeper radiation damage who were investigated by magnetic resonance imaging (MRI). We compared the clinical findings, C-reactive protein (CRP) levels and MRI results. A total of 22 MRI examinations were performed between 2005 and 2010 in 7 patients; 6 patients had increased CRP levels and MRI abnormalities. They were treated by surgery and local cellular therapy. One patient had no CRP or MRI abnormalities, and had a spontaneous good outcome. Eighteen abnormal MR examinations demonstrated high STIR signal and/or abnormal enhancement in the dermis and muscle tissues. Three MRI examinations demonstrated skeletal abnormalities, consistent with radionecrosis. The four normal MRI examinations were associated only with minor clinical manifestations such as pain and pigmentation disorders. MRI seems to be a useful and promising imaging investigation in radiation burns management i.e. initial lesion evaluation, treatment evaluation and complication diagnosis. MRI findings correlated perfectly with clinical stage and no false negative examinations were obtained. In particular, the association between normal MRI and low CRP level seems to be related to good outcome without specific treatment. (orig.)

  11. Pelvic radiation disease: Updates on treatment options.

    Frazzoni, Leonardo; La Marca, Marina; Guido, Alessandra; Morganti, Alessio Giuseppe; Bazzoli, Franco; Fuccio, Lorenzo

    2015-12-10

    Pelvic cancers are among the most frequently diagnosed neoplasms and radiotherapy represents one of the main treatment options. The irradiation field usually encompasses healthy intestinal tissue, especially of distal large bowel, thus inducing gastrointestinal (GI) radiation-induced toxicity. Indeed, up to half of radiation-treated patients say that their quality of life is affected by GI symptoms (e.g., rectal bleeding, diarrhoea). The constellation of GI symptoms - from transient to long-term, from mild to very severe - experienced by patients who underwent radiation treatment for a pelvic tumor have been comprised in the definition of pelvic radiation disease (PRD). A correct and evidence-based therapeutic approach of patients experiencing GI radiation-induced toxicity is mandatory. Therapeutic non-surgical strategies for PRD can be summarized in two broad categories, i.e., medical and endoscopic. Of note, most of the studies have investigated the management of radiation-induced rectal bleeding. Patients with clinically significant bleeding (i.e., causing chronic anemia) should firstly be considered for medical management (i.e., sucralfate enemas, metronidazole and hyperbaric oxygen); in case of failure, endoscopic treatment should be implemented. This latter should be considered the first choice in case of acute, transfusion requiring, bleeding. More well-performed, high quality studies should be performed, especially the role of medical treatments should be better investigated as well as the comparative studies between endoscopic and hyperbaric oxygen treatments. PMID:26677440

  12. Hematopoietic Acute Radiation Syndrome (Bone marrow syndrome, Aplastic Anemia): Molecular Mechanisms of Radiation Toxicity.

    Popov, Dmitri

    Key Words: Aplastic Anemia (AA), Pluripotential Stem Cells (PSC) Introduction: Aplastic Anemia (AA) is a disorder of the pluripotential stem cells involve a decrease in the number of cells of myeloid, erythroid and megakaryotic lineage [Segel et al. 2000 ]. The etiology of AA include idiopathic cases and secondary aplastic anemia after exposure to drugs, toxins, chemicals, viral infections, lympho-proliferative diseases, radiation, genetic causes, myelodisplastic syndromes and hypoplastic anemias, thymomas, lymphomas. [Brodskyet al. 2005.,Modan et al. 1975., Szklo et al. 1975]. Hematopoietic Acute Radiation Syndrome (or Bone marrow syndrome, or Radiation-Acquired Aplastic Anemia) is the acute toxic syndrome which usually occurs with a dose of irradiation between 0.7 and 10 Gy (70- 1000 rads), depending on the species irradiated. [Waselenko et al., 2004]. The etiology of bone morrow damage from high-level radiation exposure results depends on the radiosensitivity of certain bone marrow cell lines. [Waselenko et al. 2004] Aplastic anemia after radiation exposure is a clinical syndrome that results from a marked disorder of bone marrow blood cell production. [Waselenko et al. 2004] Radiation hematotoxicity is mediated via genotoxic and other specific toxic mechanisms, leading to aplasia, cell apoptosis or necrosis, initiation via genetic mechanisms of clonal disorders, in cases such as the acute radiation-acquired form of AA. AA results from radiation injury to pluripotential and multipotential stem cells in the bone marrow. The clinical signs displayed in reticulocytopenia, anemia, granulocytopenia, monocytopenia, and thrombocytopenia. The number of marrow CD34+ cells (multipotential hematopoietic progenitors) and their derivative colony-forming unit{granulocyte-macrophage (CFU-GM) and burst forming unit {erythroid (BFU{E) are reduced markedly in patients with AA. [Guinan 2011, Brodski et al. 2005, Beutler et al.,2000] Cells expressing CD34 (CD34+ cell) are normally

  13. Pharmacological management of acute radiation morbidity

    Zimmermann, J.S.; Kimmig, B. [Klinik fuer Strahlentherapie (Radioonkologie), Christian-Albrecht-Universitaet Kiel (Germany)

    1998-11-01

    Background: The acute radiation morbidity may be a serious problem for the patient and may be decreased by pharmacological approaches. Material and methods: A database research (Medline, Cancerlit, DIMDI, etc.) was performed in order to obtain pharmacological approaches to decrease the acute radiation morbidity. The evaluation was focused on therapeutic principles but not on special drugs. Results: Different approaches may be chosen to protect healthy tissues from the effects of ionizing radiation: 1. Administration of cyto- or radioprotective agents prior to irradiation, 2. administration of agents to avoid additional secondary toxicity by inflammation or superinfection during the treatment cycle (supportive care) and 3. administration of rescue agents, such as bone marrow CSFs or hyperbaric oxygen (HBO), after therapy. For radioprotection, there are reports on cellular protection by vitamine E, vitamine C, beta carotene, ribose-cysteine, glutamine, Mgcl2/adenosine triphosphate and WR-2721 (amifostine). In general, preclinical studies show that the combination of pretreatment with amifostine, irradiation, and G-CSF after radiation enhances hematologic recovery. Assessment of these combined effects, including local supportive therapies, merits further clinical investigation. There are data from prospective studies as well as from empirical clinical experience, that radioprotection and clinical supportive care may reduce the treatment related morbidity by 10 to 30% either. Conclusions: A further improvement of the therapeutic ratio is to be expected by systemically combined application of radioprotectors, supportive care and rescue agents. (orig.) [Deutsch] Hintergrund: Die strahlentherapeutische Fruehmorbiditaet kann auf das Ergebnis einer Strahlenbehandlung Einfluss nehmen und kann durch medikamentoese Verfahren gelindert werden. Material und Methoden: Eine Datenbankrecherche (Medline, Cancerlit, DIMDI u.a.) wurde durchgefuehrt, um einen Ueberblick ueber

  14. Hematological parameters after acute radiation injury

    According to clinical experiences of radiation accidents during the past two decades, utilization of measured hematologic changes as a direcrt indicator of the severity of radiation injury provides important information for diagnosis and prognostic evaluation in individual cases. Hematologic changes can be described in terms of prognostic categories based on the possible outcome of the acute radiation syndrome. The five categories suggested by Wald according to the grade of severity. By the actual application of this category to our experience of the 1971 Chiba accident of exposure to irridium 192, it was proved that the estimated dose was well correlated to the value by cytogenetic analysis and physical estimation used of thermo-luminescence phenomena. In hematological parameters, a decrease of lymphocytes occurs whithin 24 hours after the exposure. The level of this early lymphopenia is regarded as one of the best indicators of severity of radiation injury. For the decision of therapeutic procedures, however, the total granulocyte count and platelet count are more valuable to exclude severe infection and bleeding symptoms occurred one month after the exposure. The limitation of the approach by hematologic data must exist in the case exposed in a non-uniform fashion. To overwhelm this difficulty, the application of rapid marrow scanning by short-lived RI such as 52Fe is expected and the bone marrow imaging by magnetic resonance studies is more exciting. For more sensitive and technically easy-drived methods detecting hematologic injury, our new method of detecting micro-nucleus in polychromatic erythroblasts from cultured erythroid colonies from peripheral blood is now developing. Preliminary data have shown the sensitivity of this method is comparable to the cytogenetic study of pheripheral lymphocytes. (author)

  15. Mesenchymal stem cell therapy for acute radiation syndrome.

    Fukumoto, Risaku

    2016-01-01

    Acute radiation syndrome affects military personnel and civilians following the uncontrolled dispersal of radiation, such as that caused by detonation of nuclear devices and inappropriate medical treatments. Therefore, there is a growing need for medical interventions that facilitate the improved recovery of victims and patients. One promising approach may be cell therapy, which, when appropriately implemented, may facilitate recovery from whole body injuries. This editorial highlights the current knowledge regarding the use of mesenchymal stem cells for the treatment of acute radiation syndrome, the benefits and limitations of which are under investigation. Establishing successful therapies for acute radiation syndrome may require using such a therapeutic approach in addition to conventional approaches. PMID:27182446

  16. Acute recurrent pancreatitis: An autoimmune disease?

    Raffaele Pezzilli

    2008-01-01

    In this review article,we will briefly describe the main characteristics of autoimmune pancreatitis and then we will concentrate on our aim,namely,evaluating the clinical characteristics of patients having recurrence of pain from the disease.In fact,the open question is to evaluate the possible presence of autoimmune pancreatitis in patients with an undefined etiology of acute pancreatitis and for this reason we carried out a search in the literature in order to explore this issue.In cases of recurrent attacks of pain in patients with "idiopathic"pancreatitis,we need to keep in mind the possibility that our patients may have autoimmune pancreatitis.Even though the frequency of this disease seems to be quite low,we believe that in the future,by increasing our knowledge on the subject,we will be able to diagnose an ever-increasing number of patients having acute recurrence of pain from autoimmune pancreatitis.

  17. MINIMAL RESIDUAL DISEASE IN ACUTE LYMPHOBLASTIC LEUKEMIA

    Campana, Dario

    2009-01-01

    In patients with acute lymphoblastic leukemia (ALL), monitoring of minimal residual disease (MRD) offers a way to precisely assess early treatment response and detect relapse. Established methods to study MRD are flow cytometric detection of abnormal immunophenotypes, polymerase chain reaction (PCR) amplification of antigen-receptor genes, and PCR amplification of fusion transcripts. The strong correlation between MRD levels and risk of relapse in childhood ALL is well established; studies in...

  18. Acute and Chronic Cutaneous Reactions to Ionizing Radiation Therapy

    Bray, Fleta N.; Simmons, Brian J.; Aaron H. Wolfson; Nouri, Keyvan

    2016-01-01

    Ionizing radiation is an important treatment modality for a variety of malignant conditions. However, development of radiation-induced skin changes is a significant adverse effect of radiation therapy (RT). Cutaneous repercussions of RT vary considerably in severity, course, and prognosis. When they do occur, cutaneous changes to RT are commonly graded as acute, consequential-late, or chronic. Acute reactions can have severe sequelae that impact quality of life as well as cancer treatment. Th...

  19. Acute radiation nephritis. Its evolution on sequential bone imaging

    Acute radiation nephritis typically affects the kidneys 3-12 months after radiation exposure and may occur with doses as low as 2500 rads. After an initial latent period, the affected portions of the kidneys become swollen and edematous, and develop multiple petechiae. Necrotizing vasculitis and interstitial hemorrhage occur, and the end stage is that of scarring. Two patients are presented in whom localized acute radiation nephritis developed, and whose kidneys demonstrated the characteristic sequential changes of this entity on serial bone imaging

  20. Role of toll-like receptors in acute gastrointestinal radiation syndrome

    Ionizing radiation induces various disorders according to the radiation sensitivity of each organ. Acute gastrointestinal radiation syndrome is a serious illness that is caused by exposure of gastrointestinal tract to high amounts of ionizing radiation in radiation accidents or radiation therapy in cancer treatment. Although the pathological mechanism have been well studied in human and animals, no effective treatments have been developed to date. The Toll-like receptor (TLR) family is one of the best-characterized families of innate immune receptors, which induce innate immune response against pathogen infection. However, contrary to their protective function, recent studies have suggested that immune responses triggered by TLRs play deleterious roles by aggravating tissue inflammation in some inflammatory and autoimmune diseases. This review describes recent advancement of our understanding of acute gastrointestinal radiation syndrome and the contributions of TLR to its pathological mechanisms. (author)

  1. Explanation of nurse standard of external exposure acute radiation sickness

    National occupational health standard-Nurse Standard of External Exposure Acute Radiation Sickness has been approved and issued by the Ministry of Health. Based on the extensive research of literature, collection of the previous nuclear and radiation accidents excessive exposed personnel data and specific situations in China, this standard was enacted according to the current national laws, regulations, and the opinions of peer experts. It is mainly used for care of patients with acute radiation sickness, and also has directive significance for care of patients with iatrogenic acute radiation sickness which due to the hematopoietic stem cell transplantation pretreatment. To correctly carry out this standard and to reasonably implement nursing measures for patients with acute radiation sickness, the contents of this standard were interpreted in this article. (authors)

  2. Characteristics of long-term consequences of acute radiation sickness

    In persons who suffered from acute radiation sickness (ARS) as a result of the Chernobyl accident in course of time there are revealed the stochastic and non-stochastic effects of irradiation both in 'critical' and 'non-critical' organism systems. It is connected with maintenance of somatic mutation high level and steady changes in membranes subcellular structures, biomolecules as well as metabolic disturbances. Stable changes of hemopoietic and immune system indexes have to be considered as pre-pathological status with high hazard of stochastic effects development. Frequency rate of typical radiation cataracts (posterior subcapsular) is correlated with ARS severity degree; fundus oculi vessel pathology have essential weight in total eye pathology. Chronic radiation dermatitis is an important clinical problem being a long-term consequence of irradiation. It demands a constant attention in order to prevent trophic secondary skin lesions. Radiation damage of eye and skin as well as high frequency of chronic somatic diseases and neuropsychiatric disorders conditioned the high level of disablement in ARS-patients

  3. Crohn's Disease and Acute Pancreatitis: A Review of Literature

    Sarfaraz Jasdanwala

    2015-03-01

    Full Text Available Crohn's disease, a transmural inflammatory bowel disease, has many well-known extra-intestinal manifestations and complications. Although acute pancreatitis has a higher incidence in patients with Crohn's disease as compared to the general population, acute pancreatitis is still relatively uncommon in patients with Crohn's disease. Patients with Crohn's disease are at an approximately fourfold higher risk than the general population to develop acute pancreatitis. The risk of developing acute pancreatitis is higher in females as compared to males. Acute pancreatitis can occur at any age with higher incidence reported in patients in their 20s and between 40- 50 years of age. The severity and prognosis of acute pancreatitis in patients with Crohn's disease is the same as in general population. Acute pancreatitis can occur before onset of intestinal Crohn's disease, this presentation being more common in children than adults. It can also occur as the presenting symptom. However, most commonly it occurs after intestinal symptoms have manifest with a mean time interval between the initial presentation and development of acute pancreatitis being 2 years. There are several etiological factors contributing to acute pancreatitis in patients with crohn's disease. It is not clear whether acute pancreatitis is a direct extra-intestinal manifestation of Crohn's disease; however majority of the cases of acute pancreatitis in patients with Crohn's disease are due to GS and medications. Drugs used for the treatment of Crohn's disease that have been reported to cause acute pancreatitis include 5-ASA agents, azathioprine and 6 mercaptopurine, metornidazole and corticosteroids. Recent evidence has emerged correlating both type 1 and 2 autoimmune pancreatitis with Crohn's disease. Understanding the association between the two disease entities is key to effectively manage patients with Crohn's disease and acute pancreatitis.

  4. Transvaginal sonography of acute pelvic inflammatory disease

    To determine the value of transvaginal sonography in evaluating women with acute pelvic inflammatory disease (PID). Transvaginal sonography was performed in 25 patients with clinically suggested PID during recent 36 months. The sonographic findings of fallopian tubes and ovaries were analyzed and correlated with pathological findings of 2 fallopian tubes and 19 ovaries in 16 patients who had operations. The correct diagnosis of acute PID was made in 20/25 (80%) by transvaginal sonography. the abnormal sonographic findings of the fallopian tube include tubal thickening or dilatation with internal echo. The sensitivity, specificity, and accuracy for tubal abnormality were 88%, 96%, and 86% , respectively. Ovarian changes were seen on TVS in 14/19 (73%), which include multiple follicular enlargement in 5, tubo-ovarian complex in 9 (tubo-ovarian adhesion in 3, tubo-ovarian abscess in 6). At surgery, the ovay was not involved in all three women who showed tubo-ovarian adhesion on TVS. Among 6 women who showed tubo-ovarian abscess on TVS, tubo-ovarian abscess was confirmed in 3 and the remaining 3 had ovarian cysts. Trandvaginal sonography, a facilitative and accurate modality, is highly sensitive in detecting the abnormality of the tube and useful in differentiating the tubo-ovarian complex in patients with acute PID.

  5. Involvement of Toll-like receptors in acute radiation syndrome and radiation therapy for cancer

    Toll-like receptors (TLR) are one of pattern recognition receptors that are indispensable for antibacterial and antiviral immunity. After TLRs sense pathogen-derived components, they activate intracellular signaling pathways, which results in the induction of proinflammatory cytokines. Although it is well known that radiation therapy is one of effective cancer therapies, radiation affects immune system. Recent evidences show the involvement of TLR in acute radiation syndrome and radiation therapy for cancer. I summarize to date knowledge on the involvement of Toll-like receptors in acute radiation syndromes and radiation therapy for cancer, and discuss the effects of ionizing radiation on TLR of innate immune cells. (author)

  6. Acute radiation proctitis. A clinical, histopathological and histochemical study

    The aim of the study is: 1) A sequential description of the clinical course of acute radiation proctitis during pelvic RT. 2) A sequential description of the rectal mucosal histopathology during pelvic RT as a possible substrate for clinical toxicity. 3) To assess the mucosal protease activity during RT as a possible explanation of the observed tissue changes. 4) To assess the efficacy of prophylactic sucralfate in acute radiation proctitis a randomised study was initiated and carried out together with a meta-analysis of previously available data. 5) Most studies on clinical acute toxicity in pelvic RT use either the RTOG/EORTC score system or focus on diarrhoea/stool frequency. A more differentiated and sensitive recording was developed and tested to pick up symptoms escaping the commonly used scores. 6) Study the relation between histopathological findings and the clinical picture. 4 papers presenting various studies are included. The titles are: 1) Acute radiation proctitis: a sequential clinicopathologic study during pelvic radiotherapy. 2) Clinical significance of increased gelatinolytic activity in the rectal mucosa during external beam radiation therapy of prostate cancer. 3) Profiles and time course of acute radiation toxicity symptoms during conformal radiotherapy for cancer of the prostate. 4) Sucralfate does not ameliorate acute radiation proctitis. Some future prospects are discussed

  7. Acute radiation proctitis. A clinical, histopathological and histochemical study

    Hovdenak, Nils

    2004-07-01

    The aim of the study is: 1) A sequential description of the clinical course of acute radiation proctitis during pelvic RT. 2) A sequential description of the rectal mucosal histopathology during pelvic RT as a possible substrate for clinical toxicity. 3) To assess the mucosal protease activity during RT as a possible explanation of the observed tissue changes. 4) To assess the efficacy of prophylactic sucralfate in acute radiation proctitis a randomised study was initiated and carried out together with a meta-analysis of previously available data. 5) Most studies on clinical acute toxicity in pelvic RT use either the RTOG/EORTC score system or focus on diarrhoea/stool frequency. A more differentiated and sensitive recording was developed and tested to pick up symptoms escaping the commonly used scores. 6) Study the relation between histopathological findings and the clinical picture. 4 papers presenting various studies are included. The titles are: 1) Acute radiation proctitis: a sequential clinicopathologic study during pelvic radiotherapy. 2) Clinical significance of increased gelatinolytic activity in the rectal mucosa during external beam radiation therapy of prostate cancer. 3) Profiles and time course of acute radiation toxicity symptoms during conformal radiotherapy for cancer of the prostate. 4) Sucralfate does not ameliorate acute radiation proctitis. Some future prospects are discussed.

  8. Radiation-induced acute myeloid leukaemia in mice

    Ample epidemiological studies of human populations implicate ionizing radiation as a carcinogen and these quantitative studies provide the foundation for the core estimates of radiation cancer risk. The majority of the epidemiological data originate from situations of radiation exposure at high dose and high dose rate. The relevance of risk estimates based on such exposures to the more commonly encountered low dose and dose rate situation has been questioned frequently. Thus, there is a need to investigate and quantitate low dose and dose rate effects. A number of approaches may be considered, for example, very large scale epidemiology, very large scale animal experimentation; however, both of these present problems of a practical and/or ethical nature. A further possible approach is that of mechanistic modelling. This requires a fairly detailed understanding of neoplastic disease and how it develops post-irradiation. Many factors and variables have to be taken into consideration in mechanistic modelling approaches. Testing of mechanistic modelling schemes is best carried out using animal model systems. Acute myeloid leukaemia (AML) is a radiogenic cancer of significance in man and several good mouse models of the disease are available. Here, recent studies conducted at NRPB with the aim of elucidating the post-irradiation development of AML will be discussed. In particular three areas critical for developing a sound mechanistic model will be covered, definition of the initiating event; study of disease progression, this addresses the question of the frequency of conversion of initiated cells into the neoplastic state and the influence of genetic background on leukaemogenesis. (author)

  9. Acute renal dysfunction in liver diseases

    2007-01-01

    Renal dysfunction is common in liver diseases, either as part of multiorgan involvement in acute illness or secondary to advanced liver disease. The presence of renal impairment in both groups is a poor prognostic indicator. Renal failure is often multifactorial and can present as pre-renal or intrinsic renal dysfunction. Obstructive or post renal dysfunction only rarely complicates liver disease. Hepatorenal syndrome (MRS) is a unique form of renal failure associated with advanced liver disease or cirrhosis, and is characterized by functional renal impairment without significant changes in renal histology. Irrespective of the type of renal failure, renal hypoperfusion is the central pathogenetic mechanism, due either to reduced perfusion pressure or increased renal vascular resistance. Volume expansion, avoidance of precipitating factors and treatment of underlying liver disease constitute the mainstay of therapy to prevent and reverse renal impairment. Splanchnic vasoconstrictor agents, such as terlipressin, along with volume expansion, and early placement of transjugular intrahepatic portosystemic shunt (TIPS) may be effective in improving renal function in HRS. Continuous renal replacement therapy (CRRT) and molecular absorbent recirculating system (MARS) in selected patients may be life saving while awaiting liver transplantation.

  10. A case of acute viral hepatitis interfering with acute fatty liver disease of pregnancy

    Abdulkadir Turgut

    2013-03-01

    Full Text Available Acute hepatitis A is a rarely seen infection during pregnancy.In terms of clinical and laboratory findings, it can beinterfere with acute fatty liver disease which can be quitemortal during pregnancy. Since liver function tests are elevatedin both conditions, hepatitis A infection should alsobe kept in mind in differential diagnosis. We present a 30year-old pregnant woman with 35 weeks of gestation whopresented to our clinic with a suspection of acute fattyliver disease but finally diagnosed as acute hepatitis A infection.J Clin Exp Invest 2013; 4 (1: 123-125Key words: Hepatitis A, pregnancy, acute fatty liver disease

  11. Pathophysiology of acute small bowel disease with CT correlation

    The objective of this article is to review the pathophysiology of acute small bowel diseases, and to correlate the mechanisms of disease with computed tomography (CT) findings. Disease entities will be classified into the following: immune mediated and infectious causes, vascular causes, mechanical causes, trauma, and others. Having an understanding of acute small bowel pathophysiology is a useful teaching tool, and can lead to imaging clues to the most likely diagnosis of acute small bowel disorders.

  12. Pathophysiology of acute small bowel disease with CT correlation

    Sarwani, N., E-mail: nsarwani@hmc.psu.ed [Department of Radiology, Section of Abdominal Imaging, Penn State Milton Hershey Medical Center, Hershey, PA (United States); Tappouni, R.; Tice, J. [Department of Radiology, Section of Abdominal Imaging, Penn State Milton Hershey Medical Center, Hershey, PA (United States)

    2011-01-15

    The objective of this article is to review the pathophysiology of acute small bowel diseases, and to correlate the mechanisms of disease with computed tomography (CT) findings. Disease entities will be classified into the following: immune mediated and infectious causes, vascular causes, mechanical causes, trauma, and others. Having an understanding of acute small bowel pathophysiology is a useful teaching tool, and can lead to imaging clues to the most likely diagnosis of acute small bowel disorders.

  13. Report of board IV: Radiation damages and radiation induced diseases

    Board IV (radiation damage and radiation-induced diseases) worked on the effects of ionizing radiation on living organisms and studies the radiation damage it entailed. Investigations with cells or model systems serve to recognize certain causal relationships in an organism out of the diversity of reactions encountered. (orig./AK)

  14. Acute rheumatic fever and rheumatic heart disease.

    Carapetis, Jonathan R; Beaton, Andrea; Cunningham, Madeleine W; Guilherme, Luiza; Karthikeyan, Ganesan; Mayosi, Bongani M; Sable, Craig; Steer, Andrew; Wilson, Nigel; Wyber, Rosemary; Zühlke, Liesl

    2016-01-01

    Acute rheumatic fever (ARF) is the result of an autoimmune response to pharyngitis caused by infection with group A Streptococcus. The long-term damage to cardiac valves caused by ARF, which can result from a single severe episode or from multiple recurrent episodes of the illness, is known as rheumatic heart disease (RHD) and is a notable cause of morbidity and mortality in resource-poor settings around the world. Although our understanding of disease pathogenesis has advanced in recent years, this has not led to dramatic improvements in diagnostic approaches, which are still reliant on clinical features using the Jones Criteria, or treatment practices. Indeed, penicillin has been the mainstay of treatment for decades and there is no other treatment that has been proven to alter the likelihood or the severity of RHD after an episode of ARF. Recent advances - including the use of echocardiographic diagnosis in those with ARF and in screening for early detection of RHD, progress in developing group A streptococcal vaccines and an increased focus on the lived experience of those with RHD and the need to improve quality of life - give cause for optimism that progress will be made in coming years against this neglected disease that affects populations around the world, but is a particular issue for those living in poverty. PMID:27188830

  15. Preliminary studies of radiation port in children receiving cranial irradiation for preventing central nervous system (CNS) disease of acute lymphoblastic leukemia (ALL)

    For preventing CNS leukemia in children with ALL, simple whole skull irradiation that included only retro-orbital spaces and not anterior part of the cribriform plate and first two cervical vertebrae had been given until March 1982 to patients who had remission after drug therapy. Since March 1982, however, such patients have received new modified cranial irradiation of Pinkel's method of preventive CNS therapy to include the cribriform plate. Pinkel's method usually includes first two cervical vertebrae in radiation port, but sometimes his method of radiation fails to reach the brain and the meninges on the anterior parts of the lamina cribrosa. In this study, a comparison of CNS-relapes ratio between these two methods of preventive CNS therapy was carried out. The frequency of CNS leukemia was remarkably high in patients given the simple whole skull irradiation. Of 18 patients, 7 developed CNS leukemia. Among these 7, 5 patients (71 %) had occurence of CNS-relapse within 1 year 7 months with the other one patient, making a total of 86 %, having CNS-relapse within 1 year 11 months. On the other hand, 17 of 39 patients who received new modified cranial irradiation were followed up for more than 1 year 9 months, and all patient had no CNS-relapse to date. This result showed that the irradiation of whole circulation areas of cerebrospinal fluid of the brain and the spine at first two cervical vertebra levels had great importance in preventing CNS-relapse after achievement of drug-induced remission. (author)

  16. Principles of medical rehabilitation of survivors of acute radiation sickness induced by gamma and beta and gumma and neutron radiation

    The purpose of this study is to reveal the principles of medical rehabilitation different degree acute radiation syndrome (ARS) survivors, who exposed γβ- and γη-irradiation in different radiation accidents. The main reasons of working disability in the late consequences of ARS period are consequences of local radiation injures (LRI) and joining somatic diseases. Its revealing and treatment considerably improves quality of life of the patients. The heaviest consequence of LRI of a skin at γβ- radiation exposure is the development of late radiation ulcers and radiation fibrosis, which require repeated plastic surgery. LRI at γη-radiation exposure differ by the greater depth of destruction of a underlying tissues and similar defects require the early amputations. Last 10 years microsurgery methods of plastic surgery allow to save more large segments of extremities and to decrease expression of the late consequences (radiation fibrosis and late radiation ulcers) LRI severe and extremely severe degrees. Medical rehabilitation of radiation cataract (development at doses more than 2.0 Gy) includes its extraction and artificial lens implantation, if acuity of vision is considerably decreased. Changes of peripheral blood, observed at the period of the long consequences, as a rule, different, moderate, transient and not requiring treatment. Only one ARS survivor dead from chronic myeloid leukemia. Thyroid nodes, not requiring operative intervention, are found out in Chernobyl survivors. Within the time course the concurrent somatic disease become the major importance for patients disability growth, which concurrent diseases seem to be unrelated to radiation dose and their structure does not differ from that found in general public of Russia. The rehabilitation of the persons who have transferred ARS as a result of radiating failure, should be directed on restoration of functions critical for ionizing of radiation of bodies and systems causing reduction of a level of

  17. Principles of medical rehabilitation of survivors of acute radiation sickness induced by gamma and beta and gumma and neutron radiation

    Nedejina, N.M.; Galstian, I.A.; Savitsky, A.A.; Sachkov, A.V.; Rtisheva, J.N.; Uvatcheva, I.V.; Filin, S.V. [State Research Center of Russia, Moscow (Russian Federation). Inst. of Biophysics

    2000-05-01

    The purpose of this study is to reveal the principles of medical rehabilitation different degree acute radiation syndrome (ARS) survivors, who exposed {gamma}{beta}- and {gamma}{eta}-irradiation in different radiation accidents. The main reasons of working disability in the late consequences of ARS period are consequences of local radiation injures (LRI) and joining somatic diseases. Its revealing and treatment considerably improves quality of life of the patients. The heaviest consequence of LRI of a skin at {gamma}{beta}- radiation exposure is the development of late radiation ulcers and radiation fibrosis, which require repeated plastic surgery. LRI at {gamma}{eta}-radiation exposure differ by the greater depth of destruction of a underlying tissues and similar defects require the early amputations. Last 10 years microsurgery methods of plastic surgery allow to save more large segments of extremities and to decrease expression of the late consequences (radiation fibrosis and late radiation ulcers) LRI severe and extremely severe degrees. Medical rehabilitation of radiation cataract (development at doses more than 2.0 Gy) includes its extraction and artificial lens implantation, if acuity of vision is considerably decreased. Changes of peripheral blood, observed at the period of the long consequences, as a rule, different, moderate, transient and not requiring treatment. Only one ARS survivor dead from chronic myeloid leukemia. Thyroid nodes, not requiring operative intervention, are found out in Chernobyl survivors. Within the time course the concurrent somatic disease become the major importance for patients disability growth, which concurrent diseases seem to be unrelated to radiation dose and their structure does not differ from that found in general public of Russia. The rehabilitation of the persons who have transferred ARS as a result of radiating failure, should be directed on restoration of functions critical for ionizing of radiation of bodies and

  18. Acute and Chronic Cutaneous Reactions to Ionizing Radiation Therapy.

    Bray, Fleta N; Simmons, Brian J; Wolfson, Aaron H; Nouri, Keyvan

    2016-06-01

    Ionizing radiation is an important treatment modality for a variety of malignant conditions. However, development of radiation-induced skin changes is a significant adverse effect of radiation therapy (RT). Cutaneous repercussions of RT vary considerably in severity, course, and prognosis. When they do occur, cutaneous changes to RT are commonly graded as acute, consequential-late, or chronic. Acute reactions can have severe sequelae that impact quality of life as well as cancer treatment. Thus, dermatologists should be informed about these adverse reactions, know how to assess their severity and be able to determine course of management. The majority of measures currently available to prevent these acute reactions are proper skin hygiene and topical steroids, which limit the severity and decrease symptoms. Once acute cutaneous reactions develop, they are treated according to their severity. Treatments are similar to those used in prevention, but incorporate wound care management that maintains a moist environment to hasten recovery. Chronic changes are a unique subset of adverse reactions to RT that may develop months to years following treatment. Chronic radiation dermatitis is often permanent, progressive, and potentially irreversible with substantial impact on quality of life. Here, we also review the etiology, clinical manifestations, pathogenesis, prevention, and management of late-stage cutaneous reactions to radiotherapy, including chronic radiation dermatitis and radiation-induced fibrosis. PMID:27250839

  19. A case of acute viral hepatitis interfering with acute fatty liver disease of pregnancy

    Abdulkadir Turgut; Ali Özler; Neval Yaman Görük; Senem Yaman Tunç; Nurullah Peker; Recep Tekin

    2013-01-01

    Acute hepatitis A is a rarely seen infection during pregnancy.In terms of clinical and laboratory findings, it can beinterfere with acute fatty liver disease which can be quitemortal during pregnancy. Since liver function tests are elevatedin both conditions, hepatitis A infection should alsobe kept in mind in differential diagnosis. We present a 30year-old pregnant woman with 35 weeks of gestation whopresented to our clinic with a suspection of acute fattyliver disease but finally diagnosed ...

  20. Ionizing Radiation-induced Diseases in Korea

    Jin, Young-Woo; Jeong, Meeseon; Moon, Kieun; Jo, Min-Heui; Kang, Seong-Kyu

    2010-01-01

    Radiation risk has become well known through epidemiological studies of clinically or occupationally exposed populations, animal experiments, and in vitro studies; however, the study of radiation related or induced disease has been limited in Korea. This study is to find the level of occupational radiation exposure for various kinds of accidents, compensated occupational diseases, related studies, and estimations on future occupational disease risks. Research data of related institutions were...

  1. Stem cell-based therapies for acute radiation syndrome

    Exposure to high doses of ionizing radiation in the event of accidental or intentional incident such as nuclear/radiological terrorism can lead to debilitating injuries to multiple organs resulting in death within days depending on the amount of radiation dose and the quality of radiation. Unfortunately, there is not a single FDA-licensed drug approved against acute radiation injury. The RadStem Center for Medical Countermeasures against Radiation (RadStem CMGR) program at Einstein is developing stem cell-based therapies to treat acute radiation syndrome (ARS). We have demonstrated that intravenous transplantation of bone marrow-derived and adipose-derived stromal cells, consisting of a mixture of mesenchymal, endothelial and myeloid progenitors can mitigate mice exposed to whole body irradiation of 12 Gy or whole abdominal irradiation of up to 20 Gy. We identified a variety of growth and differentiation factors that individually is unable to improve survival of animals exposed to lethal irradiation, but when administered sequentially mitigates radiation injury and improves survival. We termed this phenomenon as synthetic survival and describe a new paradigm whereby the 'synthetic survival' of irradiated tissues can be promoted by systemic administration of growth factors to amplify residual stem cell clonogens post-radiation exposure, followed by a differentiation factor that favors tissue stem cell differentiation. Synthetic survival can be applied to mitigate lethal radiation injury in multiple organs following radiation-induced hematopoeitic, gastrointestinal and pulmonary syndromes. (author)

  2. Effects of Ozonated Olive Oil on Acute Radiation Proctitis in Rats

    Gültekin, Fatma Ayça; BAKKAL, Bekir Hakan; Sümer, Demet; Köktürk, Füruzan; Bektaş, Sibel

    2013-01-01

    Background: Acute radiation proctitis is a common complication of pelvic radiation and management of acute radiation proctitis is under evaluation. The beneficial effects of ozonated olive oil (OzOO) have already been shown in the treatment of chronic wounds. Thus, this study was designed to evaluate the therapeutic effects of topical OzOO on acute radiation proctitis. Aims: To evaluate the therapeutic effects of topical OzOO on acute radiation proctitis. Study Design: An...

  3. Radiation-induced coronary artery disease

    This report describes three patients who developed myocardial infarction at an untimely age, 4 to 12 years after radiation therapy for Hodgkin's disease. These cases lend credence to the cause and effect relation of such therapy to coronary artery disease

  4. Acute Cerebrovascular Radiation Syndrome: Radiation Neurotoxicity , mechanisms of CNS radiation injury, advanced countermeasures for Radiation Protection of Central Nervous System.

    Popov, Dmitri; Jones, Jeffrey; Maliev, Slava

    Key words: Cerebrovascular Acute Radiation Syndrome (Cv ARS), Radiation Neurotoxins (RNT), Neurotransmitters, Radiation Countermeasures, Antiradiation Vaccine (ArV), Antiradiation Blocking Antibodies, Antiradiation Antidote. Psychoneuroimmunology, Neurotoxicity. ABSTRACT: To review the role of Radiation Neurotoxins in triggering, developing of radiation induced central nervous system injury. Radiation Neurotoxins - rapidly acting blood toxic lethal agent, which activated after irradiation and concentrated, circulated in interstitial fluid, lymph, blood with interactions with cell membranes, receptors and cell compartments. Radiation Neurotoxins - biological molecules with high enzymatic activity and/or specific lipids and activated or modified after irradiation. The Radiation Neurotoxins induce increased permeability of blood vessels, disruption of the blood-brain barrier, blood-cerebrospinal fluid (CSF) barrier and developing severe disorder of blood macro- and micro-circulation. Principles of Radiation Psychoneuro-immunology and Psychoneuro-allergology were applied for determination of pathological processes developed after irradiation or selective administration of Radiation Neurotoxins to radiation naïve mammals. Effects of radiation and exposure to radiation can develop severe irreversible abnormalities of Central Nervous System, brain structures and functions. Antiradiation Vaccine - most effective, advanced methods of protection, prevention, mitigation and treatment and was used for of Acute Radiation Syndromes and elaboration of new technology for immune-prophylaxis and immune-protection against ϒ, Heavy Ion, Neutron irradiation. Results of experiments suggested that blocking, antitoxic, antiradiation antibodies can significantly reduce toxicity of Radiation Toxins. New advanced technology include active immune-prophylaxis with Antiradiation Vaccine and Antiradiation therapy that included specific blocking antibodies to Radiation Neurotoxins

  5. Acute Diarrhoeal Diseases Among Preschool Children in Western Maharashtra, India.

    Mahesh B Tondare , Vaishali V Raje, Satish V Kakade , Madhavi V Rayate

    2014-01-01

    "Background: Malnutrition and infectious diseases both occur in the same unfortunate children and together they play a major role in causing the high morbidity and mortality in them. Out of all the childhood illnesses, acute respiratory tract infections, diarrhoeal diseases and malnutrition are the principle causes of illness and death in the developing countries. Acute Diarrhoeal diseases (ADD’s) are reported to be the 2nd leading cause of child morbidity and mortality. Objectives: ...

  6. Clinico-morphological characteristics of reparation of acute radiation ulcer

    The mechanism of reparative processes under the effect of various drugs was studied in experimental acute radiation ulcer of rats. It was established that at the stage of marked exudative-necrotic processes the use of antiinflammatory and antiexudative substances (bariz, dimethylsulfoxyde) led to normalization of the microcirculation that reduced the time of radiation ulcer healing. The use of anabolic steroids (retabolil) intensified metabolism that also produced a favourable effect on the reparative processes

  7. Risk of cardiovascular disease following radiation exposure

    Excess radiation-induced cardiac mortalities have been reported among radiotherapy patients. Many case reports describe the occurrence of atherosclerosis following radiotherapy for Hodgkin's disease and breast cancer. Some case reports describe the cerebral infarction following radiotherapy to neck region, and of peripheral vascular disease of the lower extremities following radiotherapy to the pelvic region. The association of atomic bomb radiation and cardiovascular disease has been examined recently by incidence studies and prevalence studies of various endpoints of atherosclerosis; all endpoints indicated an increase of cardiovascular disease in the exposed group. It is almost certain that the cardiovascular disease is higher among atomic bomb survivors. However, since a heavy exposure of 10-40 Gy is delivered in radiotherapy and the bomb survivors were exposed to radiation at high dose and dose-rate, the question is whether the results can be extrapolated to individuals exposed to lower levels of radiation. Some recent epidemiological studies on occupationally exposed workers and population living near Chernobyl have provided the evidence for cardiovascular disease being a significant late effect at relatively low doses of radiation. However, the issue of non-cancer mortality from radiation is complicated by lack of adequate information on doses, and many other confounding factors (e.g., smoking habits or socio-economic status). This presentation will evaluate possible radiobiological mechanisms for radiation-induced cardiovascular disease, and will address its relevance to radiation protection management at low doses and what the impact might be on future radiation risk assessments. (authors)

  8. Minimal residual disease in acute lymphoblastic leukemia.

    Campana, Dario

    2009-01-01

    In patients with acute lymphoblastic leukemia (ALL), monitoring of minimal residual disease (MRD) offers a way to precisely assess early treatment response and detect relapse. Established methods to study MRD are flow cytometric detection of abnormal immunophenotypes, polymerase chain reaction (PCR) amplification of antigen-receptor genes, and PCR amplification of fusion transcripts. The strong correlation between MRD levels and risk of relapse in childhood ALL is well demonstrated; studies in adult patients also support its prognostic value. Hence, results of MRD studies can be used to select treatment intensity and duration, and to estimate the optimal timing for hematopoietic stem cell transplantation. Practical issues in the implementation of MRD assays in clinical studies include determining the most informative time point to study MRD and the levels of MRD that will trigger changes in treatment intensity, as well as the relative cost and informative power of different methodologies. The identification of new markers of leukemia and the use of increasingly refined assays should further facilitate routine monitoring of MRD and help to clarify the cellular and biologic features of leukemic cells that resist chemotherapy in vivo. PMID:19100372

  9. Acute radiation syndrones and their management

    Radiation syndromes produced by large doses of ionizing radiation are divided into three general groups depending on dose of radiation and time after exposure. The CNS syndrome requires many thousands of rad, appears in minutes to hours, and kills within hours to days. The GIS appears after doses of a few hundred to 2000 rad. It is characterized by nausea, vomiting, diarrhea, and disturbances of water and electrolyte metabolism. It has a high mortality in the first week after exposure. Survivors will then experience the HS as a result of marrow aplasia. Depending on dose, survival is possible with antibiotic and transfusion therapy. The relationship of granulocyte depression to mortality in dogs and human beings is illustrated. The role of depth dose pattern of mortality of radiation exposure is described and used as an indication of why air exposure doses may be misleading. The therapy of radiation injury is described based on antibiotics, transfusion therapy, and use of molecular regulators. The limited role of matched allogenic bone marrow transplants is discussed. 52 refs., 13 figs

  10. Acute radiation syndrones and their management

    Cronkite, E.P.

    1988-01-01

    Radiation syndromes produced by large doses of ionizing radiation are divided into three general groups depending on dose of radiation and time after exposure. The CNS syndrome requires many thousands of rad, appears in minutes to hours, and kills within hours to days. The GIS appears after doses of a few hundred to 2000 rad. It is characterized by nausea, vomiting, diarrhea, and disturbances of water and electrolyte metabolism. It has a high mortality in the first week after exposure. Survivors will then experience the HS as a result of marrow aplasia. Depending on dose, survival is possible with antibiotic and transfusion therapy. The relationship of granulocyte depression to mortality in dogs and human beings is illustrated. The role of depth dose pattern of mortality of radiation exposure is described and used as an indication of why air exposure doses may be misleading. The therapy of radiation injury is described based on antibiotics, transfusion therapy, and use of molecular regulators. The limited role of matched allogenic bone marrow transplants is discussed. 52 refs., 13 figs.

  11. Developing diagnostic guidelines for the acute radiation syndrome

    Diagnostic guidelines seem to be promising for improving medical care. One aspect of a diagnostic guideline for the acute radiation syndrome has been tested against an extensive case history database. Subsequently, the guideline has been optimized for a small set of case histories. The improved performance has been proven by a test against the rest of the case history database

  12. Psychological Aspects of Acute Radiation Accidents

    This paper generally describes personality structure and needs and then relates these to the psychological aspects of radiation injury. Three levels in the personality structure are defined as child, adult, and parent. This is followed by a description of two major need systems the first of which, if not met, results in the death of the individual and the second, if not met, results in significant emotional disruption of the individual. This is followed by a discussion of coping phases and stress patterns of radiation injury, including the effects of the illusion of immunity characterized by the feeling that ''things can happen to others, but not to me'', and the ''nuclear mystique'' which is characterized by a magical quality attached to radiation due partly to the lack of sense organ response to radiation exposure. Following impact, treatment in the reactive.phase, which includes moderate and severe emotional reactions, involves a series of compensating emotions. These include the illusion of centrality, the feeling of abandonment, altruism, and amorality. The ''aftermath'' reaction is treated from the standpoint of the ''tormenting memory'', the ''amnesiac reaction'', the ''fear of recurrence'' and the individual’s need to cope with both his medical condition and reactions of others to his condition. The recovery phase is treated from the standpoint of unacceptable and acceptable disability. Finally, a recommended psychological treatment for the physician to use in radiation accident cases is made involving the individual's psychological needs, as well as the physician's psychological role which includes: authoritative support, acceptance, optimism, and avoidance of the appearance of an overly scientific approach. Effective organizing, planning or training for the care of radiation accident cases must consider the psychological factors developed. Recommendations for mental health programs which include employee screening and counselling programs are made

  13. Pathophysiology of coronary artery disease leading to acute coronary syndromes

    Ambrose, John A; Singh, Manmeet

    2015-01-01

    Acute myocardial infarction (AMI) and sudden cardiac death (SCD) are among the most serious and catastrophic of acute cardiac disorders, accounting for hundreds of thousands of deaths each year worldwide. Although the incidence of AMI has been decreasing in the US according to the American Heart Association, heart disease is still the leading cause of mortality in adults. In most cases of AMI and in a majority of cases of SCD, the underlying pathology is acute intraluminal coronary thrombus f...

  14. Acute Splenic Sequestration Crisis in a 70-Year-Old Patient With Hemoglobin SC Disease.

    Squiers, John J; Edwards, Anthony G; Parra, Alberto; Hofmann, Sandra L

    2016-01-01

    A 70-year-old African American female with a past medical history significant for chronic bilateral shoulder pain and reported sickle cell trait presented with acute-onset bilateral thoracolumbar pain radiating to her left arm. Two days after admission, Hematology was consulted for severely worsening microcytic anemia and thrombocytopenia. Examination of the patient's peripheral blood smear from admission revealed no cell sickling, spherocytes, or schistocytes. Some targeting was noted. A Coombs test was negative. The patient was eventually transferred to the medical intensive care unit in respiratory distress. Hemoglobin electrophoresis confirmed a diagnosis of hemoglobin SC disease. A diagnosis of acute splenic sequestration crisis complicated by acute chest syndrome was crystallized, and red blood cell exchange transfusion was performed. Further research is necessary to fully elucidate the pathophysiology behind acute splenic sequestration crisis, and the role of splenectomy to treat hemoglobin SC disease patients should be better defined. PMID:27047980

  15. The Effects of Radiation and Dose-Fractionation on Cancer and Non-Tumor Disease Development

    Woloschak, Gayle E.; Tatjana Paunesku; David J Grdina; Kwasny, Mary J; Jian-Jian Li; Haley, Benjamin M.; William Liu

    2012-01-01

    The Janus series of radiation experiments, conducted from 1970 to 1992, explored the effects of gamma and neutron radiation on animal lifespan and disease development. Data from these experiments presents an opportunity to conduct a large scale analysis of both tumor and non-tumor disease development. This work was focused on a subset of animals from the Janus series of experiments, comparing acute or fractionated exposures of gamma or neutron radiation on the hazards associated with the deve...

  16. Radiation-induced carotid artery disease

    Nine patients with atherosclerotic carotid artery disease associated with neck radiation were compared to 40 control patients. The data suggest that significant differences in age, incidence of coronary and peripheral vascular disease, elevated lipids and serum cholesterol, and the angiographic incidence of disseminated atherosclerosis justify the description of radiation-induced carotid disease as a clinical entity. Elevated serum cholesterol and hyperlipidemia may contribute to the development of radiation-induced vascular disease. Successful surgical reconstruction does not appear to be influenced by the prior radiotherapy, although periarterial fibrosis and increased difficulty in separating the plaques from the vascular media was encountered

  17. Chronic radiation disease. Consequences and outcomes

    Chronic Radiation Disease (CRD), induced by chronic external gamma-irradiation in cumulative dose 1.0-10.0 Gy ever a period of employment from 7 months to 7 years was described for the atomic enterprise workers during adjustment of that enterprise (1948-54). Key clinical syndromes of CRD were cytopenia in the peripheral blood (decrease of a number of thrombocytes, leukocytes, neutrophils to 50-60% from an initial level), changes in the nervous system (vegetative-vascular dysfunction of the hypotonic type, asthenic syndrome and at a cumulative dose more than 4.0 Gy - demyelinatied encephalomyelosis). The annual medical examination allowed assessing consequences of CRD for long-term period of monitoring (35-40 years) of 632 workers. By 10-15 years after termination of an exposure the characteristics of the peripheral blood are reverted to initial level (before employment at enterprise). However even by 40th year of observation in a part of cases the moderate hypoplasia of bone marrow (7.3%) and partial hypoplasia granulocytopoiesis (4.3%) is diagnosed. In lymphocytes of the peripheral blood the frequency of chromosome aberrations 4-5 times greater than a spontaneous level. Decrease of parameters of T-cell immunity remains. In cases of high exposure doses (cumulative dose more than 3.5-4.0 Gy) the early cerebral atherosclerosis (not older than 45) was diagnosed. By 40th year of monitoring the radiation cataracts were not detected. During the first decade of monitoring prevailing causes of death were an acute myeloid leukemia, during subsequent 30 years of monitoring - lung cancer was prevailing causes of death for worker who had contact with plutonium 239. (author)

  18. ACUTE RESPIRATORY DISEASE AS THE DEBUT OF SYSTEMIC LUPUS ERYTHEMATOSUS

    A. Yu. Ischenko

    2015-01-01

    Full Text Available Systemic lupus erythematosus — a chronic autoimmune disease that is often associated with infectious processes. The paper presents two clinical cases of systemic lupus erythematosus , debuted with acute respiratory infection.

  19. [Acute pancreatitis with hypertriglyceridemia--an underestimated disease?].

    Wild, Wolfgang; Tajjiou, Morad; Ferschke, Melanie; Bormann, Fabian; Dörr, Pius; Schwarzbach, Matthias

    2016-01-01

    Hypertriglyceridemia is a rare, but since a long time well known etiology for acute pancreatitis. It could occure alone or coactive with other triggers like alcohlic excess. Nevertheless it found no approach to the current classifications and parameters of prognosis of the acute pancreatitis. We refer about two patients with hypertriglyceridemia and acute pancreatitis, whose initial disease was limited on the tail of the pancreas with just a circumscripted or--in the other case--no necrosis. However, in both cases and although a consequent treatment started immediately, a serious process developed including a life-threatening acute respiratory distress syndrome in one case, which necessitated an extracorporal membrane oxygenation. PMID:26710203

  20. Acute Demyelinating Disease after Oral Therapy with Herbal Extracts

    Alex Kostianovsky

    2011-06-01

    Full Text Available Central nervous system demyelinating processes such as multiple sclerosis and acute disseminated encephalomyelitis constitute a group of diseases not completely understood in their physiopathology. Environmental and toxic insults are thought to play a role in priming autoimmunity. The aim of the present report is to describe a case of acute demyelinating disease with fatal outcome occurring 15 days after oral exposure to herbal extracts.

  1. Exposed persons at the Chernobyl Atomic Power Station accident: acute radiation effects

    Observation made over 115 patients with acute radiation sickness due to exposure external γ- and β-rays confirmed high efficiency of the earlier proposed principles of prognostication of the degree of severity by clinical manifestations of the primary disease response and those of separate syndromes, using the methods of hematological and cytogenetic analyses. Out of 115 victims, 56 persons had radiation burns (RB), 17 intestinal syndrome (IS), 80 - oropharengeal syndrome (ORS), 7 - interstitial radiation pneumonitis (IRP). In thanatogenesis, of prime importance were: RB (more than 40% of the body surface) - 19 persons and IRP - 7 persons. A severe course of intestinal and oropharengeal syndromes was combined with other fatal manifestations of radiation injury. Early isolation of patients (2-4 stages), selective decontamination of the intestine, prescription of a wide spectrum antibiotics, antimycotic and antiviral drugs, as well as γ-globulin could practically remove the risk of the development of fatal infectious complications during a medullary andtransitory forms of radiation sickness

  2. Extramammary Paget's disease: role of radiation therapy

    Extra mammary Paget's disease (EMPD) is an uncommon premalignant skin condition that has been traditionally managed with surgery. A report of long-standing Paget's disease with transformation to invasive adenocarcinoma definitively managed with radiation therapy is presented. A review of cases of extramammary Paget's disease treated with radiation therapy is discussed. The use of radiation therapy should be considered in selected cases, as these studies demonstrate acceptable rates of local control when used as an adjunct to surgery, or as a definitive treatment modality. Copyright (2002) Blackwell Science Pty Ltd

  3. [Demyelinating diseases in children with acute neurological symptoms].

    Olofsson, Isa Amalie; Skov, Liselotte; Miranda, Maria Jose

    2015-12-01

    Demyelinating diseases in children is a broad group of illnesses, which affect the central nervous system. Demyelinating diseases can be monophasic or chronic and comprise acute disseminated encephalomyelitis, optic neuritis, transverse myelitis, multiple sclerosis and neuromyelitis optica. Demyelinating diseases are rare, but it is important for the physician to recognize these diseases, as well as to understand the differential diagnoses. This review summarizes the current knowledge of demyelinating disorders in children, focusing on an approach to diagnosis and management. PMID:26651911

  4. Space radiation and cardiovascular disease risk.

    Boerma, Marjan; Nelson, Gregory A; Sridharan, Vijayalakshmi; Mao, Xiao-Wen; Koturbash, Igor; Hauer-Jensen, Martin

    2015-12-26

    Future long-distance space missions will be associated with significant exposures to ionizing radiation, and the health risks of these radiation exposures during manned missions need to be assessed. Recent Earth-based epidemiological studies in survivors of atomic bombs and after occupational and medical low dose radiation exposures have indicated that the cardiovascular system may be more sensitive to ionizing radiation than was previously thought. This has raised the concern of a cardiovascular disease risk from exposure to space radiation during long-distance space travel. Ground-based studies with animal and cell culture models play an important role in estimating health risks from space radiation exposure. Charged particle space radiation has dense ionization characteristics and may induce unique biological responses, appropriate simulation of the space radiation environment and careful consideration of the choice of the experimental model are critical. Recent studies have addressed cardiovascular effects of space radiation using such models and provided first results that aid in estimating cardiovascular disease risk, and several other studies are ongoing. Moreover, astronauts could potentially be administered pharmacological countermeasures against adverse effects of space radiation, and research is focused on the development of such compounds. Because the cardiovascular response to space radiation has not yet been clearly defined, the identification of potential pharmacological countermeasures against cardiovascular effects is still in its infancy. PMID:26730293

  5. Managing acute and chronic renal stone disease.

    Moran, Conor P; Courtney, Aisling E

    2016-02-01

    Nephrolithiasis, or renal stone disease, is common and the incidence is increasing globally. In the UK the lifetime risk is estimated to be 8-10%. On a population level, the increase in stone incidence, erosion of gender disparity, and younger age of onset is likely to reflect increasing prevalence of obesity and a Western diet with a high intake of animal protein and salt. Stones can be detected by a variety of imaging techniques. The gold standard is a non-contrast CT of kidneys, ureters and bladder (CT KUB) which can identify > 99% of stones. CT KUB should be the primary mode of imaging for all patients with colic unless contraindicated. In such instances, or if a CT KUB is not available, an ultrasound KUB is an alternative. This has advantages in terms of radiation exposure and cost, but is limited in sensitivity, particularly for ureteric stones. Once diagnosed, a plain film KUB can be used for follow-up of radiopaque stones. For most patients diclofenac is a reasonable first choice of analgesia, e.g. 50-100 mg rectally, or 75 mg IM. Opioid medication can worsen nausea and be less effective, but should be used if there is a contraindication to NSAIDs. A combination of diclofenac, paracetamol, and/or codeine regularly can provide adequate pain control in many cases. Failure of this analgesic combination should prompt consideration of secondary care support. If a ureteric stone 10 mm in diameter should be discussed with the urology service as they are unlikely to pass spontaneously. PMID:27032222

  6. Radiation therapy in prostate cancer: evaluation of acute toxicity

    Goals: The present work documents the increasing demand of curative intent radiation therapy (CIRT) for localized prostate cancer and assesses acute reactions caused by ionizing radiation to intrapelvic organs. Patients and methods: From January 1995 to December 2001, 166 patients with prostatic cancer received radiation therapy, 70% of them (n=116) with curative intent. Treatment was completed as planned in 108 patients: 55 with pelvic irradiation and prostatic boost (PRT), 42 with three-dimensional conformal radiotherapy (3DCRT), 10 with a permanent 125 I implant (IPI) and 1 with combined radiotherapy. Patients were classified as at high- or low-risk according to tumor volume, Gleason score, regional lymph node status and pretreatment specific prostatic antigen level. High-risk patients were assigned to PRT and low-risk patients to local treatment only (either 3DCRT or IPI). Mean doses were 46 Gy for pelvis and 73 Gy for prostate with PRT; 75 Gy with 3DCRT and 127 Gy with IPI and combined radiation therapy. Acute rectal toxicity (ART) and acute urinary toxicity (AUT) were assessed according to the RTOG scale. Statistical analysis was performed with Fischer's exact test. Results: The proportion of patients receiving CIRT increased from 46% (n=28) in 1995-1998 to 84% (n=88) in 1999-2001; p < 0.0001. No patient developed ART or AUT beyond degree 2. ART was lower with 3DCRT (71% degree 0 or 1) than with PRT (45% degree 0 or 1); p= 0.0134. No significant difference was found in AUT. Conclusions: In recent years the demand for CIRT has almost doubled, with a concomitant decrease in palliative radiotherapy. In high-risk patients, pelvic irradiation increased mild and moderate ART, without compromising their life quality. None of the techniques employed was associated with severe acute toxicity. (author)

  7. Vascularization of bone regeneration products in acute radiation sickness

    In 119 rabbits with acute radiation sickness the vascularization process in bone regeneration products was studied by microangiography. The formation of arteries and of bone structures was retarded in irradiated animals. The deficient formation of veins and capillaries did not cause conditions for venous blood circulation and resulted in a slow resorption of newly formed bone structures and gristle. That is one of the reasons for an extended healing process of fractures and for formation of false articulations in irradiated animals. (author)

  8. Cerebrospinal Fluid Proteome of Patients with Acute Lyme Disease

    Angel, Thomas E.; Jacobs, Jon M.; Smith, Robert P.; Pasternack, Mark S.; Elias, Susan; Gritsenko, Marina A.; Shukla, Anil K.; Gilmore, Edward C.; McCarthy, Carol; Camp, David G.; Smith, Richard D.

    2012-10-05

    Acute Lyme disease results from transmission of and infection by the bacterium Borrelia burgdorferi following a tick bite. During acute infection, bacteria can disseminate to the central nervous system (CNS) leading to the development of Lyme meningitis. Here we have analyzed pooled cerebrospinal fluid (CSF) allowing for a deep view into the proteome for a cohort of patients with early-disseminated Lyme disease and CSF inflammation leading to the identification of proteins that reflect host responses, which are distinct for subjects with acute Lyme disease. Additionally, we analyzed individual patient samples and quantified changes in protein abundance employing label-free quantitative mass spectrometry based methods. The measured changes in protein abundances reflect the impact of acute Lyme disease on the CNS as presented in CSF. We have identified 89 proteins that differ significantly in abundance in patients with acute Lyme disease. A number of the differentially abundant proteins have been found to be localized to brain synapse and thus constitute important leads for better understanding of the neurological consequence of disseminated Lyme disease.

  9. The mechanisms of the T-cell immunodeficit formation in some indices of the periphery link of the immune system in liquidators and patients suffered from the acute radiation disease in five years after the influence of radiation accident factors

    The immunologic observation of liquidators and patients undergone in five years after the influence of the Chernobyl' accident factors has been presented. Some of them such as the complex of changes connected with the radiation aging of the immune system (the decrease of the concentration of tymozine, the content of the cells), the fale of B-lymphocyte contentmay be considered to be the induces of the development of the secondary impairment in the immune system due to the injury or the disorder of the function of the epithelial cell thymus. 21 refs.; 4 figs.; 1 tabs

  10. Blocking Interleukin-1β in Acute and Chronic Autoinflammatory Diseases

    Dinarello, Charles A

    2011-01-01

    An expanding spectrum of acute and chronic inflammatory diseases are considered “autoinflammatory” diseases. This review considers autoinflammatory diseases as being distinct from “autoimmune” diseases. Autoimmune diseases are associated with dysfunctional T-cells and treated with “biologicals” including anti-TNFα, CTLA-Ig, anti-IL-12/23, anti-CD20, anti-IL-17 and anti-IL-6 receptor. In contrast, autoinflammatory diseases are uniquely due to a dysfunctional monocyte caspase-1 activity and sec...

  11. Effect Of Oligomeric Enteral Nutrition On Symptoms Of Acute Radiation Enteritis

    Radiotherapy of abdominal and pelvic tumours is frequently associated with acute radiation enteritis. Predominant symptoms include diarrhea, watery stools, abdominal pain, nausea and vomiting. There are very few effective interventions available for this condition. Enteral oligomeric nutrition has been used in bowel diseases with functional failure similar to radiation enteritis. The aim of presented work was to observe occurrence of symptoms of radiation enteritis in patients undergoing abdominal or pelvic radiotherapy. Apart from diet and pharmacological therapy, oral oligomeric enteral nutrition (Peptisorb Powder Nutricia) at the dose of 1000 - 2000 ml per day was administered for minimum of 4 days. Planned period of administration was 14 days and longer. Symptoms of radiation enteritis were evaluated at the beginning and in the end of administration. Prevalence of all evaluated symptoms of radiation enteritis was decreased and difference was statistically significant for diarrhea, watery stools, abdominal pain, nausea and vomiting. The use of evaluated oligomeric nutritional support might, in conjunction with pharmacotherapy and diet, alleviate symptoms of acute radiation enteritis and maintain nutritional status of patients. (author)

  12. Natural background radiation and oncologic disease incidence

    Cause and effect relationships between oncologic disease incidence in human population and environmental factors are examined using investigation materials of Soviet and foreign authors. The data concerning US white population are adduced. The role and contribution of natural background radiation oncologic disease prevalence have been determined with the help of system information analysis. The probable damage of oncologic disease is shown to decrease as the background radiation level diminishes. The linear nature of dose-response relationspip has been established. The necessity to include the life history of the studied population along with environmental factors in epidemiological study under conditions of multiplicity of cancerogenesis causes is emphasized

  13. Acute Chagas Disease Induces Cerebral Microvasculopathy in Mice

    Nisimura, Lindice Mitie; Estato, Vanessa; de Souza, Elen Mello; Reis, Patricia A.; Lessa, Marcos Adriano; de Castro-Faria-Neto, Hugo Caire; Pereira, Mirian Claudia de Souza; Tibiriçá, Eduardo; Garzoni, Luciana Ribeiro

    2014-01-01

    Cardiomyopathy is the main clinical form of Chagas disease (CD); however, cerebral manifestations, such as meningoencephalitis, ischemic stroke and cognitive impairment, can also occur. The aim of the present study was to investigate functional microvascular alterations and oxidative stress in the brain of mice in acute CD. Acute CD was induced in Swiss Webster mice (SWM) with the Y strain of Trypanosoma cruzi (T. cruzi). Cerebral functional capillary density (the number of spontaneously perf...

  14. Multifocal atherosclerosis in patient after acute first degree radiation sickness.

    Metlyaeva N.A.

    2014-12-01

    Full Text Available Purpose: assessment the heavy psychosomatic and all-somatic cardiovascular and cerebrovascular pathology of patient, transferred an acute I degree radiation sickness, from the general evenly gamma-beta radiation. Conclusions. The subdepressive and disturbing-depressive syndrome of patient, transferred an acute radiation sickness (ARS of I degree, from the general evenly gamma-beta radiation, was independent risk factor of development of multifocal atherosclerosis; Features of development of all-somatic and psychosomatic pathology of patient are based on a combination of genetic prerequisites, environment influences (the stress caused by accident on the ChNPP and social factors, influencing on him during a course of life, especially during early socialization. Thus at development of psychosomatic frustration the combination of feature of the mental reaction connected with the personal characteristic and special relationship between mental (stress and physiological (somatic by aspects of reaction which led to metabolism violation, to aging, decrease in adaptation opportunities of an organism and development age — dependent pathology took place.

  15. Intestinal acute graft versus host disease

    Rovani, C; Danse, E; Dragean, C

    2010-01-01

    Background: We present a case of a 23-year-old man having drug addiction. He is managed by the department of hematology for an idiopathic medullar aplasia. Two months before his admission, he was treated with bone marrow transplantation. During follow-up, we noted a nonspecific recent cutaneous lesion. He was admitted for acute digestive symptoms including anorexia, nausea, vomiting and abdominal pain.

  16. Cerebrovascular Acute Radiation Syndrome : Radiation Neurotoxins, Mechanisms of Toxicity, Neuroimmune Interactions.

    Popov, Dmitri; Maliev, Slava

    Introduction: Cerebrovascular Acute Radiation Syndrome (CvARS) is an extremely severe in-jury of Central Nervous System (CNS) and Peripheral Nervous System (PNS). CvARS can be induced by the high doses of neutron, heavy ions, or gamma radiation. The Syndrome clinical picture depends on a type, timing, and the doses of radiation. Four grades of the CvARS were defined: mild, moderate, severe, and extremely severe. Also, four stages of CvARS were developed: prodromal, latent, manifest, outcome -death. Duration of stages depends on the types, doses, and time of radiation. The CvARS clinical symptoms are: respiratory distress, hypotension, cerebral edema, severe disorder of cerebral blood microcirculation, and acute motor weakness. The radiation toxins, Cerebro-Vascular Radiation Neurotoxins (SvARSn), determine development of the acute radiation syndrome. Mechanism of action of the toxins: Though pathogenesis of radiation injury of CNS remains unknown, our concept describes the Cv ARS as a result of Neurotoxicity and Excitotoxicity, cell death through apoptotic necrosis. Neurotoxicity occurs after the high doses radiation exposure, formation of radiation neuro-toxins, possible bioradicals, or group of specific enzymes. Intracerebral hemorrhage can be a consequence of the damage of endothelial cells caused by radiation and the radiation tox-ins. Disruption of blood-brain barrier (BBB)and blood-cerebrospinal fluid barrier (BCFB)is possibly the most significant effect of microcirculation disorder and metabolic insufficiency. NMDA-receptors excitotoxic injury mediated by cerebral ischemia and cerebral hypoxia. Dam-age of the pyramidal cells in layers 3 and 5 and Purkinje cell layer the cerebral cortex , damage of pyramidal cells in the hippocampus occur as a result of cerebral ischemia and intracerebral bleeding. Methods: Radiation Toxins of CV ARS are defined as glycoproteins with the molec-ular weight of RT toxins ranges from 200-250 kDa and with high enzymatic activity

  17. Cranial radiation in childhood acute lymphocytic leukemia. Neuropsychologic sequelae

    A battery of neuropsychologic tests was administered ''blindly'' to 18 children with acute lymphocytic leukemia (ALL) who had been randomly assigned to treatment regimens with or without cranial radiation. These children were all in complete continuous remission for more than 3 1/2 years and were no longer receiving therapy. The results indicated no substantial differences between groups as a function of radiation therapy. However, decreased neuropsychologic performance was found when the entire sample was compared with population norms. These data do not support the hypothesis that cranial radiation therapy is responsible for the neuropsychologic sequelae seen in these survivors of ALL. Post hoc multiple regression analysis indicated that parental education levels accounted for more of the neuropsychologic variability seen in these children than other factors such as age at diagnosis, type of therapy, or sex of child

  18. Methods for assessing the extent of acute radiation injury

    Previous radiation accidents have shown that the medical management of exposed persons cannot be performed without the use of 'biological indicators' of effect and of repair. For the clinical management of a patient with the acute radiation syndrome, it is essential to obtain information on the subjective symptomatology as well as on laboratory parameters, especially during the first 3 to 6 days after exposure. The medical doctor responsible for the clinical care of patients has to rely on the use of what has been described as 'sequential diagnosis'. This approach consists essentially of the determination of a limited number of parameters as a function of time. From the analysis of the pattern of the determined and evaluated signs and symptoms in the first hours and days, one is able to characterize patients according to type and severity of symptomatology. This has been clearly demonstrated in the Moscow - Ulm Radiation Accident Database (MURAD) developed in a collaborative project between the Institute of Biophysics in Moscow and the Department of Clinical Physiology and Occupational Medicine of the University of Ulm. On the basis of the radiation accident clinical response pattern observed early after irradiation, one is able to develop a first approach for therapeutic strategies. It is the purpose of this contribution to outline the diagnostic and prognostic significance of blood cell changes and to discuss the following problem areas: significance and elements of a sequential diagnosis; significance of blood lymphocytes for radiation accident diagnosis; significance of blood granulocyte changes for the prognosis of the acute radiation syndrome; analysis of granulocyte changes by means of regulated system models; utilization of indicators of response and repair for planning therapeutic options

  19. Secondary Disease in Radiation Chimeras

    A review of research dealing directly or indirectly with the development of bidirectional tolerance in radiation chimeras has been made, emphasizing some of the contemporary research on this subject in Oak Ridge and Knoxville. By controlling such factors as cell dose, age of donor animal and day of cell injection, it was possible to achieve bidirectional tolerance. Attempts to reduce bidirectional tolerance in favour of increasing the graft-versus-host reaction were less successful. Hypoxic caging demonstrated a new approach to achieving bidirectional tolerance through physiological competition for growth. Graft-versus-host reactions have a lower growth priority than marrow regeneration or erythropoietic hyperplasia. Study of pathologic processes, immunologic capability and the-biochemical lesions in radiation chimeras all lead to new ideas that involve bidirectional tolerance. The investigations on dose rate in radiation suppression of the immune response and on LD50 (30- to 90-day)values after injection of different numbers of marrow cells all have a bearing on control of the host-versus-graft response and therefore are important in understanding bidirectional tolerance. (author)

  20. Relationship between acute and chronic disease epidemiology.

    Kuller, L.H. (Lewis H.)

    1987-01-01

    Epidemiology is the study of epidemics. The primary goal of epidemiological studies should be the identification of the determinants of disease in order to decrease morbidity and mortality. Epidemiological studies evolve through descriptive, analytical, and experimental approaches. The traditional infectious disease epidemiology studies were primarily concerned with identification of an agent, incubation period, mode of transmission, population at risk, and methods of disease control. Chronic...

  1. Acute syndrome of radiation: injuries to the gastrointestinal tract

    Acute syndrome of radiation: injuries to the gastrointestinal tract. Exposure to ionising radiation at medium to high doses results in the manifestation of mixed pathologies. Following the analysis of several radiation accidents it is clear that intestinal injury influences patient survival. However the appearance of the classically defined gastrointestinal syndrome is not always evident. Nevertheless injury to the gastrointestinal tract, in particular loss of barrier function, seems to play an important role in the development of Multiple Organ Failure such as reported in the recent accident at Tokai Mura. Ionising radiation overexposure results in changes in intestinal motility and nutrient, fluid and electrolyte absorption and secretion all which may contribute to the genesis of diarrhea. In addition to modified cellular transport properties for nutrients or electrolytes, important loss of epithelial cells is also a major contributing factor. Intestinal functions are controlled by many factors such as neurotransmitters, locally released mediators from endocrine cells or immunocompetent cells in addition to luminal agents. To date, treatment of radiation-induced gastrointestinal injury is mainly symptomatic. However treatments such as growth factors, anti-inflammatory cytokines as well as cellular transplantation remain to be validated in the radiation accident situation. (author)

  2. Spectrum of diseases in acute intestinal obstruction

    To determine the etiological spectrum of acute intestinal obstruction in our clinical setup Military Hospital Rawalpindi. Study Design: Descriptive study. Place and Duration of Study: Surgical department of Military Hospital, Rawalpindi from Jul 2012 to Jul 2013, over a period of about 1 year. Material and Methods: A total of 120 patients with acute mechanical intestinal obstruction who underwent laparotomy were included in our study while those with non-mechanical intestinal obstruction like history of trauma and paralytic ileus were excluded from the study. All the patients were selected by non-probability purposive sampling technique. Emergency laparotomy was done and operative findings were recorded. Results: A total of 120 patients with mechanical intestinal obstruction were included in this study out of which 93 (69.17%) were female and remaining 27 (30.83%) were males. Male to female ratio was 1:2.24. Age range of patients was 22-85 years. Out of 120 patients operated for acute intestinal obstruction post-op adhesions were found in 37 (30.83%) patients followed by intestinal tuberculosis in 23 (19.17%) patients, obstructed inguinal hernias in 13 (10.83%), gut malignancies in 15 (12.5%) , Meckel's diverticulum with bands in 7 (5.83%), volvulus in 7 (5.83%), perforated appendix in 6 (5%), intussusception in 2 (1.7%), inflammatory bands in 5 (4.17%), trichobezoar and faecal impaction in 2 (1.7%) while in 3 (2.5%) patients no definite cause was found. Conclusion: Post-op adhesions are the commonest cause of mechanical intestinal obstruction in our setup followed by intestinal tuberculosis as second most common clinical pattern of presentation. (author)

  3. M.V. Vasin. Prophylactic and treatment of radiation disease (Student's book). M.: State Research Institute of Military Medicine, 2000

    Review of the educational supply on the agents of prophylaxis and treatment of radiation injuries, intended for postgraduate training of nuclear medicine specialists, is presented. Book consists of two parts: the first one dedicates to pharmaceuticals for prophylaxis of ionizing radiation detrimental effect, the second one - to pharmaceuticals for treatment of acute radiation disease and skin radiation injuries. Text-book covers the all spectrum of current problems and all sections of radiation pharmacology

  4. Potential for a pluripotent adult stem cell treatment for acute radiation sickness

    Rodgerson, Denis O.; Reidenberg, Bruce E; Harris, Alan G; Pecora, Andrew L.

    2012-01-01

    Accidental radiation exposure and the threat of deliberate radiation exposure have been in the news and are a public health concern. Experience with acute radiation sickness has been gathered from atomic blast survivors of Hiroshima and Nagasaki and from civilian nuclear accidents as well as experience gained during the development of radiation therapy for cancer. This paper reviews the medical treatment reports relevant to acute radiation sickness among the survivors of atomic weapons at Hir...

  5. Blood transfusion for the treatment of acute anaemia in inflammatory bowel disease and other digestive diseases

    García-Erce, José Antonio; Gomollón, Fernando; Muñoz, Manuel

    2009-01-01

    Allogeneic blood transfusion (ABT) is frequently used as the first therapeutic option for the treatment of acute anaemia in patients with inflammatory bowel disease (IBD), especially when it developed due to gastrointestinal or perioperative blood loss, but is not risk-free. Adverse effects of ABT include, but are not limited to, acute hemolytic reaction (wrong blood or wrong patient), febrile non-hemolytic transfusional reaction, bacterial contamination, transfusion-related acute lung injury...

  6. Radiation-attenuated vaccine for lungworm disease

    The work done at the Indian Veternary Research Institute, Izatnagar, on the development of a vaccine for lungworm diseases is reported. Research work done includes: (1) studies on the epidemiology and the incidence of the lungworm infections, (ii) studies on the radiation-attenuated lungworm Dictyocaulus filaria vaccine, (iii) studies on other parasites using ionizing radiation, (iv) incidence of lungworm infection in sheep in Jammu and Kashmir State, (v) suitable dose of gamma radiation for attenuation, (vi) laboratory studies with radiation-attenuated D. filaria vaccine, (vii) serology of D. filaria infection, (viii) field trials with the radiation-attenuated vaccine, (ix) immune response of previously exposed lambs to vaccination, (x) comparative susceptibility of sheep and goats to infection with D. filaria, (xi) quantitative studies of D. filaria in lambs and (xii) production and supply of lungworm vaccine. (A.K.)

  7. Quantitative assessment of acute radiation injury of the lens

    An attempt is made to unify various approaches to the assessment of acute radiation injury of the organ of vision. The development of cataracts was studied on mice subjected to local irradiation of the head at doses: 7, 10, 12, 15, 20 and 25 Gy. A clinical picture of radiation injury of the eye at different X-ray doses at different stages was established during ophthalmological examination using a manual electroophthalmoscope (X5). A method of the quantitative assessment of radiation injury of the mouse eye at different radiation doses was proposed using the light transmission factor tau; its experimental value was obtained, values for different clinical stages of cataracts were established. The time course of the development of radiation cataracts in mice subjected to X-ray irradiation in a wide spectrum of doses, was observed; clinical features of the process were revealed. Dose fractionation under the above conditions did not make aprotective effect on the lens. Dependence of a degree of lens injury on irradiation dose obtained owing to the use of the light transmission factor tau, was described with the following equation: N=Nsub(0)esup(-D/Dsup(0))

  8. Influence of acute hypoxia and radiation quality on cell survival

    Tinganelli, Walter; Ma, Ning-Yi; von Neubeck, Cläre; Maier, Andreas; Schicker, Corinna; Kraft-Weyrather, Wilma; Durante, Marco

    2013-01-01

    To measure the effect of acute oxygen depletion on cell survival for different types of radiation, experiments have been performed using Chinese hamster ovary (CHO) cells and RAT-1 rat prostate cancer cells. A special chamber has been developed to perform irradiations under different levels of oxygenation. The oxygen concentrations used were normoxia (air), hypoxia (94.5% N2, 5% CO2, 0.5% O2) and anoxia (95% N2, 5% CO2). Cells were exposed to X-rays and to C-, N- or O-ions with linear energy ...

  9. Acute Radiation Effects Resulting from Exposure to Solar Particle Event-Like Radiation

    Kennedy, Ann; Cengel, Keith

    2012-07-01

    A major solar particle event (SPE) may place astronauts at significant risk for the acute radiation syndrome (ARS), which may be exacerbated when combined with other space flight stressors, such that the mission or crew health may be compromised. The National Space Biomedical Research Institute (NSBRI) Center of Acute Radiation Research (CARR) is focused on the assessment of risks of adverse biological effects related to the ARS in animal models exposed to space flight stressors combined with the types of radiation expected during an SPE. As part of this program, FDA-approved drugs that may prevent and/or mitigate ARS symptoms are being evaluated. The CARR studies are focused on the adverse biological effects resulting from exposure to the types of radiation, at the appropriate energies, doses and dose-rates, present during an SPE (and standard reference radiations, gamma rays or electrons). The ARS is a phased syndrome which often includes vomiting and fatigue. Other acute adverse biologic effects of concern are the loss of hematopoietic cells, which can result in compromised bone marrow and immune cell functions. There is also concern for skin damage from high SPE radiation doses, including burns, and resulting immune system dysfunction. Using 3 separate animal model systems (ferrets, mice and pigs), the major ARS biologic endpoints being evaluated are: 1) vomiting/retching and fatigue, 2) hematologic changes (with focus on white blood cells) and immune system changes resulting from exposure to SPE radiation with and without reduced weightbearing conditions, and 3) skin injury and related immune system functions. In all of these areas of research, statistically significant adverse health effects have been observed in animals exposed to SPE-like radiation. Countermeasures for the management of ARS symptoms are being evaluated. New research findings from the past grant year will be discussed. Acknowledgements: This research is supported by the NSBRI Center of Acute

  10. Is Progressive Chronic Kidney Disease a Slow Acute Kidney Injury?

    Cowgill, Larry D; Polzin, David J; Elliott, Jonathan; Nabity, Mary B; Segev, Gilad; Grauer, Gregory F; Brown, Scott; Langston, Cathy; van Dongen, Astrid M

    2016-11-01

    International Renal Interest Society chronic kidney disease Stage 1 and acute kidney injury Grade I categorizations of kidney disease are often confused or ignored because patients are nonazotemic and generally asymptomatic. Recent evidence suggests these seemingly disparate conditions may be mechanistically linked and interrelated. Active kidney injury biomarkers have the potential to establish a new understanding for traditional views of chronic kidney disease, including its early identification and possible mediators of its progression, which, if validated, would establish a new and sophisticated paradigm for the understanding and approach to the diagnostic evaluation, and treatment of urinary disease in dogs and cats. PMID:27593574

  11. Rays Sting: The Acute Cellular Effects of Ionizing Radiation Exposure.

    Franco, A; Ciccarelli, M; Sorriento, D; Napolitano, L; Fiordelisi, A; Trimarco, B; Durante, M; Iaccarino, G

    2016-05-01

    High-precision radiation therapy is a clinical approach that uses the targeted delivery of ionizing radiation, and the subsequent formation of reactive oxygen species (ROS) in high proliferative, radiation sensitive cancers. In particular, in thoracic cancer ratdiation treatments, can not avoid a certain amount of cardiac toxicity. Given the low proliferative rate of cardiac myocytes, research has looked at the effect of radiation on endothelial cells and consequent coronary heart disease as the mechanism of ratdiation induced cardiotoxicity. In fact, little is known concerning the direct effect of radiation on mitochondria dynamis in cardiomyocyte. The main effect of ionizing radiation is the production of ROS and recent works have uncovered that they directly participates to pivotal cell function like mitochondrial quality control. In particular ROS seems to act as check point within the cell to promote either mitochondrial biogenesis and survival or mitochondrial damage and apoptosis. Thus, it appears evident that the functional state of the cell, as well as the expression patterns of molecules involved in mitochondrial metabolism may differently modulate mitochondrial fate in response to radiation induced ROS responses. Different molecules have been described to localize to mitochondria and regulate ROS production in response to stress, in particular GRK2. In this review we will discuss the evidences on the cardiac toxicity induced by X ray radiation on cardiomyocytes with emphasis on the role played by mitochondria dynamism. PMID:27326395

  12. Acute Diarrhoeal Diseases Among Preschool Children in Western Maharashtra, India.

    Mahesh B Tondare , Vaishali V Raje, Satish V Kakade , Madhavi V Rayate

    2014-01-01

    Full Text Available "Background: Malnutrition and infectious diseases both occur in the same unfortunate children and together they play a major role in causing the high morbidity and mortality in them. Out of all the childhood illnesses, acute respiratory tract infections, diarrhoeal diseases and malnutrition are the principle causes of illness and death in the developing countries. Acute Diarrhoeal diseases (ADD’s are reported to be the 2nd leading cause of child morbidity and mortality. Objectives: To study the attack rate of Acute Diarrhoeal Disease among pre-school children and to study the socio-demographic variables of pre-school children suffering from Acute Diarrhoeal Disease. Methods: A Longitudinal study was conducted among preschool children (3-5years who were selected from Private pre-primary school of urban area and followed for the period of one year. Mother/guardian/teacher was interviewed by using pre-tested proforma during this period. Results: About 56% of children found suffering from ADD with 0.6 episodes per children per year among private pre-primary school. Higher proportions of ADD affected children were residing in nuclear type of family, belonging to middle socio-economic class, mothers were literate & housewives, born with order >2 compared to non ADD affected children. Conclusion: Maximum number of children from private pre-primary schools suffered with nearly one attack of Acute Diarrhoeal Disease with maternal illiteracy and working mothers found favorable factors. Immunization coverage, EBF and proper weaning play a very important role in prevention of infections."

  13. Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease

    Wedzicha, Wisia

    2014-01-01

    Simon E Brill, Jadwiga A Wedzicha Airway Disease Section, National Heart and Lung Institute, Imperial College, London, UK Abstract: Acute exacerbations of chronic obstructive pulmonary disease (COPD) are important events in the history of this debilitating lung condition. Associated health care utilization and morbidity are high, and many patients require supplemental oxygen or ventilatory support. The last 2 decades have seen a substantial increase in our understanding of the best way to ma...

  14. Acute type II cryoglobulinaemic vasculitis mimicking atherosclerotic peripheral vascular disease.

    Saeed, A

    2012-01-31

    Atherosclerotic peripheral vascular disease is a common presenting cause for digital ischaemia in life long smokers. Acute severe Type II Cryoglobulinaemic vasculitis is a rare yet important cause, which may present with similar clinical features and which if undiagnosed may be rapidly fatal. Following the instigation of therapy with intravenous methylprednisolone and cyclophosphamide this patient made an excellent recovery.

  15. The role of radiation therapy in childhood acute leukemia. A review from the viewpoint of basic and clinical radiation oncology

    Radiation therapy has been playing important roles in the treatment of childhood acute leukemia since the 1970s. The first is the preventive cranial irradiation for central nervous system therapy in acute lymphoblastic leukemia. The second is the total body irradiation as conditioning before bone marrow transplantation for children with acute myeloid leukemia in first remission and with acute lymphoblastic leukemia in second remission. Although some late effects have been reported, a part of them could be overcome by technical improvement in radiation and salvage therapy. Radiation therapy for children might have a successful outcome on a delicate balance between efficiencies and potential late toxicities. The role of radiation therapy for childhood acute leukemia was reviewed from the standpoint of basic and clinical radiation oncology in this paper. (author)

  16. Insights from radiation treatment for benign disease

    Bleehen, N.M.

    1987-08-29

    This note compares mortality figures for patients treated with low dose ionizing radiation for benign conditions between the 1920's and 1950's with figures available from the Japanese A-bomb survivors. X radiation for ringworm, ankylosing spondylitis and post-partum mastitis are considered. Figures for leukemia are roughly comparable between radiotherapy groups and A-bomb survivors. Figures for the increased relative risk of breast cancer in spondylitis patients were in marked contrast to bomb survivors who received comparable doses, but compatible with the increase among women given x-rays for acute post-partum mastitis in the 1940's and 1950's. This study also suggests the possibility of different time patterns of risk between different cancers. (U.K.).

  17. Insights from radiation treatment for benign disease

    This note compares mortality figures for patients treated with low dose ionizing radiation for benign conditions between the 1920's and 1950's with figures available from the Japanese A-bomb survivors. X radiation for ringworm, ankylosing spondylitis and post-partum mastitis are considered. Figures for leukemia are roughly comparable between radiotherapy groups and A-bomb survivors. Figures for the increased relative risk of breast cancer in spondylitis patients were in marked contrast to bomb survivors who received comparable doses, but compatible with the increase among women given x-rays for acute post-partum mastitis in the 1940's and 1950's. This study also suggests the possibility of different time patterns of risk between different cancers. (U.K.)

  18. Anti-infection treatment of iatrogenic acute radiation sickness

    Objective: To occumulatle experience of anti-infection treatment in acute radiation sickness (ARS) induced by medical treatment in order to provide beneficial help for victims of accidental of acute radiation sickness. Methods: The changes of peripheral blood indices, body temperature and clinical symptoms of 17 cases who were clinically irradiated with 6.0-7.2 Gy X-rays were observed both before peripheral blood stem cell transplantation(PBSCT) and after anti-infection treatment. Results: WBC count began to decrease to below 1 x 109/L from the 8th to 10th days after irradiation and maintained at row level for 4 days or for 13.3 days if the patients had not received rhG-CSF treatment. In 29.4% of patients the body temperature was higher than 38.5 degree C. After comprehensive enviromental protection and anti-infection treatment, all patients could successfully tide over the period of bone marrow depression without appearance of the typical critical phase of ARS. Conclusion: PBSCT and rhG-CSF treatment can reduce the time span for reconstruction of bone marrow. Comprehensive enviromental protection and combined anti-infection treatment are key points fm successful treatment. (authors)

  19. Treatment for infections complications of experimental acute radiation sickness with sulacillin, a combined antibiotic

    The therapeutic efficiency of sulacillin (combination of ampicillin antibiotic with beta-lactamase sulbactam inhibitor) used for prevention and treatment of infections complications of the acute radiation disease (ARD) is considered. It is shown that sulacillin antiinfections effect essentially exceeds the activity of ampicillin by treatment of irradiated mice infected with a beta-lactamase-producing strain of Kl pneumoniae. Inclusion of the sulacillin as a principal antibiotic into the ARD therapeutic scheme provides for the 66.6 % survival of dogs at LD90/45

  20. Assessment of recovery of the intestine after acute radiation injury

    Baer, A.R.; Cheeseman, C.I.; Thomson, A.B.

    1987-02-01

    Several aspects of intestinal function and morphology are affected by acute radiation damage, including changes in the activity of proliferative cells in the crypts, immune cell populations, and the transport of various substrates. This study was designed to compare the time course of the recovery of intestinal proliferation, transport, and leukocyte population following radiation injury. Rats received a single dose of 6 Gy to the abdomen from a /sup 137/Cs source and were studied 3, 7, and 14 days later. No changes in the passive uptake of L-glucose or D-leucine were observed in the jejunum. Active transport of D-glucose and maximal water uptake were reduced at 3 days but had returned to normal by 7 days, whereas L-leucine uptake required more than 7 days to return to control levels. Mucosal permeability, assessed by an in vivo potential difference technique, remained increased 7 days after irradiation. Ornithine decarboxylase, an indicator of DNA synthetic activity, was elevated following radiation treatment and remained so even after 14 days. By comparison, myeloperoxidase activity, used as a quantitative monitor of granulocyte numbers, was still reduced after 7 days. These data indicate that while certain parameters of gut function may return to normal soon after radiation injury, the recovery of other factors is more prolonged. Thus the return of transport function to normal values post irradiation may be viewed as an adaptive change rather than simply the recovery of the tissue.

  1. Radiation-induced hypopituitarism in children with acute lymphoblastic leukemia

    Mehrdad Mirouliaei

    2013-01-01

    Full Text Available Background: Acute Lymphoblastic Leukemia (ALL is the most common malignancy among children for whom radiotherapy and chemotherapy are used for treatment. When hypothalamus-pituitary axis is exposed to radiotherapy, children′s hormone level and quality of life are influenced. The aim of this study is to determine late effects of radiotherapy on hormonal level in these patients. Materials and Methods: In this study 27 children with ALL, who have been referred to Shahid Ramezanzadeh Radiation Oncology Center in Yazd-Iran and received 18-24 Gy whole brain radiation with Cobalt 60 or 9 MV linear accelerator, were assessed. These patient′s basic weight, height and hormonal levels were measured before radiotherapy and also after different periods of time. Results: GHD (growth hormone deficiency after clonidine stimulation test was observed in 44% ( n=12 and that in 50% of them ( n=6, less than 1 year, had been passed from their radiation therapy. None of these patients demonstrated hormone deficiency in other axes. Conclusions: This study showed that even application of a 18-24 Gy radiation dose might influence growth hormone levels; therefore, we recommend reduction of radiotherapy dose in such patients whenever possible.

  2. Perspectives of radiation therapy in benign diseases

    Purpose: the numbers of patients with nonmalignant diseases referred for radiation therapy had to be evaluated for the last 4 years. Patients and methods: in the years 2002, 2004, and 2005 radiation therapy was performed in 61, 40, and 26 patients, respectively. Regularly, more women than men were treated, median age annually was 57, 54, and 55 years, respectively (table 1). The radiotherapy scheme was not modified within the evaluated period. Results: the proportion of nonmalignant diseases among all patients treated decreased from 4.7% in 2002 to 3.3% in 2004 and 2.2% in 2005, respectively. A shift was noticed toward the treatment of four main diseases (endocrine orbitopathy, prevention of heterotopic ossification, meningeoma, tendinitis, table 2). The number of referring physicians decreased from 19 to six. Conclusion: due to administrative restrictions for treatment in hospitals, budget restrictions in private practices and lasting, insufficient revenues for radiotherapy in nonmalignant diseases, radiation therapy for the entire group of benign diseases is endangered. (orig.)

  3. [Acute cardiovascular disease and job retention].

    Fantoni-Quinton, Sophie; Tellart, Anne-Sophie; Cambier-Langrand, Evodie; Fassier, Jean Baptiste; Mounier-Vehier, Claire

    2016-05-01

    Since it allows a better quality of life, return to work must be considered ever since the early stages of the health care pathway following a cardiovascular disease. Seeing the occupational physician beforehand, so as to anticipate the return to work, is crucial. Dialogue between cardiologists, general practitioners and occupational physician, still observing medical confidentiality, must allow a better quality of return to work. Being recognized as a handicapped worker is a key element in the prevention of socio-professional exclusion. Even when dealing with long sick leave, permanent functional injuries or job loss, guiding the patients towards the appropriate person can improve return to work and job retention in the long term. PMID:27021479

  4. Pulmonary thromboembolic disease. Clinical management of acute and chronic disease.

    Torbicki, Adam

    2010-07-01

    Pulmonary thromboembolism falls between the areas of pulmonology and cardiology, internal medicine and intensive care, radiology and nuclear medicine, and hematology and cardiothoracic surgery. Depending on their clinical background, physicians faced with a patient with a pulmonary thromboembolism may speak different languages and adopt different treatment approaches. Now, however, there is an opportunity to end the Tower of Babel surrounding pulmonary thromboembolism. There is a growing acknowledgement that the key clinical problems in both acute pulmonary embolism and chronic thromboembolic pulmonary hypertension are linked to right ventricular pressure overload and right ventricular failure. As a result, cardiologists and cardiac intensive care specialists are taking an increasing interest in understanding and combating these conditions. The European Society of Cardiology was the first to elaborate comprehensive clinical practice guidelines for pulmonary thromboembolism and chronic thromboembolic pulmonary hypertension. The task forces involved in producing these guidelines included radiologists, pulmonologists, hematologists, intensive care physicians and surgeons, which ensured that the final document was universally acceptable. The aim of this article was to provide an overview of the epidemiology, risk factors, diagnosis, treatment, prognosis and prevention of acute pulmonary thromboembolism and chronic thromboembolic pulmonary hypertension, while taking into account European Society of Cardiology guidelines and incorporating new evidence where necessary. PMID:20609317

  5. Acute renal failure: outcomes and risk of chronic kidney disease.

    Block, C A; Schoolwerth, A C

    2007-09-01

    Acute renal failure (ARF) is a common condition, especially among the critically ill, and confers a high mortality. The incidence of ARF is increasing. Efforts such as the Acute Dialysis Quality Initiative (ADQI) are being undertaken to establish a consensus definition of ARF, and to distinguish between varying degrees of acute kidney injury that might confer a different prognosis. Data are emerging to allow comparison of the epidemiology of ARF across institutions internationally. There is ongoing recognition of the important interaction between ARF and chronic kidney disease and more information regarding recovery from ARF is available. Controversy exists regarding the optimal management of ARF. Recent publications emphasize the importance of timing and dose of renal replacement therapy rather than the modality of treatment (intermittent hemodialysis vs continuous therapies). These issues are explored in this review. PMID:17912228

  6. Chromosomal mechanisms in murine radiation acute myeloid leukemogenesis

    Chromosome 2 abnormalities, particularly interstitial deletions, characterize murine radiation-induced acute myeloid leukaemias (AMLs). Here, G-band analyses in CBA/H mice of early (1-6 month) post 3 Gy X-radiation events in bone marrow cells in vivo and karyotype evolution in one unusual AML are presented. The early event analysis showed that all irradiated animals carry chromosome 2 abnormalities, that chromosome 2 abnormalities are more frequent than expected and that interstitial deletions are more common in chromosome 2 than in the remainder of the genome. On presentation AML case N122 carried a t(2; 11) terminal translocation which, with passaging, evolved into a del2(C3F3). Therefore two pathways in leukaemogenesis might exist, one deletion-driven, the other terminal tranlocation-driven involving interstitial genes and terminal genes respectively of chromosome 2. As all irradiated individuals carried chromosome 2 abnormalities, the formation of these aberrations does not determine individual leukaemogenic sensitivity as only 20-25% of animals would be expected to develop AML. Similar lines of argument suggest that chromosome 2 abnormalities are necessary but not sufficient for radiation leukaemogenesis in CBA/H nor are they rate limiting in leukaemogenesis. (Author)

  7. Chromosomal mechanisms in murine radiation acute myeloid leukemogenesis

    Bouffler, S.D.; Breckon, G.; Cox, R. [National Radiological Protection Board, Chilton (United Kingdom)

    1996-04-01

    Chromosome 2 abnormalities, particularly interstitial deletions, characterize murine radiation-induced acute myeloid leukaemias (AMLs). Here, G-band analyses in CBA/H mice of early (1-6 month) post 3 Gy X-radiation events in bone marrow cells in vivo and karyotype evolution in one unusual AML are presented. The early event analysis showed that all irradiated animals carry chromosome 2 abnormalities, that chromosome 2 abnormalities are more frequent than expected and that interstitial deletions are more common in chromosome 2 than in the remainder of the genome. On presentation AML case N122 carried a t(2; 11) terminal translocation which, with passaging, evolved into a del2(C3F3). Therefore two pathways in leukaemogenesis might exist, one deletion-driven, the other terminal tranlocation-driven involving interstitial genes and terminal genes respectively of chromosome 2. As all irradiated individuals carried chromosome 2 abnormalities, the formation of these aberrations does not determine individual leukaemogenic sensitivity as only 20-25% of animals would be expected to develop AML. Similar lines of argument suggest that chromosome 2 abnormalities are necessary but not sufficient for radiation leukaemogenesis in CBA/H nor are they rate limiting in leukaemogenesis. (Author).

  8. Antiradiation Antitoxin IgG : Immunological neutralization of Radiation Toxins at Acute Radiation Syndromes.

    Popov, Dmitri; Maliev, Slava

    Introduction: High doses of radiation induce apoptotic necrosis of radio-sensitive cells. Mild doses of radiation induce apoptosis or controlled programmed death of radio-sensitive cells with-out development of inflammation and formation of Radiation Toxins. Cell apoptotic necrosis initiates Radiation Toxins (RT)formation. Radiation Toxins play an important role as a trig-ger mechanism for inflammation development and cell lysis. If an immunotherapy approach to treatment of the acute radiation syndromes (ARS) were to be developed, a consideration could be given to neutralization of radiation toxins (Specific Radiation Determinants-SRD) by specific antiradiation antibodies. Therapeutic neutralization effects of the blocking anti-radiation antibodies on the circulated RT had been studied. Radiation Toxins were isolated from the central lymph of irradiated animals with Cerebrovascular(Cv ARS),Cardiovascular (Cr ARS),Gastrointestinal(Gi ARS) and Haemopoietic (Hp ARS) forms of ARS. To accomplish this objective, irradiated animals were injected with a preparation of anti-radiation immunoglobulin G (IgG) obtained from hyperimmune donors. Radiation-induced toxins that we call Specific Radiation Determinants (SRD) possess toxic (neurotoxic, haemotoxic) characteristics as well as specific antigenic properties. Depending on direct physiochemical radiation damage, they can induce development of many of the pathological processes associated with ARS. We have tested several specific hyperimmune IgG preparations against these radiation toxins and ob-served that their toxic properties were neutralized by the specific antiradiation IgGs. Material and Methods: A scheme of experiments was following: 1.Isolation of radiation toxins (RT) from the central lymph of irradiated animals with different form of ARS. 2.Transformation of a toxic form of the RT to a toxoid form of the RT. 3.Immunization of radiation naive animals. Four groups of rabbits were inoculated with a toxoid form of SRD

  9. Impact of radiation therapy for benign diseases

    Radiation therapy of benign diseases represent a wide panel of indications. Some indications are clearly identified as treatment of arteriovenous malformations (AVM), hyperthyroid ophthalmopathy, postoperative heterotopic bone formations or keloid scars. Some indications are under evaluation as complications induced by neo-vessels of age-related macular degeneration or coronary restenosis after angioplasty. Some indications remain controversial with poor evidence of efficiency as treatment of bursitis, tendinitis or Dupuytren's disease. Some indications are now obsolete such as warts, or contra-indicated as treatment of infant and children. (authors)

  10. Psychoneurological character of persons who had acute radiation syndrome

    Survivors of the Chernobyl accident who had an acute radiation syndrome (ARS,110 persons) were observed for 8 years after Chernobyl accident. It has been found that the cerebrovascular pathology and vertebral osteochondrosis rate increase as well as abnormal psychoorganic changes in personality and endogenic-like psychoorganic process, their rate being in proportion to the ARS heaviness. The EEG and evoked potentials have confirmed the dyscirculatory and toxic-metabolic organic disorders of the central nervous system as a result of irradiation in the remote period of the ARS consequences. It is necessary for early and differential diagnostic of the psychoneurological disorders after ARS to carry out the neuro- and psychophysiological examination as well as computer tomography, nucleic magnetic resonance and positron emission tomography of the brain

  11. Type 2 Gaucher Disease (Acute Infantile Gaucher Disease or Neuropathic Type

    Mohammad Mehdi TAGHDIRI

    2012-12-01

    Full Text Available How to Cite this Article: Taghdiri MM. Type 2 Gaucher Disease (Acute Infantile Gaucher Disease or Neuropathic Type. Iran J Child Neurol Autumn 2012; 6:4 (suppl. 1:12. Pls see PDF. 

  12. Clinical symptoms of the acute radiation syndrome in cattle. Comparison between dairy cow and calf

    In 4 experiments 39 cows aged between 3.5 and 11.5 years and in 5 experiments 38 calves, aged between 2.5 and 4 months, were exposed to bilateral ionizing whole-body irradiation using roentgen or gamma rays. In both complexes an acute radiation sickness was produced ranging from LD0/30 to LD100/30. The course of the radiation disease and the overall clinical picture were basically similar in the comparable lethality range. But in the main reaction phase, 3 complexes were more severe in calves: infectious processes of the respiratory organs, diarrhea, and heamorrhagic diathesis. The causes are supposed in the different influence of the germ setting. (author)

  13. Aspirin as Primary Prevention of Acute Coronary Heart Disease Events

    Glasser, Stephen P.; Hovater, Martha; Brown, Todd M.; Howard, George; Safford, Monika M.

    2014-01-01

    Background/Objective Aspirin for primary prophylaxis is controversial. This study evaluated associations between prophylactic aspirin use and incident acute coronary heart disease (CHD) events. Methods and Results The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study was accessed for aspirin use examining black and white hazards for incident CHD, for men and women, each adjusting incrementally for sampling, sociodemographics, and CHD risk factors. Stratified models exami...

  14. Minimal Residual Disease Assessment in Childhood Acute Lymphoblastic Leukemia

    Thörn, Ingrid

    2009-01-01

    Traditionally, response to treatment in hematological malignancies is evaluated by light microscopy of bone marrow (BM) smears, but due to more effective therapies more sensitive methods are needed. Today, detection of minimal residual disease (MRD) using immunological and molecular techniques can be 100 times more sensitive than morphology. The main aim of this thesis was to compare and evaluate three currently available MRD methods in childhood acute lymphoblastic leukemia (ALL): (i) real-t...

  15. Investigation of the acute inflammatory response in Crohn's disease.

    MARKS, D. J. B.

    2006-01-01

    Most theories concerning the primary cause of Crohn's disease focus on over-activation of the immune response. Paradoxically, the defect may instead relate to diminished acute inflammation. Neutrophil accumulation to sites of dermal trauma has been shown to be reduced. Were the same phenomenon to occur in the gut, it might impair bacterial clearance thus provoking granuloma formation. In this thesis, a novel technique demonstrated attenuated neutrophil accumulation following trauma to the bow...

  16. Metabolomics and Its Application to Acute Lung Diseases.

    Stringer, Kathleen A; McKay, Ryan T; Karnovsky, Alla; Quémerais, Bernadette; Lacy, Paige

    2016-01-01

    Metabolomics is a rapidly expanding field of systems biology that is gaining significant attention in many areas of biomedical research. Also known as metabonomics, it comprises the analysis of all small molecules or metabolites that are present within an organism or a specific compartment of the body. Metabolite detection and quantification provide a valuable addition to genomics and proteomics and give unique insights into metabolic changes that occur in tangent to alterations in gene and protein activity that are associated with disease. As a novel approach to understanding disease, metabolomics provides a "snapshot" in time of all metabolites present in a biological sample such as whole blood, plasma, serum, urine, and many other specimens that may be obtained from either patients or experimental models. In this article, we review the burgeoning field of metabolomics in its application to acute lung diseases, specifically pneumonia and acute respiratory disease syndrome (ARDS). We also discuss the potential applications of metabolomics for monitoring exposure to aerosolized environmental toxins. Recent reports have suggested that metabolomics analysis using nuclear magnetic resonance (NMR) and mass spectrometry (MS) approaches may provide clinicians with the opportunity to identify new biomarkers that may predict progression to more severe disease, such as sepsis, which kills many patients each year. In addition, metabolomics may provide more detailed phenotyping of patient heterogeneity, which is needed to achieve the goal of precision medicine. However, although several experimental and clinical metabolomics studies have been conducted assessing the application of the science to acute lung diseases, only incremental progress has been made. Specifically, little is known about the metabolic phenotypes of these illnesses. These data are needed to substantiate metabolomics biomarker credentials so that clinicians can employ them for clinical decision-making and

  17. Diagnostic accuracy of computed tomography using lower doses of radiation for patients with Crohn's disease.

    Craig, Orla

    2012-08-01

    Magnetic resonance and ultrasonography have increasing roles in the initial diagnosis of Crohn\\'s disease, but computed tomography (CT) with positive oral contrast agents is most frequently used to identify those with acute extramural complications. However, CT involves exposure of patients to radiation. We prospectively compared the diagnostic accuracy of low-dose CT (at a dose comparable to that used to obtain an abdominal radiograph) with conventional-dose CT in patients with active Crohn\\'s disease.

  18. The acute radiation syndrome in the miniature pig Troll

    8 animals at an average age of 230 days and an average body weight of 24.9 kg were whole-body gamma-irradiated from a cobalt-60 source with 3.0 Gy midline dose. 4 of the 8 pigs survived, the others died within day 14 and 17 after irradiation, mainly due to thrombopenia dependent hemorrhage. Hematologic examinations showed as well that the platelets decreased to a minimum on day 14 p.r. The granulocyte values and yet remarkable the lymphocyte values decreased at an earlier time. The absolute lymphocyte counts reached their lowest mark already on the first day after irradiation. The reticulocytes, which also decreased markedly on day 1 p.r., sank further on the following days, till after two weeks when they started to increase again. Furthermore 25 biochemical serum parameters have been investigated. The major pathological findings of the acute radiation sickness were the mostly heavy hemorrhages. Histological studies indicated primarily aplasia of bone marrow, intestinal mucosa damages and atrophy of lymphatic tissues. Signs for septicemia were rarely found. The investigations in Troll-pigs showed, their reactions to an irradiation of middle-lethal doses are similar to those of other pigs. Only the Vietnamese pot-bellied swine reacts differently: Profuse diarrheas already after low radiation-doses are reported. (orig./MG)

  19. Bile loss in the acute intestinal radiation syndrome in rats

    The effects of bile duct ligation (BDL), choledochostomy, bile acid sequestering within the intestinal lumen by cholestyramine, and fluid and electrolyte replacement on survival time and development of diarrhea after whole-body exposure to doses of ionizing radiation that result in death from acute intestinal injury were studied. BDL significantly prolonged survival and delayed the onset of diarrhea after exposure to 137Cs gamma rays, fission neutrons, or cyclotron-produced neutrons in the range of doses that produce intestinal death or death from a combination of intestinal and hematopoietic injuries. Cannulation of the bile duct with exteriorized bile flow (choledochostomy) to protect the irradiated intestine from the mucolytic action of bile salts did not duplicate the effect of BDL in increasing survival time. Choledochostomy without fluid replacement eliminated the occurrence of diarrhea in 15.4 Gy irradiated rats. Diarrhea did occur in irradiated animals with choledochostomy if they received duodenal injections of fluid and electrolytes to replace the fluid lost as a result of bile drainage. Duodenal injection of fluid and electrolytes had no significant effect on survival time in irradiated rats. Injection of fluid and electrolytes into the peritoneal cavity of irradiated rats resulted in an increase in survival time that was comparable to that observed after BDL. Addition of antibiotics to the peritoneally injected fluid and electrolytes further increased survival time (up to 9 days). This survival time approached that seen in animals receiving the same radiation dose but which had the intestine exteriorized and shielded to minimize radiation injury to the intestine. Postmortem histological examinations of the irradiated small intestine showed mucosal regeneration in these long-term survivors receiving fluid and antibiotic therapy

  20. Genomic alterations in radiation-induced murine acute myeloid leukemias

    High-dose radiation induces acute myeloid leukemia (AML) in C3H mice, most of which have a high frequent hemizygous deletion around the D2Mit15 marker on the interstitially deleted region of chromosome 2. This region involves PU.1 (Sfpi-1), which is a critical candidate gene for initiation of mouse leukemogenesis. To identify other genes contributing to leukemogenesis with PU.1, we analyzed chromosomal aberrations and changes of expression in 18 AML-related genes in 39 AMLs. Array CGH analysis revealed that 35 out of 39 AMLs had hemizygous deletions of chromosome 2, and recurrent aberrations on chromosomes 4, 6, 8, 10, 11, 12, 15, and 18. Expressions of 18 AML-related genes, within the altered chromosome regions detected by array CGH were analyzed by using RT-PCR and/or real-time PCR. Although Wnt5b, Wnt16, G-CSFR, M-CSFR, SCL/Tal-1 and GATA1 genes were down-regulated, the c-myc gene was, on the contrary, up-regulated. Expression levels of two genes, Rasgrp1 and Wt1, within the deleted region of chromosome 2 correlated with the loss of one of two alleles, although the expression of PU.1 showed an inverse correlation. In addition, the expression level of PU.1 appeared to be higher with a coincidental missense point mutation in DNA-binding domain of PU.1 in the remaining allele, suggesting a feedback transcription control on PU.1. Such an autoregulation might be relevant to the fact that PU.1 haploinsufficiency per se triggers radiation-induced AML. Together with the detection of chromosomal aberrations, these findings provide useful clues to identify cooperative genes that are responsible for molecular pathogenesis of AMLs induced by low-dose-rate radiation exposure. (author)

  1. Countermeasures for Space Radiation Induced Malignancies and Acute Biological Effects

    Kennedy, Ann

    ., Wan, X.S., Nuth, M., Davis, J., Ko, Y.-H., Sayers, C.M., Baran, M., Ware, J.H. and Kennedy, A.R. Dietary antioxidants protect hematopoietic cells and improve animal survival following total body irradiation. Radiation Res. (in press) [9] Kennedy, A.R., Davis, J.G., Carlton, W. and Ware, J.H. Effects of dietary antioxidant supplementation on the development of malignancies and other neoplastic lesions in mice exposed to proton or iron ion radiation. Radiation Res. (submitted) [10] Kennedy, A.R. The Status of Human Trials Utilizing Bowman-Birk Inhibitor Concentrate from Soybeans. In: Soy in Health and Disease Prevention, edited by Michihiro Sugano, CRC Press Press LLC, Boca Raton, Florida, Chapter 12, pp. 207-223, 2005. ACKNOWLEDGEMENTS; This work was supported by the National Space Biomedical Research Institute through NASA NCC 9-58.

  2. Explanation of diagnostic criteria for radiation-induced liver diseases

    National occupational health standard-Diagnostic Criteria for Radiation-Induced Liver Diseases has been passed by the committee of diagnostic criteria for radiation disease and in line for approval by the Ministry of Health. Based on the extensive research of literature, this standard was enacted according to the relevant laws and regulations. It is mainly used for diagnosis of radiation-induced liver diseases, and it also can serve as a guide to diagnose liver disease induced by medical radiation. To implement this standard, and to diagnose and treat the radiation-induced liver diseases patient correctly and promptly, the contents of this standard were interpreted in this article. (authors)

  3. Radiation therapy treatment of acute refractory renal allograft rejection

    radiation treatment (median 4, range 1-22), number of transplants (one transplant in 77 %), and concomitant immunosuppressive therapy. Independent factors by the Cox regression model were: Sex (P=0.005), Creatinine levels (P=0.000), HLA-DR (P=0.05), PRA-Max > 70% (P=0.014). Each factor was scored using the integral coefficients to generate four different groups. The overall actuarial graft survival from the initiation of RT was 83% at 1 month, 60% at 1 year and 36% at 5 years. The Kaplan-Meier survival analyzed by groups seems to produce an interpretable separation of the risk factors for graft loss. The number of rejections of pre-RT range from 1-6 (median 2) and post-RT range from 0-3 (median 0). Conclusions: Our experience indicates that radiation therapy provides effective treatment for acute refractory renal allograft rejection. The response to radiation therapy in patients treated with acute refractory renal graft rejection can be predicted by a new scoring system

  4. Noninvasive imaging in acute coronary disease. A clinical perspective

    Numerous highly complex and sensitive noninvasive imaging techniques have enhanced the care of patients with acute myocardial infarction. Optimum use requires specific objectives to be defined in advance, including a review of the potential impact of the test on subsequent decisions. An additional issue that is subject to scrutiny in the current climate of cost containment relates to the incremental value of a specific examination. The imaging modality to be used will partially depend on other issues, including accessibility, cost, and interindividual or institutional expertise with a particular technique. Major applications in noninvasive imaging in the acute coronary syndromes include the following: (1) diagnosis, including identification of associated diseases and contraindications for acute reperfusion; (2) evaluation and management of complications; (3) determination of prognosis (both early and late); (4) estimation of myocardial viability; (5) assessment of therapeutic efficacy; (6) investigational approaches, including 99mTc-sestamibi tomographic imaging, ultrafast cine computed tomographic scanning, and nuclear magnetic resonance imaging. Previous studies in the prethrombolytic era have documented the powerful impact of radionuclide stress testing on prognosis, but this needs to be reevaluated in the light of the changing current population undergoing stress testing. Preliminary data imply that the prognostic accuracy of stress testing after thrombolytic therapy is diminished. Moreover, the role of the open infarct-related artery in traditional estimates of prognosis requires further study. Noninvasive imaging has multiple applications in the diagnosis and management of patients with acute coronary disease, but the decision to use a specific technology in a particular circumstance mandates good clinical judgment and selectivity. 82 references

  5. The role of MRI in the diagnosis of acute radiation reaction in breast cancer patient

    Startseva, Zh A.; Musabaeva, L. I.; Usova, AV; Frolova, I. G.; Simonov, K. A.; Velikaya, V. V.

    2016-02-01

    A clinical case with acute radiation reaction of the left breast after organ-preserving surgery with 10 Gy IORT (24.8 Gy) conventional radiation therapy has been presented. Comprehensive MRI examination showed signs of radiation- induced damage to skin, soft tissues and vessels of the residual breast.

  6. Evidence Report: Risk of Acute and Late Central Nervous System Effects from Radiation Exposure

    Nelson, Gregory A.; Simonsen, Lisa; Huff, Janice L.

    2016-01-01

    Possible acute and late risks to the central nervous system (CNS) from galactic cosmic rays (GCR) and solar particle events (SPE) are concerns for human exploration of space. Acute CNS risks may include: altered cognitive function, reduced motor function, and behavioral changes, all of which may affect performance and human health. Late CNS risks may include neurological disorders such as Alzheimer's disease (AD), dementia and premature aging. Although detrimental CNS changes are observed in humans treated with high-dose radiation (e.g., gamma rays and 9 protons) for cancer and are supported by experimental evidence showing neurocognitive and behavioral effects in animal models, the significance of these results on the morbidity to astronauts has not been elucidated. There is a lack of human epidemiology data on which to base CNS risk estimates; therefore, risk projection based on scaling to human data, as done for cancer risk, is not possible for CNS risks. Research specific to the spaceflight environment using animal and cell models must be compiled to quantify the magnitude of CNS changes in order to estimate this risk and to establish validity of the current permissible exposure limits (PELs). In addition, the impact of radiation exposure in combination with individual sensitivity or other space flight factors, as well as assessment of the need for biological/pharmaceutical countermeasures, will be considered after further definition of CNS risk occurs.

  7. The modes of death in mammals exposed to whole body radiation (acute radiation syndromes)

    When an animal is exposed to a sufficient amount of radiation, there will be changes in many organs of the body, and as a result of either the effects in one particular organ or the interaction of effects in several organs, the animal as a whole will show characteristic syndromes. Some syndromes result inevitably in death. Others may or may not be lethal, depending on the extent of the tissue damage. The time of appearance of the syndromes, their duration, and the survival of the organism depend on many factors. Whole body acute doses of radiation produce the same spectrum of Central Nervous System (CNS), Gastrointestinal (GI) and Bone Marrow (BM) injury in man as was described for animals. Damage to the skin, ovary and testis are an integral and important part of the symptoms. (author)

  8. Compared with parenteral nutrition, enteral feeding attenuates the acute phase response and improves disease severity in acute pancreatitis

    Windsor, A; Kanwar, S; Li, A.; Barnes, E.; Guthrie, J; Spark, J; Welsh, F.; Guillou, P; Reynolds, J

    1998-01-01

    Background—In patients with major trauma and burns, total enteral nutrition (TEN) significantly decreases the acute phase response and incidence of septic complications when compared with total parenteral nutrition (TPN). Poor outcome in acute pancreatitis is associated with a high incidence of systemic inflammatory response syndrome (SIRS) and sepsis. 
Aims—To determine whether TEN can attenuate the acute phase response and improve clinical disease severity in patients with ac...

  9. Lithium-induced minimal change disease and acute kidney injury

    Parul Tandon

    2015-01-01

    Full Text Available Context: Lithium carbonate is a psychiatric medication commonly used in the treatment of bipolar disorder. It has been implicated in inducing nephrogenic diabetes inspidus, chronic tubulointerstitial nephropathy, and acute tubular necrosis. We describe a case of lithium-induced minimal change disease (MCD and acute kidney injury (AKI. Case Report: A 32-year-old female with a medical history of bipolar disorder treated with chronic lithium therapy presented with anasarca, fatigue, and tremors. Work-up revealed supra-therapeutic lithium levels, hypoalbuminemia, and significant proteinuria. The patient was treated conservatively with fluids and discontinuation of lithium therapy. Subsequently, she developed significant AKI and persistent proteinuria. She underwent a renal biopsy that demonstrated effacement of podocyte foot processes consistent with lithium-induced MCD. This was treated with corticosteroids, which decreased the proteinuria and resolved all the patient′s symptoms. Conclusion: Lithium-induced MCD is a rare disease that affects patients of all ages. It is often associated with therapeutic lithium and is typically resolved with discontinuation of lithium. In some cases, concurrent AKI may result due to vascular obstruction from hyperalbuminuria and associated renal interstitial edema. Corticosteroids may be needed to reduce the proteinuria and prevent progression to chronic kidney disease. As such, patients on lithium therapy may benefit from monitoring of glomerular function via urinalysis to prevent the onset of nephrotic syndrome.

  10. Clinical effect of rhEGF on acute radiation stomatitis

    Objective: To evaluate the clinical effect of recombinant human epidermal growth factor (rhEGF) on acute radiation stomatitis (ARS). Methods: A total of 90 patients with head and neck malignant tumor going to receive radiotherapy were randomized into 3 groups: prophylactic application group (group A); therapeutic application group (group B) and the control group(group C). The irradiated mucous membrane was sprayed with rhEGF at the beginning of radiotherapy in group A and sprayed after grade I radiation stomatitis had appeared in group B. Comparison was made with control patients (group C) who received routine oral care with Dobell's solution. The rate of ARS and the clinical effect of rhEGF were evaluated. Results: The ARS appeared in 73% (22/30) of the patients after irradiated at a dose more than 10 Gy in group A, and appeared in 83% (25/30) of the patients irradiated at a dose less than 10 Gy in group C. In groups A and B, the rates of grades III and IV ARS were obviously lower than those in group C. The average curative time of the rhEGF treatment groups (group A or B) was less than 7 days whereas, that of the control group (group C) was more than 10 days. The total effective rate of the rhEGF treatment groups was significantly higher than that of the control group (P<0.01). Conclusion: Prophylactic application of rhEGF can postpone the development of ARS. rhEGF can reduce the incidence of grades III and IV of ARS and shorten the curative time of ARS by either prophylactic or therapeutic application. Therefore, it should be highly recommended and popularized. (authors)

  11. Influence of acute hypoxia and radiation quality on cell survival

    The purpose of this study was to measure the effect of acute oxygen depletion on cell survival for different types of radiation, experiments have been performed using Chinese hamster ovary (CHO) cells and R-3327-AT1 (RAT-1) rat prostate cancer cells. A special chamber has been developed to perform irradiations under different levels of oxygenation. The oxygen concentrations used were normoxia (air), hypoxia (94.5% N2, 5% CO2, 0.5% O2) and anoxia (95% N2, 5% CO2). Cells were exposed to X-rays and to C-, N- or O-ions with linear energy transfer (LET) values ranging from 100-160 keV/μm. The oxygen enhancement ratio (OER) and relative biological effectiveness (RBE) values have been calculated from the measured clonogenic survival curves. For both cell lines, the X-ray OER depended on the survival level. For particle irradiation, OER was not dependent on the survival level but decreased with increasing LET. The RBE of CHO cells under oxic conditions reached a plateau for LET values above 100 keV/μm, while it was still increasing under anoxia. In conclusion, the results demonstrated that our chamber could be used to measure radiosensitivity under intermediate hypoxia. Measurements suggest that ions heavier than carbon could be of additional advantage in the irradiation, especially of radioresistant hypoxic tumor regions. (author)

  12. Relationship Between Periodontal Disease and Acute Myocardial Infarction

    M Zamirian

    2008-07-01

    Full Text Available Background: Conventional risk factors for coronary artery disease and myocardial infarction do not explain all of the clinical and epidemiological features of the disease. Periodontal disease is a common bacterial and destructive disorder of oral tissues. Many studies demonstrate close association between chronic periodontitis and development of generalized inflammation, vascular endothelial injury, and atherosclesis. Periodontal disease has been convincingly emerging as an important independent risk factor for ischemic heart disease. A case - control study was carried out to assess the prevalence of periodontitis in patients with Acute myocardial Infarction (AMI and evaluate the possible relationship between AMI and chronic periodontitis. Patients and Methods: A number of 160 patients, aged 35 to 70 years old, enrolled in the study. Eighty patients (43 men, 37 women were examined four days after hospitalization due to AMI. Control group consisted of 80 persons (38 men, 42 women with normal coronary angiography. The following periodontal parameters were examined: Plaque index (PI, gingiral index (GI, bleeding on probing (BOP, probing depth (PD, clinical attachment loss (CAL and number of sites with CAL.Results: The case, compared to control showed significantly worse results for some periodontal variables studied: The mean of PD and PD > 3 mm, CAL, and number of sites with CAL, had worse results compared to control despite similar oral hygiene and frequency of brushing. The confounding factors for the present study were found to be hypertension and diabetes. Conclusion: The association between periodontitis and acute myocardial infarction was significant after adjusting for conventional risk factors for AMI.

  13. Role of anaerobes in acute pelvic inflammatory disease

    Saini S

    2003-01-01

    Full Text Available Pouch of Douglas aspirates were collected from 50 women with history and examination suggestive of acute pelvic inflammatory disease (PID and 20 healthy women admitted for tubal ligation served as control. A total of 57 microorganisms were isolated from 37 patients out of 50 in study group. Of 37 positive cultures 21(56.7% were monomicrobial and 16(43.2% were polymicrobial. Most common symptom in study group was lower abdominal pain (90%, vaginal discharge (70% and irregular bleeding (40% and 30% patients had history of intrauterine contraceptive device (IUCD implantation. The predominant aerobic isolates were Escherichia coli, Coagulase Negative Staphylococcus (CONS, Staphylococcus aureus, Klebsiella pneumoniae while common anaerobes were Bacteroides fragilis, Prevotella melaninogenica, Fusobacterium nucleatum and Peptostreptococcus spp. Our study shows that cefotaxime, cefuroxime and gentamicin may be used for gram negative aerobic bacilli; cloxacillin, cephaloridine and erythromycin for aerobic gram positive cocci and amikacin and ceftazidime for Pseudomonas aeruginosa. Thus for optimum therapy of acute PID it is beneficial to keep in mind major conceptual changes and therapeutic realities that have influenced current understanding of acute PID and have affected the choice of therapy.

  14. Role of anaerobes in acute pelvic inflammatory disease.

    Saini, S; Gupta, N; Batra, G; Arora, D R

    2003-01-01

    Pouch of Douglas aspirates were collected from 50 women with history and examination suggestive of acute pelvic inflammatory disease (PID) and 20 healthy women admitted for tubal ligation served as control. A total of 57 microorganisms were isolated from 37 patients out of 50 in study group. Of 37 positive cultures 21(56.7%) were monomicrobial and 16(43.2%) were polymicrobial. Most common symptom in study group was lower abdominal pain (90%), vaginal discharge (70%) and irregular bleeding (40%) and 30% patients had history of intrauterine contraceptive device (IUCD) implantation. The predominant aerobic isolates were Escherichia coli, Coagulase Negative Staphylococcus (CONS), Staphylococcus aureus, Klebsiella pneumoniae while common anaerobes were Bacteroides fragilis, Prevotella melaninogenica, Fusobacterium nucleatum and Peptostreptococcus spp. Our study shows that cefotaxime, cefuroxime and gentamicin may be used for gram negative aerobic bacilli; cloxacillin, cephaloridine and erythromycin for aerobic gram positive cocci and amikacin and ceftazidime for Pseudomonas aeruginosa. Thus for optimum therapy of acute PID it is beneficial to keep in mind major conceptual changes and therapeutic realities that have influenced current understanding of acute PID and have affected the choice of therapy. PMID:17643017

  15. Pathogenic mechanisms of Acute Graft versus Host Disease

    Ferrara James L.M.

    2002-01-01

    Full Text Available Graft-versus-host-disease (GVHD is the major complication of allogeneic Bone Marrow Transplant (BMT. Older BMT recipients are a greater risk for acute GVHD after allogeneic BMT, but the causes of this association are poorly understood. Using well-characterized murine BMT models we have explored the mechanisms of increased GVHD in older mice. GVHD mortality and morbidity, and pathologic and biochemical indices were all worse in old recipients. Donor T cell responses were significantly increased in old recipients both in vivo and in vitro when stimulated by antigen-presenting cells (APCs from old mice. In a haploidential GVHD model, CD4+ donor T cells mediated more severe GVHD in old mice. We confirmed the role of aged APCs in GVHD using bone marrow chimera recipient created with either old or young bone marrow. APCs from these mice also stimulated greater responses from allogeneic cells in vitro. In a separate set of experiments we evaluated whether alloantigen expression on host target epithelium is essential for tissue damage induced by GVHD. Using bone marrow chimeras recipients in which either MHC II or MHC I alloantigen was expressed only on APCs, we found that acute GVHD does not require alloantigen expression on host target epithelium and that neutralization of tumor necrosis factor-alpha and interleukin-1 prevents acute GVHD. These results pertain to CD4-mediated GVHD and to a lesser extent in CD8-mediated GVHD, and confirm the central role of most APCs as well as inflammatory cytokines.

  16. Cardiovascular system and physical working capacity in patients who had acute radiation syndrome as the result of Chernobyl accident

    The functional state of cardiovascular system has been studied since 1986 in 168 patients who had acute radiation syndrome as the result of Chernobyl accident. There was revealed a progressive increase of cardiovascular system pathology. The number of patients with pathological signs at ECG increased from 4.8 % in 1987 to 11.3 % in 1994 and with myocardial hypertrophy from 1.2 % to 22.6 %. The number of patients with coronary heart disease increased on 17.2% and with essential hypertension on 15.5%. The physical working capacity reduced to 50-60 % of a due level for healthy persons. Two patients suffered from acute myocardial infarction during this period of observation. Thirteenth patients died from 1987 to 1995. Among them 4 patient died in a result of acute cardiac failure. The development of cardiovascular pathology has no any correlation with a dose of exposure. Three factors of cardiovascular pathology growth are supposed

  17. The acute radiation syndrome in the 137Cs Brazilian accident, 1987

    Eight patients with the most severe degreed of bone marrow impairment are studied. Case descriptions are limited to manifestations and complications related to the 'Acute Radiation Syndrome' (ARS). Medical facilities, exams and therapeutic management are discussed. (MAC)

  18. Formas agudas de periodontitis Acute conditions of periodontal disease

    L. Pérez-Salcedo

    2008-04-01

    Full Text Available La clasificación de las Enfermedades Periodontales ha cambiado en las últimas décadas. En la clasificación la AAP de 1989 la periodontitis necrotizante ocupaba el cuarto lugar. En el Workshop Europeo de 1993 la periodontitis necrotizante aparece en el grupo de los descriptores primarios. Según el Internacional Workshop for a Classification of Periodontal Diseases and Conditions 1999 en el que se revisó y se modificó la clasificación de las patologías periodontales, las enfermedades periodontales necrotizantes ocupan el punto cinco, diferenciándose entre Gingivitis Necrotizante y Periodontitis Necrotizante. Y se añade en la clasificación el grupo de abscesos periodontales. En este artículo de revisión vamos a profundizar acerca de las formas agudas de periodontitis.The Periodontal Diseases classification had changed in the last decades. In AAP classification of 1989 the necrotize was in the 4th position. In the European Workshop was in the group of primary descriptors. According to the International Workshop for a Classification of Periodontal Diseases and Conditions 1999, review and modificated the classification of periodontal pathologies, the periodontal necrotize diseases are in the 5th position, distinguishing between Necrotize Gingivitis and Necrotize Periodontitis. And Peridontal Abscesses was add to the classification. In this paper we are going to review about the acute forms of Periodontal Diseases.

  19. Salivary biochemical markers as potential acute toxicity parameters for acute radiation injury: A study on small experimental animals.

    Soni, S; Agrawal, P; Kumar, N; Mittal, G; Nishad, D K; Chaudhury, N K; Bhatnagar, A; Basu, M; Chhillar, N

    2016-03-01

    Researchers have been evaluating several biodosimetric/screening approaches to assess acute radiation injury, related to mass causality. Keeping in mind this background, we hypothesized that effect of whole-body irradiation in single fraction in graded doses can affect the secretion of various salivary components that could be used as acute radiation injury/toxicity marker, which can be used in screening of large population at the time of nuclear accidents/disaster. Thirty Sprague Dawley rats treated with whole-body cobalt-60 gamma irradiation of dose 1-5 Gy (dose rate: 0.95 Gy/min) were included in this study. Whole mixed saliva was collected from all animals before and after radiation up to 72 h postradiation. Saliva was analyzed for electrolytes, total protein, urea, and amylase. Intragroup comparison of salivary parameters at different radiation doses showed significant differences. Potassium was significantly increased as the dose increased from 1 Gy to 5 Gy (p 0.5). Sodium was significantly altered after 3-5 Gy (p 0.5), except 1 and 2 Gy, whereas changes in sodium level were nonsignificant (p > 0.5). Urea, total protein, and amylase levels were also significantly increased as the radiation dose increased (p 0.5). This study suggests that salivary parameters were sensitive toward radiation even at low radiation dose which can be used as a predictor of radiation injury. PMID:25813962

  20. Health status of grandchildren of subjects occupationally exposed to chronic radiation. Communication 3. Disease incidence

    The morbidity of 1557 grandchildren of subjects occupationally exposed to chronic radiation were analyzed. Three groups were singled out. Group 1 consisted of children whose grandfathers were exposed, group 2 of children grandmothers were exposed and group 3 of children whose both grandparent were exposed. Total morbidity level and morbidity structure for 13 classes of diseases and 60 nosological entities was assessed. The study showed that disease incidence in general, structure by disease and individual nosological entities, the share of frequently falling ill children, and health index in the test group corresponded to those in controls. Reliable differences were observed only for respiratory diseases, at the expense of acute respiratory diseases, which were frequent during the second-third years of life in children whose both grandparents were occupationally exposed to radiation

  1. Acute exacerbations of chronic obstructive pulmonary disease: causes and impacts.

    Chhabra, Sunil K; Dash, Devi Jyoti

    2014-01-01

    Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are recognised clinically as episodes of increased breathlessness and productive cough requiring a more intensive treatment. A subset of patients with this disease is especially prone to such exacerbations. These patients are labelled as 'frequent exacerbators'. Though yet poorly characterised in terms of host characteristics, including any genetic basis, these patients are believed to represent a distinct phenotype as they have a different natural history with a more progressive disease and a poorer prognosis than those who get exacerbations infrequently. Most exacerbations appear to be associated with infective triggers, either bacterial or viral, although 'non-infective' agents, such as air pollution and other irritants may also be important. Susceptibility to exacerbations is determined by multiple factors. Several risk factors have been identified, some of which are modifiable. Chronic obstructive pulmonary disease (COPD) exacerbations are major drivers of health status and patient-centered outcomes, and are a major reason for health care utilisation including hospitalisations and intensive care admissions. These are associated with considerable morbidity and mortality, both immediate and long-term. These episodes have a negative impact on the patient and the disease including high economic burden, increased mortality, worsening of health status, limitation of activity, and aggravation of comorbidities including cardiovascular disease, osteoporosis and neuro-psychiatric complications. Exacerbations also increase the rate of progression of disease, increasing the annual decline in lung function and leading to a poorer prognosis. Evaluation of risk of exacerbations is now included as a major component of the initial assessment of a patient with COPD in addition to the traditionally used lung function parameter, forced expiratory volume in one second (FEV1). Decreasing the risk of exacerbations

  2. Acute toxicity in comprehensive head and neck radiation for nasopharynx and paranasal sinus cancers: cohort comparison of 3D conformal proton therapy and intensity modulated radiation therapy

    To evaluate acute toxicity endpoints in a cohort of patients receiving head and neck radiation with proton therapy or intensity modulated radiation therapy (IMRT). Forty patients received comprehensive head and neck radiation including bilateral cervical nodal radiation, given with or without chemotherapy, for tumors of the nasopharynx, nasal cavity or paranasal sinuses, any T stage, N0-2. Fourteen received comprehensive treatment with proton therapy, and 26 were treated with IMRT, either comprehensively or matched to proton therapy delivered to the primary tumor site. Toxicity endpoints assessed included g-tube dependence at the completion of radiation and at 3 months after radiation, opioid pain medication requirement compared to pretreatment normalized as equivalent morphine dose (EMD) at completion of treatment, and at 1 and 3 months after radiation. In a multivariable model including confounding variables of concurrent chemotherapy and involved nodal disease, comprehensive head and neck radiation therapy using proton therapy was associated with a lower opioid pain requirement at the completion of radiation and a lower rate of gastrostomy tube dependence by the completion of radiation therapy and at 3 months after radiation compared to IMRT. Proton therapy was associated with statistically significant lower mean doses to the oral cavity, esophagus, larynx, and parotid glands. In subgroup analysis of 32 patients receiving concurrent chemotherapy, there was a statistically significant correlation with a greater opioid pain medication requirement at the completion of radiation and both increasing mean dose to the oral cavity and to the esophagus. Proton therapy was associated with significantly reduced radiation dose to assessed non-target normal tissues and a reduced rate of gastrostomy tube dependence and opioid pain medication requirements. This warrants further evaluation in larger studies, ideally with patient-reported toxicity outcomes and quality of life

  3. Detection of acute hepatopancreatic necrosis disease (AHPND) in Mexico.

    Nunan, Linda; Lightner, Donald; Pantoja, Carlos; Gomez-Jimenez, Silvia

    2014-08-21

    Acute hepatopancreatic necrosis disease (AHPND), which has also been referred to as early mortality syndrome (EMS), initially emerged as a destructive disease of cultured shrimp species in Asia in 2009. The pathogen associated with the disease, Vibrio parahaemolyticus, subsequently spread to the Western Hemisphere and emerged in Mexico in early 2013. The spread to the Western Hemisphere is a major concern to shrimp producers in the region. To date, the only peer-reviewed published method for determining whether mortalities are due to AHPND is through histological examination. A novel PCR detection method was employed to assess samples from Mexico in order to confirm the presence of the pathogen in this country. This manuscript details the detection methods used to confirm the presence of AHPND in Mexico. Both immersion and per os challenge studies were used to expose the Penaeus vannamei to the bacteria in order to induce the disease. Histological analysis confirmed AHPND status following the challenge studies. Also provided are the details of the molecular test by PCR that was used for screening candidate V. parahaemolyticus isolates. A rapid PCR assay for detection of AHPND may help with early detection and help prevent the spread of AHPND to other countries. PMID:25144120

  4. Explanation of diagnostic criteria for radiation thyroid diseases

    National occupational health standard-Diagnostic Criteria for Radiation Thyroid Diseases has been approved and issued by the Ministry of Health. Based on the extensive research of literature, this standard was enacted according to the relevant laws and regulations. It is mainly used for diagnosis of thyroid diseases caused by occupational radiation, and it also can serve as a guide to diagnose thyroid disease induced by medical radiation. To implement this standard, and to diagnose and treat the radiation thyroid diseases patient correctly and timely, the contents of this standard were interpreted in this article. (authors)

  5. Computed tomographic findings of radiation-induced acute adrenal injury with associated radiation nephropathy: a case report

    Radiation nephropathy was first recognized in 1906. The kidney is a radiosensitive organ with a tolerance dose (5% complications in 5 years) of 20 Gray. The imaging findings of acute and chronic radiation induced renal injury are previously described. Radiation-induced adrenal injury, to our knowledge, has not been described in the literature. Unlike the kidneys and other upper abdominal organs, the adrenal glands are traditionally thought to be radio-resistant, protected from radiation-induced injury by proximity to adjacent organs and by the adrenal medulla which reportedly has increased radio-resistance. We present the computed tomographic imaging findings of a patient with acute radiation induced adrenal injury which resulted in adrenal insufficiency following radiotherapy of an adjacent thecal metastasis

  6. Predictors of Severe Acute and Late Toxicities in Patients With Localized Head-and-Neck Cancer Treated With Radiation Therapy

    Purpose: Radiation therapy (RT) causes acute and late toxicities that affect various organs and functions. In a large cohort of patients treated with RT for localized head and neck cancer (HNC), we prospectively assessed the occurrence of RT-induced acute and late toxicities and identified characteristics that predicted these toxicities. Methods and Materials: We conducted a randomized trial among 540 patients treated with RT for localized HNC to assess whether vitamin E supplementation could improve disease outcomes. Adverse effects of RT were assessed using the Radiation Therapy Oncology Group Acute Radiation Morbidity Criteria during RT and one month after RT, and the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Late Radiation Morbidity Scoring Scheme at six and 12 months after RT. The most severe adverse effect among the organs/tissues was selected as an overall measure of either acute or late toxicity. Grade 3 and 4 toxicities were considered as severe. Stepwise multivariate logistic regression models were used to identify all independent predictors (p < 0.05) of acute or late toxicity and to estimate odds ratios (OR) for severe toxicity with their 95% confidence intervals (CI). Results: Grade 3 or 4 toxicity was observed in 23% and 4% of patients, respectively, for acute and late toxicity. Four independent predictors of severe acute toxicity were identified: sex (female vs. male: OR = 1.72, 95% confidence interval [CI]: 1.06–2.80), Karnofsky Performance Status (OR = 0.67 for a 10-point increment, 95% CI: 0.52–0.88), body mass index (above 25 vs. below: OR = 1.88, 95% CI: 1.22–2.90), TNM stage (Stage II vs. I: OR = 1.91, 95% CI: 1.25–2.92). Two independent predictors were found for severe late toxicity: female sex (OR = 3.96, 95% CI: 1.41–11.08) and weight loss during RT (OR = 1.26 for a 1 kg increment, 95% CI: 1.12–1.41). Conclusions: Knowledge of these predictors easily collected in a clinical

  7. Predictors of Severe Acute and Late Toxicities in Patients With Localized Head-and-Neck Cancer Treated With Radiation Therapy

    Meyer, Francois, E-mail: francois.meyer@chuq.qc.ca [Laval University Cancer Research Center, Centre hospitalier universitaire de Quebec - L' Hotel-Dieu de Quebec, Quebec (Canada); Fortin, Andre; Wang, Chang Shu [Radiation Therapy Department, Centre hospitalier universitaire de Quebec - L' Hotel-Dieu de Quebec, Quebec (Canada); Liu, Geoffrey [Applied Molecular Oncology, Ontario Cancer Institute/Princess Margaret Hospital, Toronto (Canada); Bairati, Isabelle [Laval University Cancer Research Center, Centre hospitalier universitaire de Quebec - L' Hotel-Dieu de Quebec, Quebec (Canada)

    2012-03-15

    Purpose: Radiation therapy (RT) causes acute and late toxicities that affect various organs and functions. In a large cohort of patients treated with RT for localized head and neck cancer (HNC), we prospectively assessed the occurrence of RT-induced acute and late toxicities and identified characteristics that predicted these toxicities. Methods and Materials: We conducted a randomized trial among 540 patients treated with RT for localized HNC to assess whether vitamin E supplementation could improve disease outcomes. Adverse effects of RT were assessed using the Radiation Therapy Oncology Group Acute Radiation Morbidity Criteria during RT and one month after RT, and the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Late Radiation Morbidity Scoring Scheme at six and 12 months after RT. The most severe adverse effect among the organs/tissues was selected as an overall measure of either acute or late toxicity. Grade 3 and 4 toxicities were considered as severe. Stepwise multivariate logistic regression models were used to identify all independent predictors (p < 0.05) of acute or late toxicity and to estimate odds ratios (OR) for severe toxicity with their 95% confidence intervals (CI). Results: Grade 3 or 4 toxicity was observed in 23% and 4% of patients, respectively, for acute and late toxicity. Four independent predictors of severe acute toxicity were identified: sex (female vs. male: OR = 1.72, 95% confidence interval [CI]: 1.06-2.80), Karnofsky Performance Status (OR = 0.67 for a 10-point increment, 95% CI: 0.52-0.88), body mass index (above 25 vs. below: OR = 1.88, 95% CI: 1.22-2.90), TNM stage (Stage II vs. I: OR = 1.91, 95% CI: 1.25-2.92). Two independent predictors were found for severe late toxicity: female sex (OR = 3.96, 95% CI: 1.41-11.08) and weight loss during RT (OR = 1.26 for a 1 kg increment, 95% CI: 1.12-1.41). Conclusions: Knowledge of these predictors easily collected in a clinical setting could help

  8. The Effects of Radiation and Dose-Fractionation on Cancer and Non-Tumor Disease Development

    Gayle E. Woloschak

    2012-12-01

    Full Text Available The Janus series of radiation experiments, conducted from 1970 to 1992, explored the effects of gamma and neutron radiation on animal lifespan and disease development. Data from these experiments presents an opportunity to conduct a large scale analysis of both tumor and non-tumor disease development. This work was focused on a subset of animals from the Janus series of experiments, comparing acute or fractionated exposures of gamma or neutron radiation on the hazards associated with the development of tumor and non-tumor diseases of the liver, lung, kidney or vascular system. This study also examines how the co-occurrence of non-tumor diseases may affect tumor-associated hazards. While exposure to radiation increases the hazard of dying with tumor and non-tumor diseases, dose fractionation modulates these hazards, which varies across different organ systems. Finally, the effect that concurrent non-cancer diseases have on the hazard of dying with a tumor also differs by organ system. These results highlight the complexity in the effects of radiation on the liver, lung, kidney and vascular system.

  9. Managing the acutely ill adult with sickle cell disease.

    Brown, Marvelle

    Sickle cell disease (SCD) is an autosomal recessively inherited condition, affecting the structure of the haemoglobin. SCD is a long-term chronic condition which is manifested by periods of acute painful sickling crisis, known as vaso-occlusive crisis (VOC) and is the cause of 90% of sickle cell-related hospital admissions. SCD is one of the most common genetic conditions worldwide and in the UK there are approximately 12,500 people living with it (Streetly et al,1997; Howard et al, 2008), making it more common than cystic fibrosis, yet there still remains many challenges in managing these patients when they become acutely ill. Lack of awareness and understanding of the illness, concerns regarding addiction and limited attention to the psycho-social implications of the illness, leads to less than effective care for this patient group when they are hospitalized. The aims of this article are to outline the pathophysiology of SCD, identify the causes of VOC and discuss the key principles of nursing management for patients experiencing a VOC. PMID:22306637

  10. Granulocyte Colony-Stimulating Factor in the Treatment of Acute Radiation Syndrome: A Concise Review

    Hofer, Michal; Pospíšil, Milan; Komůrková, Denisa; Hoferová, Zuzana

    2014-01-01

    Roč. 19, č. 4 (2014), s. 4770-4778. ISSN 1420-3049 R&D Projects: GA ČR(CZ) GAP303/11/0128 Institutional support: RVO:68081707 Keywords : granulocyte colony-stimulating factor * radiation accidents * acute radiation syndrome Subject RIV: BO - Biophysics Impact factor: 2.416, year: 2014

  11. Thymus endocrine function in acute radiation sickness resulted from Chernobyl accident

    Data are presented on the role of inhibition of endocrine function of the thymus in the pathogenesis of acute radiation sickness resulted from the direct and indirect (via the increased glucocorticoid production) effects of ionizing radiation. The complex treatment, including nonspecific active immunotherapy, permitted to normalize the thymic hormone level and certain parameters of the immune system

  12. An Overview of NASA's Risk of Cardiovascular Disease from Radiation Exposure

    Patel, Zarana S.; Huff, Janice L.; Simonsen, Lisa C.

    2015-01-01

    The association between high doses of radiation exposure and cardiovascular damage is well established. Patients that have undergone radiotherapy for primary cancers of the head and neck and mediastinal regions have shown increased risk of heart and vascular damage and long-term development of radiation-induced heart disease [1]. In addition, recent meta-analyses of epidemiological data from atomic bomb survivors and nuclear industry workers has also shown that acute and chronic radiation exposures is strongly correlated with an increased risk of circulatory disease at doses above 0.5 Sv [2]. However, these analyses are confounded for lower doses by lifestyle factors, such as drinking, smoking, and obesity. The types of radiation found in the space environment are significantly more damaging than those found on Earth and include galactic cosmic radiation (GCR), solar particle events (SPEs), and trapped protons and electrons. In addition to the low-LET data, only a few studies have examined the effects of heavy ion radiation on atherosclerosis, and at lower, space-relevant doses, the association between exposure and cardiovascular pathology is more varied and unclear. Understanding the qualitative differences in biological responses produced by GCR compared to Earth-based radiation is a major focus of space radiation research and is imperative for accurate risk assessment for long duration space missions. Other knowledge gaps for the risk of radiation-induced cardiovascular disease include the existence of a dose threshold, low dose rate effects, and potential synergies with other spaceflight stressors. The Space Radiation Program Element within NASA's Human Research Program (HRP) is managing the research and risk mitigation strategies for these knowledge gaps. In this presentation, we will review the evidence and present an overview of the HRP Risk of Cardiovascular Disease and Other Degenerative Tissue Effects from Radiation Exposure.

  13. Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease

    Brill SE

    2014-11-01

    Full Text Available Simon E Brill, Jadwiga A Wedzicha Airway Disease Section, National Heart and Lung Institute, Imperial College, London, UK Abstract: Acute exacerbations of chronic obstructive pulmonary disease (COPD are important events in the history of this debilitating lung condition. Associated health care utilization and morbidity are high, and many patients require supplemental oxygen or ventilatory support. The last 2 decades have seen a substantial increase in our understanding of the best way to manage the respiratory failure suffered by many patients during this high-risk period. This review article examines the evidence underlying supplemental oxygen therapy during exacerbations of COPD. We first discuss the epidemiology and pathophysiology of respiratory failure in COPD during exacerbations. The rationale and evidence underlying oxygen therapy, including the risks when administered inappropriately, are then discussed, along with further strategies for ventilatory support. We also review current recommendations for best practice, including methods for improving oxygen provision in the future. Keywords: chronic obstructive pulmonary disease (COPD, exacerbation, oxygen therapy, respiratory failure, hypercapnia

  14. Mitochondrial dysfunction in inherited renal disease and acute kidney injury.

    Emma, Francesco; Montini, Giovanni; Parikh, Samir M; Salviati, Leonardo

    2016-05-01

    Mitochondria are increasingly recognized as key players in genetic and acquired renal diseases. Most mitochondrial cytopathies that cause renal symptoms are characterized by tubular defects, but glomerular, tubulointerstitial and cystic diseases have also been described. For example, defects in coenzyme Q10 (CoQ10) biosynthesis and the mitochondrial DNA 3243 A>G mutation are important causes of focal segmental glomerulosclerosis in children and in adults, respectively. Although they sometimes present with isolated renal findings, mitochondrial diseases are frequently associated with symptoms related to central nervous system and neuromuscular involvement. They can result from mutations in nuclear genes that are inherited according to classic Mendelian rules or from mutations in mitochondrial DNA, which are transmitted according to more complex rules of mitochondrial genetics. Diagnosis of mitochondrial disorders involves clinical characterization of patients in combination with biochemical and genetic analyses. In particular, prompt diagnosis of CoQ10 biosynthesis defects is imperative because of their potentially reversible nature. In acute kidney injury (AKI), mitochondrial dysfunction contributes to the physiopathology of tissue injury, whereas mitochondrial biogenesis has an important role in the recovery of renal function. Potential therapies that target mitochondrial dysfunction or promote mitochondrial regeneration are being developed to limit renal damage during AKI and promote repair of injured tissue. PMID:26804019

  15. CT appearance of acute inflammatory disease of the renal interstitium

    Today, infection remains the most common disease of the urinary tract and constitutes almost 75% of patient problems requiring urologic evaluation. There have been several major factors responsible for our better understanding of the nature and pathophysiology of urinary tract infection. One has been quantitated urine bacteriology and another, the discovery that a significant part of the apparently healthy adult female population has asymptomatic bacteriuria. Abnormal conditions such as neurogenic bladder, bladder malignancy, prolonged catheter drainage and reflux, altered host resistance, diabetes mellitus, and urinary tract obstruction, as well as pregnancy, may either predispose to or be implicated in the pathogenesis of urinary tract infection. There is a wide range of conditions that result in acute renal inflammation and those under discussion affect primarily the interstitium. This term refers to the connective tissue elements separating the tubules in the cortex and medulla. Hence, the interstitial nephritides are to be distinguished from the glomerulonephritides and fall into two general etiologic categories: infectious and noninfectious

  16. Acute Psychosis as Major Clinical Presentation of Legionnaires’ Disease

    Ricardo Coentre

    2016-01-01

    Full Text Available We report a case of a 61-year-old woman who presented with acute psychosis as a major manifestation of Legionnaires’ disease in the absence of other neuropsychiatric symptoms. Clinical history revealed dry cough and nausea. Observation showed fever and auscultation crackles in the lower lobe of the right lung. Laboratory testing demonstrated elevated C-reactive protein and lung chest radiograph showed patchy peribronchial and right lower lobe consolidation. Soon after admission, she started producing purulent sputum. Epidemiological data suggested Legionella pneumophila as possible cause of the clinical picture that was confirmed by urinary antigen detection and polymerase chain reaction of the sputum. She was treated with levofloxacin 750 mg/day for 10 days with complete remission of pulmonary and psychiatric symptoms. She has not had further psychotic symptoms.

  17. Invasive fungal diseases in patients with acute lymphoid leukemia.

    Nicolato, Andrea; Nouér, Simone A; Garnica, Marcia; Portugal, Rodrigo; Maiolino, Angelo; Nucci, Marcio

    2016-09-01

    Invasive fungal disease (IFD) represents an important complication in patients with acute lymphoid leukemia (ALL). The objectives of this study were to determine the prevalence of IFD in ALL patients with neutropenia, identify factors associated with IFD, and estimate the impact of IFD on the outcome. All patients with ALL who developed febrile neutropenia from 1987 to 2013 were evaluated. Cases of IFD were classified as proven or probable. Factors associated with IFD were evaluated by comparing episodes with and without a diagnosis of IFD. Among 350 episodes of febrile neutropenia, 31 IFDs were diagnosed (8.8%). Prolonged neutropenia was the only factor associated with IFD caused by yeasts. Factors associated with IFD caused by molds by multivariate analysis were the period after 2008, receipt of allogeneic transplant, relapsed ALL and prolonged neutropenia. Patients in relapse should receive induction chemotherapy in rooms with HEPA filter and receive antifungal prophylaxis. PMID:26949001

  18. Medical precautions of radiation diseases and radiation accidents; Medizinische Vorsorge bei Strahlenerkrankungen und Strahlenunfaellen

    Fehringer, Franz; Ludwig, Thomas [Berufsgenossenschaft Energie Textil Elektro, Koeln (Germany). Inst. fuer Strahlenschutz; List, Volker [Forschungszentrum Karlsruhe GmbH, Karlsruhe (Germany). Medizinische Abt.; Schneider, Rita [Klinik und Poliklinik fuer Nuklearmedizin, WHO REMPAN Kollaborationszentrum, Wuerzburg (Germany)

    2009-07-01

    The main topic deals essentially with the role of the Authorized Physician in industrial medicine, with the occupational diseases caused by ionizating radiation, with the tasks of regional radiation protection centers, and with the WHO REMPAN network. (orig.)

  19. Preventive measures for Acute Rheumatic Fever/ Rheumatic Heart Disease : A literature review

    Shrestha, Usha; Kunwar, Nabina

    2013-01-01

    Acute rheumatic disease is a major burden in the developing countries and also a major cause of premature death in children and young adults every year. Aim: The aim of this study is to investigate the factors contributing to prevention of acute rheumatic fever and rheumatic heart disease in developing countries. This will offers appropriate knowledge to the care provider to identify risk factors for acute rheumatic fever and implement in-terventions timely. The research questions are followi...

  20. Acute Kidney Injury due to Crescentic Glomerulonephritis in a Patient with Polycystic Kidney Disease

    Maggard, Reuben; Makary, Raafat; Monteiro, Carmela l.; James, Leighton R.

    2013-01-01

    Polycystic kidney disease is an inherited condition, characterized by the development of cysts in the kidney, as well as in other organs. Patients with polycystic kidney can suffer from the same causes of acute kidney injury as the general population. Nephritic syndrome is an uncommon cause of acute kidney injury in the general population and less common in patients with polycystic kidney disease. We report the second case of crescentic glomerulonephritis, causing acute kidney injury, in a pa...

  1. Uric acid levels and their relation to incapacities in acute cerebrovascular disease

    Julio López Argüelles; Joan Rojas Fuentes; Ricardo Verdecia Fraga

    2010-01-01

    Background: cerebrovascular disease and ischemic cardiopathy can be considered as an epidemic and constitute the first cause of incapacities in developed countries. Multiple studies have shown the association between uric acid levels and cerebrovascular diseases. Objective: To correlate the levels of serum uric acid and incapacities in the acute phase of cerebrovascular disease. Methods: A correlational study was carried out with 217 patients with acute cerebrovascular disease. The patient’s ...

  2. Anti-radiation vaccine: Immunologically-based Prophylaxis of Acute Toxic Radiation Syndromes Associated with Long-term Space Flight

    Popov, Dmitri; Maliev, Vecheslav; Jones, Jeffrey; Casey, Rachael C.

    2007-01-01

    Protecting crew from ionizing radiation is a key life sciences problem for long-duration space missions. The three major sources/types of radiation are found in space: galactic cosmic rays, trapped Van Allen belt radiation, and solar particle events. All present varying degrees of hazard to crews; however, exposure to high doses of any of these types of radiation ultimately induce both acute and long-term biological effects. High doses of space radiation can lead to the development of toxicity associated with the acute radiation syndrome (ARS) which could have significant mission impact, and even render the crew incapable of performing flight duties. The creation of efficient radiation protection technologies is considered an important target in space radiobiology, immunology, biochemistry and pharmacology. Two major mechanisms of cellular, organelle, and molecular destruction as a result of radiation exposure have been identified: 1) damage induced directly by incident radiation on the macromolecules they encounter and 2) radiolysis of water and generation of secondary free radicals and reactive oxygen species (ROS), which induce chemical bond breakage, molecular substitutions, and damage to biological molecules and membranes. Free-radical scavengers and antioxidants, which neutralize the damaging activities of ROS, are effective in reducing the impact of small to moderate doses of radiation. In the case of high doses of radiation, antioxidants alone may be inadequate as a radioprotective therapy. However, it remains a valuable component of a more holistic strategy of prophylaxis and therapy. High doses of radiation directly damage biological molecules and modify chemical bond, resulting in the main pathological processes that drive the development of acute radiation syndromes (ARS). Which of two types of radiation-induced cellular lethality that ultimately develops, apoptosis or necrosis, depends on the spectrum of incident radiation, dose, dose rate, and

  3. Coronary heart disease is not significantly linked to acute kidney injury identified using Acute Kidney Injury Group criteria

    Yayan J

    2012-01-01

    Josef YayanDepartment of Internal Medicine, Vinzentius Hospital, Landau, GermanyBackground: Patients with unstable angina or myocardial infarction are at risk of acute kidney injury, which may be aggravated by the iodine-containing contrast agent used during coronary angiography; however, the relationship between these two conditions remains unclear.Objective: The current study investigated the relationship between acute kidney injury and coronary heart disease prior to coronary angiography.M...

  4. Evaluation of diseases associated to occupational exposure to ionizing radiations

    A retrospective investigation of all cases of radiation workers with diseases and injuries, considered as occupational diseases caused by ionizing radiation is presented. The investigation includes all cases registered in the Institute of Occupational Health over five years period (1990-1995). The incidence of that diseases are studied, as well as the correlation between each type of source, time of exposure and annual average equivalent individual dose

  5. Combined chemotherapy and radiation therapy in limited disease small-cell lung cancer

    This is a retrospective study to evaluate the response rate, acute toxicity, and survival rate of a combined chemotherapy and radiation therapy in limited disease small cell lung cancer. Forty six patients with limited disease small-cell lung cancer who underwent combined chemotherapy and radiation therapy between October 1994 and April 1998 were evaluated. Six cycles of chemotherapy were planned either using a VIP regimen (etoposide, ifosfamide, and cis-platin) or a EP regimen (etoposide and cis-platin). Thoracic radiation therapy was planned to deliver 44 Gy using 10MV X-ray, starting concurrently with chemotherapy. Response was evaluated 4 weeks after the completion of the planned chemotherapy and radiation therapy, and the prophylactic cranial irradiation was planned only for the patients with complete responses. Acute toxicity was evaluated using the SWOG toxicity criteria, and the overall survival and disease-free survival were calculated using the Kaplan-Meier Method. The median follow-up period was 16 months (range:2 to 41 months). Complete response was achieved in 30 (65%) patients, of which 22 patients received prophylactic cranial irradiations. Acute toxicities over grade III were granulocytopenia in 23 (50%), anemia in 17 (37%), thrombo-cytopenia in nine (20%), alopecia in nine (20%), nausea/vomiting in five (11%), and peripheral neuropathy in one (2%). Chemotherapy was delayed in one patient, and the chemotherapy doses were reduced in 58 (24%) out of the total 246 cycles. No radiation esophagitis over grade III was observed, while interruption during radiation therapy for a mean of 8.3 days occurred in 21 patients. The local recurrences were observed in 8 patients and local progressions were in 6 patients, and the distant metastases in 17 patients. Among these, four patients had both the local relapse and the distant metastasis. Brain was the most common metastatic site (10 patients), followed by the liver as the next common site (4 patients). The

  6. Combined chemotherapy and radiation therapy in limited disease small-cell lung cancer

    Kim, Moon Kyung; Ahn, Yong Chan; Park, Keun Chil; Lim Do Hoon; Huh, Seung Jae; Kim, Dae Yong; Shin, Kyung Hwan; Lee, Kyu Chan; Kwon, O Jung [College of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    1999-03-01

    This is a retrospective study to evaluate the response rate, acute toxicity, and survival rate of a combined chemotherapy and radiation therapy in limited disease small cell lung cancer. Forty six patients with limited disease small-cell lung cancer who underwent combined chemotherapy and radiation therapy between October 1994 and April 1998 were evaluated. Six cycles of chemotherapy were planned either using a VIP regimen (etoposide, ifosfamide, and cis-platin) or a EP regimen (etoposide and cis-platin). Thoracic radiation therapy was planned to deliver 44 Gy using 10MV X-ray, starting concurrently with chemotherapy. Response was evaluated 4 weeks after the completion of the planned chemotherapy and radiation therapy, and the prophylactic cranial irradiation was planned only for the patients with complete responses. Acute toxicity was evaluated using the SWOG toxicity criteria, and the overall survival and disease-free survival were calculated using the Kaplan-Meier Method. The median follow-up period was 16 months (range:2 to 41 months). Complete response was achieved in 30 (65%) patients, of which 22 patients received prophylactic cranial irradiations. Acute toxicities over grade III were granulocytopenia in 23 (50%), anemia in 17 (37%), thrombo-cytopenia in nine (20%), alopecia in nine (20%), nausea/vomiting in five (11%), and peripheral neuropathy in one (2%). Chemotherapy was delayed in one patient, and the chemotherapy doses were reduced in 58 (24%) out of the total 246 cycles. No radiation esophagitis over grade III was observed, while interruption during radiation therapy for a mean of 8.3 days occurred in 21 patients. The local recurrences were observed in 8 patients and local progressions were in 6 patients, and the distant metastases in 17 patients. Among these, four patients had both the local relapse and the distant metastasis. Brain was the most common metastatic site (10 patients), followed by the liver as the next common site (4 patients). The

  7. Diagnostic criteria for acute liver failure due to Wilson disease

    Christoph Eisenbach; Olivia Sieg; Wolfgang Stremmel; Jens Encke; Uta Merle

    2007-01-01

    AIM: To describe the diagnostic criteria for acute liver failure due to Wilson disease (WD), which is an uncommon cause of acute liver failure (ALF).METHODS: We compared findings of patients presenting with ALF due to WD to those with ALF of other etiologies.RESULTS: Previously described criteria, such as low alkaline phosphatase activity, ratio of low alkaline phosphatase to total bilirubin or ratio of high aspartate aminotransferase (AST) to alanine aminotransferase (ALT), failed to identify patients with ALF due to WD. There were significant differences in low ALT and AST activities (53 ± 43 vs 1982 ± 938, P < 0.0001 and 87 ± 44 vs 2756 ± 2941, P = 0.037, respectively), low choline esterase activity (1.79 ± 1.2 vs 4.30 ± 1.2, P = 0.009), high urine copper concentrations (93.4 ± 144.0 vs 3.5 ± 1.8, P = 0.001) and low hemoglobin (7.0 ± 2.2 vs 12.6 ± 1.8, P < 0.0001) in patients with ALF caused by WD as compared with other etiologies. Interestingly, 4 of 7 patients with ALF due to WD survived without liver transplantation.CONCLUSION: In ALF, these criteria can help establish a diagnosis of WD. Where applicable, slit-lamp examination for presence of Kayser-Fleischer rings and liver biopsy for determination of hepatic copper concentration still remain important for the diagnosis of ALF due to WD. The need for liver transplantation should be evaluated carefully as the prognosis is not necessarily fatal.

  8. Review of Elephant Endotheliotropic Herpesviruses and Acute Hemorrhagic Disease.

    Long, Simon Y; Latimer, Erin M; Hayward, Gary S

    2016-02-24

    More than 100 young captive and wild Asian elephants are known to have died from a rapid-onset, acute hemorrhagic disease caused primarily by multiple distinct strains of two closely related chimeric variants of a novel herpesvirus species designated elephant endotheliotropic herpesvirus (EEHV1A and EEHV1B). These and two other species of Probosciviruses (EEHV4 and EEHV5) are evidently ancient and likely nearly ubiquitous asymptomatic infections of adult Asian elephants worldwide that are occasionally shed in trunk wash secretions. Although only a handful of similar cases have been observed in African elephants, they also have proved to harbor their own multiple and distinct species of Probosciviruses-EEHV2, EEHV3, EEHV6, and EEHV7-found in lung and skin nodules or saliva. For reasons that are not yet understood, approximately 20% of Asian elephant calves appear to be susceptible to the disease when primary infections are not controlled by normal innate cellular and humoral immune responses. Sensitive specific polymerase chain reaction (PCR) DNA blood tests have been developed, routine monitoring has been established, the complete large DNA genomes of each of the four Asian EEHV species have now been sequenced, and PCR gene subtyping has provided unambiguous evidence that this is a sporadic rather than epidemic disease that it is not being spread among zoos or other elephant housing facilities. Nevertheless, researchers have not yet been able to propagate EEHV in cell culture, determine whether or not human antiherpesvirus drugs are effective inhibitors, or develop serology assays that can distinguish between antibodies against the multiple different EEHV species. PMID:26912715

  9. Pathogenesis of acute hepatopancreatic necrosis disease (AHPND) in shrimp.

    Lai, Hung-Chiao; Ng, Tze Hann; Ando, Masahiro; Lee, Chung-Te; Chen, I-Tung; Chuang, Jie-Cheng; Mavichak, Rapeepat; Chang, Sheng-Hsiung; Yeh, Mi-De; Chiang, Yi-An; Takeyama, Haruko; Hamaguchi, Hiro-o; Lo, Chu-Fang; Aoki, Takashi; Wang, Han-Ching

    2015-12-01

    Acute hepatopancreatic necrosis disease (AHPND), also called early mortality syndrome (EMS), is a recently emergent shrimp bacterial disease that has resulted in substantial economic losses since 2009. AHPND is known to be caused by strains of Vibrio parahaemolyticus that contain a unique virulence plasmid, but the pathology of the disease is still unclear. In this study, we show that AHPND-causing strains of V. parahaemolyticus secrete the plasmid-encoded binary toxin PirAB(vp) into the culture medium. We further determined that, after shrimp were challenged with AHPND-causing bacteria, the bacteria initially colonized the stomach, where they started to produce PirAB(vp) toxin. At the same early time point (6 hpi), PirB(vp) toxin, but not PirA(vp) toxin, was detected in the hepatopancreas, and the characteristic histopathological signs of AHPND, including sloughing of the epithelial cells of the hepatopancreatic tubules, were also seen. Although some previous studies have found that both components of the binary PirAB(vp) toxin are necessary to induce a toxic effect, our present results are consistent with other studies which have suggested that PirB(vp) alone may be sufficient to cause cellular damage. At later time points, the bacteria and PirA(vp) and PirB(vp) toxins were all detected in the hepatopancreas. We also show that Raman spectroscopy "Whole organism fingerprints" were unable to distinguish between AHPND-causing and non-AHPND causing strains. Lastly, by using minimum inhibitory concentrations, we found that both virulent and non-virulent V. parahaemolyticus strains were resistant to several antibiotics, suggesting that the use of antibiotics in shrimp culture should be more strictly regulated. PMID:26549178

  10. The acute radiation syndrome: A study of ten cases and a review of the problem

    Hempelmann, L.H.; Lisco, H.

    1950-03-17

    In this report ten cases of acute radiation syndrome are described resulting from two accidents occurring at the Los Alamos Scientific Laboratory of unique nature involving fissionable material. These cases are described in considerable detail. The report comprises ten sections. This volume, part II of the report, is comprised of sections entitled: (1) the Biological Basis for the Clinical Response seen in the Acute radiation Syndrome, (2) Clinical Signs and Symptoms, (3) Discussion of Hematological Findings, (4) Chemistry of the Blood and Urine, (5) Discussion of Pathological Findings, and (6) Reconsiderations of the Calculated Radiation Doses in Terms of the Observed Biological Response of the Patients. This report was prepared primarily for the clinician who is interested in radiation injuries and therefore emphasis has been placed on the correlation of clinical and pathological changes with the type of cytogenetic change known to be produced by ionizing radiation.

  11. Acute Radiation Syndrome Severity Score System in Mouse Total-Body Irradiation Model.

    Ossetrova, Natalia I; Ney, Patrick H; Condliffe, Donald P; Krasnopolsky, Katya; Hieber, Kevin P

    2016-08-01

    Radiation accidents or terrorist attacks can result in serious consequences for the civilian population and for military personnel responding to such emergencies. The early medical management situation requires quantitative indications for early initiation of cytokine therapy in individuals exposed to life-threatening radiation doses and effective triage tools for first responders in mass-casualty radiological incidents. Previously established animal (Mus musculus, Macaca mulatta) total-body irradiation (γ-exposure) models have evaluated a panel of radiation-responsive proteins that, together with peripheral blood cell counts, create a multiparametic dose-predictive algorithm with a threshold for detection of ~1 Gy from 1 to 7 d after exposure as well as demonstrate the acute radiation syndrome severity score systems created similar to the Medical Treatment Protocols for Radiation Accident Victims developed by Fliedner and colleagues. The authors present a further demonstration of the acute radiation sickness severity score system in a mouse (CD2F1, males) TBI model (1-14 Gy, Co γ-rays at 0.6 Gy min) based on multiple biodosimetric endpoints. This includes the acute radiation sickness severity Observational Grading System, survival rate, weight changes, temperature, peripheral blood cell counts and radiation-responsive protein expression profile: Flt-3 ligand, interleukin 6, granulocyte-colony stimulating factor, thrombopoietin, erythropoietin, and serum amyloid A. Results show that use of the multiple-parameter severity score system facilitates identification of animals requiring enhanced monitoring after irradiation and that proteomics are a complementary approach to conventional biodosimetry for early assessment of radiation exposure, enhancing accuracy and discrimination index for acute radiation sickness response categories and early prediction of outcome. PMID:27356057

  12. Health consequences in the Chernobyl emergency workers surviving after confirmed acute radiation sickness. Chapter 1

    On April 26, 1986 the accident at the Unit 4 of the Chernobyl Nuclear Power Plant (ChNPP) took place during the planned test of one of the safety systems. According to the International Nuclear Event Scale (INES of the IAEA) the Chernobyl accident is classified as the only event by today at the 7th (most severe) level. The accident caused the deaths within a few days or weeks of 30 ChNPP employees and firemen (including 28 deaths that were due to radiation exposure), brought about the evacuation of about 116,000 people from areas surrounding the reactor during 1986, and the relocation, after 1986, of about 220 000 people from Belarus, the Russian Federation, and Ukraine. The highest doses were received by the approximately 600 emergency workers who were on the site of the Chernobyl power plant during the night of the accident. The most important exposures were due to external irradiation, as the intake of radionuclides through inhalation was relatively small in most cases. Acute radiation sickness (ARS) was confirmed for 134 of those emergency workers. Forty-one of these patients received whole-body doses from external irradiation of less than 2.1 Gy. Ninety-three patients received higher doses and had more severe ARS: 50 persons with doses between 2.2 and 4.1 Gy, 22 between 4.2 and 6.4 Gy, and 21 between 6.5 and 16 Gy. In 1986-1987 237 emergency workers were diagnosed with ARS. Later, this disease was confirmed in 134 patients, of which 108 were treated in Russia and 26 in Ukraine. Of these confirmed 134 patients, 28 died in the acute period (first 3 months) after the accident due to extremely severe radiation induced bone marrow and skin damages. Between 1987 and 2001, a further 14 ARS patients and 7 NOARS patients died. The main causes of their death were sudden coronary death (7 cases), oncohaematological pathology (3 cases), liver cirrhosis (2 cases) and infectious lung diseases (2 cases). In Ukraine stochastic health effects (malignant neoplasms) have been

  13. Radiation-induced coronary artery disease. One observation

    Twenty-seven reports (26 from the literature) of radiation ischemic heart diseases are studied in order to specify their clinical and pathological findings and their natural history. This complications appear after treatment of radiation-curable diseases with a mean delay of 4 years in young patients (mean age of 31). Several coronary arteries are often injuried with fibrous and or atherosclerotic anatomical lesions. The frequency of this coronary artery diseases is certainly more important than reported since they are often latent but probably progressive. However, atherogenetic factors increase the risk and must be lowered in a preventive aim; as a rule, the radiotherapic technique must also be as perfect as possible. The prognosis of this radiation induced coronary artery diseases is poor: 19 myocardial infarctions and 12 deaths are observed but no cardiac death occured in patients who received a by-pass graft. So, radiation ischemic heart disease needs active investigation and therapy

  14. Overcoming tumour radiation resistance resulting from acute hypoxia

    Radioresistant hypoxic cells in tumours are believed to compromise the success of clinical radiotherapy. This brief article discusses three methods of overcoming acute hypoxia in tumours, all of which are applicable in clinical radiotherapy. Of these nicotinamide probably has the greatest clinical potential. (UK)

  15. Management of two patients with intestinal form of acute radiation sickness and extremely severe bone marrow form of acute radiation sickness complicated with disseminated fungous infection

    Objective: To present two patients diagnosed as intestinal form of acute radiation sickness (patient A) and extremely severe bone marrow form of acute radiation sickness(patient B) complicated with disseminated fungous infection in China. Methods: On October 21st, 2004, a nuclear accident occurred in Jining, Shandong Province, China. Two individuals were accidentally irradiated by a 60Co source. They were transferred to our hospital, and performed allogeneic stem cell transplantation and soon acquired hematopoiesis recovery; however, refractory disseminated fungous infection occurred in two patients. Results: High dosage of amphotericin B combined with itraconazole and concidas were used to kill fungi. The infection was once controlled, but the radiation injury and infection were still becoming worse even after many kinds of treatment. The patients finally died of multiple organ failure on day 33 and day 75, respectively after the accident. Conclusions: The combination of Ampghotec (amphotericin B) with Caspofungin (concidas) and Itraconazole in the treatment of disseminated fungous infection was effective and with no related toxicity. But during the continuous injury of radiation, we couldn't eradicate the fungous infection. The patients were finally died of multiple organs failure related with radiation and infection. (authors)

  16. The inflammatory response plays a major role in the acute radiation syndrome induced by fission radiation

    Agay, D.; Chancerelle, Y.; Hirodin, F.; Mathieu, J.; Multon, E.; Van Uye, A.; Mestries, J.C. [Centre de Recherches du Service de Sante des Armees Emile Parde, Departement de Radiologie, 38 - La Tronche (France)

    1997-03-01

    At high dose rates, both gamma and neutron irradiation induce an acute inflammatory syndrome with huge intercellular communication disorders. This inflammatory syndrome evolves in two phases, separated by a latency phase. During the prodromal phase, the molecular and cellular lesions induced by free radicals trigger an initial response which associates cellular repair and multicellular interactions involving both humoral and nervous communications. A large part of perturbations constitute a non specific inflammatory syndrome and clinically silent coagulation disorders which are linked by common intercellular mediators. All these perturbations are rapidly reversible and there is no correlation between the radiation dose and the severity of the response. During the manifest-illness phase, both inflammatory and coagulation disorders resume, slightly preceding the clinical symptoms. Biochemical symptoms are moderate in the animals which will survive, but they escape regulatory mechanisms in those which will die, giving rise to a vicious circle. These biochemical disorders are largely responsible for the death. With lower dose rates, it cannot be excluded that great cellular communication disorders take place at the tissue level, with limited blood modifications. This aspect should be taken into account for the optimization of cytokine therapies. (authors)

  17. Clinical report of an extremely severe bone marrow form of acute radiation sickness

    Objective: To sum up the experiences from the diagnosis and treatment of patient B subjected to an accidental 60Co exposure on October 21st, 2004, in Jining, Shandong Province, China. Methods: Radiation dose of B was assessed by analysis of chromosome aberration and microneucleus assay, simulation test of the accident site, autopsy and electron spin resonance (ESR). The ultimate clinical diagnosis was based on analysis of irradiation dose, clinical manifestations and laboratory results. In therapeutical aspects, total environmental protection, HLA-identical allogeneic peripheral blood stem cell transplantation (PBSCT), anti- infection and protection managements of organs were given. Results: Patient B was diagnosed as extremely severe bone marrow form of acute radiation sickness (ARS). HLA-identical allogeneic PBSCT was performed on the patient from his brother on the 7th day after the accident. The hematopoietic recovery began on the 9th day after transplantation. The patient acquired permanent full donor' engraftment without graft versus host disease (GVHD), But the radiation injury was continuing and the patient complicated with polyinfection in lung, and cardiac insufficiency. On the 45th day after the accident, patient B was performed with tracheotomy and maintained ventilation with respirator. On the 75th day after the accident, patient B died of multiple organ failure. Conclusions: Early triage diagnosis and total environmental protection should be performed as soon as possible for extremely severe bone marrow form of ARS. It is very important to perform a successful HLA-identical allogeneic PBSCT, in order to extend the life time of the patient. Multiple organ injuries and infections of bacteria and fungi usually occurred on this kind of patients, so intense measures of anti-infection and protection of multiple organs should be taken. The important and difficult point in the treatment of this kind ARS might be for help the immune-reconstruction and tissue

  18. IMMUNOBIOLOGY OF ACUTE GRAFT-VERSUS-HOST DISEASE

    G. A. Efimov

    2016-01-01

    significant limitation for clinical applications of stem cell transplantation. Severe immunesuppression or depletion of mature donor T cells from the transplant leads to increased probability of relapse and weakens anti-infectious immunity. Hence, further search for alternative, more specific ways to prevent GVHD is required. This review will focus on the mechanisms of alloreactive T lymphocyte clone development and key pathogenetic stages of acute “graft versus host” disease.

  19. Acute kidney injury: Renal disease in the ICU.

    Seller-Pérez, G; Más-Font, S; Pérez-Calvo, C; Villa-Díaz, P; Celaya-López, M; Herrera-Gutiérrez, M E

    2016-01-01

    Acute kidney injury (AKI) in the ICU frequently requires costly supportive therapies, has high morbidity, and its long-term prognosis is not as good as it has been presumed so far. Consequently, AKI generates a significant burden for the healthcare system. The problem is that AKI lacks an effective treatment and the best approach relies on early secondary prevention. Therefore, to facilitate early diagnosis, a broader definition of AKI should be established, and a marker with more sensitivity and early-detection capacity than serum creatinine - the most common marker of AKI - should be identified. Fortunately, new classification systems (RIFLE, AKIN or KDIGO) have been developed to solve these problems, and the discovery of new biomarkers for kidney injury will hopefully change the way we approach renal patients. As a first step, the concept of renal failure has changed from being a "static" disease to being a "dynamic process" that requires continuous evaluation of kidney function adapted to the reality of the ICU patient. PMID:27388683

  20. Modelling the effects of ionizing radiation on survival of animal population: acute versus chronic exposure.

    Kryshev, A I; Sazykina, T G

    2015-03-01

    The objective of the present paper was application of a model, which was originally developed to simulate chronic ionizing radiation effects in a generic isolated population, to the case of acute exposure, and comparison of the dynamic features of radiation effects on the population survival in cases of acute and chronic exposure. Two modes of exposure were considered: acute exposure (2-35 Gy) and chronic lifetime exposure with the same integrated dose. Calculations were made for a generic mice population; however, the model can be applied for other animals with proper selection of parameter values. In case of acute exposure, in the range 2-11 Gy, the population response was in two phases. During a first phase, there was a depletion in population survival; the second phase was a recovery period due to reparation of damage and biosynthesis of new biomass. Model predictions indicate that a generic mice population, living in ideal conditions, has the potential for recovery (within a mouse lifetime period) from acute exposure with dose up to 10-11 Gy, i.e., the population may recover from doses above an LD50 (6.2 Gy). Following acute doses above 14 Gy, however, the mice population went to extinction without recovery. In contrast, under chronic lifetime exposures (500 days), radiation had little effect on population survival up to integrated doses of 14-15 Gy, so the survival of a population subjected to chronic exposure was much better compared with that after an acute exposure with the same dose. Due to the effect of "wasted radiation", the integrated dose of chronic exposure could be about two times higher than acute dose, producing the same effect on survival. It is concluded that the developed generic population model including the repair of radiation damage can be applied both to acute and chronic modes of exposure; results of calculations for generic mice population are in qualitative agreement with published data on radiation effects in mice. PMID

  1. Acute adverse effects of radiation therapy on HIV-positive patients in Japan. Study of 31 cases at Tokyo Metropolitan Komagome Hospital

    Recently, the number of human immunodeficiency virus (HIV)-positive patients has increased in Japan. HIV-positive patients are at a higher risk of cancer than the general population. This paper retrospectively reports the acute adverse effects of radiation therapy on HIV-positive patients who were treated at Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital (TMCICK). Thirty-one cases involving 24 HIV-positive cancer patients who were treated at TMCICK from January 1997 to March 2009 were included in this study. All acute adverse effects of radiation therapy were examined during, and one month after, the last radiation therapy session. Acute adverse effects were classified according to the site of radiation therapy treatment and analyzed using the Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. Grade 3 acute adverse effects were seen in 17% of cases, and Grade 2 toxicities were found in 23% of patients. Damage to the skin and mucosa, including stomatitis or diarrhea, tended to occur after low-dose radiation therapy; however, no severe acute adverse effects were seen in other organs, such as the brain, lung, and bone. Acute adverse effects tended to occur earlier in HIV-positive patients and became severe more frequently than in the general population. In particular, disorders of the mucosa, such as those of the oral cavity, pharynx, and intestine, tended to occur rapidly. It was shown that radiation therapy is safe when treatment is performed carefully and that it is a very useful treatment for cancer in HIV-positive patients. (author)

  2. The effects of acute radiation exposure on the serum components

    The blood samples were collected from the experimental animals 24 hrs after irradiation of gamma doses upto 80 Gy. Native PAGE showed a decreasing trend in gamma globulin fraction of serum from the irradiated group compared to control, while SDS PAGE indicated an enhanced tendency in protein of molecular weight 30,000 to 40,000. Serum albumin slightly decreased with radiation doses as a result of decrease in total protein amount. Radiation exposure had little or no effects on such lipid related components as phospholipid, triglyceride, and cholesterol, respectively. Among others, glutamic pyryvic transaminase (GPT) showed a drastic decrease in its amount 24 hrs after radiation exposure, which can be applied to the health care program for radiation workers. (Author)

  3. Alleviation of acute radiation damages by post-irradiation treatments

    Radiation induced hematopoietic and gastro-intestinal damages in mice were tried to alleviate experimentally by post-treatment. Combined treatment of OK-432 and aztreonam clearly prevented the radiation induced sepsis and elevated the survival rate in mice; the survival was 80% in the OK-432 plus aztreonam group while it was 55% in the group treated with OK-432 alone and 0% with saline. Irsogladine maleate, an anti-ulcer drug, increased the survival rate of jejunal crypt stem cells with a clear dose-related trend. The D0 for irsogladine maleate was 2.8 Gy although it was 2.3 Gy for saline, These findings suggest that some conventional drugs are effective for radiation induced hematopoietic and gastro-intestinal damages and the possibility that they can be applied for people exposed to radiation accidentally. (author)

  4. Etanercept for steroid-refractory acute graft versus host disease following allogeneic hematopoietic stem cell transplantation

    Park, Joo Han; Lee, Hyo Jung; Kim, Sei Rhan; Song, Ga Won; Lee, Seung Kyong; Park, Sun Young; Kim, Ki Chan; Hwang, Sun Hyuk; Park, Joon Seong

    2014-01-01

    Background/Aims The treatment for steroid-refractory acute graft versus host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT) needs to be standardized. We report our clinical experience with etanercept for steroid-refractory acute GVHD. Methods Eighteen patients who underwent allo-SCT and presented with steroid-refractory acute GVHD at Ajou University Hospital were studied retrospectively. They were given 25 mg of etanercept subcutaneously twice weekly for 4 weeks. The cli...

  5. Occupational diseases in uranium and ore miners in connection with radiation exposure in the Czech Republic

    Dozens cases of diseases are submitted to judgement as occupational diseases every year in the Czech Republic. Patients or attending physicians suggest that these cases are caused by occupational ionizing radiation. Only a part of these cases is qualified as occupational disease. The term 'occupational disease' is rather a juridical term which underlies the right to financial compensation. The causal association with exposure to ionizing radiation cannot be indisputably verified by expert medical opinion. Most diseases, which are proposed as occupational disease, are malignant tumors of the lungs. Total majority of judged cases are lung cancers from radioactive agents. In 2002, a total of 33 cases of lung cancer in former uranium or ore miners have been acknowledged as occupational diseases. The decision about occupational disease is derived from probabilistic approach based on estimation of probability of causation of irradiation on disease origin (methodical guideline No. 15 of Ministry of Health Bulletin, part 9, 1998). The presented paper gives a general information about all judged causes of occupational diseases in former uranium and ore miners in the Czech Republic in 2002. A total of 72 cases were submitted to judgement of conditions of disease origin to the National Radiation Protection Institute in 2002. 67 cases were lung cancers, 1 case was chronic myeloid leukemia, acute myeloid leukemia, basaliom, cancer of larynx and cancer of nasal septum. The probability of causation was assessed as prevailing in 32 cases of lung cancer, borderline in 5 cases and low in other 30 cases of lung cancer. The probability of causation was prevailing in both cases of myeloid leukemia. (author)

  6. Pneumothorax following thoracic radiation therapy for Hodgkin's disease

    Radiation therapy alone to the nodal drainage sites above the diaphragm, namely a ''mantle'' field, is often standard treatment for early stage Hodgkin's disease and may be used in combination with chemotherapy in more advanced disease. Localised pneumonitis and fibrosis are recognised treatment related sequelae; however, other pulmonary complications, including pneumothorax, have been described. Two cases of spontaneous pneumothorax following mantle radiation therapy are presented. (author)

  7. Statistical issues in modelling radiation effects on disease incidence

    The author attempts to outline an overview of some models which have proven useful in recent work with radiation effects data. Topics addressed are mathematical models for radiation effects on disease incidence, modelling of background rates, relative versus excess risk models, dose-response effects, dose effect modification (sex and age at exposure), temporal variation in risks. (Author)

  8. Effects of chronic kidney disease on platelet response to antiplatelet therapy in acute myocardial infarction patients

    邓捷

    2012-01-01

    Objective To elucidate the effects of dual antiplatelet therapy on platelet response in acute myocardial infarction patients with chronic kidney disease. Methods From September 2011 to June 2012,a total of 195 acute myocardial infarction patients with drug eluting stent implanting were enrolled. Among them,133 cases had normal

  9. Breast Intensity-Modulated Radiation Therapy Reduces Time Spent With Acute Dermatitis for Women of All Breast Sizes During Radiation

    Purpose: To study the time spent with radiation-induced dermatitis during a course of radiation therapy for breast cancer in women treated with conventional or intensity-modulated radiation therapy (IMRT). Methods and Materials: The study population consisted of 804 consecutive women with early-stage breast cancer treated with breast-conserving surgery and radiation from 2001 to 2006. All patients were treated with whole-breast radiation followed by a boost to the tumor bed. Whole-breast radiation consisted of conventional wedged photon tangents (n = 405) earlier in the study period and mostly of photon IMRT (n = 399) in later years. All patients had acute dermatitis graded each week of treatment. Results: The breakdown of the cases of maximum acute dermatitis by grade was as follows: 3%, Grade 0; 34%, Grade 1; 61%, Grade 2; and 2%, Grade 3. The breakdown of cases of maximum toxicity by technique was as follows: 48%, Grade 0/1, and 52%, Grade 2/3, for IMRT; and 25%, Grade 0/1, and 75%, Grade 2/3, for conventional radiation therapy (p < 0.0001). The IMRT patients spent 82% of weeks during treatment with Grade 0/1 dermatitis and 18% with Grade 2/3 dermatitis, compared with 29% and 71% of patients, respectively, treated with conventional radiation (p < 0.0001). Furthermore, the time spent with Grade 2/3 toxicity was decreased in IMRT patients with small (p = 0.0015), medium (p < 0.0001), and large (p < 0.0001) breasts. Conclusions: Breast IMRT is associated with a significant decrease both in the time spent during treatment with Grade 2/3 dermatitis and in the maximum severity of dermatitis compared with that associated with conventional radiation, regardless of breast size.

  10. Blood transfusion for the treatment of acute anaemia in inflammatory bowel disease and other digestive diseases

    José Antonio García-Erce, Fernando Gomollón, Manuel Muñoz

    2009-10-01

    Full Text Available Allogeneic blood transfusion (ABT is frequently used as the first therapeutic option for the treatment of acute anaemia in patients with inflammatory bowel disease (IBD, especially when it developed due to gastrointestinal or perioperative blood loss, but is not risk-free. Adverse effects of ABT include, but are not limited to, acute hemolytic reaction (wrong blood or wrong patient, febrile non-hemolytic transfusional reaction, bacterial contamination, transfusion-related acute lung injury, transfusion associated circulatory overload, transfusion-related immuno-modulation, and transmission of almost all infectious diseases (bacteria, virus, protozoa and prion, which might result in increased risk of morbidity and mortality. Unfortunately, the main physiological goal of ABT, i.e. to increase oxygen consumption by the hypoxic tissues, has not been well documented. In contrast, the ABT is usually misused only to increase the haemoglobin level within a fixed protocol [mostly two by two packed red blood cell (PRC units] independently of the patient’s tolerance to normovolemic anaemia or his clinical response to the transfusion of PRC units according to a “one-by-one” administration schedule. Evidence-based clinical guidelines may promote best transfusion practices by implementing restrictive transfusion protocols, thus reducing variability and minimizing the avoidable risks of transfusion, and the use of autologous blood and pharmacologic alternatives. In this regard, preoperative autologous blood donation (PABD consistently diminished the frequency of ABT, although its contribution to ABT avoidance is reduced when performed under a transfusion protocol. In addition, interpretation of utility of PABD in surgical IBD patients is hampered by scarcity of published data. However, the role of autologous red blood cells as drug carriers is promising. Finally, it must be stressed that a combination of methods used within well-constructed protocols

  11. {sup 1}H-MRS for the diagnosis of acute disseminated encephalomyelitis: insight into the acute-disease stage

    Ben Sira, Liat; Miller, Elka [Tel Aviv Sourasky Medical Center, Department of Radiology, Tel-Aviv (Israel); Artzi, Moran [Tel Aviv Sourasky Medical Center, Functional Brain Imaging Center, Tel-Aviv (Israel); Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Fattal-Valevski, Aviva; Constantini, Shlomi [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Tel Aviv Medical Center, Paediatric Neurology Unit, The Paediatric Neurosurgery Department, Tel Aviv (Israel); Ben Bashat, Dafna [Tel Aviv Sourasky Medical Center, Functional Brain Imaging Center, Tel-Aviv (Israel)

    2010-01-15

    Acute disseminated encephalomyelitis (ADEM) is a demyelinating disorder of the central nervous system (CNS). Differentiating ADEM from other inflammatory disorders, such as multiple sclerosis, is not always conclusive using conventional MRI. To evaluate longitudinal magnetic resonance spectroscopy (MRS) changes that distinguish ADEM from other inflammatory disorders. MRI/MRS scans were performed in seven patients with ADEM during the acute and chronic phases of the disease. Partial recovery was detected between the acute and chronic phases in choline/creatine ratio. Major elevation of lipids and reduction in myo-inositol/creatine ratio was detected in all patients during the acute phase, followed by a reduction in lipids peak and elevation above normal in myo-inositol/creatine ratio during the chronic phase. Consistent and unique MRS changes in metabolite ratios between the acute and chronic presentations of the disease were found. To the best of our knowledge, these patterns have not been described in other inflammatory disorders and might assist in the early diagnosis of ADEM. (orig.)

  12. Preliminary early evaluation of radiation acute syndrome severity in an animal model

    To improve the knowledge of Radiation Acute Syndrome radiopathological picture, whole body x-rays irradiation at 2Gy of a primate (Cebus apella paraguayanus) used as model has been performed. Early evaluations of clinical symptoms and dose and damage biological indicators have shown that this primate has given out similar responses to those of man. (author)

  13. Pathmorphological investigation of pulmonary infections complications in persons dying from acute radiation sickness after Chernobyl accident

    Lungs of 27 persons who participated in liquidation of Chernobyl accident and died from acute radiation sickness were studied histologically. Pulmonary infections were found, including invasion of viral, bacterial and fungal agents. Being depended on hematopoietic function the inflammatory reactions were areactive during postirradiation aplasia and became typical within the recovery beginning

  14. Granulocyte Colony-Stimulating Factor in the Treatment of Acute Radiation Syndrome: A Concise Review

    Michal Hofer

    2014-04-01

    Full Text Available This article concisely summarizes data on the action of one of the principal and best known growth factors, the granulocyte colony-stimulating factor (G-CSF, in a mammalian organism exposed to radiation doses inducing acute radiation syndrome. Highlighted are the topics of its real or anticipated use in radiation accident victims, the timing of its administration, the possibilities of combining G-CSF with other drugs, the ability of other agents to stimulate endogenous G-CSF production, as well as of the capability of this growth factor to ameliorate not only the bone marrow radiation syndrome but also the gastrointestinal radiation syndrome. G-CSF is one of the pivotal drugs in the treatment of radiation accident victims and its employment in this indication can be expected to remain or even grow in the future.

  15. Acute Myocardial Infarction: The First Manifestation of Ischemic Heart Disease and Relation to Risk Factors

    Manfroi Waldomiro Carlos

    2002-01-01

    Full Text Available OBJECTIVE: To assess the association between cardiovascular risk factors and acute myocardial infarction as the first manifestation of ischemic heart disease, correlating them with coronary angiographic findings. METHODS: We carried out a cross-sectional study of 104 patients with previous acute myocardial infarction, who were divided into 2 groups according to the presence or absence of angina prior to acute myocardial infarction. We assessed the presence of angina preceding acute myocardial infarction and risk factors, such as age >55 years, male sex, smoking, systemic arterial hypertension, lipid profile, diabetes mellitus, obesity, sedentary lifestyle, and familial history of ischemic heart disease. On coronary angiography, the severity of coronary heart disease and presence of left ventricular hypertrophy were assessed. RESULTS: Of the 104 patients studied, 72.1% were males, 90.4% were white, 73.1% were older than 55 years, and 53.8% were hypertensive. Acute myocardial infarction was the first manifestation of ischemic heart disease in 49% of the patients. The associated risk factors were systemic arterial hypertension (RR=0.19; 95% CI=0.06-0.59; P=0.04 and left ventricular hypertrophy (RR=0.27; 95% CI=0,.8-0.88; P=0.03. The remaining risk factors were not statistically significant. CONCLUSION: Prevalence of acute myocardial infarction as the first manifestation of ischemic heart disease is high, approximately 50%. Hypertensive individuals more frequently have symptoms preceding acute myocardial infarction, probably due to ventricular hypertrophy associated with high blood pressure levels.

  16. Gender differences in the management and outcome of patients with acute coronary artery disease

    Raine, R; Black, N; Bowker, T; Wood, D.

    2002-01-01

    Study objectives: To compare the clinical management and health outcomes of men and women after admission with acute coronary syndromes, after adjusting for disease severity, sociodemographic, and cardiac risk factors.

  17. Mesenchymal stem cell therapy for acute radiation syndrome:Innovative medical approaches in military medicine

    Erik B.Eaton Jr.; Timothy R.Varney

    2014-01-01

    After a radiological or nuclear event, acute radiation syndrome (ARS) will present complex medical challenges that could involve the treatment of hundreds to thousands of patients. Current medical doctrine is based on limited clinical data and remains inadequate. Efforts to develop medical innovations that address ARS complications are unlikely to be generated by the industry because of market uncertainties specific to this type of injury. A prospective strategy could be the integration of cellular therapy to meet the medical demands of ARS. The most clinically advanced cellular therapy to date is the administration of mesenchymal stem cells (MSCs). Results of currently published investigations describing MSC safety and efficacy in a variety of injury and disease models demonstrate the unique qualities of this reparative cell population in adapting to the specific requirements of the damaged tissue in which the cells integrate. This report puts forward a rationale for the further evaluation of MSC therapy to address the current unmet medical needs of ARS. We propose that the exploration of this novel therapy for the treatment of the multivariate complications of ARS could be of invaluable benefit to military medicine.

  18. Amifostine ameliorates recognition memory defect in acute radiation syndrome caused by relatively low-dose of gamma radiation

    Lee, Hae-June; Kim, Joong-Sun; Song, Myoung-Sub; Seo, Heung-Sik; Yang, Miyoung; Kim, Jong Choon; Jo, Sung-Kee; Shin, Taekyun; Moon, Changjong; Kim, Sung-Ho

    2010-01-01

    This study examined whether amifostine (WR-2721) could attenuate memory impairment and suppress hippocampal neurogenesis in adult mice with the relatively low-dose exposure of acute radiation syndrome (ARS). These were assessed using object recognition memory test, the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay, and immunohistochemical markers of neurogenesis [Ki-67 and doublecortin (DCX)]. Amifostine treatment (214 mg/kg, i.p.) prior to irradiation significan...

  19. Elemental diet as primary treatment of acute Crohn's disease: a controlled trial.

    O'Moráin, C; Segal, A. W.; Levi, A J

    1984-01-01

    Acute exacerbations of Crohn's disease are usually treated with prednisolone or potentially more toxic immunosuppressive drugs or by surgery. In pilot studies replacing the normal diet by a protein free elemental diet also induced remission. A controlled trial was therefore conducted in which 21 patients acutely ill with exacerbations of Crohn's disease were randomised to receive either prednisolone 0.75 mg/kg/day or an elemental diet (Vivonex) for four weeks. Assessment at four and 12 weeks ...

  20. A CASE REPORT ON SICKLE CELL DISEASE WITH HEMOLYTIC ANEMIA, NEPHROTIC SYNDROME AND ACUTE CHEST SYNDROME

    Putta; Yamini Devi

    2015-01-01

    Sickle cell disease is an autoimmune hemolytic anemia due to abnormal hemoglobin. Sickling of RBCs occur due to abnormal hemoglobin which leads to vaso - occlusive crisis. This disease manifests as hemolytic anemia, acute chest syndrome, stroke, ischemic leg ulcers and nephrotic syndrome. This patient presented with hemolytic anemia, nephrotic syndrome and acute chest syndrome. This case was diagnosed by electrophoresis of h emoglobin and peripheral smear. Thi...

  1. Effect of revascularization strategy in patients with acute myocardial infarction and renal insufficiency with multivessel disease

    Park, Hyukjin; Hong, Young Joon; Rhew, Si Hyun; Kim, Sung Soo; Jeong, Young Wook; Jeong, Hae Chang; Cho, Jae Yeong; Jang, Soo Young; Lee, Ki Hong; Park, Keun Ho; Sim, Doo Sun; Yoon, Nam Sik; Yoon, Hyun Ju; Kim, Kye Hun; Park, Hyung Wook

    2015-01-01

    Background/Aims The aim of this study was to compare the risk of complications and outcome between infarct-related artery (IRA)-only revascularization and multivessel (MV) revascularization in patients with acute myocardial infarction (MI) with renal insufficiency and MV disease. Methods A total of 1,031 acute MI patients with renal insufficiency and MV disease who were registered in the Korea Working Group on Myocardial Infarction were enrolled. They were divided into two groups (IRA-only re...

  2. Radiation diagnosis of hepatic and biliary diseases

    The paper deals with combined diagnosis of hepatic and biliary diseases, involving a wide range of nosological entities. It shown the potentialities of currently available diagnostic techniques for the most common diseases. A complex of the used diagnostic techniques involved ultrasonic scanning, X-ray computed tomography, hepatobiliary scintigraphy, angiography, retrograde cholangiopancreatography, transhepatic cholangiography, etc. The authors have demonstrated that each method used is highly diagnostically effective. At the same time they have shown the limits of each technique in the diagnosis of certain diseases. The authors' data suggest that the total efficiency of the applied complex of diagnostic means approaches 100%. 64 refs., 7 figs., 3 tabs

  3. Therapeutic Approach to the Management of Pediatric Demyelinating Disease: Multiple Sclerosis and Acute Disseminated Encephalomyelitis.

    Brenton, J Nicholas; Banwell, Brenda L

    2016-01-01

    Acquired pediatric demyelinating diseases manifest acutely with optic neuritis, transverse myelitis, acute disseminated encephalomyelitis, or with various other acute deficits in focal or polyfocal areas of the central nervous system. Patients may experience a monophasic illness (as in the case of acute disseminated encephalomyelitis) or one that may manifest as a chronic, relapsing disease [e.g., multiple sclerosis (MS)]. The diagnosis of pediatric MS and other demyelinating disorders of childhood has been facilitated by consensus statements regarding diagnostic definitions. Treatment of pediatric MS has been modeled after data obtained from clinical trials in adult-onset MS. There are now an increasing number of new therapeutic agents for MS, and many will be formally studied for use in pediatric patients. There are important efficacy and safety concerns regarding the use of these therapies in children and young adults. This review will discuss acute management as well as chronic immunotherapies in acquired pediatric demyelination. PMID:26496907

  4. T2-weighted cardiovascular magnetic resonance in acute cardiac disease

    Eitel Ingo; Friedrich Matthias G

    2011-01-01

    Abstract Cardiovascular magnetic resonance (CMR) using T2-weighted sequences can visualize myocardial edema. When compared to previous protocols, newer pulse sequences with substantially improved image quality have increased its clinical utility. The assessment of myocardial edema provides useful incremental diagnostic and prognostic information in a variety of clinical settings associated with acute myocardial injury. In patients with acute chest pain, T2-weighted CMR is able to identify acu...

  5. Bacterial etiology in acute hospitalized chronic obstructive pulmonary disease exacerbations

    Asli Gorek Dilektasli; Ezgi Demirdogen Cetinoglu; Nilufer Aylin Acet Ozturk; Funda Coskun; Guven Ozkaya; Ahmet Ursavas; Cuneyt Ozakin; Mehmet Karadag; Esra Uzaslan

    2016-01-01

    Introduction. The most common cause of acute COPD exacerbation (AECOPD) is the respiratory tract infections. We sought to determine the bacteriological etiology of hospitalized acute exacerbations of COPD requiring hospitalization in consecutive two years. Methods. We aimed to determine the bacteriological etiology underlying in patients whom admitted to Uludag University Faculty of Medicine, Department of Pulmonary Medicine and hospitalized with AECOPD in the last two years. Medical records ...

  6. Supplemental vitamin A prevents the acute radiation-induced defect in wound healing

    Acute radiation injury leads to thymic involution, adrenal enlargement, leukopenia, thrombocytopenia, gastrointestinal ulceration, and impaired wound healing. The authors hypothesized that supplemental vitamin A would mitigate these adverse effects in rats exposed to acute whole-body radiation. To test their hypothesis, dorsal skin incisions and subcutaneous implantation of polyvinyl alcohol sponges were performed in anesthetized Sprague-Dawley rats at varying times following sham radiation or varying doses of whole-body radiation (175-850 rad). In each experiment, the control diet [which contains about 18,000 IU vit. A/kg chow (3 X the NRC RDA for normal rats)] was supplemented with 150,000 IU vit. A/kg diet beginning at, before, or after sham radiation and wounding or radiation and wounding. The supplemental vitamin A prevented the impaired wound healing and lessened the weight loss, leukopenia, thrombocytopenia, thymic involution, adrenal enlargement, decrease in splenic weight, and gastric ulceration of the radiated (750-850 rad) wounded rats. This was true whether the supplemental vitamin A was begun before (2 or 4 days) or after (1-2 hours to 4 days) radiation and wounding; the supplemental vitamin A was more effective when started before or up to 2 days after radiation and wounding. The authors believe that prevention of the impaired wound healing following radiation by supplemental vitamin A is due to its enhancing the early inflammatory reaction to wounding, including increasing the number of monocytes and macrophages at the wound site; possible effect on modulating collagenase activity; effect on epithelial cell (and possible mesenchymal cell) differentiation; stimulation of immune responsiveness; and lessening of the adverse effects of radiation

  7. Radiation Induced Acute Changes During Early Organogenesis of Mammalian

    Several experiments were performed to study the acute changes induced during early embryonic organogenesis after gamma irradiation to doses 0.5,1,2,and 3 Gy on the ninth day of gestation. The changes observed at full term included number of viable fetuses, fetal size, fetal weight and incidence of embryonic absorption sites. Other parameters observed were related to dimensions of lateral fetal length, tail length and antro-posterior and lateral measurements of skull. Results indicated that embryonic absorption sites showed a significant incidence at higher doses of two and three Gy, which reflected on the number of fetuses reaching full term. The occurrence of these and the other changes observed are related to dose magnitude and the mechanisms underlying them are considered due to the high radiosensitivity of embryonic tissue during early organogenesis. The data obtained has a serious implications related to exposures of pregnant women

  8. Acute skin lesions due to localized ''hot particle'' radiation exposures

    Purpose of the studies was to determine incidence and severity of lesions resulting from localized deposition of dose to the skin from small (2 at 70μm depth) from isotopes having max beta particle energies from about 0.3-3 MeV. Incidence of erythema and scabs (indicating ulceration) were scored routinely for up to 71 days post-irradiation. Responses followed normal probability distributions, and thus, no true threshold could be defined. Ten and 50% incidence rates were deduced using probit analyses. Lowest dose producing 10% incidence was about 1 Gy for exposures to Yb-175 (0.5 MeV max energy) beta particles. Severity of lesions was estimated using diameters and persistence. From preliminary considerations of probability of induction, size, and persistence of acute lesions, a special limit for hot particle exposures in the range of 5-50 Gy may be reasonable, with an action level between about 1 Gy and the limit

  9. Side effect of cranial radiation in childhood acute leukemia, 1

    We examined the somnolence syndrome, which is one of the side effects of cranial irradiation. Out of 53 patients in acute leukemia who had received cranial irradiation, nine patients (17%) developed the somnolence syndrome. Patients with the somnolence syndrome showed slow waves on EEG. Some patients had ventricular dilatation and widening of sulci before cranial irradiation on CT findings, but these findings improved after cranial irradiation. Out of nine cases with the somnolence syndrome, 6 patients survived and did not experience difficulties in school. But one patient showed calcification on CT brain scan. It is considered that the cause of the somnolence syndrome is a trasient inhibition of myelin synthesis and most patients improved without serious sequelae. It is necessary to follow up many cases of somnolence syndrome. (author)

  10. Radiation for not-so-benign coronary artery disease

    The role of radiation therapy in the treatment of malignant disease has long been accepted. More limited application of radiation in the treatment of benign conditions has been proven but generally not pursued. On the centennial anniversary of radiation therapy, a promising, but as yet unproved, application of radiation for treatment of benign vascular disease has become an exciting field of research, speculation, and controversy. This panel presentation will discuss the rationales and dilemmas of applying radiation in the prevention of arterial restenosis after therapeutic intervention. Coronary artery bypass grafting and more recently coronary angioplasty have become accepted, effective therapies to reverse significant coronary stenosis, and thereby benefit the majority of patients with coronary artery disease. However, a large proportion of patients will suffer restenosis in spite of optimal conventional therapy. The search for a means to prevent such restenosis has been partially successful by therapies, and even engineering intravascular devices. In spite of these efforts, a significant number of patients will fail today's conventional therapy and suffer arterial restenosis. Fibroblast myointimal proliferation is felt to be a major element in this restenosis process. Clinical experience shows that radiation inhibits other similar benign fibroblast proliferative processes such as keloid scar formation and heterotopic ossification. Radiation is now being considered as a means to inhibit myointimal fibroblast proliferation and hopefully prevent attendant arterial restenosis as well. This has catalyzed various animal model investigations that have shown significant arteries. Promising results in the animal model and in very early human institutional trials. These trials are designed to determine if radiation is truly effective and can be safely delivered to prevent restenosis in diseased human arteries. This panel discussion will provide a firm basic science and

  11. Acute necrotizing encephalopathy of childhood: typical findings in an atypical disease

    Skelton, Brandon W.; Phillips, C.D. [University of Virginia Health System, Department of Neuroradiology, Charlottesville, VA (United States); Hollingshead, Michael C.; Castillo, Mauricio [University of North Carolina School of Medicine, Neuroradiology Section, Chapel Hill, NC (United States); Sledd, Andrew T. [University of Virginia Health System, Department of Pediatrics, Charlottesville, VA (United States)

    2008-07-15

    Acute necrotizing encephalopathy of childhood (ANEC) is a disease entity seen nearly exclusively in East Asian children that is characterized by multifocal, symmetric lesions involving the thalami, brainstem, cerebellum, and white matter. We present a child who developed dramatic neurologic symptoms following a viral prodrome. Serial MRI examinations demonstrated characteristic lesions of ANEC, while laboratory analyses revealed evidence of acute infection with human herpesvirus-6 (HHV-6). We highlight the MRI findings in both the acute and convalescent phases of ANEC, discuss the implications of neuroimaging on the child's clinical course, and emphasize the integral role of the radiologist in correctly diagnosing this rare disease. (orig.)

  12. Relationship between dental disease and radiation necrosis of the mandible

    Preirradiation panoramic radiographs of forty-six dentate patients were examined for the presence of significant dental disease. Evidence of a positive association between dental disease present before radiation therapy and subsequent necrosis of the mandible was found leading to a recommendation that significant disease be eradicated before irradiation of oral tissues. Considerable suffering results from bone necrosis, which can be reduced by careful and rational dental diagnosis and treatment

  13. Graves' disease with special reference to radiation therapy

    Graves' disease, although not malignant, nevertheless can lead to serious events such as permanent loss of vision if it remains untreated. This review article describes the clinical symptoms of the disease, includes a commentary on the Graves' disease subgroup of thyroid-associated orbitipathy (TAO), and defines clinical activity scoring systems which grade the severity of the disease in patients (clinical activity, NOSPECS and LEMO scoring ). An review of radiotherapy in the 1980s is followed by a summary of the 2003 German national survey on radiotherapy for Graves' disease. Radiation therapy technique is then described and discussed. Case histories are from the Alfred Krupp Hospital in Essen. (author)

  14. Mometasone Furoate Cream Reduces Acute Radiation Dermatitis in Patients Receiving Breast Radiation Therapy: Results of a Randomized Trial

    Purpose: We wanted to confirm the benefit of mometasone furoate (MF) in preventing acute radiation reactions, as shown in a previous study (Boström et al, Radiother Oncol 2001;59:257-265). Methods and Materials: The study was a double-blind comparison of MF with D (Diprobase), administered daily from the start of radiation therapy for 5 weeks in patients receiving breast radiation therapy, 40 Gy in 2.67-Gy fractions daily over 3 weeks. The primary endpoint was mean modified Radiation Therapy Oncology Group (RTOG) score. Results: Mean RTOG scores were significantly less for MF than for D (P=.046). Maximum RTOG and mean erythema scores were significantly less for MF than for D (P=.018 and P=.012, respectively). The Dermatology Life Quality Index (DLQI) score was significantly less for MF than for D at weeks 4 and 5 when corrected for Hospital Anxiety and Depression (HAD) questionnaire scores. Conclusions: MF cream significantly reduces radiation dermatitis when applied to the breast during and after radiation therapy. For the first time, we have shown a significantly beneficial effect on quality of life using a validated instrument (DLQI), for a topical steroid cream. We believe that application of this cream should be the standard of care where radiation dermatitis is expected

  15. Mometasone Furoate Cream Reduces Acute Radiation Dermatitis in Patients Receiving Breast Radiation Therapy: Results of a Randomized Trial

    Hindley, Andrew, E-mail: andrew.hindley@lthtr.nhs.uk [Rosemere Cancer Centre, Royal Preston Hospital, Preston (United Kingdom); Zain, Zakiyah [College of Arts and Sciences, Universiti Utara Malaysia, Kedah (Malaysia); Wood, Lisa [Department of Social Sciences, Lancaster Medical School, Lancaster (United Kingdom); Whitehead, Anne [Medical and Pharmaceutical Statistics Research Unit, Lancaster University, Lancaster (United Kingdom); Sanneh, Alison; Barber, David; Hornsby, Ruth [Rosemere Cancer Centre, Royal Preston Hospital, Preston (United Kingdom)

    2014-11-15

    Purpose: We wanted to confirm the benefit of mometasone furoate (MF) in preventing acute radiation reactions, as shown in a previous study (Boström et al, Radiother Oncol 2001;59:257-265). Methods and Materials: The study was a double-blind comparison of MF with D (Diprobase), administered daily from the start of radiation therapy for 5 weeks in patients receiving breast radiation therapy, 40 Gy in 2.67-Gy fractions daily over 3 weeks. The primary endpoint was mean modified Radiation Therapy Oncology Group (RTOG) score. Results: Mean RTOG scores were significantly less for MF than for D (P=.046). Maximum RTOG and mean erythema scores were significantly less for MF than for D (P=.018 and P=.012, respectively). The Dermatology Life Quality Index (DLQI) score was significantly less for MF than for D at weeks 4 and 5 when corrected for Hospital Anxiety and Depression (HAD) questionnaire scores. Conclusions: MF cream significantly reduces radiation dermatitis when applied to the breast during and after radiation therapy. For the first time, we have shown a significantly beneficial effect on quality of life using a validated instrument (DLQI), for a topical steroid cream. We believe that application of this cream should be the standard of care where radiation dermatitis is expected.

  16. Risk of acute pancreatitis in patients with cronic inflammatory bowel disease

    Rasmussen, Henrik Højgaard; Fonager, Kirsten; Sørensen, Henrik Toft;

    1999-01-01

    BACKGROUND: There are few epidemiologic data about the risk of acute pancreatitis in chronic inflammatory bowel diseases; we therefore wanted to estimate the risk of a first episode of acute pancreatitis in patients with Crohn's disease and ulcerative colitis in the total Danish population. METHODS......: The study included all patients discharged from Danish hospitals with a diagnosis of Crohn's disease or ulcerative colitis registered in the Danish National Registry of Patients in the period from 1977 to 1992. The first episode of acute pancreatitis was identified in the cohort. The observed number...... of patients with acute pancreatitis was compared with expected numbers on the basis of age, sex, and calendar-specific incidence rates in the general population. RESULTS: Overall, 15,526 patients were discharged and followed up for 112,824 person-years. The standardized incidence ratio (SIR) for...

  17. Thrombotic thrombocytopenic purpura and myoglobinuric acute renal failure following radiation therapy in a patient with polymyositis and cervical cancer

    A 73-year-old woman was admitted to receive radiation treatment for uterine cervical cancer, however a complex series of events ensued, leading to death. She developed an acute exacerbation of polymyositis complicated by thrombocytopenic purpura, rhabdomyolysis and acute renal failure. Radiation therapy may have produced an immune disturbance leading to the acute exacerbation of polymyositis. Auto-immune-mediated endothelial damage might have triggered a series of events leading to thrombotic thrombocytopenic purpura. Rhabdomyolysis seemed to be the main cause of acute renal failure. (author)

  18. Prediction of Acute Respiratory Disease in Current and Former Smokers With and Without COPD

    Kim, Victor; Regan, Elizabeth; Williams, André A. A.; Santorico, Stephanie A.; Make, Barry J.; Lynch, David A.; Hokanson, John E.; Washko, George R.; Bercz, Peter; Soler, Xavier; Marchetti, Nathaniel; Criner, Gerard J.; Ramsdell, Joe; Han, MeiLan K.; Demeo, Dawn; Anzueto, Antonio; Comellas, Alejandro; Crapo, James D.; Dransfield, Mark; Wells, J. Michael; Hersh, Craig P.; MacIntyre, Neil; Martinez, Fernando; Nath, Hrudaya P.; Niewoehner, Dennis; Sciurba, Frank; Sharafkhaneh, Amir; Silverman, Edwin K.; van Beek, Edwin J. R.; Wilson, Carla; Wendt, Christine; Wise, Robert A.; Curtis, Jeffrey; Kazerooni, Ella; Hanania, Nicola; Alapat, Philip; Bandi, Venkata; Guntupalli, Kalpalatha; Guy, Elizabeth; Lunn, William; Mallampalli, Antara; Trinh, Charles; Atik, Mustafa; DeMeo, Dawn; Hersh, Craig; Jacobson, Francine; Graham Barr, R.; Thomashow, Byron; Austin, John; MacIntyre, Neil; Washington, Lacey; Page McAdams, H.; Rosiello, Richard; Bresnahan, Timothy; McEvoy, Charlene; Tashjian, Joseph; Wise, Robert; Hansel, Nadia; Brown, Robert; Casaburi, Richard; Porszasz, Janos; Fischer, Hans; Budoff, Matt; Sharafkhaneh, Amir; Niewoehner, Dennis; Allen, Tadashi; Rice, Kathryn; Foreman, Marilyn; Westney, Gloria; Berkowitz, Eugene; Bowler, Russell; Friedlander, Adam; Meoni, Eleonora; Criner, Gerard; Kim, Victor; Marchetti, Nathaniel; Satti, Aditi; James Mamary, A.; Steiner, Robert; Dass, Chandra; Bailey, William; Dransfield, Mark; Gerald, Lynn; Nath, Hrudaya; Ramsdell, Joe; Ferguson, Paul; Friedman, Paul; McLennan, Geoffrey; van Beek, Edwin JR; Martinez, Fernando; Han, MeiLan; Thompson, Deborah; Kazerooni, Ella; Wendt, Christine; Allen, Tadashi; Sciurba, Frank; Weissfeld, Joel; Fuhrman, Carl; Bon, Jessica; Anzueto, Antonio; Adams, Sandra; Orozco, Carlos; Santiago Restrepo, C.; Mumbower, Amy; Crapo, James; Silverman, Edwin; Make, Barry; Regan, Elizabeth; Samet, Jonathan; Willis, Amy; Stinson, Douglas; Beaty, Terri; Klanderman, Barbara; Laird, Nan; Lange, Christoph; Ionita, Iuliana; Santorico, Stephanie; Silverman, Edwin; Lynch, David; Schroeder, Joyce; Newell, John; Reilly, John; Coxson, Harvey; Judy, Philip; Hoffman, Eric; San Jose Estepar, Raul; Washko, George; Leek, Rebecca; Zach, Jordan; Kluiber, Alex; Rodionova, Anastasia; Mann, Tanya; Crapo, Robert; Jensen, Robert; Farzadegan, Homayoon; Murphy, James; Everett, Douglas; Wilson, Carla; Hokanson, John

    2014-01-01

    BACKGROUND: The risk factors for acute episodes of respiratory disease in current and former smokers who do not have COPD are unknown. METHODS: Eight thousand two hundred forty-six non-Hispanic white and black current and former smokers in the Genetic Epidemiology of COPD (COPDGene) cohort had longitudinal follow-up (LFU) every 6 months to determine acute respiratory episodes requiring antibiotics or systemic corticosteroids, an ED visit, or hospitalization. Negative binomial regression was used to determine the factors associated with acute respiratory episodes. A Cox proportional hazards model was used to determine adjusted hazard ratios (HRs) for time to first episode and an acute episode of respiratory disease risk score. RESULTS: At enrollment, 4,442 subjects did not have COPD, 658 had mild COPD, and 3,146 had moderate or worse COPD. Nine thousand three hundred three acute episodes of respiratory disease and 2,707 hospitalizations were reported in LFU (3,044 acute episodes of respiratory disease and 827 hospitalizations in those without COPD). Major predictors included acute episodes of respiratory disease in year prior to enrollment (HR, 1.20; 95% CI, 1.15-1.24 per exacerbation), airflow obstruction (HR, 0.94; 95% CI, 0.91-0.96 per 10% change in % predicted FEV1), and poor health-related quality of life (HR, 1.07; 95% CI, 1.06-1.08 for each 4-unit increase in St. George’s Respiratory Questionnaire score). Risks were similar for those with and without COPD. CONCLUSIONS: Although acute episode of respiratory disease rates are higher in subjects with COPD, risk factors are similar, and at a population level, there are more episodes in smokers without COPD. PMID:24945159

  19. Dissimilar genome response to acute and chronic low-dose radiation in male and female mice

    The long-term genetic consequences of chronic exposure to low-dose irradiation constitutes a major concern to the general public and research community, especially as chronic radiation has recently been proven to be much more mutagenic and carcinogenic than previously thought. Here we report the results of the first ever comparison of the effects of acute and chronic whole body low-dose radiation exposure on global gene expression. We found a substantial difference between males and females in the expression of genes involved in signaling, growth control, transcription and other pathways upon acute and chronic radiation exposure. Specifically, we found sex differences in the expression of genes coding for G protein-coupled receptors and nuclear receptors. We also found different induction of PKCδ, PKCβ and PKCμ, members of PKC signaling pathway as well as in TGF and WNT signaling in males and females. Very pronounced difference, that was confirmed on the level of protein, was observed in the expression of WNT5A that plays an important role in carcinogenesis and muscle regeneration. WNT5A expression was significantly elevated only in chronically exposed females. We also provide the first evidence of the effect of ionizing radiation on the estrogen receptor in females. Repetitive irradiation of muscle tissue has been linked to development of rhabdomyosarcoma (RMS), which, enigmatically, occurs more frequently in males. Our data may be used to study possible mechanisms of RMS development upon chronic radiation exposure. They may provide some clues about the molecular background of the sex differences of RMS occurrence and may in the future lead to the discovery of new biomarkers for RMS predisposition in the irradiated tissue. Overall, differences in male and female responses to acute and chronic low-dose radiation obtained by this study were more drastic than we could have predicted. If confirmed in other experimental systems, these findings could potentially lead

  20. Acute neurocognitive impairment during cranial radiation therapy in patients with intracranial tumors

    The objective of the current study was to evaluate the acute effects of cranial radiation therapy (CNS-RT) using different radiation doses (0, 1.8, 2, 3, ≤ 20 Gy) on cognitive function with special emphasis on memory. We assessed patients with and without intracranial tumors to distinguish between direct and indirect radiation effects on brain tissue. Eighty-two patients were evaluated with neuropsychological testing before and acutely after radiotherapy (RT). Sixty-four patients received RT to the brain (55 with, 9 without intracranial tumor). Eighteen patients treated with RT to the breast served as controls. Patients with intracranial tumor demonstrated attention (19-38th percentile) and verbal memory scores (34-46th percentile) below the population average at baseline. The average Verbal Memory score was significantly different between patients with intracranial tumor and controls both at baseline (38th vs. 58th percentile) and after irradiation (27th vs. 52th percentile). Patients with preexisting peritumoral edema performed worse than patients without edema and controls. Radiation dose-related deficits were seen for working memory performance in patients with intracranial tumor. Our data indicate no measurable impairment of cognitive functioning acutely after prophylactic cranial irradiation. Patients with intracranial tumor show a deterioration of almost all memory functions with a dose-dependent impairment in working memory. Patients with preexisting peritumoral brain edema show the strongest deterioration. (orig.)

  1. Acute neurocognitive impairment during cranial radiation therapy in patients with intracranial tumors

    Welzel, Grit; Mai, Sabine K.; Hermann, Brigitte; Kraus-Tiefenbacher, Uta; Wenz, Frederik [University Medical Center Mannheim, Heidelberg Univ. (Germany). Dept. of Radiation Oncology; Fleckenstein, Katharina [University Medical Center Mannheim, Heidelberg Univ. (Germany). Dept. of Radiation Oncology]|[Duke University Medical Center Durham, NC (United States). Dept. of Radiation Oncology

    2008-12-15

    The objective of the current study was to evaluate the acute effects of cranial radiation therapy (CNS-RT) using different radiation doses (0, 1.8, 2, 3, {<=} 20 Gy) on cognitive function with special emphasis on memory. We assessed patients with and without intracranial tumors to distinguish between direct and indirect radiation effects on brain tissue. Eighty-two patients were evaluated with neuropsychological testing before and acutely after radiotherapy (RT). Sixty-four patients received RT to the brain (55 with, 9 without intracranial tumor). Eighteen patients treated with RT to the breast served as controls. Patients with intracranial tumor demonstrated attention (19-38th percentile) and verbal memory scores (34-46th percentile) below the population average at baseline. The average Verbal Memory score was significantly different between patients with intracranial tumor and controls both at baseline (38th vs. 58th percentile) and after irradiation (27th vs. 52th percentile). Patients with preexisting peritumoral edema performed worse than patients without edema and controls. Radiation dose-related deficits were seen for working memory performance in patients with intracranial tumor. Our data indicate no measurable impairment of cognitive functioning acutely after prophylactic cranial irradiation. Patients with intracranial tumor show a deterioration of almost all memory functions with a dose-dependent impairment in working memory. Patients with preexisting peritumoral brain edema show the strongest deterioration. (orig.)

  2. New developments in the treatment of the acute radiation syndrome

    Radiation accidents associated with the use of nuclear power, radiation devices and industrial applications have resulted in a number of individuals with significant partial or total body exposures, in a limited number with lethal outcome. Such exposures generally result in life-threatening suppression of bone marrow and immune functions and may be accompanied by high doses to the skin and underlying tissues. In recent years, new methods of diagnosis and treatment of such patients have entered development, while experience with relatively large-scale accidents, such as the Chernobyl cases, have clearly demonstrated the limitations of previous approaches. In particular bone marrow transplantation has met with limited success, mostly due to the inhomogeneous nature of accidental exposures as well as the frequent occurrence of other injuries other man bone marrow damage. Present day technology allows for direct estimates of the number of residual bone marrow stem cells to enable a rapid decision on the type of treatment indicated, while some twenty-five recombinant hemopoietic growth factors are under investigation to accelerate the recovery of white blood cells and platelets, as well as immune functions. If applied appropriately, such growth factor treatment will successfully replace bone marrow transplantation in the majority of accident cases. Advances in hemopoietic stem cell biology, both in terms of source of stem cells as well as their isolation, will on the other hand make stem cell infusion a much less risky operation than bone marrow transplantation has been in the past

  3. AML1 gene rearrangements and mutations in radiation-associated acute myeloid leukemia and myelodysplastic syndromes

    Several studies suggested a causal link between AML1 gene rearrangements and both radiation-induced acute myeloid leukaemia (AML) and myelodysplastic syndromes (MDS). Fifty-three AML samples were analyzed for the presence of AML1 abnormalities using fluorescent in-situ hybridization (FISH) and reverse transcription polymerase chain reaction (RT-PCR). Of these patients, 24 had experienced radiation exposure due to the Chernobyl accident, and 29 were non-irradiated spontaneous AML cases and served as controls. AML1/ETO translocations were found in 9 of 29 spontaneous AML but only in 1 of 24 radiation-associated AML cases. This difference between translocation frequencies is statistically significant in the age-unstratified cohorts (p=0.015). Following age stratification, the difference becomes less pronounced but remains on borderline significance (p=0.053). AML1 mutation status was assessed in 5 clean-up workers at Chemobyl NPP with MDS, or AML following MDS, by direct sequencing of genomic DNA from the coding region (exon 3 through 8). In one patient who developed MDS following an acute radiation syndrome, a hexanucleotide duplication of CGGCAT in exon 8 was found, inserted after base position 1502. Our results suggest that AML1 gene translocations are infrequent in radiation-induced leukemogenesis but are consistent with the idea that radiation may contribute to the development of MDS through AML1 gene mutation. (author)

  4. Prophylaxis and treatment of acute radiation ulcers in rats with low-power infrared laser radiation

    Kursova, Larisa V.; Kaplan, Michael A.; Nikitina, Rosa G.; Maligina, Antonina I.

    1999-12-01

    Exposure of radiation ulcers in rats to low-power infrared laser radiation (LPLR) (wavelength--890 nm, pulse power--6 W, frequency--150 and 300 Hz, irradiation time--10 min) noticeably accelerates their healing, reduces exudative processes, increases number of specialized cells in wound. Application of LPLR prior to radiation damage decreases ulcer dimensions.

  5. Relationship Between Periodontal Disease and Acute Myocardial Infarction

    M. Zamirian; S Raoofi; Khosropanah, H; R Javanmardi

    2008-01-01

    Background: Conventional risk factors for coronary artery disease and myocardial infarction do not explain all of the clinical and epidemiological features of the disease. Periodontal disease is a common bacterial and destructive disorder of oral tissues. Many studies demonstrate close association between chronic periodontitis and development of generalized inflammation, vascular endothelial injury, and atherosclesis. Periodontal disease has been convincingly emerging as an important independ...

  6. Evidence Report: Risk of Cardiovascular Disease and Other Degenerative Tissue Effects from Radiation Exposure

    Patel, Zarana; Huff, Janice; Saha, Janapriya; Wang, Minli; Blattnig, Steve; Wu, Honglu; Cucinotta, Francis

    2015-01-01

    Occupational radiation exposure from the space environment may result in non-cancer or non-CNS degenerative tissue diseases, such as cardiovascular disease, cataracts, and respiratory or digestive diseases. However, the magnitude of influence and mechanisms of action of radiation leading to these diseases are not well characterized. Radiation and synergistic effects of radiation cause DNA damage, persistent oxidative stress, chronic inflammation, and accelerated tissue aging and degeneration, which may lead to acute or chronic disease of susceptible organ tissues. In particular, cardiovascular pathologies such as atherosclerosis are of major concern following gamma-ray exposure. This provides evidence for possible degenerative tissue effects following exposures to ionizing radiation in the form of the GCR or SPEs expected during long-duration spaceflight. However, the existence of low dose thresholds and dose-rate and radiation quality effects, as well as mechanisms and major risk pathways, are not well-characterized. Degenerative disease risks are difficult to assess because multiple factors, including radiation, are believed to play a role in the etiology of the diseases. As additional evidence is pointing to lower, space-relevant thresholds for these degenerative effects, particularly for cardiovascular disease, additional research with cell and animal studies is required to quantify the magnitude of this risk, understand mechanisms, and determine if additional protection strategies are required.The NASA PEL (Permissive Exposure Limit)s for cataract and cardiovascular risks are based on existing human epidemiology data. Although animal and clinical astronaut data show a significant increase in cataracts following exposure and a reassessment of atomic bomb (A-bomb) data suggests an increase in cardiovascular disease from radiation exposure, additional research is required to fully understand and quantify these adverse outcomes at lower doses (less than 0.5 gray

  7. Acute bone crises in sickle cell disease: the T1 fat-saturated sequence in differentiation of acute bone infarcts from acute osteomyelitis

    Aim: To prove the hypothesis that acute bone infarcts in sickle cell disease are caused by sequestration of red blood cells (RBCs) in bone marrow, and to evaluate the unenhanced T1 fat-saturated (fs) sequence in the differentiation of acute bone infarction from acute osteomyelitis in patients with sickle-cell disease. Materials and methods: Two studies were undertaken: an experimental study using in-vitro packed red blood cells and normal volunteers, and a retrospective clinical study of 86 magnetic resonance imaging (MRI) studies. For the experimental study containers of packed RBCs were placed between the knees of four healthy volunteers with a saline bag under the containers as an additional control, and were scanned with the pre-contrast T1-fs sequence. Signal intensity (SI) ratios were obtained for packed RBCs:skeletal muscle and packed RBCs:saline. For the clinical study, the SIs of normal bone marrow, packed RBCs, bone and/or soft-tissue lesions, and normal skeletal muscle of 74 patients (86 MRI studies) were measured using unenhanced, T1 fat-saturated MRI. The ratios of the above SIs to normal skeletal muscle were calculated and subjected to statistical analysis. Results: Fifty-one of 86 MRI studies were included in the final analysis. The ratios of SIs for normal bone marrow, packed red cells, bone infarction, acute osteomyelitis, and soft-tissue lesions associated with bone infarct, compared with normal skeletal muscle were (mean ± SD) 0.9 ± 0.2, 2.1 ± 0.7, 1.7 ± 0.5, 1.0 ± 0.3, and 2.2 ± 0.7, respectively. The difference in the ratio of SIs of bone infarcts and osteomyelitis was significant (p = 0.003). The final diagnoses were bone infarction (n = 50), acute osteomyelitis (n = 1), and co-existent bone infarction and osteomyelitis (n = 2). Seven patients who had suspected osteomyelitis underwent image-guided aspiration. Conclusion: Acute bone infarcts in sickle cell disease are caused by sequestration of red blood cells in the bone marrow. The

  8. Acute bone crises in sickle cell disease: the T1 fat-saturated sequence in differentiation of acute bone infarcts from acute osteomyelitis

    Jain, R. [Department of Radiology, College of Medicine, Sultan Qaboos University, Muscat (Oman)], E-mail: rajeevjn@yahoo.com; Sawhney, S. [Department of Radiology, College of Medicine, Sultan Qaboos University, Muscat (Oman); Rizvi, S.G. [Department of Community Medicine and Public Health, College of Medicine, Sultan Qaboos University, Muscat (Oman)

    2008-01-15

    Aim: To prove the hypothesis that acute bone infarcts in sickle cell disease are caused by sequestration of red blood cells (RBCs) in bone marrow, and to evaluate the unenhanced T1 fat-saturated (fs) sequence in the differentiation of acute bone infarction from acute osteomyelitis in patients with sickle-cell disease. Materials and methods: Two studies were undertaken: an experimental study using in-vitro packed red blood cells and normal volunteers, and a retrospective clinical study of 86 magnetic resonance imaging (MRI) studies. For the experimental study containers of packed RBCs were placed between the knees of four healthy volunteers with a saline bag under the containers as an additional control, and were scanned with the pre-contrast T1-fs sequence. Signal intensity (SI) ratios were obtained for packed RBCs:skeletal muscle and packed RBCs:saline. For the clinical study, the SIs of normal bone marrow, packed RBCs, bone and/or soft-tissue lesions, and normal skeletal muscle of 74 patients (86 MRI studies) were measured using unenhanced, T1 fat-saturated MRI. The ratios of the above SIs to normal skeletal muscle were calculated and subjected to statistical analysis. Results: Fifty-one of 86 MRI studies were included in the final analysis. The ratios of SIs for normal bone marrow, packed red cells, bone infarction, acute osteomyelitis, and soft-tissue lesions associated with bone infarct, compared with normal skeletal muscle were (mean {+-} SD) 0.9 {+-} 0.2, 2.1 {+-} 0.7, 1.7 {+-} 0.5, 1.0 {+-} 0.3, and 2.2 {+-} 0.7, respectively. The difference in the ratio of SIs of bone infarcts and osteomyelitis was significant (p = 0.003). The final diagnoses were bone infarction (n = 50), acute osteomyelitis (n = 1), and co-existent bone infarction and osteomyelitis (n = 2). Seven patients who had suspected osteomyelitis underwent image-guided aspiration. Conclusion: Acute bone infarcts in sickle cell disease are caused by sequestration of red blood cells in the bone

  9. The radiation therapy of benign diseases

    X-ray should only be applied when other forms of treatment of good-natured diseases do not provide equally good results. One should note that somatic lesion should be completely avoided and genetic lesion avoided to the greatest probability. One can distinguish according to ones aims between inflammation irradiation, pain irradiation, stimulation therapy and functional therapy. An indication for inflammation irradiation can be post-operative parotitis, furuncle in the face, mastitis puerperalis, panaritium ossale, recurrent sudoriparouns abscesses and repelling reactions after transplanting organs. Pain irradiation is indicated with degenerative diseases of the skeleton system. A further possible application is radiotherapy of hypotrophic processes and benign tumours. Functional radiotherapy is indicated with hyperendocrinism, neurovegetative disorders and allergies. (MG)

  10. Radiation-induced external ear canal cholesteatoma-like disease

    Three cases of cholesteatoma-like disease in the ear canals after radiation therapy for head and neck tumor were reported. Effect of irradiation on bone and soft tissue including skin brings about pathological reaction to the external ear canal as well. Two types of disease resembling cholesteatomas have been recognized: keratosis obturans (KO) and external auditory canal cholesteatoma (EACC). KO appears to be derived from disease of canal skin involved with keratinization, creating a widning of the canal. EACC, on the other hand, seems to develop in the disease of bony canal where a localized absorption of its bone with invasion of squamous epithelium takes place. (author)

  11. Soluble CD163 is increased in patients with acute pancreatitis independent of disease severity.

    Karrasch, Thomas; Brünnler, Tanja; Hamer, Okka W; Schmid, Karin; Voelk, Markus; Herfarth, Hans; Buechler, Christa

    2015-10-01

    Macrophages are crucially involved in the pathophysiology of acute pancreatitis. Soluble CD163 (sCD163) is specifically released from macrophages and systemic levels are increased in inflammatory diseases. Here, sCD163 was measured in serum of 50 patients with acute pancreatitis to find out possible associations with disease activity. Admission levels of systemic sCD163 were nearly three-fold higher in patients with acute pancreatitis compared to controls. In patients sCD163 did not correlate with C-reactive protein and leukocyte count as established markers of inflammation. Levels were not associated with disease severity assessed by the Schroeder score, Balthazar score, Acute Physiology, Age, and Chronic Health Evaluation (Apache) II score and peripancreatic necrosis score. Soluble CD163 was not related to complications of acute pancreatitis. These data show that serum sCD163 is increased in acute pancreatitis indicating activation of macrophages but is not associated with disease severity and outcome. PMID:26209500

  12. Optimal combinations of acute phase proteins for detecting infectious disease in pigs

    Heegaard, Peter M. H.; Stockmarr, Anders; Piñeiro, Matilde;

    2011-01-01

    The acute phase protein (APP) response is an early systemic sign of disease, detected as substantial changes in APP serum concentrations and most disease states involving inflammatory reactions give rise to APP responses. To obtain a detailed picture of the general utility of porcine APPs to dete...

  13. Relationship between haze and acute cardiovascular, cerebrovascular, and respiratory diseases in Beijing.

    Zhang, Jin-Jun; Cui, Meng-Meng; Fan, Da; Zhang, De-Shan; Lian, Hui-Xin; Yin, Zhao-Yin; Li, Jin

    2015-03-01

    Haze is an atmospheric phenomenon in which dry particulate pollutants obscure the sky. Haze has been associated with chronic diseases, but its relationship with acute diseases is less clear. We aimed to determine the association between haze and acute cardiovascular, cerebrovascular, and respiratory diseases, in order to determine the influence of haze on human health. We compared the number of cases of acute cardiovascular, cerebrovascular, and respiratory diseases in Beijing Emergency Center between 2006 and 2013, with haze data from Beijing Observatory. The relationship between the number of hazy days and the number of cases of the above types of diseases was analyzed using univariate analyses. Both the number of cases and the number of hazy days showed a rising trend. The average number of cases per day for all three diseases was higher on hazy days than on non-hazy days. There was a positive correlation between the number of hazy days and the number of cases, and this correlation showed a hysteretic quality. Haze has an influence on acute cardiovascular (CVDs), cerebrovascular (CBDs), and respiratory system (RSDs) diseases. Haze seems to have an additive effect, since the associations between haze and number of cases were stronger in the following month than in the preceding month. The increasing trend in the number of hazy days might worsen the problem of haze-related diseases. PMID:25292298

  14. Acute exacerbations of chronic obstructive pulmonary disease provide a unique opportunity to take care of patients

    Bianca Beghé

    2013-04-01

    Full Text Available Exacerbation of chronic obstructive pulmonary disease (ECOPD identifies the acute phase of COPD. The COPD patient is often frail and elderly with concomitant chronic diseases. This requires the physician not only looks at specific symptoms or organs, but to consider the patient in all his or her complexity.

  15. Acute interstitial pneumonia in mink kits inoculated with defined isolates of Aleutian mink disease parvovirus

    Alexandersen, Søren; Larsen, S; Aasted, B;

    1994-01-01

    The present study addressed the causal role of Aleutian mink disease parvovirus (ADV) in acute interstitial pneumonia in mink kits. All the examined isolates of ADV caused interstitial pneumonia in newborn kits, although the severity of disease and the mortality varied. These findings indicate that...

  16. Immuno-therapy of Acute Radiation Syndromes : Extracorporeal Immuno-Lympho-Plasmo-Sorption.

    Popov, Dmitri; Maliev, Slava

    Methods Results Summary and conclusions Introduction: Existing Medical Management of the Acute Radiation Syndromes (ARS) does not include methods of specific immunotherapy and active detoxication. Though the Acute Radiation Syndromes were defined as an acute toxic poisonous with development of pathological processes: Systemic Inflammatory Response Syndrome (SIRS), Toxic Multiple Organ Injury (TMOI), Toxic Multiple Organ Dysfunction Syndrome(TMODS), Toxic Multiple Organ Failure (TMOF). Radiation Toxins of SRD Group play an important role as the trigger mechanisms in development of the ARS clinical symptoms. Methods: Immuno-Lympho-Plasmo-Sorption is a type of Immuno-therapy which includes prin-ciples of immunochromato-graphy, plasmopheresis, and hemodialysis. Specific Antiradiation Antitoxic Antibodies are the active pharmacological agents of immunotherapy . Antiradia-tion Antitoxic Antibodies bind selectively to Radiation Neurotoxins, Cytotoxins, Hematotox-ins and neutralize their toxic activity. We have developed the highly sensitive method and system for extracorporeal-immune-lypmh-plasmo-sorption with antigen-specific IgG which is clinically important for treatment of the toxic and immunologic phases of the ARS. The method of extracorporeal-immune-lypmh-plasmo-sorption includes Antiradiation Antitoxic Antibodies (AAA) immobilized on microporous polymeric membranes with a pore size that is capable to provide diffusion of blood-lymph plasma. Plasma of blood or lymph of irradiated mammals contains Radiation Toxins (RT) that have toxic and antigenic properties. Radiation Toxins are Antigen-specific to Antitoxic blocking antibodies (Immunoglobulin G). Plasma diffuses through membranes with immobilized AAA and AA-antibodies bind to the polysaccharide chain of tox-ins molecules and complexes of AAA-RT that are captured on membrane surfaces. RT were removed from plasma. Re-transfusion of plasma of blood and lymph had been provided. We show a statistical significant

  17. Medical management of severe local radiation injury after acute X-ray exposure

    Medical management during acute period in a case of severe local radiation injury after acute X-ray exposure includes 3 stages. During the fist stage patient got conservative treatment according to the common pathogenetic mechanisms of LRI (dis aggregating therapy, stimulation of regeneration, dis intoxication therapy, antibiotic therapy, pain relief therapy, Local anti-burn therapy-specific non-adhesive bandage with antiseptic and anti-burn medicaments); estimation of severity, deepness and area of injury by clinical picture and dates of instrumental methods of examining; defining necessity and volume of surgical treatment; preparing arrangements for surgical treatment. This stage ends with forming of demarcation line of a very hard severity of a Local Radiation Injure. The second stage includes necrectomy of the area of a very hard severity with microsurgical plastic by re vascularized flap and auto dermoplastic. The third stage - adaptation of re vascularized flap and total epithelization of injured area. (author)

  18. Effect of low dose gamma-radiation upon Newcastle disease virus antibody level in chicken

    The specific antibody response against Newcastle disease virus in the blood serum of chickens hatched from eggs exposed to low dose gamma-radiation was studied. Materials and methods: Two groups of eggs of commercial meat chicken lines were irradiated with the dose of 0.30 Gy 60Co gamma-rays before incubation and on the 19th day of incubation, respectively. The same number of eggs unexposed to gamma-radiation served as controls. After hatching the group of chicken hatched from eggs irradiated on the 19th day of incubation was not vaccinated while the group of chicken hatched from eggs irradiated before incubation was vaccinated on the 14 day. Specific serum anti-Newcastle disease virus antibodies were quantified by the hemagglutination inhibition assay with 4 HA units of Newcastle disease virus La Sota strain. Result: Specific antibody titres against Newcastle disease virus in the blood serum of chickens hatched from eggs irradiated before incubation and vaccinated on the 14th day significantly increased on the 28th day. Specific antibody titre against Newcastle disease virus in the blood serum of chickens hatched from eggs irradiated on the 19th day of incubation and non-vaccinated was significantly higher on the 1st and 14th day. Conclusion: Acute irradiation of heavy breeding chicken eggs with the dose of 0.30 Gy 60Co gamma-rays before incubation and on the 19th day of incubation could have a stimulative effect on humoral immunity in chickens.

  19. New scoring system identifies kidney outcome with radiation therapy in acute renal allograft rejection

    Purpose: To evaluate the role of radiation therapy for acute refractory renal rejection after failure of medical intervention, and to identify risk factors that influence graft survival following radiation therapy. Methods: Between June 1989 and December 1995, 53 renal transplant recipients (34 men and 19 women) were treated with localized radiation therapy for acute renal allograft rejection. Graft rejection was defined as an increase in serum creatinine with histologic evidence of rejection on renal biopsy. Ninety-one percent were cadaveric transplant recipients. The majority of patients who experienced acute graft rejection initially received corticosteroid therapy, except for 25% who were referred for radiation therapy and steroids for the first rejection. In more recent years, patients with moderate or severe steroid-resistant or recurrent rejection received OKT3, a polyclonal antilymphocyte antibody (ATGAM), tacrolimus (FK506), or mycophenolate mofetil (MMF). Patients who failed to respond to medical treatment were then referred for radiation therapy. Ultrasound was performed for kidney localization. Treatment consisted of a dose of 600 cGy given in 3 or 4 fractions using 6 MV photons, delivered AP or AP/PA. Results: The overall actuarial graft survival from the initiation of RT was 83% at 1 month, 60% at 1 year, and 36% at 5 years. The median follow-up from the date of transplant to the last follow-up was 22 months. The median time from the date of transplant to the initiation of radiotherapy was 3 months, and the median time from the initiation of radiotherapy to the last follow-up was 10 months. Variables evaluated were as follows: human leukocyte antigen matching on HLA-A, HLA-B, and HLA-DR, the transplant panel-reactive antibodies (PRA) at transplantation, number of acute rejection episodes, interval from the date of the transplant to the first rejection, serum creatinine levels at the time of the first radiation treatment, number of transplants, and

  20. Therapy and prophylaxis of acute and late radiation-induced sequelae of the esophagus

    Background: Radiation-induced esophagitis is a frequent acute side effect in curative and palliative radiotherapy of thoracal and cervical tumors. Late reactions are rare but might be severe. Methods: A resarch for reports on prophylactic and supportive therapies of radiation-induced esophagitis was performed (Medline, Cancerlit, and others). Results: Nutrition must be ensured and symptomatic relief of sequelae is important, especially in the case of dysphagia. The latter can be improved by topic or systemic analgetics. If esophageal spasm occurs, calcium antagonists might help. In case of gastro-esophageal reflux proton pump inhibitors should be used. There is no effective prophylactic measure for radiation esophagitis. Late side effects with clinical relevance are rare in conventional radiotherapy. Chronic ulcera, fistula or stenosis may develop. Before any treatment, a tumor infiltration of the esophagus should be excluded by biopsy. This can lead more often to late complications than radiation therapy itself. Nutrition should be ensured by endoscopic dilation, stent-implantation, or endoscopic percutaneous gastrostomy. Local injection of steroids might be used to avoid an early restenosis. Conclusions: An intensive symptomatic therapy of acute esophagitis is reasonable. Effective prophylaxis do not exist. Late radiation induced sequelae is rare. Therefore, a tumor recurrence should be excluded in cases of dysphagia. Securing nutrition by PEG, stent, or port is well in the fore. (orig.)

  1. FIRST REPORT OF ACUTE CHAGAS DISEASE BY VECTOR TRANSMISSION IN RIO DE JANEIRO STATE, BRAZIL

    Luiz Henrique Conde SANGENIS

    2015-08-01

    Full Text Available SUMMARY Chagas disease (CD is an endemic anthropozoonosis from Latin America of which the main means of transmission is the contact of skin lesions or mucosa with the feces of triatomine bugs infected by Trypanosoma cruzi. In this article, we describe the first acute CD case acquired by vector transmission in the Rio de Janeiro State and confirmed by parasitological, serological and PCR tests. The patient presented acute cardiomyopathy and pericardial effusion without cardiac tamponade. Together with fever and malaise, a 3 cm wide erythematous, non-pruritic, papule compatible with a "chagoma" was found on his left wrist. This case report draws attention to the possible transmission of CD by non-domiciled native vectors in non-endemic areas. Therefore, acute CD should be included in the diagnostic workout of febrile diseases and acute myopericarditis in Rio de Janeiro.

  2. Radiation therapy in patients with hematologic diseases; La radiotherapie en hematologie

    Hennequin, C.; Maylin, C. [Hopital Saint-Louis, 75 - Paris (France)

    1995-06-01

    Radiation therapy has a significant place in the treatment of hematologic diseases. Irradiation is a key component of the treatment strategy for Hodgkin`s disease and has benefited from clinical studies aimed at improving its therapeutic index. There have been many recent improvements, in particular with regard to accuracy of techniques, imagery, dosimetry, and implementation of quality-control procedures. In localized non-Hodgkin`s lymphoma, the gold-standard treatment is radiation therapy coupled with a short course of chemotherapy. In contrast, the place of irradiation in disseminated lymphomas remains to be defined. Prophylactic irradiation of the brain is still used in patients with acute lymphoblastic leukemia. Radiation therapy is of value as palliative treatment of bone lesions of myeloma, in chemo-resistant lymphomas, and in relapses of leukemia. Total body irradiation is a cumbersome but irreplaceable method, which has also benefited from recent clinical and biological studies. Optimal radiation therapy with the best possible therapeutic index requires adequate technological and human resources. (authors). 30 refs., 1 tab.

  3. Strategy and tactics for stimulation of haemopoiesis in patients developing the acute radiation syndrome. Chapter 8

    This paper is essentially based on the outcome of a concerted research action of the European Communities entitled 'Medical Treatment Protocols for Radiation Accident Victims as a Basis for a Computerized Guidance System' (METREPOL) which was conducted as a joint effort between research establishments in Paris, Oxford, Rotterdam, Munich and Ulm. The results of this concerted action have been published by the British Institute of Radiology in 2001 with the following title: 'Medical Management of Radiation Accidents: Manual on the Acute Radiation Syndrome'. In this manual, experience was used from more than 800 case histories of persons that were subjected to whole body radiation exposure during radiation accidents. A total of 70 accidents in 14 countries provided the material for the manual including data on medical management and follow-up of the Chernobyl and Tokaimura accidents presented in detail in this Technical Document. These case histories form the core of an international database system entitled SEARCH (System for Evaluation and Archiving of Radiation Accidents based on Case Histories). The haematopoietic cell renewal systems are of paramount importance in the clinical management of the acute radiation syndrome for two reasons. First of all, the haematopoietic tissue is distributed throughout the skeleton characterized by an enormous haematopoietic cell turnover as well as by a high radiation sensitivity. Furthermore, it is regulated to act as one organ by humoral factors and by a continuous monitoring of stem cell content in the bone marrow units by a migration stream of circulating haematopoietic stem cells. Therefore, the haematopoietic blood cell response patterns after total body exposure to ionizing radiation reflect in a very precise way the extent of damage to the entire organism and are able to predict the probable clinical course of the patient and allows preparation for the different treatment options. Thus, it is obvious that the

  4. [Acute gastrointestinal involvement in dengue disease by serotype 4: a case report and literature review].

    Marín, Johan; Vilcarromero, Stalin; Forshey, Brett M; Celis-Salinas, Juan C; Ramal-Asayag, Cesar; Morrison, Amy C; Laguna-Torres, Alberto; Casapía, Martín; Halsey, Eric S

    2013-10-01

    Dengue fever is the world's most important arboviral disease, presenting a wide clinical spectrum. We report for the first time in Peru, a case caused by dengue virus serotype 4 with significant gastrointestinal involvement (acute acalculous cholecystitis and acute hepatitis). In addition we carried out a review of the literature atypical presentation illustrating the importance of the characteristics of abdominal pain (right upper quadrant); presence of Murphy's sign, ultrasound, and liver enzymes levels, for appropriate diagnosis and clinical management. PMID:24248170

  5. ACUTE PHASE REACTANCTS IN PERICARDIAL FLUID ARE INDICATORS OF CORONARY ARTERY DISEASE

    Yılmaz Mehmet Ali; Simsek Erdal; Karapinar Kasim; Azboy Davut; Erdolu Burak

    2012-01-01

    Inflammation in formation of atherosclerosis, and acute phase reactants in the site of inflammation have major functions. Thus, do the acute phase reactants constitute the biggest risk factor for coronary artery disease? 55 patients are included in the study. Patients with coronary artery bypass surgery are included in Group I (38 patients) and patients with valve operation are included in Group II (17 patients). CABG patients are further divided into two sub-groups as on-pump and off-pump. I...

  6. Review of ventilatory techniques to optimize mechanical ventilation in acute exacerbation of chronic obstructive pulmonary disease

    Reddy, Raghu M.; Guntupalli, Kalpalatha K.

    2007-01-01

    Chronic obstructive pulmonary disease (COPD) is a major global healthcare problem. Studies vary widely in the reported frequency of mechanical ventilation in acute exacerbations of COPD. Invasive intubation and mechanical ventilation may be associated with significant morbidity and mortality. A good understanding of the airway pathophysiology and lung mechanics in COPD is necessary to appropriately manage acute exacerbations and respiratory failure. The basic pathophysiology in COPD exacerbat...

  7. Increased Serum Phospholipase A2 Activity in Advanced Chronic Liver Disease as an Expression of the Acute Phase Response

    Mario Pirisi; Carlo Fabris; Maria Piera Panozzo; Giorgio Soardo; Pierluigi Toniutto; Ettore Bartou

    1993-01-01

    Phospholipase A2 (PLA2) modifications were investigated in patients with acute and chronic liver diseases, PLA2 variations were related to indices of liver function as well as to parameters of the acute phase response. Serum PLA2 activity modifications were f1uorimetrically measured in 105 patients affected by acute and chronic liver diseases or extra-hepatic diseases. One-way ANOV A demonstrated a significant difference among groups (F= 4.53, P

  8. Life-threatening acute pneumonitis in mixed connective tissue disease: a case report and literature review.

    Rath, Eva; Zandieh, Shahin; Löckinger, Alexander; Hirschl, Mirko; Klaushofer, Klaus; Zwerina, Jochen

    2015-10-01

    Mixed connective tissue disease (MCTD) is a rare connective tissue disease frequently involving the lungs. The main characteristic is a systemic sclerosis-like picture of slowly progressing interstitial lung disease consistent with lung fibrosis, while pulmonary arterial hypertension is rare. Herein, we present a case of a newly diagnosed MCTD patient developing life-threatening acute pneumonitis similar to lupus pneumonitis. Previous literature on this exceptionally rare complication of MCTD is reviewed and differential diagnosis and management discussed. PMID:26142172

  9. Post-infectious glomerulonephritis presenting as acute renal failure in a patient with Lyme disease

    Rolla, Davide; Conti, Novella; Ansaldo, Francesca; Panaro, Laura; Lusenti, Tiziano

    2013-01-01

    Introduction: We report a case of a patient with acute renal failure in Lyme disease-associated focal proliferative mesangial nephropathy. Lyme disease is a vector-borne disease caused by Borrelia burgdorferi, transmitted by the bite of an infected ixodes tick. Post-infectious glomerulonephritis (GN)secondary to Borrelia burgdorferi infection in man could be fatal, as it is in canine Lyme borreliosis. Case: A 61-year old man with chronic ethanolic hepatitis was admitted to a provincial hospit...

  10. Acute Kidney Injury after Using Contrast during Cardiac Catheterization in Children with Heart Disease

    Hwang, Young Ju; Hyun, Myung Chul; Choi, Bong Seok; Chun, So Young; Cho, Min Hyun

    2014-01-01

    Acute kidney injury (AKI) is closely associated with the mortality of hospitalized patients and long-term development of chronic kidney disease, especially in children. The purpose of our study was to assess the evidence of contrast-induced AKI after cardiac catheterization in children with heart disease and evaluate the clinical usefulness of candidate biomarkers in AKI. A total of 26 children undergoing cardiac catheterization due to various heart diseases were selected and urine and blood ...

  11. Epidemiological studies on radiation carcinogenesis in human populations following acute exposure: nuclear explosions and medical radiation

    The current knowledge of the carcinogenic effect of radiation in man is considered. The discussion is restricted to dose-incidence data in humans, particularly to certain of those epidemiological studies of human populations that are used most frequently for risk estimation for low-dose radiation carcinogenesis in man. Emphasis is placed solely on those surveys concerned with nuclear explosions and medical exposures

  12. Chanqes of osseous tissue following radiation therapy and in acute radiation trauma

    The studies on ionizing radiation effect with harmful doses on man skeleton are analyzed. Pathomorphological and rentgenological changes in bones of patients, who underwent radiotherapy course are studied; the pointed out changes were observed as radiation complications. It is noted that pathological process in the bone develops comparatively slowly following therapeutic fractionated irradiation

  13. Psychiatric Disease and Post-Acute Traumatic Brain Injury.

    Zgaljardic, Dennis J; Seale, Gary S; Schaefer, Lynn A; Temple, Richard O; Foreman, Jack; Elliott, Timothy R

    2015-12-01

    Psychiatric disorders are common following traumatic brain injury (TBI) and can include depression, anxiety, and psychosis, as well as other maladaptive behaviors and personality changes. The epidemiologic data of psychiatric disorders post-TBI vary widely, although the incidence and prevalence rates typically are higher than in the general population. Although the experience of psychiatric symptoms may be temporary and may resolve in the acute period, many patients with TBI can experience psychopathology that is persistent or that develops in the post-acute period. Long-term psychiatric disorder, along with cognitive and physical sequelae and greater risk for substance use disorders, can pose a number of life-long challenges for patients and their caregivers, as they can interfere with participation in rehabilitation as well as limit functional independence in the community. The current review of the literature considers the common psychiatric problems affecting individuals with TBI in the post-acute period, including personality changes, psychosis, executive dysfunction, depression, anxiety, and substance misuse. Although treatment considerations (pharmacological and nonpharmacological) are referred to, an extensive description of such protocols is beyond the scope of the current review. The impact of persistent psychiatric symptoms on perceived caregiver burden and distress is also discussed. PMID:25629222

  14. Topical Calendula and Betamethasone Valerate in the prevention of acute radiation dermatitis: a randomized prospective trial

    Fotouhi M

    2007-07-01

    Full Text Available Background: Acute radiation dermatitis is a very common side effect of radiation therapy for many cancers, including breast cancer. Despite the high prevalence of acute radiation dermatitis as well as wet desquamation, only a few trials studying the prophylaxis of this complication using topical treatment have been conducted. In spite of these studies, some controversy still exists about regarding treatments for acute radiation dermatitis, as does some concern about their long-term complications. For this reason, we conducted a clinical trial for a new treatment with the same effectiveness as corticosteroids, but fewer complications. Methods: This trial included 60 patients with pathologic diagnoses of breast cancer for whom radiotherapy had been planned. Patients were 30-73 years old. Patients with radical mastectomy received 5000 cGy over five weeks, and those with conservative surgery received 6000 cGy over six weeks divided in 200 cGy fractions. Patients were divided randomly into two groups: one group received a moderately-potent glucocorticoid steroid, 0.1% betamethasone ointment (30, and the other received the new treatment, 0.1% calendula ointment (30. All patients applied their respective drugs twice daily within the tangential field from the first day of radiation treatment until one month after treatment was completed. Starting one week after radiation therapy commenced, patients were monitored weekly for symptoms of dermatitis and the degree of severity as well as possible adverse drug effects, in addition to such monitoring on the days of their appointments. Four weeks after termination of therapy, patients were again examined, at which time they completed a questionnaire about dermatologic complications. Results: The mean time to develop dermatitis was 3.7 weeks for the betamethasone group and 3.87 weeks for the calendula group. Maximal dermatitis intensity during treatment in the betamethasone group was: 0, 6.7%; I, 73.3%; II, 16

  15. Outcomes of Noninvasive Ventilation for Acute Exacerbations of Chronic Obstructive Pulmonary Disease in the United States, 1998–2008

    Chandra, Divay; Stamm, Jason A.; Taylor, Brian; Ramos, Rose Mary; Satterwhite, Lewis; Krishnan, Jerry A.; Mannino, David; Sciurba, Frank C.; Holguín, Fernando

    2012-01-01

    Rationale: The patterns and outcomes of noninvasive, positive-pressure ventilation (NIPPV) use in patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD) nationwide are unknown.

  16. Acute myelogenous leukemia developed after radioactive iodine therapy and palliative radiation therapy in metastatic papillary thyroid cancer

    Ko, Tae Young; Kwak, Jae Sik; Oh, Kyung Suk; Lee, Seung Bai; Chung, Byung Sun; Kim, Eun Sil; Kim, Chong Soon [Hanil Hospital, Seoul (Korea, Republic of)

    1998-08-01

    Radioactive iodine treatment has been widely used for nearly 50 years in the treatment of thyroid cancer to ablate residual thyroid tissue after thyroidectomy and to treat metastatic disease. Leukemia is a rare complication associated with the radioactive iodine therapy. The occurrence of leukemia is known to be related to the cumulative dosage of I-131 more than 37 GBq (1 Ci) and also associated with the intervals of less than 12 months between the repeated doses. We report a case of a 52 year-old female patient with papillary cancer of thyroid who developed acute myelogenous leukemia after the total 20.4 GBq (550 mCi) of I-131 therapy over 3.2 years and palliative radiation therapy ( 3000 cGy) due to multiple bone metastasis of papillary cancer.

  17. Acute myelogenous leukemia developed after radioactive iodine therapy and palliative radiation therapy in metastatic papillary thyroid cancer

    Radioactive iodine treatment has been widely used for nearly 50 years in the treatment of thyroid cancer to ablate residual thyroid tissue after thyroidectomy and to treat metastatic disease. Leukemia is a rare complication associated with the radioactive iodine therapy. The occurrence of leukemia is known to be related to the cumulative dosage of I-131 more than 37 GBq (1 Ci) and also associated with the intervals of less than 12 months between the repeated doses. We report a case of a 52 year-old female patient with papillary cancer of thyroid who developed acute myelogenous leukemia after the total 20.4 GBq (550 mCi) of I-131 therapy over 3.2 years and palliative radiation therapy ( 3000 cGy) due to multiple bone metastasis of papillary cancer

  18. Protective effects of parmelia tinctorum preparations on acute radiation-injured mice

    Objective: To investigate the radiation protection effect of Parmelia tinctorum preparations in dosage, drug administration time, administration methods and different preparation methods on acute radiation-injured mice, and find out the best therapeutic project. Methods: Kunming mice were injected (ip) with 10 mg/kg, 20 mg/kg, 40 mg/kg, 80 mg/kg of Parmelia tinctorum preparations before irradiation respectively, then irradiated by 9 Gy 60Co γ-ray. The 30-day survival rates and the protection factors were observed. By the same method, another group of mice were injected (ip) with Parmelia tinctorum preparations at 15 min, 30 min, 1 h, 2 h, 4 h before irradiation respectively, the 30-day survival rates and the protection factors were observed. The protective effect of Parmelia tinctorum preparations from intramuscular and oral routes were compared with the same method. The protective effect of Parmelia tinctorum water extract preparations and alcohol extract preparations were compared. Results: A certain dosage (20-80 mg/kg) of Parmelia tinctorum preparations could greatly improve the 30-day survival rates and the protection factors of radiation-injured mice. Parmelia tinctorum preparations had significant therapeutic effect on 60Co γ-ray radiation-injured mice at 15 min-1 h before irradiation. Administration of Parmelia tinctorum preparations by intramuscular injection showed a little lower efficacy than by intraperitoneal injection, but administration the same dose orally had no significant radiation protective effect. Parmelia tinctorum preparations extracted by water injected (ip) before irradiation had the same radiation protective effect with those extracted by 50% alcohol. Conclusion: Parmelia tinctorum preparations have a certain protective effect on acute radiation-injured mice. The best therapeutic project is injected (ip) with 40 mg/kg of Parmelia tinctorum preparations at 30 min before irradiation. (authors)

  19. Elemental diet as primary treatment of acute Crohn's disease: a controlled trial.

    O'Moráin, C; Segal, A W; Levi, A J

    1984-06-23

    Acute exacerbations of Crohn's disease are usually treated with prednisolone or potentially more toxic immunosuppressive drugs or by surgery. In pilot studies replacing the normal diet by a protein free elemental diet also induced remission. A controlled trial was therefore conducted in which 21 patients acutely ill with exacerbations of Crohn's disease were randomised to receive either prednisolone 0.75 mg/kg/day or an elemental diet (Vivonex) for four weeks. Assessment at four and 12 weeks showed that the patients treated with the elemental diet had improved as much as and by some criteria more than the steroid treated group. Elemental diet is a safe and effective treatment for acute Crohn's disease. PMID:6428577

  20. Acute pelvic inflammatory disease: pictorial essay focused on computed tomography and magnetic resonance imaging findings

    Febronio, Eduardo Miguel; Rosas, George de Queiroz; D' Ippolito, Giuseppe, E-mail: giuseppe_dr@uol.com.br [Department of Imaging Diagnosis, Escola Paulista de Medicina - Universidade Federal de Sao Paulo (EPMUnifesp), Sao Paulo, SP (Brazil)

    2012-11-15

    The present study was aimed at describing key computed tomography and magnetic resonance imaging findings in patients with acute abdominal pain derived from pelvic inflammatory disease. Two radiologists consensually selected and analyzed computed tomography and magnetic resonance imaging studies performed between January 2010 and December 2011 in patients with proven pelvic inflammatory disease leading to presentation of acute abdomen. Main findings included presence of intracavitary fluid collections, anomalous enhancement of the pelvic excavation and densification of adnexal fat planes. Pelvic inflammatory disease is one of the leading causes of abdominal pain in women of childbearing age and it has been increasingly been diagnosed by means of computed tomography and magnetic resonance imaging supplementing the role of ultrasonography. It is crucial that radiologists become familiar with the main sectional imaging findings in the diagnosis of this common cause of acute abdomen (author)

  1. Acute pelvic inflammatory disease: pictorial essay focused on computed tomography and magnetic resonance imaging findings

    The present study was aimed at describing key computed tomography and magnetic resonance imaging findings in patients with acute abdominal pain derived from pelvic inflammatory disease. Two radiologists consensually selected and analyzed computed tomography and magnetic resonance imaging studies performed between January 2010 and December 2011 in patients with proven pelvic inflammatory disease leading to presentation of acute abdomen. Main findings included presence of intracavitary fluid collections, anomalous enhancement of the pelvic excavation and densification of adnexal fat planes. Pelvic inflammatory disease is one of the leading causes of abdominal pain in women of childbearing age and it has been increasingly been diagnosed by means of computed tomography and magnetic resonance imaging supplementing the role of ultrasonography. It is crucial that radiologists become familiar with the main sectional imaging findings in the diagnosis of this common cause of acute abdomen (author)

  2. Atypical presentation of acute and chronic coronary artery disease in diabetics

    Hadi; AR; Hadi; Khafaji; Jassim; M; Al; Suwaidi

    2014-01-01

    In patients with diabetes mellitus, cardiovascular disease is the principal cause of mortality and chest pain is the most frequent symptom in patients with stable and acute coronary artery disease. However, there is little knowledge concerning the pervasiveness of uncommon presentations in diabetics. The symptomatology of acute coronary syndrome, which comprises both pain and non-pain symptoms, may be affected by traditional risk factors such as age, gender, smoking, hypertension, diabetes, and dyslipidemia. Such atypical symptoms may range from silent myocardial ischemia to a wide spectrum of non-chest pain symptoms. Worldwide, few studies have highlighted this under-investigated subject, and this aspect of ischemic heart disease has also been under-evaluated in the major clinical trials. The results of these studies are highly diverse which makes definitive conclusions regarding the spectrum of atypical presentation of acute and even stable chronic coronay artery disease difficult to confirm. This may have a significant impact on the morbidity and mortality of coronary artery disease in diabetics. In this up-to-date review we will try to analyze the most recent studies on the atypical presentations in both acute and chronic ischemic heart disease which may give some emphasis to this under-investigated topic.

  3. Uric acid levels and their relation to incapacities in acute cerebrovascular disease

    Julio López Argüelles

    2010-02-01

    Full Text Available Background: cerebrovascular disease and ischemic cardiopathy can be considered as an epidemic and constitute the first cause of incapacities in developed countries. Multiple studies have shown the association between uric acid levels and cerebrovascular diseases. Objective: To correlate the levels of serum uric acid and incapacities in the acute phase of cerebrovascular disease. Methods: A correlational study was carried out with 217 patients with acute cerebrovascular disease. The patient’s incapacity level was measured by using the Barthel Index and those results were related with the serum uric acid levels and other variables. Results: Male patients have higher levels of uric acid (p=0, 04; r=0, 13. Age and Barthel index were p < 0,001; r = -0, 30 and uric acid levels and Barthel Index were p=0, 03; r=-0, 14. The principal predicting factors of incapacity in the acute phase of cerebrovascular disease were the high levels of uric acid, age and diabetes mellitus. Conclusions: It is shown that the highest is the level of uric acid at advanced age; the greatest is the risk of suffering from incapacity in acute phases of cerebrovascular diseases.

  4. Association of Acute Radiation Syndrome and Rain after the Bombings in Atomic Bomb Survivors.

    Ozasa, K; Sakata, R; Cullings, H M; Grant, E J

    2016-06-01

    Acute radiation-induced symptoms reported in survivors after the atomic bombings in Hiroshima and Nagasaki have been suspected to be associated with rain that fell after the explosions, but this association has not been evaluated in an epidemiological study that considers the effects of the direct dose from the atomic bombs and other factors. The aim of this study was to evaluate this association using information from a fixed cohort, comprised of 93,741 members of the Life Span Study who were in the city at the time of the bombing. Information on acute symptoms and exposure to rain was collected in surveys conducted by interviewers, primarily in the 1950s. The proportion of survivors developing severe epilation was around 60% at levels of direct radiation doses of 3 Gy or higher and less than 0.2% at levels <0.005 Gy regardless of reported rain exposure status. The low prevalence of acute symptoms at low direct doses indicates that the reported fallout rain was not homogeneously radioactive at a level sufficient to cause a substantial probability of acute symptoms. We observed that the proportion of reported acute symptoms was slightly higher among those who reported rain exposure in some subgroups, however, suggestions that rain was the cause of these reported symptoms are not supported by analyses specific to the known areas of radioactive fallout. Misclassification of exposure and outcome, including symptoms due to other causes and recall bias, appears to be a more plausible explanation. However, the insufficient and retrospective nature of the available data limited our ability to quantify the attribution to those possible causes. PMID:27223827

  5. A two-mutation model of radiation-induced acute myeloid leukemia using historical mouse data.

    Dekkers, Fieke; Bijwaard, Harmen; Bouffler, Simon; Ellender, Michele; Huiskamp, René; Kowalczuk, Christine; Meijne, Emmy; Sutmuller, Marjolein

    2011-03-01

    From studies of the atomic bomb survivors, it is well known that ionizing radiation causes several forms of leukemia. However, since the specific mechanism behind this process remains largely unknown, it is difficult to extrapolate carcinogenic effects at acute high-dose exposures to risk estimates for the chronic low-dose exposures that are important for radiation protection purposes. Recently, it has become clear that the induction of acute myeloid leukemia (AML) in CBA/H mice takes place through two key steps, both involving the Sfpi1 gene. A similar mechanism may play a role in human radiation-induced AML. In the present paper, a two-mutation carcinogenesis model is applied to model AML in several data sets of X-ray- and neutron-exposed CBA/H mice. The models obtained provide good fits to the data. A comparison between the predictions for neutron-induced and X-ray-induced AML yields an RBE for neutrons of approximately 3. The model used is considered to be a first step toward a model for human radiation-induced AML, which could be used to estimate risks of exposure to low doses. PMID:20842369

  6. Evidence Report: Risk of Acute Radiation Syndromes Due to Solar Particle Events

    Carnell, Lisa; Blattnig, Steve; Hu, Shaowen; Huff, Janice; Kim, Myung-Hee; Norman, Ryan; Patel, Zarana; Simonsen, Lisa; Wu, Honglu

    2016-01-01

    Crew health and performance may be impacted by a major solar particle event (SPE), multiple SPEs, or the cumulative effect of galactic cosmic rays (GCR) and SPEs. Beyond low-Earth orbit, the protection of the Earth's magnetosphere is no longer available, such that increased shielding and protective mechanisms are necessary in order to prevent acute radiation sickness and impacts to mission success or crew survival. While operational monitoring and shielding are expected to minimize radiation exposures, there are EVA scenarios outside of low-Earth orbit where the risk of prodromal effects, including nausea, vomiting, anorexia, and fatigue, as well as skin injury and depletion of the blood-forming organs (BFO), may occur. There is a reasonable concern that a compromised immune system due to high skin doses from a SPE or due to synergistic space flight factors (e.g., microgravity) may lead to increased risk to the BFO. The primary data available at present are derived from analyses of medical patients and persons accidentally exposed to acute, high doses of low-linear energy transfer (LET) (or terrestrial) radiation. Data more specific to the space flight environment must be compiled to quantify the magnitude of increase of this risk and to develop appropriate protection strategies. In particular, information addressing the distinct differences between solar proton exposures and terrestrial exposure scenarios, including radiation quality, dose-rate effects, and non-uniform dose distributions, is required for accurate risk estimation.

  7. Gamma radiation influences postharvest disease incidence of pineapple fruits

    The application of gamma radiation for improving the storage of pineapple fruits [Ananas comosus (L.) Merr. cv. Queen] has been studied in an attempt to reduce decay caused by fungal pathogens such as Ceratocystis paradoxa (Dade)-Moreau and Penicillium purpurogenum Stoll. Gamma radiation at 50, 75, 100, 150, and 250 Gy improved shelf life. The maximum tolerable dose was approximately 250 Gy. Fruits irradiated with up to 150 Gy and then stored at 25 to 28C maintained their texture better than did the controls. Radiation, particularly at doses 250 Gy, caused browning of the skin and softening of tissues. Browning increased with increasing radiation dose and storage duration. Excessively high doses promoted spoilage. Doses in the range of 50 to 250 Gy, in combination with storage at 11 to 13C, can be used to reduce postharvest losses in pineapple due to fungal diseases and senescence, thereby extending shelf life

  8. Epidemiological studies on radiation carcinogenesis in human populations following acute exposure: nuclear explosions and medical radiation

    The present review provides an understanding of our current knowledge of the carcinogenic effect of low-dose radiation in man, and surveys the epidemiological studies of human populations exposed to nuclear explosions and medical radiation. Discussion centers on the contributions of quantitative epidemiology to present knowledge, the reliability of the dose-incidence data, and those relevant epidemiological studies that provide the most useful information for risk estimation of cancer-induction in man. Reference is made to dose-incidence relationships from laboratory animal experiments where they may obtain for problems and difficulties in extrapolation from data obtained at high doses to low doses, and from animal data to the human situation. The paper describes the methods of application of such epidemiological data for estimation of excess risk of radiation-induced cancer in exposed human populations, and discusses the strengths and limitations of epidemiology in guiding radiation protection philosophy and public health policy

  9. Epidemiological studies on radiation carcinogenesis in human populations following acute exposure: nuclear explosions and medical radiation

    Fabrikant, J.I.

    1982-08-01

    The present review provides an understanding of our current knowledge of the carcinogenic effect of low-dose radiation in man, and surveys the epidemiological studies of human populations exposed to nuclear explosions and medical radiation. Discussion centers on the contributions of quantitative epidemiology to present knowledge, the reliability of the dose-incidence data, and those relevant epidemiological studies that provide the most useful information for risk estimation of cancer-induction in man. Reference is made to dose-incidence relationships from laboratory animal experiments where they may obtain for problems and difficulties in extrapolation from data obtained at high doses to low doses, and from animal data to the human situation. The paper describes the methods of application of such epidemiological data for estimation of excess risk of radiation-induced cancer in exposed human populations, and discusses the strengths and limitations of epidemiology in guiding radiation protection philosophy and public health policy.

  10. HIDA and ultrasound scans in the diagnosis of acute gall bladder disease

    97 patients with suspected acute gall bladder disease were subjected to cholescintigraphy (HIDA) and ultrasonography (US) to evaluate their diagnostic accuracy in detecting acute cholecystitis (AC). Three patients with non-biliary disease had normal HIDA and sonography scans, while the remaining 94 were operated on within 48 hours of admission to the hospital. Of these 62 (66%) were proved to have AC at operation and on histopathological examination. HIDA scans correctly diagnosed AC in 57 of them (92%), while sonography revealed dilated and oedematous gall bladders, and thus diagnosed AC in 30 patients (48%). (orig.)

  11. A Puzzle of Vestibular Physiology in a Meniere’s Disease Acute Attack

    Marta Martinez-Lopez; Raquel Manrique-Huarte; Nicolas Perez-Fernandez

    2015-01-01

    The aim of this paper is to present for the first time the functional evaluation of each of the vestibular receptors in the six semicircular canals in a patient diagnosed with Meniere's disease during an acute attack. A 54-year-old lady was diagnosed with left Meniere's disease who during her regular clinic review suffers an acute attack of vertigo, with fullness and an increase of tinnitus in her left ear. Spontaneous nystagmus and the results in the video head-impulse test (vHIT) are shown ...

  12. Acute Radiation Syndrome (ARS) and its harmful effects on human health

    After radiation exposure a series of many clinical syndromes appear that is called as Acute Radiation Syndrome (ARS). ARS also known as radiation toxicology or radiation sickness. Both low and higher doses radiation exposure on human body cause different types of radiation syndromes. These radiations may be ionizing radiations. X-rays and gamma rays etc. some times neutrons or radionuclides may also be deposited in human body and their effective doses cause major injuries or abnormalities even sometimes death also. ARS consist of a sequence of phased symptoms. These symptoms appear after the radiation exposure for several days to several months or sometimes for a long period or years. ARS depends on the quantity of absorbed radiation dose (rad0). ARS is characterized by an initial prodromal stage of malaise, nausea, vomiting, and diarrhea. Critical effects of ARS are Hematologic, that results infections to low white blood cells (WBC), bleeding due to low platelets and anemia due to low red blood cells (RBC), Gastrointestinal results nausea, vomiting, loss of appetite and abdominal pain (exposure doses of 600-1000 rad) and Neurovascular depending on the exposure dose. Neurovascular syndrome typically occurs at exposure doses greater than 1000 rad. It presents with neurological symptoms such as dizziness, headache, or decreased level of consciousness with an absence of vomiting. The clinical course of radiation sickness following a single intensive exposure to whole body radiation is characterized by three successive phases; a prodromal phase, which develops within minutes or hours after exposure, an ensuring latent period, which is relatively asymptomatic; and the main phase of the illness. Complete Blood Count (CBC) are helpful for the diagnosis for ARS. ARS may cause skin damage or loss of epidermis. Person suffering from nausea, vomiting, diarrhea should be admitted to well equipped hospitals or clinics. High exposured persons should be analysed CBC. Their

  13. Epidemiological studies on radiation carcinogenesis in human populations following acute exposure: nuclear explosions and medical radiation.

    Fabrikant, J. I.

    1981-01-01

    The present review provides an understanding of our current knowledge of the carcinogenic effect of low-dose radiation in man, and surveys the epidemiological studies of human populations exposed to nuclear explosions and medical radiation. Discussion centers on the contributions of quantitative epidemiology to present knowledge, the reliability of the dose-incidence data, and those relevant epidemiological studies that provide the most useful information for risk estimation of cancer inducti...

  14. Epidemiological studies on radiation carcinogenesis in human populations following acute exposure: nuclear explosions and medical radiation

    Fabrikant, J.I.

    1981-05-01

    The current knowledge of the carcinogenic effect of radiation in man is considered. The discussion is restricted to dose-incidence data in humans, particularly to certain of those epidemiological studies of human populations that are used most frequently for risk estimation for low-dose radiation carcinogenesis in man. Emphasis is placed solely on those surveys concerned with nuclear explosions and medical exposures. (ACR)

  15. The ultrasonographic findings of acute pelvic inflammatory disease

    Choi, Yeon Nam; Park, Jai Soung; Lee, Hae Kyung; Chung, Moo Chan; Lee, Beong Ho; Kim, Ki Jung [Soonchunhyang University, College of Medicine, Seoul (Korea, Republic of)

    1987-08-15

    Although ultrasonographic findings of female pelvic mass are frequently reported, those of acute PID are not well established. But differentiation of fluid collection and mass lesion of PID is exactly made by ultrasonography. We analysed the ultrasonographic findings in 26 cases of acute PID having satisfactory operative or histological proofs, examined at Soonchunhyang University Hospital from Oct. 1985 to Feb. 1987. The results were as follows: 1. The age was ranged from 17 years to 53 years of age and the majority was between 21 years and 50 years of age. 2. Ultrasonographic findings are classified to fluid collection in cul de sac 17, tuboovarian abscess, 7 pyosalpix 2, endometritis 1 and normal 2 cases. 3. In cases of pelvic mass formation, their ecnogenecity were cystic form in 6 cases (22%), mixed form in 19 cases (71%), solid form in 2 cases (7%), and shapes were mainly ovoid with irregular, ill-defined margin. The location of mass is unilateral in 17 cases (63%) bilateral in 10 cases (37%)

  16. The ultrasonographic findings of acute pelvic inflammatory disease

    Although ultrasonographic findings of female pelvic mass are frequently reported, those of acute PID are not well established. But differentiation of fluid collection and mass lesion of PID is exactly made by ultrasonography. We analysed the ultrasonographic findings in 26 cases of acute PID having satisfactory operative or histological proofs, examined at Soonchunhyang University Hospital from Oct. 1985 to Feb. 1987. The results were as follows: 1. The age was ranged from 17 years to 53 years of age and the majority was between 21 years and 50 years of age. 2. Ultrasonographic findings are classified to fluid collection in cul de sac 17, tuboovarian abscess, 7 pyosalpix 2, endometritis 1 and normal 2 cases. 3. In cases of pelvic mass formation, their ecnogenecity were cystic form in 6 cases (22%), mixed form in 19 cases (71%), solid form in 2 cases (7%), and shapes were mainly ovoid with irregular, ill-defined margin. The location of mass is unilateral in 17 cases (63%) bilateral in 10 cases (37%)

  17. Acute exacerbation of idiopathic pulmonary fibrosis as the initial presentation of the disease

    K. Sakamoto

    2009-06-01

    Full Text Available The clinical course of patients with idiopathic pulmonary fibrosis (IPF is generally marked by a decline in pulmonary function over time, although recently there is increasing recognition that fatal deterioration from acute exacerbation can occur at any stage. The patient described in the present case study was a 65-yr-old male who presented with exertional dyspnoea and fever of 2 weeks' duration. He had no history of chronic lung disease or physiological or radiological hallmarks of pre-existing disease. He underwent surgical lung biopsy and the histological examination showed a background pattern of usual interstitial pneumonia (UIP with a pattern of focal acute diffuse alveolar damage (DAD in the area where normal lung architecture was preserved. It is notable that the pathological diagnosis of this rapidly progressive interstitial pneumonia was DAD on UIP, which is typically seen in acute exacerbations of IPF. Unusual findings on high-resolution computed tomography scan were also noted. We presume that in this case acute exacerbation developed in the very early course of IPF. Given the possibility that similar cases may have arisen among patients diagnosed with acute interstitial pneumonia or acute respiratory distress syndrome, the histopathology of rapidly progressive interstitial pneumonia may need to be revisited.

  18. The role of inflammation and interleukin-1 in acute cerebrovascular disease

    Galea J

    2013-08-01

    Full Text Available James Galea,1 David Brough21Manchester Academic Health Sciences Center, Brain Injury Research Group, Clinical Sciences Building, Salford Royal Foundation Trust, Salford, UK; 2Faculty of Life Sciences, University of Manchester, AV Hill Building, Manchester, UKAbstract: Acute cerebrovascular disease can affect people at all stages of life, from neonates to the elderly, with devastating consequences. It is responsible for up to 10% of deaths worldwide, is a major cause of disability, and represents an area of real unmet clinical need. Acute cerebrovascular disease is multifactorial with many mechanisms contributing to a complex pathophysiology. One of the major processes worsening disease severity and outcome is inflammation. Pro-inflammatory cytokines of the interleukin (IL-1 family are now known to drive damaging inflammatory processes in the brain. The aim of this review is to discuss the recent literature describing the role of IL-1 in acute cerebrovascular disease and to provide an update on our current understanding of the mechanisms of IL-1 production. We also discuss the recent literature where the effects of IL-1 have been targeted in animal models, thus reviewing potential future strategies that may limit the devastating effects of acute cerebrovascular disease.Keywords: cerebral ischemia, stroke, inflammation, microglia, interleukin-1, caspase-1

  19. Serum-mucoid fraction content in development of skin acute radiation necrosis in rats

    Serum-mucoid fraction composition (in polyacrilamide gel) in rats during the different stages of local acute radiation injury of skin (6000 rad irradiation) has been studied. For this injury type during all the periods no appearance of new, unusual for the norm, fractions of serum-mucoids is noted. 2 stages of changes in serum-mucoid fractions have been revealed: the simultaneous increase in the content of all the serum-mucoid components is observed during acute period (bullous dermatitis); during a necrotic period of development of acute skin radiation injury the level of the third fraction increases, the number of the first fraction decreases, the content of the second and forth fractions changes slightly. The level of total serum-mucoids is predominantly determined by the changes of the third fraction, growth of which during the ulcer-necrotic period depends clearly on an injury degree. The determination of the third fraction containing, likely, low molecular haptoglobin in these cases can be of prognostic and diagnostic values

  20. Overexpression of extracellular superoxide dismutase reduces acute radiation induced lung toxicity

    Golson Maria L

    2005-06-01

    Full Text Available Abstract Background Acute RT-induced damage to the lung is characterized by inflammatory changes, which proceed to the development of fibrotic lesions in the late phase of injury. Ultimately, complete structural ablation will ensue, if the source of inflammatory / fibrogenic mediators and oxidative stress is not removed or attenuated. Therefore, the purpose of this study is to determine whether overexpression of extracellular superoxide dismutase (EC-SOD in mice ameliorates acute radiation induced injury by inhibiting activation of TGFβ1 and downregulating the Smad 3 arm of its signal transduction pathway. Methods Whole thorax radiation (single dose, 15 Gy was delivered to EC-SOD overexpressing transgenic (XRT-TG and wild-type (XRT-WT animals. Mice were sacrificed at 1 day, 1 week, 3, 6, 10 and 14 weeks. Breathing rates, right lung weights, total/differential leukocyte count, activated TGFβ1 and components of its signal transduction pathway (Smad 3 and p-Smad 2/3 were assessed to determine lung injury. Results Irradiated wild-type (XRT-WT animals exhibited time dependent increase in breathing rates and right lung weights, whereas these parameters were significantly less increased (p vs. XRT-WT. Conclusion This study shows that overexpression of EC-SOD confers protection against RT-induced acute lung injury. EC-SOD appears to work, in part, via an attenuation of the macrophage response and also decreases TGFβ1 activation with a subsequent downregulation of the profibrotic TGFβ pathway.

  1. Chemical toxicity of uranium hexafluoride compared to acute effects of radiation

    The chemical effects from acute exposures to uranium hexafluoride are compared to the nonstochastic effects from acute radiation doses of 25 rems to the whole body and 300 rems to the thyroid. The analysis concludes that an intake of about 10 mg of uranium in soluble form is roughly comparable, in terms of early effects, to an acute whole body dose of 25 rems because both are just below the threshold for significant nonstochastic effects. Similarly, an exposure to hydrogen fluoride at a concentration of 25 mg/m3 for 30 minutes is roughly comparable because there would be no significant nonstochastic effects. For times t other than 30 minutes, the concentration C of hydrogen fluoride considered to have the same effect can be calculated using a quadratic equation: C = 25 mg/m3 (30 min/t). The purpose of these analyses is to provide information for developing design and siting guideline based on chemical toxicity for enrichment plants using uranium hexafluoride. These guidelines are to be similar, in terms of stochastic health effects, to criteria in NRC regulations of nuclear power plants, which are based on radiation doses. 26 refs., 1 fig., 5 tabs

  2. Advance in clinical research of radiation-induced heart disease

    Radiation-induced heart disease (RIHD) is one of common late side effects derived by thoracic radiotherapy. RIHD is often subclinical and there is an extremely long clinical latent period between radiation therapy and the first clinical presentation of radiation injury, and it did not cause clinical attention for a long time. Until the 1990s, epidemiologic investigations demonstrate that thoracic cancer radiotherapy increased rates of cardiac mortality, RIHD has partly offset the survival benefit provided by adjuvant RT. Radiotherapy techniques has undergone many improvements over the last decades, these improvements decreased both the volume and dose of radiation delivered to the heart, seem to have decreased the incidence of RIHD. Nonetheless, recent studies indicate that the problem of RIHD may persist. For instance, patients with Hodgkin's Disease, lung cancer, and esophageal may still receive either a high dose of radiation to a small part of the heart or a lower dose to the whole heart in radiotherapy. Therefore, long-term cardiac followup of these patients is essential. This article briefly review the clinical presentations, influence factors, prevention and managements, diagnosis and study advances of RIHD. (authors)

  3. Reduction of acute toxicity of the pharmaceutical fluoxetine (Prozac) submitted to ionizing radiation to Vibrio fischeri

    Santos, Dymes R.A.; Garcia, Vanessa S.G.; Vilarrubia, Anna C.S.; Borrely, Sueli I., E-mail: vanessagarcia@usp.br, E-mail: sborrely@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-07-01

    The constant use of pharmaceutical drugs by great part of the population and its continuous input into the environment creates a growing need of investigating its presence, behavior and the effects on aquatic biota, as well as new ways to treat wastewater containing such substances. The fluoxetine hydrochloride (FH) present in the drug Prozac is an active ingredient used in the treatment of depressive and anxiety disorders. Generally, these compounds enter the aquatic environment by sewage collectors systems after undergoing prior treatment in sewage treatment plants (STPs) or without any treatment. This study focused on evaluating the reduction of acute toxicity of the pharmaceutical FH, under its manipulated formula, for the marine bacterium Vibrio fischeri. It was also evaluated the acute toxicity of the aqueous solution containing the FH after its exposition to ionizing radiation from industrial electron accelerator. It was performed acute toxicity tests lasting 15 minutes, where the average EC (50) of the non-irradiated CF water solution was approximately 0.68 mg L-1. While the CF water solution irradiated with 1 kGy, 2.5 kGy, 7.5 kGy and 10 kGy, presented an average EC(50) 1.63 mg.L{sup -1}, 2.34 mg.L{sup -1}, 2.35 mg.L{sup -1} and 1.80 mg.L{sup -1}, respectively, showing a notable reduction of the acute toxicity for this organism. (author)

  4. Reduction of acute toxicity of the pharmaceutical fluoxetine (Prozac) submitted to ionizing radiation to Vibrio fischeri

    The constant use of pharmaceutical drugs by great part of the population and its continuous input into the environment creates a growing need of investigating its presence, behavior and the effects on aquatic biota, as well as new ways to treat wastewater containing such substances. The fluoxetine hydrochloride (FH) present in the drug Prozac is an active ingredient used in the treatment of depressive and anxiety disorders. Generally, these compounds enter the aquatic environment by sewage collectors systems after undergoing prior treatment in sewage treatment plants (STPs) or without any treatment. This study focused on evaluating the reduction of acute toxicity of the pharmaceutical FH, under its manipulated formula, for the marine bacterium Vibrio fischeri. It was also evaluated the acute toxicity of the aqueous solution containing the FH after its exposition to ionizing radiation from industrial electron accelerator. It was performed acute toxicity tests lasting 15 minutes, where the average EC (50) of the non-irradiated CF water solution was approximately 0.68 mg L-1. While the CF water solution irradiated with 1 kGy, 2.5 kGy, 7.5 kGy and 10 kGy, presented an average EC(50) 1.63 mg.L-1, 2.34 mg.L-1, 2.35 mg.L-1 and 1.80 mg.L-1, respectively, showing a notable reduction of the acute toxicity for this organism. (author)

  5. Proprioception in Parkinson's disease is acutely depressed by dopaminergic medications

    O'Suilleabhain, P; Bullard, J; Dewey, R

    2001-01-01

    OBJECTIVES—Impaired proprioception has been previously reported in patients with Parkinson's disease. It was hypothesised that dopaminergic medications transiently depress proprioception, with amplification of adventitious movements as a result. This study tested for effects on proprioception of dopaminergic drugs, and for associations between such effects and drug induced dyskinesias.
METHODS—In 17 patients with Parkinson's disease, arm proprioception was tested in the ...

  6. Psycho-social factors are important for the perception of disease in patients with acute coronary disease

    Bekke-Hansen, Sidsel; Weinman, John; Thastum, Mikael;

    2014-01-01

    INTRODUCTION: Little is presently known about determinants of cardiac illness perceptions, especially regarding psycho-social factors. MATERIAL AND METHODS: Questionnaire study among 97 consecutively recruited inpatients (72.2% male; mean age 60.6 years) with acute coronary syndrome. We examined...... the role of socio-demographic, illness-related and psycho-social factors (Multidimensional Scale of Perceived Social Support, General Self-Efficacy Scale and Life Orientation Test-Revised) for perceived consequences, controllability and causes (Revised Illness Perception Questionnaire) with standard....... Also, gender, educational status, previous heart disease and family history of cardiovascular disease were significantly related to illness perceptions, whereas present disease severity (Global Registry of Acute Coronary Events) was not. CONCLUSION: Psycho-social resources and illness history were more...

  7. Topical betamethasone for the prevention of acute radiation dermatitis in breast cancer patients

    Background: Acute radiation dermatitis is a very common side effect of radiation therapy in large numbers of cancers including breast cancer. Despite high prevalence rate of acute radiation dermatitis and also wet desquamation, a few trials on prophylaxis of this complication using topical treatment have been conducted. Despite effectiveness of topical corticosteroids in treatment of acute radiation dermatitis which are focused in the literature, yet there are some controversy about their usage in this regard. For this reason we attempted to investigate this subject via conducting a clinical trial. Materials and Methods: This trial included 76 patients with pathologic diagnosis of breast cancer for whom radiotherapy has been planned. Patients were 27-70 years old. Patients with radical mastectomy received 5000 cGy within 5 weeks, and those with conservative surgery received 6000 cGy within 6 weeks devided in 200 centigray fractions. Patients were divided randomly into two groups, betamethasone and placebo, 38 patients in each group. In placebo group, 3 patients did not attend for weekly assessment. Additional one patient did not refer during follow-up period. Thus, they were excluded from the study. One group was given betamethasone o.1% and other group was administered base of ointment as placebo. All patient consumed drug or placebo from the 1st day of treatment until one week after treatment completion as twice daily within tangential field. Patients were monitored for assessing dermatitis severity and its symptoms and also possible drug adverse effects one week after the therapy commenced and afterwards by one-week intervals as well as in an appointed day. Three weeks after termination of therapy, patients were also visited, and each examination provided information about dermatologic complications which were registered in the questionnaire. Results: Mean times development of dermatitis in both betamethasone and placebo groups were 3.2500 and 2.2571 (weeks

  8. Medical Management of Acute Radiation Syndromes : Comparison of Antiradiation Vaccine and Antioxidants radioprotection potency.

    Maliev, Slava; Popov, Dmitri; Lisenkov, Nikolai

    Introduction: This experimental study of biological effects of the Antiradiation Vaccine and Antioxidants which were used for prophylaxis and treatment of the Acute Radiation Syndromes caused by high doses of the low-LET radiation. An important role of Reactive Oxyden Species (Singlet oxygen, hydroxyl radicals, superoxide anions and bio-radicals)in development of the Acute Radiation Syndromes could be defined as a "central dogma" of radiobiology. Oxida-tion and damages of lipids, proteins, DNA, and RNA are playing active role in development of postradiation apoptosis. However, the therapeutic role of antioxidants in modification of a postradiation injury caused by high doses of radiation remains controversial.Previous stud-ies had revealed that antioxidants did not increase a survival rate of mammals with severe forms of the Acute Radiation Syndromes caused by High Doses of the low-LET radiation. The Antiradiation Vaccine(ARV) contains toxoid forms of the Radiation Toxins(RT) from the Specific Radiation Determinants Group (SRD). The RT SRD has toxic and antigenic prop-erties at the same time and stimulates a specific antibody elaboration and humoral response form activated acquired immune system. The blocking antiradiation antibodies induce an im-munologically specific effect and have inhibiting effects on radiation induced neuro-toxicity, vascular-toxicity, gastrointestinal toxcity, hematopoietic toxicity, and radiation induced cytol-ysis of selected groups of cells that are sensitive to radiation. Methods and materials: Scheme of experiments: 1. Irradiated animals with development of Cerebrovascular ARS (Cv-ARS), Cardiovascular ARS (Cr-ARS) Gastrointestinal ARS(GI-ARS), Hematopoietic ARS (H-ARS) -control -were treated with placebo administration. 2. Irradiated animals were treated with antioxidants prophylaxisis and treatment of Cv-ARS, Cr-SRS, GI-ARS, Hp-ARS forms of the ARS. 3. irradiated animals were treated with radioprotection by Antiradiation Vaccine

  9. Spontaneous pneumothorax after upper mantle radiation therapy for Hodgkin disease

    Between 1967 and 1981, 158 of 256 consecutive adult patients received upper mantle (UM) radiation therapy as part of initial treatment of Hodgkin disease at the Hamilton Regional Cancer Centre. Chemotherapy was also part of the initial treatment in 21 of 158 patients who received UM radiation therapy. Spontaneous pneumothorax was observed in six of 158 patients during remission after UM radiation therapy in this series. Three cases were incidental findings on follow-up radiographs, but three other patients were seen initially with symptoms of spontaneous pneumothorax. The entity occurred in three of 21 patients (14%) treated with UM radiation therapy and chemotherapy, and in three of 137 (2%) treated with UM radiation therapy (P < .05). Within the range of UM doses (3,500-4,000 cGy in 4 weeks), higher dose was not associated with higher risk of spontaneous pneumothorax. Although these cases of spontaneous pneumothorax are clustered in an age range classic for this entity, the incidence of spontaneous pneumothorax in this group of patients is higher than the anticipated lifetime incidence of 1:500 for the general population. This risk of spontaneous pneumothorax after UM radiation therapy may be even higher in patients who also receive chemotherapy

  10. A CASE REPORT ON SICKLE CELL DISEASE WITH HEMOLYTIC ANEMIA, NEPHROTIC SYNDROME AND ACUTE CHEST SYNDROME

    Putta

    2015-03-01

    Full Text Available Sickle cell disease is an autoimmune hemolytic anemia due to abnormal hemoglobin. Sickling of RBCs occur due to abnormal hemoglobin which leads to vaso - occlusive crisis. This disease manifests as hemolytic anemia, acute chest syndrome, stroke, ischemic leg ulcers and nephrotic syndrome. This patient presented with hemolytic anemia, nephrotic syndrome and acute chest syndrome. This case was diagnosed by electrophoresis of h emoglobin and peripheral smear. This patient recovered with blood transfusion, antibiotics, steroids, diuretics and oxygen inhalation. Sickle cell patients have a known predisposition to bacterial infection, particularly pneumococcal infection. The most si gnificant advance in the therapy of sickle cell anemia has been the introduction of hydroxyurea, but hydroxyurea should be considered in patients experiencing repeated episodes of acute chest syndrome. But in this patient as this is first episode, hydroxyu rea was not given and he recovered well.

  11. Gene rearrangement study for minimal residual disease monitoring in children with acute lymphocytic leukemia

    Juliana Godoy Assumpcao

    2013-01-01

    Full Text Available OBJECTIVE To detect markers for minimal residual disease monitoring based on conventional polymerase chain reaction for immunoglobulin, T-cell receptor rearrangements and the Sil-Tal1 deletion in patients with acute lymphocytic leukemia. METHODS Fifty-nine children with acute lymphocytic leukemia from three institutions in Minas Gerais, Brazil, were prospectively studied. Clonal rearrangements were detected by polymerase chain reaction followed by homo/heteroduplex clonality analysis in DNA samples from diagnostic bone marrow. Follow-up samples were collected on Days 14 and 28-35 of the induction phase. The Kaplan-Meier and multivariate Cox methods were used for survival analysis. RESULTS Immunoglobulin/T-cell receptor rearrangements were not detected in 5/55 children screened (9.0%. For precursor-B acute lymphocytic leukemia, the most frequent rearrangement was IgH (72.7%, then TCRG (61.4%, and TCRD and IgK (47.7%; for T-acute lymphocytic leukemia, TCRG (80.0%, and TCRD and Sil-Tal deletion (20.0% were the most common. Minimal residual disease was detected in 35% of the cases on Day 14 and in 22.5% on Day 28-35. Minimal residual disease on Day 28-35, T-acute lymphocytic leukemia, and leukocyte count above 50 x 109/L at diagnosis were bad prognostic factors for leukemia-free survival in univariate analysis. Relapse risk for minimal residual disease positive relative to minimal residual disease negative children was 8.5 times higher (95% confidence interval: 1.02-70.7. CONCLUSION Immunoglobulin/T-cell receptor rearrangement frequencies were similar to those reported before. Minimal residual disease is an independent prognostic factor for leukemia-free survival, even when based on a non-quantitative technique, but longer follow-ups are needed.

  12. Intensity-Modulated Radiation Therapy Significantly Improves Acute Gastrointestinal Toxicity in Pancreatic and Ampullary Cancers

    Purpose: Among patients with upper abdominal malignancies, intensity-modulated radiation therapy (IMRT) can improve dose distributions to critical dose-limiting structures near the target. Whether these improved dose distributions are associated with decreased toxicity when compared with conventional three-dimensional treatment remains a subject of investigation. Methods and Materials: 46 patients with pancreatic/ampullary cancer were treated with concurrent chemoradiation (CRT) using inverse-planned IMRT. All patients received CRT based on 5-fluorouracil in a schema similar to Radiation Therapy Oncology Group (RTOG) 97-04. Rates of acute gastrointestinal (GI) toxicity for this series of IMRT-treated patients were compared with those from RTOG 97-04, where all patients were treated with three-dimensional conformal techniques. Chi-square analysis was used to determine if there was a statistically different incidence in acute GI toxicity between these two groups of patients. Results: The overall incidence of Grade 3-4 acute GI toxicity was low in patients receiving IMRT-based CRT. When compared with patients who had three-dimensional treatment planning (RTOG 97-04), IMRT significantly reduced the incidence of Grade 3-4 nausea and vomiting (0% vs. 11%, p = 0.024) and diarrhea (3% vs. 18%, p = 0.017). There was no significant difference in the incidence of Grade 3-4 weight loss between the two groups of patients. Conclusions: IMRT is associated with a statistically significant decrease in acute upper and lower GI toxicity among patients treated with CRT for pancreatic/ampullary cancers. Future clinical trials plan to incorporate the use of IMRT, given that it remains a subject of active investigation.

  13. Radiation exposure and the risk of mortality from noncancer respiratory diseases in the life span study, 1950-2005.

    Pham, Truong-Minh; Sakata, Ritsu; Grant, Eric J; Shimizu, Yukiko; Furukawa, Kyoji; Takahashi, Ikuno; Sugiyama, Hiromi; Kasagi, Fumiyoshi; Soda, Midori; Suyama, Akihiko; Shore, Roy E; Ozasa, Kotaro

    2013-11-01

    An apparent association between radiation exposure and noncancer respiratory diseases (NCRD) in the Life Span Study (LSS) of atomic bomb survivors has been reported, but the biological validity of that observation is uncertain. This study investigated the possibility of radiation causation of noncancer respiratory diseases in detail by examining subtypes of noncancer respiratory diseases, temporal associations, and the potential for misdiagnosis and other confounding factors. A total of 5,515 NCRD diagnoses listed as the underlying cause of death on the death certificate were observed among the 86,611 LSS subjects with estimated weighted absorbed lung doses. Radiation dose-response analyses were conducted using Cox proportional hazard regression for pneumonia/influenza, other acute respiratory infections, chronic obstructive pulmonary disease and asthma. The linear excess relative risks (ERR) per gray (Gy) were 0.17 (95% CI 0.08, 0.27) for all NCRD and 0.20 (CI 0.09, 0.34) for pneumonia/influenza, which accounted for 63% of noncancer respiratory disease deaths. Adjustments for lifestyle and sociodemographic variations had almost no impact on the risk estimates. However, adjustments for indications of cancer and/or cardiovascular disease decreased the risk estimates, with ERR for total noncancer respiratory diseases declined by 35% from 0.17 to 0.11. Although it was impossible to fully adjust for the misdiagnosis of other diseases as noncancer respiratory diseases deaths in this study because of limitations of available data, nevertheless, the associations were reduced or eliminated by the adjustment that could be made. This helps demonstrates that the association between noncancer respiratory diseases and radiation exposure in previous reports could be in part be attributed to coincident cancer and/or cardiovascular diseases. PMID:24148011

  14. The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease

    Seckeler, Michael D.; Hoke, Tracey R

    2011-01-01

    Michael D Seckeler, Tracey R HokeDepartment of Pediatrics, Division of Cardiology, University of Virginia, Charlottesville, VA, USAAbstract: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are significant public health concerns around the world. Despite decreasing incidence, there is still a significant disease burden, especially in developing nations. This review provides background on the history of ARF, its pathology and treatment, and the current reported worldwide incidence...

  15. Association between Periodontal Disease and Elevated C-reactive Protein in Acute Myocardial Infarction Patients

    G. Radafshar; B. Shad; M. Mirfeizi

    2006-01-01

    Statement of problem: Periodontal disease (PD) has been linked to adverse cardiovascular events by unknown mechanisms. C-reactive protein (CRP) is a prognostic marker for cardiovascular disease, with reported elevated serum levels during PD.Purpose: The aim of the present study was to evaluate the association between PD and higher CRP levels in the serum of acute myocardial infarction (AMI) patients.Materials and Methods: In this cross-sectional study, periodontal examinations and CRP serum l...

  16. [Sweet syndrome (acute febrile neutrophilic dermatosis) and erythema nodosum in Crohn disease].

    Schlegel Gómez, R; Kiesewetter, F; von den Driesch, P; Hornstein, O P

    1990-07-01

    We report on 2 patients who developed an acute febrile neutrophilic dermatosis (Sweet's syndrome) and erythema nodosum in association with Crohn's disease. The first patient showed symmetrical painful erythemas on her cheeks after hemicolectomy. Additionally, red painful nodules appeared on her lower legs. The second patient disclosed typical Sweet's syndrome-like lesions with pustules and plaques on her face, scalp and extremities after activation of Crohn's disease. Simultaneously, erythema nodosum-like lesions appeared on her lower legs. PMID:2144848

  17. Sympathoadrenal activation and endothelial damage in patients with varying degrees of acute infectious disease

    Ostrowski, Sisse R; Gaïni, Shahin; Pedersen, Court;

    2015-01-01

    infectious disease severity, correlated with SOFA score, and predicted mortality together with plasma noradrenaline. Sympathoadrenal activation......PURPOSE: To investigate levels, associations between, and predictive value of plasma catecholamines and biomarkers of endothelial damage in patients with acute infectious illness stratified according to infection type and sepsis severity. MATERIAL AND METHODS: This is a post hoc study of plasma...... with increasing disease severity (both P

  18. Acute myocardial ischemia in adults secondary to missed Kawasaki disease in childhood

    Rizk, SRY; El Said, G; Daniels, LB; Burns, JC; El Said, H; Sorour, KA; Gharib, S; Gordon, JB

    2015-01-01

    © 2015 Elsevier Inc. All rights reserved. Coronary artery aneurysms that occur in 25% of untreated Kawasaki disease (KD) patients may remain clinically silent for decades and then thrombose resulting in myocardial infarction. Although KD is now the most common cause of acquired heart disease in children in Asia, the United States, and Western Europe, the incidence of KD in Egypt is unknown. We tested the hypothesis that young adults in Egypt presenting with acute myocardial ischemia may have ...

  19. Crypt abscess-associated microbiota in inflammatory bowel disease and acute self-limited colitis

    Harry; Sokol; Nadia; Vasquez; Nadia; Hoyeau-Idrissi; Philippe; Seksik; Laurent; Beaugerie; Anne; Lavergne-Slove; Philippe; Pochart; Philippe; Marteau

    2010-01-01

    AIM:To evaluate whether crypt abscesses frominflammatory bowel disease(IBD)patients containbacteria and to establish their nature.METHODS:We studied 17 ulcerative colitis patients,11 Crohn's disease patients,7 patients with acute selflimited colitis(ASLC)and normal colonic biopsies from5 subjects who underwent colonoscopy for colon cancer screening.A fluorescent in situ hybridization techniquewas applied to colonic biopsies to assess the microbiotacomposition of the crypts and crypt abscesses.RESULTS:Crypts...

  20. Bacteriology in acute exacerbation of chronic obstructive pulmonary disease in patients admitted to hospital

    Larsen, Mette V; Janner, Julie H; Nielsen, Susanne D; Friis-Møller, Alice; Ringbaek, Thomas; Lange, Peter

    2009-01-01

    We investigated the bacterial flora and antimicrobial sensitivity in sputum from patients admitted to hospital with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in order to recommend the best empirical treatment for these patients. The survey was a retrospective study of a...... AECOPD we recommend either cefuroxime for intravenous treatment or amoxicillin-clavulanate for oral treatment....

  1. Circulating endothelial cells in coronary artery disease and acute coronary syndrome

    Schmidt, David E; Manca, Marco; Höfer, Imo E

    2015-01-01

    Circulating endothelial cells (CECs) have been put forward as a promising biomarker for diagnosis and prognosis of coronary artery disease and acute coronary syndromes. This review entails current insights into the physiology and pathobiology of CECs, including their relationship with circulating en

  2. Poloxamer 188 and antioxidants prevent acute radiation necrosis of adult skeletal muscle cells

    Full text: To date there are no effective therapeutic agents widely available for acute radiation sickness. Acute cellular necrosis occurring minutes to hours after exposure to high doses of ionizing radiation (IR) results from rapid membrane lipid peroxidation, blebbing and membrane breakdown. Not only can repairing the membrane prevent acute necrosis, but it can also provide a critical time period to address other mechanisms of cell death, such as apoptosis or mitotic arrest, which manifest over a longer time frame. We have previously shown that certain polymer surfactants can restore structural integrity and transport barrier function of cell membranes following high-dose IR. We now present data showing that the amphiphillic surfactant Poloxamer 188 (P188), a tri-block copolymer composed of two hydrocephalic blocks separated by a hydrophobic central block, has efficacy in preventing acute necrosis of adult rat skeletal muscle cells after high-dose IR and that at doses in which P188 is effective, adding the antioxidant ascorbate or n-acetyl cysteine further increases cell survival. Explanted rat flexor digitoum brevis muscle cells received 10, 40 or 40 Gy IR from Co 60 in a 21% oxygen atmosphere and their viability was determined using fluorometric probes (Calcein-AM and Ethidium homodimer) at 4 and 18 hours after IR. Compared to unirradiated cells, 10 Gy did not cause acute necrosis. Significant acute necrosis was observed after 40 and 80 Gy in a dose-dependent manner. Post-IR treatment with P188 significantly enhanced the cells' viability. By comparison, treating with 10 kDa neutral Dextran, a purely hydrophilic polymer, was not found to be effective. Despite progressive cell death over 18 h after high-dose IR, cells treated with P188 showed greater survival than cells grown only in media or Dextran-treated cells. Cells treated with 40 Gy survived better than those treated with 80 Gy, indicating some limits to the efficacy of treatment with P188. Cells

  3. Does ionizing radiation influence Alzheimer's disease risk?

    Alzheimer's disease (AD) is a human neurodegenerative disease, and its global prevalence is predicted to increase dramatically in the following decades. There is mounting evidence describing the effects of ionizing radiation (IR) on the brain, suggesting that exposure to IR might ultimately favor the development of AD. Therefore better understanding the possible connections between exposure to IR and AD pathogenesis is of utmost importance. In this review, recent developments in the research on the biological and cognitive effects of IR in the brain will be explored. Because AD is largely an age-related pathology, the effects of IR on ageing will be investigated

  4. Clinical study on the effect of Yangyinjiandu decoction on acute radiation esophagitis

    Objective: To investigate the effect of Yangyinjiandu decoction for acute radiation esophagitis. Methods: Lung cancer and mediastinal tumor treated by radiotherapy(portals including oesophagus to a radical tumoricidal dose≥40 Gy, with≥10 cm oesophagus include in radiotherapy). Patients were randomly divided according to the time of acceptance into the treatment group and the control group. All parameters of the two groups were basically similar and comparable. The treatment group was given Yangyinjiandu decoction (one dose daily, water decoction, 200 ml, twice a day) taken in the morning and in the evening before the end of radiotherapy. The control group was given oral vitamin C tablet 100 mg once a day before the end of radiotherapy. Five days after radio-therapy, the control group took oral prednisone 5 mg three times a day and amoxicillin 5g three times a day. All the above medicines were continued for 7 days. Results: The commencement of complication was 14.86 ± 0.34 days in the treatment group and 13.55 ± 0.26 days in the control group (P<0.01). The degree of complication was significant]y less mild in the treated group than the control group. Complication of acute group II and III radiation esophagitis rates were 5 and 0 in the treatment group and 16 and 6 in the control group (P<0.05). The overall effective rate were 95.2% and marked effective rate 12.0% of the treated group but were statistically higher than those of the control group. Conclusions: Yangyinjiandu decoction is effective and better reliable in treating acute radiation esophagitis. (authors)

  5. Prostate Hypofractionated Radiation Therapy With Injection of Hyaluronic Acid: Acute Toxicities in a Phase 2 Study

    Chapet, Olivier, E-mail: olivier.chapet@chu-lyon.fr [Department of Radiation Oncology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Benite (France); EMR3738, Université Lyon 1, Lyon (France); Decullier, Evelyne; Bin, Sylvie [Pole Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon (France); Université Lyon 1, Lyon (France); EA SIS, Université de Lyon, Lyon (France); Faix, Antoine [Department of Urology, Clinique Beausoleil, Montpellier (France); Ruffion, Alain [Université Lyon 1, Lyon (France); Department of Urology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Benite (France); Jalade, Patrice [Department of Medical Physics, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Benite (France); Fenoglietto, Pascal [Department of Radiation Oncology and Physics, Institut du Cancer de Montpellier, Montpellier (France); Udrescu, Corina; Enachescu, Ciprian [Department of Radiation Oncology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Benite (France); Azria, David [Department of Radiation Oncology and Physics, Institut du Cancer de Montpellier, Montpellier (France)

    2015-03-15

    Purpose: Hypofractionated radiation therapy (RT) in prostate cancer can be developed only if the risk of rectal toxicity is controlled. In a multicenter phase 2 trial, hypofractionated irradiation was combined with an injection of hyaluronic acid (HA) to preserve the rectal wall. Tolerance of the injection and acute toxicity rates are reported. Methods and Materials: The study was designed to assess late grade 2 toxicity rates. The results described here correspond to the secondary objectives. Acute toxicity was defined as occurring during RT or within 3 months after RT and graded according to the Common Terminology Criteria for Adverse Events version 4.0. HA tolerance was evaluated with a visual analog scale during the injection and 30 minutes after injection and then by use of the Common Terminology Criteria at each visit. Results: From 2010 to 2012, 36 patients with low-risk to intermediate-risk prostate cancer were included. The HA injection induced a mean pain score of 4.6/10 ± 2.3. Thirty minutes after the injection, 2 patients still reported pain (2/10 and 3/10), which persisted after the intervention. Thirty-three patients experienced at least 1 acute genitourinary toxicity and 20 patients at least 1 acute gastrointestinal toxicity. Grade 2 toxicities were reported for 19 patients with urinary obstruction, frequency, or both and for 1 patient with proctitis. No grade 3 or 4 toxicities were reported. At the 3-month visit, 4 patients described grade 2 obstruction or frequency, and no patients had any grade 2 gastrointestinal toxicities. Conclusions: The injection of HA makes it possible to deliver hypofractionated irradiation over 4 weeks with a dose per fraction of > 3 Gy, with limited acute rectal toxicity.

  6. Prostate Hypofractionated Radiation Therapy With Injection of Hyaluronic Acid: Acute Toxicities in a Phase 2 Study

    Purpose: Hypofractionated radiation therapy (RT) in prostate cancer can be developed only if the risk of rectal toxicity is controlled. In a multicenter phase 2 trial, hypofractionated irradiation was combined with an injection of hyaluronic acid (HA) to preserve the rectal wall. Tolerance of the injection and acute toxicity rates are reported. Methods and Materials: The study was designed to assess late grade 2 toxicity rates. The results described here correspond to the secondary objectives. Acute toxicity was defined as occurring during RT or within 3 months after RT and graded according to the Common Terminology Criteria for Adverse Events version 4.0. HA tolerance was evaluated with a visual analog scale during the injection and 30 minutes after injection and then by use of the Common Terminology Criteria at each visit. Results: From 2010 to 2012, 36 patients with low-risk to intermediate-risk prostate cancer were included. The HA injection induced a mean pain score of 4.6/10 ± 2.3. Thirty minutes after the injection, 2 patients still reported pain (2/10 and 3/10), which persisted after the intervention. Thirty-three patients experienced at least 1 acute genitourinary toxicity and 20 patients at least 1 acute gastrointestinal toxicity. Grade 2 toxicities were reported for 19 patients with urinary obstruction, frequency, or both and for 1 patient with proctitis. No grade 3 or 4 toxicities were reported. At the 3-month visit, 4 patients described grade 2 obstruction or frequency, and no patients had any grade 2 gastrointestinal toxicities. Conclusions: The injection of HA makes it possible to deliver hypofractionated irradiation over 4 weeks with a dose per fraction of > 3 Gy, with limited acute rectal toxicity

  7. Managing the acute painful episode in sickle cell disease

    B. Kaya

    2011-12-01

    Full Text Available Sickle cell pain is a complex but frequently experienced symptom. Acute painful events in children can be managed effectively in the community with appropriate support and education. If hospital management is required, rapid access to a consistent, reliable and safe analgesic pathway is recommended to ensure a good standard of care. Use of oral opiates in addition to short acting easily administrable forms of analgesia and strict adherence to protocoled monitoring will enable the acute event to be well managed and the negative pain experience minimised. An important part of the outpatient evaluation is determining the impact pain events are having on the child’s quality of life. Addressing psycho-social aspects, defining and modifying precipitating factors, if any are identified, and having a holistic approach to pain management is helpful. Education and use of self-management techniques can also be productive. Use of sickle modifying interventions such as hydroxycarbamide therapy or transfusion therapy can have a significant impact on reducing the severity and frequency of the acute pain event. 镰状细胞疼痛是一种复杂的常发症。 通过适当的支助和教育,儿童急性疼痛症可以得到有效抑制。 如果需要在医院进行护理,患者应尽快寻求持续可靠且安全的止痛方式,确保良好的护理。 除采取作用短、管理方便的止痛治疗和遵守监测协议之外,患者还需口服鸦片剂,这样,急性症状可以得到良好的抑制,还可尽量减轻疼痛感。 诊断门诊病人一个重要的部分就是确定疼痛症对患儿生活质量产生的影响。 问询生理社会方面问题,确定和修改诱发因子(如有),并整体分析可行的疼痛护理方法。 教育和使用个人护理法也很有效果。 采用镰状细胞修改干预法,例如羟基尿素疗法或输液疗法,对减轻急性疼痛症和减少发作频率有着显著效果。

  8. ACUTE PHASE REACTANCTS IN PERICARDIAL FLUID ARE INDICATORS OF CORONARY ARTERY DISEASE

    Yılmaz Mehmet Ali

    2012-12-01

    Full Text Available Inflammation in formation of atherosclerosis, and acute phase reactants in the site of inflammation have major functions. Thus, do the acute phase reactants constitute the biggest risk factor for coronary artery disease? 55 patients are included in the study. Patients with coronary artery bypass surgery are included in Group I (38 patients and patients with valve operation are included in Group II (17 patients. CABG patients are further divided into two sub-groups as on-pump and off-pump. In both groups, homocystein, high sensitivity C reactive protein, ceruloplasmin, lipoprotein A and serum amyloid A protein levels are analyzed from blood and pericardial fluid. In patients with coronary artery disease, the measured high specific C- reactive protein levels from blood and pericardial fluid are found to be significantly high compared to patients with valve operation.Homocystein levels of pericardial fluids of patients with CABG are found to be higher than patients with valve operation and it is confirmed that the situation is correlated with blood homocystein levels. Although there are lots studies expressing the relation between coronary artery disease and lipoprotein A, ceruloplasmin and serum amyloid A protein levels; no significant difference for those parameters was obtained in our study. We determined that other phase reactants are higher in patients with coronary artery disease, in accordance with the literature. We aimed to state that acute phase reactants not only increase as a result of disease, but their levels are also elevated beforehand, as an indicator of the disease.

  9. Production and utilization of radiation vaccines against helminthic diseases

    Helminthic diseases in man and in animals are various and widespread, but to date the only successful vaccines to be developed against helminths are those based on the radiation treatment of infective larvae. A panel of experts met in Vienna in December 1963 to consider how the IAEA might support and encourage developments in this field. The present report gathers together some of the important contributions of the Panel members together with the general conclusions and recommendations. 77 refs, 19 figs, 16 tabs

  10. Pathobiochemical, hematological and immunological findings in pigs with an acute radiation syndrome showing only a few clinical symptoms. 1

    The acute radiation syndrome showing only a few clinical symptoms was examined using biochemical tests. Store pigs received a whole-body irradiation of 2 Gy (200 rad). 11 biochemical tests were used for plasma and the whole blood. Activity changes were observed in the enzymes ALD, LDH, GOT and CPK after irradiation. The results show that despite of only a few clinical symptoms of the radiation syndrome considerable enzyme changes reveal individually differing radiation effects. (author)

  11. Late sequelae of preventive radiation and chemotherapy of the cerebral cranium in children with acute leukemia

    In 15 children, combined treatment of the cerebral crane (irradiation + cytostatics) was done for acute leukemia, using Pinkel's or Riehm's method. In order to judge of late sequelae on the brain tissue. the cerebral crane was explored by means of computed tomography, generally more than a year later. Of 15 children 1o revealed slight or important parenchymal alterations being imputable to the former therapy. A possible augmentation of the sensitivity to radiation due to combined chemotherapy is discussed, and a revisal of therapeutic schedules, therefore, is recommended. (orig.) 891 MG/orig. 892 MKO

  12. Cytogenetic effects of acute gamma radiation on leaf and apical meristem of scotch pine

    Tikhomirov, F.A.; Fedotov, I.S.; Prister, B.S.; Remezova, M.M.

    1977-01-01

    A study was made of the effect of acute ..gamma..-radiation on incidence of chromosomal aberrations in apical and leaf meristem of the pine in the first and second postradiation vegetation periods. It was found that the radiosensitivity of these tissues is the same. In the second postradiation vegetation period, after exposure to a dosage of 1500-2500 rad, there is normalization of the parameters studied. Restitution of tissues can occur both as a result of recovery of involved meristem cells and by means of differentiation of subapical meristem cells.

  13. Involvement of histamine released from mast cells in acute radiation dermatitis in mice

    A possible involvement of histamine in acute radiation dermatitis in mice was investigated. The dose of 40 Gy of gamma irradiation induced erythema and edema in C57BL/6 mice treated with vehicle. However, in C57BL/6 mice treated with chlorpheniramine and WBB6F1-W/WV mice, erythema and edema were not observed. In all of these mice, epilation and dry desquamation were induced, but bepotastine significantly reduced the extent of these areas. These results suggest that gamma irradiation-induced erythema and edema were caused by histamine released from mast cells via histamine H1 receptor, and epilation was induced by other inflammatory mediators. (author)

  14. Myelodysplastic syndrome. A blood disease of high risk to radiation

    Myelodysplastic syndrome (MDS) is reviewed on its classification, diagnosis, therapy, prognosis, patho-physiology, causes and relation to radiation, mainly from radiation biology aspect. MDL is a cryptogenic, progressive and refractory blood disease with abnormal morphology and dysfunction of cells of bone marrow and peripheral blood and often results in leukemia. Epidemiology shows that radiation is a potent cause of MDL as well as chemotherapy to malignant diseases and that in Hiroshima and Nagasaki A-bomb survivors, leukemia risk is linearly correlated with their exposed dose. In Hiroshima survivors, the excessive relative risk of MDL per Sv (ERR1Sv) is preliminarily reported to be as high as 13 and MDL patients is reportedly increasing in Chernobyl. T-lymphocytes from MDL patients are found more sensitive to X-ray in the micronucleus assay. However, direct causal gene(s) are obscure now. Cause and pathology of MDL are expected solved by future elucidation of gene expression concerned with radiation response and DNA repair, and of subsequent change of functional protein products. (K.H.)

  15. Diminution of acute radiation reaction of mouse skin with low-intensity infrared laser/red diodes-emitted light

    Efficiency of the application of different regimes of laser treatment of radiation-induced skin reactions in mice feet is compared. Posterior limb feet of mice were exposed to acute X radiation at 30-36 Gy dose or fractionated radiation at 45 Gy dose. In the day of primary irradiation or different time later the feet were treated using magnetic infrared laser therapeutic MILTA-01 apparatus. Magnetic and light components of the MILTA-01 apparatus reduce the effect of radiation on mice skin corresponding two time decrease in X-radiation dose

  16. Ultraviolet radiation and autoimmune disease: insights from epidemiological research

    This review examines the epidemiological evidence that suggests ultraviolet radiation (UVR) may play a protective role in three autoimmune diseases: multiple sclerosis, insulin-dependent diabetes mellitus and rheumatoid arthritis. To date, most of the information has accumulated from population studies that have studied the relationship between geography or climate and autoimmune disease prevalence. An interesting gradient of increasing prevalence with increasing latitude has been observed for at least two of the three diseases. This is most evident for multiple sclerosis, but a similar gradient has been shown for insulin-dependent diabetes mellitus in Europe and North America. Seasonal influences on both disease incidence and clinical course and, more recently, analytical studies at the individual level have provided further support for a possible protective role for UVR in some of these diseases but the data are not conclusive. Organ-specific autoimmune diseases involve Th1 cell-mediated immune processes. Recent work in photoimmunology has shown ultraviolet B (UVB) can specifically attenuate these processes through several mechanisms which we discuss. In particular, the possible contribution of an UVR-induced increase in serum vitamin D (1,25(OH)2D3) levels in the beneficial immunomodulation of these diseases is discussed

  17. Radiation induced sublethal acute symptoms appeared in a medical student who entered Hiroshima 3 days after the bombing

    An original note entitled My Experience of the ''Atomic bomb disease'' by the student in the title, confirmed to exist in the US National Archives and Records Administration, was reviewed and discussed about the exposed dose. He entered the area of Hiroshima City within 2 km distance to the hypocenter on Aug 9, 1945, began to work in a medical aid station for relief and body deal, experienced there the serious malaise, nausea, headache, throat pain and swelling of gums, and on 15, lost consciousness. Thereafter, under the treatment, pain of salivary gland, hyperthermia, unconsciousness, headache, purulence, and pain in the oral cavity appeared occasionally and/or persistently until October or later. These symptoms are virtually consistent with those of acute radiation exposure syndrome, and especially the pain of salivary gland is known to be a particular symptom due to high dose. The process suggests that the dose he was exposed to is conceivably 2-5 Gy. His note was first evaluated from the aspect of dose estimation and strongly suggested the necessity of reconsideration of the present dose assessment of residual radiation in people who had entered the city. (T.T.)

  18. Treatment disparities in acute coronary syndromes, heart failure, and kidney disease.

    McCullough, Peter A; Maynard, Robert C

    2011-01-01

    It has been consistently observed that patients with renal dysfunction have more premature, severe, complicated, and fatal cardiovascular disease than age- and sex-matched individuals with normal renal function. There have been 4 major explanations for this finding: (1) positive confounding by third variables associated with chronic kidney disease (CKD), including diabetes mellitus and hypertension; (2) therapeutic nihilism or lesser use of beneficial therapies in CKD; (3) greater toxicities of therapies, such as bleeding from anticoagulants or contrast-induced kidney injury; (4) biological factors which result directly from CKD that work to promote and accelerate cardiovascular disease. In this paper, we focus on the issue of treatment disparities or therapeutic nihilism and its contribution to poor outcomes in the setting of acute coronary syndromes and acutely decompensated heart failure. This issue is important because if we can overcome barriers to the utilization of beneficial treatments, then clinical outcomes should improve over time. PMID:21625092

  19. Acute radiation syndrome (ARS – treatment of the reduced host defense

    Heslet L

    2012-01-01

    Full Text Available Lars Heslet1, Christiane Bay2, Steen Nepper-Christensen31Serendex ApS, Gentofte; 2University of Copenhagen, Medical Faculty, Copenhagen; 3Department of Head and Neck Surgery, Otorhinolaryngology, Køge University Hospital, Køge, DenmarkBackground: The current radiation threat from the Fukushima power plant accident has prompted rethinking of the contingency plan for prophylaxis and treatment of the acute radiation syndrome (ARS. The well-documented effect of the growth factors (granulocyte colony-stimulating factor [G-CSF] and granulocyte-macrophage colony-stimulating factor [GM-CSF] in acute radiation injury has become standard treatment for ARS in the United States, based on the fact that growth factors increase number and functions of both macrophages and granulocytes.Methods: Review of the current literature.Results: The lungs have their own host defense system, based on alveolar macrophages. After radiation exposure to the lungs, resting macrophages can no longer be transformed, not even during systemic administration of growth factors because G-CSF/GM-CSF does not penetrate the alveoli. Under normal circumstances, locally-produced GM-CSF receptors transform resting macrophages into fully immunocompetent dendritic cells in the sealed-off pulmonary compartment. However, GM-CSF is not expressed in radiation injured tissue due to defervescence of the macrophages. In order to maintain the macrophage’s important role in host defense after radiation exposure, it is hypothesized that it is necessary to administer the drug exogenously in order to uphold the barrier against exogenous and endogenous infections and possibly prevent the potentially lethal systemic infection, which is the main cause of death in ARS.Recommendation: Preemptive treatment should be initiated after suspected exposure of a radiation dose of at least ~2 Gy by prompt dosing of 250–400 µg GM-CSF/m2 or 5 µg/kg G-CSF administered systemically and concomitant inhalation of

  20. Acute and delayed radiation injuries in the small intestine and colon

    The group of patients with severe actinic intestinal injuries consists of 67 patients, 46 female and 21 male. The main indication of irradiation were gynaecologic tumours with 67%. The irradiation was carried out with a telekobalt unit combined with radium. From the pathogenetic point of view, acute inflammation and necrobiotic processes in the intestinal mucosa and a restriction of the ability to regenerate are the main radiation-induced acute injuries; delayed injuries are mainly the narrowing and rarefaction of the vessels with lacking capillary budding. The cause of the completely different intervals of up to 26 years until the manifestation of the delayed injury remained unclear. The majority of the delayed symptoms were unspecific; therefore, the danger of misinterpretation was pointed out. A resection with primary anastomosis of the ends of the intestines is the goal to be reached operation-technically. The postoperative complication rate was 45.0%. The most frequent complications were the recurrence of a fistula and the formation of a new fistula, respectively, followed by anastomotic and wound insufficiency, and gastrointestinal bleedings. The postoperative lethality was 18.3%. The causes of death were, according to their frequency, peritonitis, acute failure of the coronary circulation, pneumonia, and massive bleedings. (orig./MG)

  1. Celiac disease unmasked by acute severe iron deficiency anemia

    Marcelle G. Meseeha; Maximos N. Attia; Kolade, Victor O.

    2016-01-01

    The prevalence of celiac disease (CD) appears to be increasing in the United States. However, the proportion of new CD cases with atypical presentations is also rising. We present the case of a 49-year-old woman who was diagnosed with CD in the setting of new, severe iron-deficiency anemia, 13 years into treatment of diarrhea-predominant irritable bowel syndrome associated with chronic mildly elevated liver function tests. While CD and iron deficiency anemia are common, this is a rare present...

  2. Celiac disease unmasked by acute severe iron deficiency anemia

    Meseeha, Marcelle G.; Attia, Maximos N.; Kolade, Victor O.

    2016-01-01

    The prevalence of celiac disease (CD) appears to be increasing in the United States. However, the proportion of new CD cases with atypical presentations is also rising. We present the case of a 49-year-old woman who was diagnosed with CD in the setting of new, severe iron-deficiency anemia, 13 years into treatment of diarrhea-predominant irritable bowel syndrome associated with chronic mildly elevated liver function tests. While CD and iron deficiency anemia are common, this is a rare presentation of CD. PMID:27406450

  3. Acute chondrolysis complicating Legg-Calve-Perthes disease

    Of 270 children with Legg-Calve-Perthes (LCP) disease, roentgenographic evidence of chondrolysis was noted in 12 (4.5%) within one year after diagnosis and appropriate management. Only in six hips of these 12 patients did the retrospective clinical, histological, and orthopedic findings fulfill the diagnostic requirements for chondrolysis. Sequential roentgenographic findings included initial periarticular osteoporosis and subchondral cortical irregularities, subsequent narrowing of the joint space, premature fusion of the growth plate, and eventual development of degenerative arthritis. The early roentgenographic recognition of chondrolysis is emphasized because it has an untoward effect on the prognosis of LCP and should therefore prompt a different orthopedic approach. (orig.)

  4. The burden of acute disease in Mahajanga, Madagascar - a 21 month study.

    Vijay C Kannan

    Full Text Available Efforts to develop effective and regionally-appropriate emergency care systems in sub-Saharan Africa are hindered by a lack of data on both the burden of disease in the region and on the state of existing care delivery mechanisms. This study describes the burden of acute disease presenting to an emergency unit in Mahajanga, Madagascar.Handwritten patient registries on all emergency department patients presenting between 1 January 2011 and 30 September 2012 were reviewed and data entered into a database. Data included age, sex, diagnosis, and disposition. We classified diagnoses into Clinical Classifications Software (CCS multi-level categories. The population was 53.5% male, with a median age of 31 years. The five most common presenting conditions were 1 Superficial injury; contusion, 2 Open wounds of head; neck; and trunk, 3 Open wounds of extremities, 4 Intracranial injury, and 5 Unspecified injury and poisoning. Trauma accounted for 48%, Infectious Disease for 15%, Mental Health 6.1%, Noncommunicable 29%, and Neoplasms 1.2%. The acuity seen was high, with an admission rate of 43%. Trauma was the most common reason for admission, representing 19% of admitted patients.This study describes the burden of acute disease at a large referral center in northern Madagascar. The Centre Hôpitalier Universitaire de Mahajanga sees a high volume of acutely ill and injured patients. Similar to other reports from the region, trauma is the most common pathology observed, though infectious disease was responsible for the majority of adult mortality. Typhoid fever other intestinal infections were the most lethal CCS-coded pathologies. By utilizing a widely understood classification system, we are able to highlight contrasts between Mahajanga's acute and overall disease burden as well as make comparisons between this region and the rest of the globe. We hope this study will serve to guide the development of context-appropriate emergency medicine systems in the

  5. The prevalence of natural health product use in patients with acute cardiovascular disease.

    Aws Alherbish

    Full Text Available BACKGROUND: Natural health products (NHP use may have implications with respect to adverse effects, drug interactions and adherence yet the prevalence of NHP use by patients with acute cardiovascular disease and the best method to ascertain this information is unknown. OBJECTIVE: To identify the best method to ascertain information on NHP, and the prevalence of use in a population with acute cardiovascular disease. METHODS: Structured interviews were conducted with a convenience sample of consecutive patients admitted with acute cardiovascular disease to the University of Alberta Hospital during January 2009. NHP use was explored using structured and open-ended questions based on Health Canada's definition of NHP. The medical record was reviewed, and documentation of NHP use by physicians, nurses, and pharmacists, compared against the gold-standard structured interview. RESULTS: 88 patients were interviewed (mean age 62 years, standard deviation [SD 14]; 80% male; 41% admitted for acute coronary syndromes. Common co-morbidities included hypertension (59%, diabetes (26% and renal impairment (19%. NHP use was common (78% of patients and 75% of NHP users reported daily use. The category of NHP most commonly used was vitamins and minerals (73% followed by herbal products (20%, traditional medicines including Chinese medicines (9%, homeopathic preparations (1% and other products including amino acids, essential fatty acids and probiotics (35%. In a multivariable model, only older age was associated with increased NHP use (OR 1.5 per age decile [95%CI 1.03 to 2.2]. When compared to the interview, the highest rate of NHP documentation was the pharmacist history (41%. NHP were documented in 22% of patients by the physician and 19% by the nurse. CONCLUSIONS: NHP use is common in patients admitted with acute cardiovascular disease. However, health professionals do not commonly identify NHP as part of the medication profile despite its potential importance

  6. Lethal acute demyelinization with encephalo-myelitis as a complication of cured Cushing's disease.

    Chevalier, N; Hieronimus, S; Vandenbos, F; Delmont, E; Cua, E; Cherick, F; Paquis, P; Michiels, J-F; Fenichel, P; Brucker-Davis, F

    2010-12-01

    Cushing's disease is usually associated with higher mortality rate, especially from cardiovascular causes. Development or exacerbation of autoimmune or inflammatory diseases is known to occur in patients with hypercortisolism after cure. We report for the first time a 34-year old woman with a psychiatric background, who developed four months after the surgical cure of Cushing's disease an acute disseminated encephalomyelitis (ADEM) presenting initially as a psychiatric illness. We hypothesize that the recent correction of hypercortisolism triggered ADEM and that the atypical presentation, responsible for diagnosis delay, led to the death of this patient. PMID:20850107

  7. Acute coronary syndrome after infliximab therapy in a patient with Crohn's disease

    Vasilios Panteris; Anna Perdiou; Vasilios Tsirimpis; Demetrios Georgios Karamanolis

    2006-01-01

    Infliximab is a potent anti-TNF antibody, which is used with great success in Crohn's disease patients. Since its release in clinical practice, several adverse reactions have been observed. The interest in possible consequences of its administration is still high because of the recent introduction of the drug for the long-term maintenance therapy of refractory luminal and fistulizing Crohn's disease. We present a case of acute coronary syndrome (non-STEMI) in a patient with corticoid resistant Crohn's disease after his first dose of infliximab. By reviewing the scant articles that exist in the literature on this topic we made an effort to delineate the possible mechanisms of this phenomenon.

  8. Immune Mechanisms of Mesenchymal Stem Cell Therapy for Acute Graft versus Host Disease

    Tobin, Laura M.

    2012-01-01

    The aim of this work was to investigate the role of Mesenchymal stem cells (MSC) in the modulation of immune responses, focusing on suppression and induction of immune tolerance. To date, MSC therapy has proved beneficial for the treatment of inflammatory and autoimmune diseases, such as acute Graft versus Host Disease (aGvHD) and Crohn’s disease. However, the exact mechanisms of therapeutic benefit remain unclear. The key goals of this study were to identify the role of MSC derived soluble a...

  9. Acute and late morbidity of radiation therapy in women with large pendulous breasts treated with a breast positioning ring

    Purpose: A breast positioning ring to facilitate the treatment of large/flaccid breasts has been previously described (Bentel, IJROBP 29: 879, 1994). This ring aids in the radiation treatment of patients with large pendulous breasts by positioning the breast in a more desirable location/shape on the chestwall. In general, the ring reduces skin folds and the volume of lung included in the tangential fields. We herein report the acute and late morbidity of radiation therapy in women treated with this ring. Materials and Methods: Between 9/91 and 2/97, fifty-two patients with large and/or pendulous breasts were treated using a breast positioning ring consisting of a hollow plastic tube wrapped around the base of the breast and supported by a strap. Patients generally received 46 Gy to the whole breast in 23 fractions using opposed tangential 6 MV photon fields, followed by a tumor bed boost of 16 Gy with an en face electron field. Acute and late (≥ 1 year FU) morbidity was assessed by reviewing the patients' records. Patients experiencing acute moist desquamation and these requiring a treatment break were noted. Late morbidity included pain, induration, changes in breast size or color. Cosmetic results were scored by both physicians and patients. The incidence of morbidity was correlated with patient weight and breast 'size' (estimated by the cross-sectional 'area' of the breast included in the transverse contour at the central axis of the tangential fields). Forty-eight patients are available for evaluation of acute and forty for late morbidity. Median follow up was 33.3 months, (range 12 - 65). The patients' age ranged from 31 to 83 years (mean = 59). Comparisons were made to the morbidity observed in 26 patients with large but not pendulous breasts that were similarly treated but without the ring (control group). Results: Moist desquamation occurred in 69% ((33(48))) of patients treated with the positioning ring. The incidence of moist desquamation was correlated

  10. Hypersensitivity of LEC strain rats in radiation-induced acute bone-marrow death

    LEC strain rats, which have been known to develop hereditarily spontaneous fulminant hepatitis 4 to 5 months after birth, were highly sensitive to whole-body X ray-irradiation as compared to WKAH strain rats. Radiation-induced acute bone-marrow death occurred at doses higher than 2.0 Gy in LEC rats, and at doses higher than 7.4 Gy in WKAH rats. By probit analysis of survival data, it was shown that the LD50/30 value for LEC rats was 3.0 Gy which was significantly lower than that (7.8 Gy) of WKAH rats. Histopathological examinations of the bone marrows from both strains after irradiation at a dose of 4.0 Gy revealed that a number of hemopoietic cells were recovered in WKAH rats on day 8 after irradiation, but not in LEC rats. These results suggested the hypersensitivity of LEC rats to ionizing radiation in connection with acute bone-marrow death. (author)

  11. Hypersensitivity of LEC strain rats in radiation-induced acute bone-marrow death

    Hayashi, Masanobu; Endoh, Daiji; Kon, Yasuhiro; Yamashita, Tadashi; Sato, Fumiaki; Kasai, Noriyuki; Namioka, Shigeo (Hokkaido Univ., Sapporo (Japan). Faculty of Veterinary Medicine)

    1993-02-01

    LEC strain rats, which have been known to develop hereditarily spontaneous fulminant hepatitis 4 to 5 months after birth, were highly sensitive to whole-body X ray-irradiation as compared to WKAH strain rats. Radiation-induced acute bone-marrow death occurred at doses higher than 2.0 Gy in LEC rats, and at doses higher than 7.4 Gy in WKAH rats. By probit analysis of survival data, it was shown that the LD[sub 50/30] value for LEC rats was 3.0 Gy which was significantly lower than that (7.8 Gy) of WKAH rats. Histopathological examinations of the bone marrows from both strains after irradiation at a dose of 4.0 Gy revealed that a number of hemopoietic cells were recovered in WKAH rats on day 8 after irradiation, but not in LEC rats. These results suggested the hypersensitivity of LEC rats to ionizing radiation in connection with acute bone-marrow death. (author).

  12. Activation of platelet aggregation and arachidonate metabolism in early stage of acute radiation injury

    The paper describes the changes of platelet aggregation and arachidonate metabolism in platelets and endothelial cells after 8.0-8.5 Gy γ-ray whole-body irradiation in rats. It was found that with 8.0 Gy exposure platelet aggregation rate and speed, and plasma TxB2 level were increased at 4h and on the 1st day post irradiation, and that 6-keto-PGF1α level was enhanced at 4h, then reduced to the control level on the 1st day post irradiation. The result of biological assay showed the ability for rat platelets to convert exogenous arachidonate into TxA2 was significantly raised at 4h and on the 1st day after 8.5 Gy γ-ray irradiation. It is suggested that the activation of platelet arachidonate metabolism may be one of the important causes of acute radiation injury is suggested that the activation of platelet arachidonate metabolism may be one of the important causes of acute radiation injury

  13. Hypersensitivity of LEC strain rats in radiation-induced acute bone-marrow death

    LEC strain rats, which have been known to develop hereditarily spontaneous fulminant hepatitis 4 to 5 months after birth, were highly sensitive to whole-body X ray-irradiation as compared to WKAH strain rats. Radiation-induced acute bone-marrow death occurred at doses higher than 2.0 Gy in LEC rats, and at doses higher than 7.4 Gy in WKAH rats, respectively. By probit analysis of survival data, it was shown that the LD50/30 value for LEC rats was 3.0 Gy which was significantly lower than that (7.8 Gy) of WKAH rats. Histopathological examinations of the bone marrows from both strains after irradiation at a dose of 4.0 Gy revealed that a number of hemopoietic cells were recovered in WKAH rats on day 8 after irradiation, but not in LEC rats. These results suggested the hypersensitivity of LEC rats to ionizing radiation in connection with acute bone-marrow death

  14. Regulatory T Cells Contribute to the Inhibition of Radiation-Induced Acute Lung Inflammation via Bee Venom Phospholipase A2 in Mice

    Dasom Shin; Gihyun Lee; Sung-Hwa Sohn; Soojin Park; Kyung-Hwa Jung; Ji Min Lee; Jieun Yang; Jaeho Cho; Hyunsu Bae

    2016-01-01

    Bee venom has long been used to treat various inflammatory diseases, such as rheumatoid arthritis and multiple sclerosis. Previously, we reported that bee venom phospholipase A2 (bvPLA2) has an anti-inflammatory effect through the induction of regulatory T cells. Radiotherapy is a common anti-cancer method, but often causes adverse effects, such as inflammation. This study was conducted to evaluate the protective effects of bvPLA2 in radiation-induced acute lung inflammation. Mice were focall...

  15. Protective effect of vitamin A on acute radiation injury in the small intestine

    The objective of this study was to examine the influence of vitamin A on the development of early radiation-induced reactions in the rat small intestine. The early effects of intraoperative gamma-radiation on the small bowel utilizing the terminal ileum of Sprague-Dawley rats and the protective effect of supplemental vitamin A on acute radiation injury were investigated. Three groups were included in the study: group I (10 rats) was the surgical control group; group II (13 rats) underwent only intraoperative irradiation; and group III (10 rats) was the vitamin A plus irradiation group. Exteriorized terminal ileal segments of groups II and III were exposed to a single fraction of 20 Gy of intraoperative gamma-irradiation. On the seventh postoperative day, terminal ileal segments of all rats were resected and histopathologically evaluated for ulceration, enteritis cystica profunda, atypical epithelial regeneration, fibrosis, vascular sclerosis, and inflammatory process. Although none of the above findings were present in the surgical control group, group III rats experienced less severe effects than group II rats. The results suggest the early side effects of radiation may be prevented by vitamin A supplementation. (author)

  16. Impact of invasive fungal disease on the chemotherapy schedule and event-free survival in acute leukemia patients who survived fungal disease: a case-control study

    Even, Caroline; Bastuji-Garin, Sylvie; Hicheri, Yosr; Pautas, Cécile; Botterel, Francoise; Maury, Sébastien; Cabanne, Ludovic; Bretagne, Stéphane; Cordonnier, Catherine

    2010-01-01

    Patients with acute leukemia who initially survive invasive fungal disease must receive chemotherapy or go on to transplant. Many centers change subsequent chemotherapy to decrease the risk of fungal reactivation. This case-control study compared acute leukemia patients (n=28) who developed a proven or probable fungal disease and survived four weeks later, to patients who did not (n=78), and assessed the impact of fungal disease on the chemotherapy regimens, and overall and event-free survival.

  17. Potent corticosteroid cream (mometasone furoate) significantly reduces acute radiation dermatitis: results from a double-blind, randomized study

    Purpose: Radiation-induced dermatitis is a very common side effect of radiation therapy, and may necessitate interruption of the therapy. There is a substantial lack of evidence-based treatments for this condition. The aim of this study was to investigate the effect of mometasone furoate cream (MMF) on radiation dermatitis in a prospective, double-blind, randomized study. Material and methods: The study comprised 49 patients with node-negative breast cancer. They were operated on with sector resection and scheduled for postoperative radiotherapy using photons with identical radiation qualities and dosage to the breast parenchyma. The patients were randomized to receive either MMF or emollient cream. The cream was applied on the irradiated skin twice a week from the start of radiotherapy until the 12th fraction (24 Gy) and thereafter once daily until 3 weeks after completion of radiation. Both groups additionally received non-blinded emollient cream daily. The intensity of the acute radiation dermatitis was evaluated on a weekly basis regarding erythema and pigmentation, using a reflectance spectrophotometer together with visual scoring of the skin reactions. Results: MMF in combination with emollient cream treatment significantly decreased acute radiation dermatitis (P=0.0033) compared with emollient cream alone. There was no significant difference in pigmentation between the two groups. Conclusions: Adding MMF, a potent topical corticosteroid, to an emollient cream is statistically significantly more effective than emollient cream alone in reducing acute radiation dermatitis

  18. Thyroid disorders in acute period after radiation therapy on neck region

    E I Bobrova

    2015-06-01

    Full Text Available Aim. The aim of our study was to analyze thyroid status in adult patients with Hodgkin’s lymphoma in acute period after radiotherapy on neck region. Material and methods. Thyroid function (TSH, free T 4, anti-TPO and thyroid ultrasound were evaluated in 22 adults (10 women, 12 men, mean age 30.2 yrs with a history of Hodgkin’s lymphoma (HL before radiotherapy on neck region, 7-14 days, 6 month, 1 year after treatment. Results. Incidence of subclinical hyperthyroidism was 13.6% in acute period (7-14 days after radiotherapy on neck region. There was correlation between dose of radiation and incidence of acute thyroiditis ( r = 0.67, p = 0.03. TSH level fall directly after treatment (1.08 vs 1.88 mkMEd/l р = 0.03, but 6 month after this difference disappeared. T 4 free level decreased 1 yr after treatment (1.18 vs 0.99 ng/ml in compare with measurement before treatment ( p = 0,01. Thyroid volume decreased (9.8 ml vs 5.7 ml 6 month after radiotherapy in compare with measurement before treatment ( p = 0.03, and keep on decreasing 1 yr after treatment (5.35 vs 9.7 ml p = 0.003. Conclusions. These data indicate that some patients with HL receiving high dose of radiotherapy on neck region can develop acute thyroiditis, but this abnormalities are transitory and do not reviewed treatment.

  19. New Insight for the Diagnosis of Gastrointestinal Acute Graft-versus-Host Disease

    Florent Malard

    2014-01-01

    Full Text Available Allogeneic stem cell transplantation (allo-SCT is a curative therapy for different life-threatening malignant and nonmalignant hematologic disorders. Graft-versus-host disease (GVHD remains a major source of morbidity and mortality following allo-SCT, which limits the use of this treatment in a broader spectrum of patients. Early diagnostic of GVHD is essential to initiate treatment as soon as possible. Unfortunately, the diagnosis of GVHD may be difficult to establish, because of the nonspecific nature of the associated symptoms and of the numerous differential diagnosis. This is particularly true regarding gastrointestinal (GI acute GVHD. In the recent years many progress has been made in medical imaging test and endoscopic techniques. The interest of these different techniques in the diagnosis of GI acute GVHD has been evaluated in several studies. With this background we review the contributions, limitations, and future prospect of these techniques in the diagnosis of GI acute GVHD.

  20. The epidemiology and outcome of acute renal failure and the impact on chronic kidney disease.

    Block, Clay A; Schoolwerth, Anton C

    2006-01-01

    Acute renal failure (ARF) is a common condition, especially among the critically ill, and confers a high mortality. Recent publications have highlighted changes in the epidemiology and improvement in mortality that was long thought to be static despite improvements in clinical care. The incidence of ARF is increasing. Efforts, such as the Acute Dialysis Quality Initiative, are being undertaken to establish a consensus definition of ARF, and to distinguish between varying degrees of acute kidney injury. Data are emerging to allow comparison of the epidemiology of ARF across institutions internationally. There is ongoing recognition of the important interaction between ARF and chronic kidney disease. Two brief case reports are offered to help frame the context and clinical impact of this disorder, followed by a review of some of the recent literature that addresses these points. PMID:17150044

  1. Electrocardiographic abnormalities in acute cerebrovascular events in patients with/without cardiovascular disease

    Mansoureh Togha

    2013-01-01

    Full Text Available Objectives: Electrocardiographic (ECG changes are reported frequently after acute strokes. It seems that cardiovascular effects of strokes are modulated by concomitant or pre-existent cardiac diseases, and are also related to the type of cerebrovascular disease and its localization. We aimed to determine the pattern of ECG changes associated with pathophysiologic categories of acute stroke among patients with/without cardiovascular disease and to determine if specific ECG changes are related to the location of the lesion. Materials and Methods : The electrocardiographic records of 361 patients with acute stroke were studied to assess the relative frequencies of ECG abnormalities among the pathophysiologic categories of stroke. Results: In the present study, the most common ECG abnormalities associated with stroke were T-wave abnormalities, prolonged QTc interval and arrhythmias, which were respectively found in 39.9%, 32.4%, and 27.1% of the stroke patients and 28.9%, 30.7%, and 16.2 of the patients with no primary cardiac disease. We observed that other ECG changes comprising pathologic Q- wave, ST-segment depression, ST-segment elevation, and prominent U wave may also occur in selected or non-selected stroke patients; thereby simulate an acute myocardial injury. We observed an increased number of patients with abnormal T-wave and posterior fossa bleedings and more rhythm disturbances for ischemic lesions, localized in the anterior fossa. Conclusion: Ischemia-like ECG changes and arrhythmias are frequently seen in stroke patients, even in those with no history or signs of primary heart disease, which support a central nervous system origin of these ECG abnormalities. Further study is necessary to better define the brain-heart interaction.

  2. Medical Management of Acute Radiation Syndromes : Comparison of Antiradiation Vaccine and Antioxidants radioprotection potency.

    Maliev, Slava; Popov, Dmitri; Lisenkov, Nikolai

    Introduction: This experimental study of biological effects of the Antiradiation Vaccine and Antioxidants which were used for prophylaxis and treatment of the Acute Radiation Syndromes caused by high doses of the low-LET radiation. An important role of Reactive Oxyden Species (Singlet oxygen, hydroxyl radicals, superoxide anions and bio-radicals)in development of the Acute Radiation Syndromes could be defined as a "central dogma" of radiobiology. Oxida-tion and damages of lipids, proteins, DNA, and RNA are playing active role in development of postradiation apoptosis. However, the therapeutic role of antioxidants in modification of a postradiation injury caused by high doses of radiation remains controversial.Previous stud-ies had revealed that antioxidants did not increase a survival rate of mammals with severe forms of the Acute Radiation Syndromes caused by High Doses of the low-LET radiation. The Antiradiation Vaccine(ARV) contains toxoid forms of the Radiation Toxins(RT) from the Specific Radiation Determinants Group (SRD). The RT SRD has toxic and antigenic prop-erties at the same time and stimulates a specific antibody elaboration and humoral response form activated acquired immune system. The blocking antiradiation antibodies induce an im-munologically specific effect and have inhibiting effects on radiation induced neuro-toxicity, vascular-toxicity, gastrointestinal toxcity, hematopoietic toxicity, and radiation induced cytol-ysis of selected groups of cells that are sensitive to radiation. Methods and materials: Scheme of experiments: 1. Irradiated animals with development of Cerebrovascular ARS (Cv-ARS), Cardiovascular ARS (Cr-ARS) Gastrointestinal ARS(GI-ARS), Hematopoietic ARS (H-ARS) -control -were treated with placebo administration. 2. Irradiated animals were treated with antioxidants prophylaxisis and treatment of Cv-ARS, Cr-SRS, GI-ARS, Hp-ARS forms of the ARS. 3. irradiated animals were treated with radioprotection by Antiradiation Vaccine

  3. The fecal microbiome in dogs with acute diarrhea and idiopathic inflammatory bowel disease.

    Jan S Suchodolski

    Full Text Available BACKGROUND: Recent molecular studies have revealed a highly complex bacterial assembly in the canine intestinal tract. There is mounting evidence that microbes play an important role in the pathogenesis of acute and chronic enteropathies of dogs, including idiopathic inflammatory bowel disease (IBD. The aim of this study was to characterize the bacterial microbiota in dogs with various gastrointestinal disorders. METHODOLOGY/PRINCIPAL FINDINGS: Fecal samples from healthy dogs (n = 32, dogs with acute non-hemorrhagic diarrhea (NHD; n = 12, dogs with acute hemorrhagic diarrhea (AHD; n = 13, and dogs with active (n = 9 and therapeutically controlled idiopathic IBD (n = 10 were analyzed by 454-pyrosequencing of the 16S rRNA gene and qPCR assays. Dogs with acute diarrhea, especially those with AHD, had the most profound alterations in their microbiome, as significant separations were observed on PCoA plots of unweighted Unifrac distances. Dogs with AHD had significant decreases in Blautia, Ruminococcaceae including Faecalibacterium, and Turicibacter spp., and significant increases in genus Sutterella and Clostridium perfringens when compared to healthy dogs. No significant separation on PCoA plots was observed for the dogs with IBD. Faecalibacterium spp. and Fusobacteria were, however, decreased in the dogs with clinically active IBD, but increased during time periods of clinically insignificant IBD, as defined by a clinical IBD activity index (CIBDAI. CONCLUSIONS: Results of this study revealed a bacterial dysbiosis in fecal samples of dogs with various GI disorders. The observed changes in the microbiome differed between acute and chronic disease states. The bacterial groups that were commonly decreased during diarrhea are considered to be important short-chain fatty acid producers and may be important for canine intestinal health. Future studies should correlate these observed phylogenetic differences with functional changes in the intestinal

  4. Countermeasure development : Specific Immunoprophylaxis and Immunotherapy of Combined Acute Radiation Syndromes.

    Popov, Dmitri; Maliev, Slava

    Introduction: Combined Acute Radiation Syndromes (CARS) are extremely severe injuries. Combination of Radiation and Thermal factors induce development of the acute pathologi-cal processes in irradiated mammals: systemic inflammatory response syndrome (SIRS), toxic multiple organ injury (TMOI), toxic multiple organ dysfunction syndromes (TMOD), toxic multiple organ failure (TMOF). Also, high doses of Radiation and Thermal injury induce for-mation of following Toxin groups: A. Specific Radiation Toxins; B. Specific Thermal Toxins; C. Nonspecific Histiogenic Pro-inflammatory and Inflammatory Toxins (NHIT). Specific Radi-ation Toxins (SRT) include four major group of Toxins: Cerebrovascular Radiation Toxins (Cv RT), Cardiovascular Radiation Toxins (Cr RT), Gastrointestinal Radiation Toxins (Gi RT), and Hematopoietic Radiation Toxins (Hp RT). CvRT, Cr RT, Gi RT groups of toxins are defined as Neurotoxins and Hp RT group is defined as Hematotoxins. Specific Thermal Toxins (STT) were isolated from the burned skin (Voul S., Colker I. 1972). The group of Nonspecific Histio-genic Inflammatory Toxins (NHIT) includes high amount of tissue toxins which are peptides with medium molecular weight. This group of polypeptides can be a significant factor as a part of developing of the general inflammation reaction. However, NHIT toxins can't induce many reactions and changes which are specific for radiation. Specific Radiation Toxins (SRT) can induce specific processes and reactions such as clonogenic cell death -programmed apoptotic necrosis. Although besides high doses of radiation, other forms of cell death such as Pyroptosis or Oncosis should be considered. We postulate that NHIT toxins are similar for high doses of radiation and thermal injury. Specific Radiation Toxins (SRT) are induced by high doses of radiation. Specific Thermal Toxins (STT) toxins which formation is induced by a Thermal Factor are different from SRT. Administration of STT toxins or NHIT toxins (IV or IM) to

  5. Respiratory protection and emerging infectious diseases: lessons from severe acute respiratory syndrome

    John H. Lange

    2005-01-01

    @@ The severe acute respiratory syndrome (SARS) that emerged 2002-2003 and apparently again 2004 (reported by the news media on December 27, 2003) as the first confirmed case by the World Health Organization (WHO)1,2 raised awareness of emerging infectious diseases.3 Every year there are both new and old infectious diseases emerging as potential pandemic agents.4-6 However, few of these diseases receive the public attention and concern expressed as occurred during the emergence of SARS. Much of this concern was a result of the rapid spread of the novel coronavirus (CoV) to different regions of the world and its high infectivity, especially for health care workers (HCW).3 In many ways, the high percent of HCW infected is a warning of the potential hazards of old and emerging infectious diseases.6 However, SARS was not the only disease (e.g. Monkeypox) that emerged in 2003,3 rather it received the greatest attention.

  6. Radiodiagnosis programs for the recognition of acute surgical diseases of the abdominal organs, retroperitoneal space and complications thereof

    Program for complex use of X-ray and ultrasonic diagnostic methods, X-ray computerized tomography was worked out in diseases of the abdominal organs, retroperitoneal space. Creation of such program was necessary due to acute surgical intervention in diseases of these organs (1750 patients with clinical picture of acute abdomen, 1350 patients with acute diseases of abdomen cavity organs). Obtaining of momentary information for diagnosis is required in most of cases. Schemes are suggested for complex usage of these diagnostic methods in different pathology, clinical symptoms, severity in patient state, technical possibilities of medical establishments

  7. In vitro radiosensitivity of primary human fibroblasts. Lack of correlation with acute radiation toxicity in patients with head and neck cancer

    Background and purpose: There is a considerable hope among clinicians and radiobiologists to detect genetically radiosensitive patients prior to radiotherapy. A predictive assay would enable adjustment of the total irradiation dose to the individual at a constant risk of normal tissue complications. In this prospective study, the clonogenic survival assay for primary human fibroblasts to determine radiosensitivity in vitro was evaluated and then correlated with clinically observed acute radiation reactions. Materials and methods: One hundred twenty-five independent survival experiments with primary fibroblasts derived from 63 biopsies from 55 cancer and non-cancer patients were performed. Results: A wide variation of cell survival between biopsies was detected. Statistical analysis revealed a highly significantly larger interindividual than intraindividual variation of SF2 values. However, a considerable scatter of SF2 values in repeated experiments was observed in individual cases. Age, gender, disease status (cancer patient, non-cancer patient) and origin of fibroblasts (skin, periodontal tissue) were demonstrated not to be statistically significant confounding factors on the intrinsic radiosensitivity in vitro. In a prospective study, no correlation of the SF2 and acute reactions in 25 patients with head and neck cancer treated with a primary accelerated radiochemotherapy was detected. Conclusion: Our data show that the clonogenic assay is able to distinguish between intrinsic radiosensitivities of primary human fibroblasts if a statistical approach is used but does not predict acute radiation toxicity

  8. Feasibility and Acute Toxicity of Hypofractionated Radiation in Large-breasted Patients

    Dorn, Paige L., E-mail: pdorn@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, University of Chicago Hospitals, Chicago, IL (United States); Corbin, Kimberly S.; Al-Hallaq, Hania; Hasan, Yasmin; Chmura, Steven J. [Department of Radiation and Cellular Oncology, University of Chicago Hospitals, Chicago, IL (United States)

    2012-05-01

    Purpose: To determine the feasibility of and acute toxicity associated with hypofractionated whole breast radiation (HypoRT) after breast-conserving surgery in patients excluded from or underrepresented in randomized trials comparing HypoRT with conventional fractionation schedules. Methods and Materials: A review was conducted of all patients consecutively treated with HypoRT at University of Chicago. All patients were treated to 42.56 Gy in 2.66 Gy daily fractions in either the prone or supine position. Planning was performed in most cases using wedges and large segments or a 'field-in-field' technique. Breast volume was estimated using volumetric measurements of the planning target volume (PTV). Dosimetric parameters of heterogeneity (V105, V107, V110, and maximum dose) were recorded for each treatment plan. Acute toxicity was scored for each treated breast. Results: Between 2006 and 2010, 78 patients were treated to 80 breasts using HypoRT. Most women were overweight or obese (78.7%), with a median body mass index of 29.2 kg/m{sup 2}. Median breast volume was 1,351 mL. Of the 80 treated breasts, the maximum acute skin toxicity was mild erythema or hyperpigmentation in 70.0% (56/80), dry desquamation in 21.25% (17/80), and focal moist desquamation in 8.75% (7/80). Maximum acute toxicity occurred after the completion of radiation in 31.9% of patients. Separation >25 cm was not associated with increased toxicity. Breast volume was the only patient factor significantly associated with moist desquamation on multivariable analysis (p = 0.01). Patients with breast volume >2,500 mL experienced focal moist desquamation in 27.2% of cases compared with 6.34% in patients with breast volume <2,500 mL (p = 0.03). Conclusions: HypoRT is feasible and safe in patients with separation >25 cm and in patients with large breast volume when employing modern planning and positioning techniques. We recommend counseling regarding expected increases in skin toxicity in women

  9. Feasibility and Acute Toxicity of Hypofractionated Radiation in Large-breasted Patients

    Purpose: To determine the feasibility of and acute toxicity associated with hypofractionated whole breast radiation (HypoRT) after breast-conserving surgery in patients excluded from or underrepresented in randomized trials comparing HypoRT with conventional fractionation schedules. Methods and Materials: A review was conducted of all patients consecutively treated with HypoRT at University of Chicago. All patients were treated to 42.56 Gy in 2.66 Gy daily fractions in either the prone or supine position. Planning was performed in most cases using wedges and large segments or a “field-in-field” technique. Breast volume was estimated using volumetric measurements of the planning target volume (PTV). Dosimetric parameters of heterogeneity (V105, V107, V110, and maximum dose) were recorded for each treatment plan. Acute toxicity was scored for each treated breast. Results: Between 2006 and 2010, 78 patients were treated to 80 breasts using HypoRT. Most women were overweight or obese (78.7%), with a median body mass index of 29.2 kg/m2. Median breast volume was 1,351 mL. Of the 80 treated breasts, the maximum acute skin toxicity was mild erythema or hyperpigmentation in 70.0% (56/80), dry desquamation in 21.25% (17/80), and focal moist desquamation in 8.75% (7/80). Maximum acute toxicity occurred after the completion of radiation in 31.9% of patients. Separation >25 cm was not associated with increased toxicity. Breast volume was the only patient factor significantly associated with moist desquamation on multivariable analysis (p = 0.01). Patients with breast volume >2,500 mL experienced focal moist desquamation in 27.2% of cases compared with 6.34% in patients with breast volume 25 cm and in patients with large breast volume when employing modern planning and positioning techniques. We recommend counseling regarding expected increases in skin toxicity in women with a PTV volume >2,500 mL.

  10. DTI based detection of radiation induced early acute changes in hippocampus in mice at 7T

    In last decade, it has been understood that ionizing radiation exposure influences central nervous system (CNS) functions and behaviour. Our recent studies have observed metabolic and microstructural changes in brain within 10 days post irradiation. Changes in CNS are speculated due to systemic inflammatory response which can be observed within few hours of radiation exposure. To look for the influence of systemic inflammatory response on brain, present study was carried out to identify the changes occurring in brain with special reference to hippocampus within 24 hours of radiation exposure. A total of 16 mice (n = 8 in each group) were exposed to whole body radiation dose of 5 Gy through a Tele 60Co irradiation facility. DTI study was conducted on sham radiated control mice (n = 8) and at 3 hrs and 24 hrs post irradiation of irradiated mice at 7T animal MRI system. The mice were sacrificed following imaging and immunohistochemistry, mRNA expression of pro inflammatory and anti inflammatory (TGFâ1) marker response were performed on brain tissue. The results showed marginal decrease in mean diffusivity at 3 hours but significantly decreased at 24 hours post irradiation. No significant change in FA values was observed at any time point. Marked changes in radial diffusivity was further detected compared to axial diffusivity. Altered diffusivity depicts change in diffusion characteristics of the intracellular and extra cellular water compartments including restricted water diffusion. The restricted water diffusion could be due to infiltration of inflammatory markers in the brain across the blood brain barrier. The neuroinflammatory response is further supported by increased mRNA expression of cytokines in hippocampus. Further, immunohistochemistry showed noticeable reactive astrogliosis in irradiated group compared to control that might be another reason for restricted diffusion. The study shows that systemic inflammatory response influences the brain even during

  11. Outbreak of acute Chagas disease associated with oral transmission in the Rio Negro region, Brazilian Amazon

    Rita de Cássia de Souza-Lima

    2013-10-01

    Full Text Available Introduction Chagas disease is considered as emerging in the Brazilian Amazon, usually occurring in acute outbreaks. Methods We describe 17 cases of acute Chagas disease in Rio Negro, Amazonas. Results There were 15 males (average age, 31.3 years, all positive for Trypanosoma cruzi in fresh blood smear examination, and 14 positive by xenodiagnosis and PCR. The top clinical manifestations were fever, asthenia, abdominal pain, and palpitations. Electrocardiograms featured low-voltage QRS, anterosuperior divisional block, and right bundle branch block associated with anterosuperior divisional block. Conclusions All patients had consumed açaí products from Monte Alegre in the rural area around Santa Izabel do Rio Negro, Brazil.

  12. Outbreak of acute Chagas disease associated with oral transmission in the Rio Negro region, Brazilian Amazon

    Rita de Cassia de Souza-Lima

    2013-07-01

    Full Text Available Introduction Chagas disease is considered as emerging in the Brazilian Amazon, usually occurring in acute outbreaks. Methods We describe 17 cases of acute Chagas disease in Rio Negro, Amazonas. Results There were 15 males (average age, 31.3 years, all positive for Trypanosoma cruzi in fresh blood smear examination, and 14 positive by xenodiagnosis and PCR. The top clinical manifestations were fever, asthenia, abdominal pain, and palpitations. Electrocardiograms featured low-voltage QRS, anterosuperior divisional block, and right bundle branch block associated with anterosuperior divisional block. Conclusions All patients had consumed açaí products from Monte Alegre in the rural area around Santa Izabel do Rio Negro, Brazil.

  13. Is it possible to limit the use of CT scanning in acute diverticular disease without compromising outcomes? A preliminary experience.

    Caputo, Pierpaolo; Rovagnati, Marco; Carzaniga, Pier Luigi

    2015-01-01

    The aim of our study was to determine whether the use of CT scanning in the assessment of acute diverticulitis can be reduced without a negative effect on outcome. Our series consisted of 93 out of 100 patients with acute diverticulitis admitted to the Emergency Room of our institution in the period from February 2012 to March 2013.The Hinchey classification system was used to stage disease based on findings on ultrasound (US) examination and/or computed tomography (CT) scanning. We compared the patients' Hinchey stage (HS) on admission and 72 hours later. Types of treatment were defined as emergency or delayed intervention (operative approaches (OA); ultrasound-guided percutaneous drainage (UPD), and surgery. The borderline between conservative and surgical management was identified. In patients with a HS sufficient and they can be spared the exposure to ionizing radiation associated with CT scans. The skill of the individual operator in US examination was found to be of key importance. As regards CT scanning, we found, in agreement with the literature, that it has greater specificity and sensitivity than US, and is therefore indicated if the patient's condition has deteriorated. PMID:25816854

  14. Treatment of radiation-induced acute oral mucositis in a rat model

    The stem cells of the epithelial lining of the oral mucosa are non-specifically affected by many anti-cancer agents including radiation. Radiation-induced mucositis of upper aerodigestive tract is a major dose-limiting factor in the treatment of head and neck tumours. A new non-toxic drug (Compound A) consisting of Curcumin, -tocopherol and sun flower oil (SFO) was developed and its efficacy was tested in the treatment of radiation-induced normal tissue lesions. Mature (12 weeks old; 200-225g) female Sprague-Dawley rats were used in compliance with the Animal (Scientific Procedures) Act 1986. While under anaesthesia the animals tongue was slightly extended outside and a region of the underside of the tongue was irradiated in-situ with single doses of 2.27 MeV -rays from a 5mm diameter 90Sr/90Y plaque. The dose-rate of the source was ∼10Gy/min at the surface of the mucus membrane. Irradiations and subsequent assessment of the lesion were carried out under general anesthesia maintained by a 1.5% Halothane, oxygen mixture. Four groups of 36 animals were irradiated with single doses of either 13.5, 15, 16.5 or 18 Gy. Following irradiation the animals in each dose group were subdivided into four treatment subgroups of 9 rats to receive 0.5 ml per day of either Compound A, SFO, -tocopherol or water by oral gavage until the end of experiments. Nine animals were used at each dose point in each treatment group. Mucosal ulceration (erosion of mucosal epithelium) was considered as an end-point and this is referred by radiation-induced mucositis in the context of present experiments. From the day after irradiation until any acute radiation-induced oral mucosal lesion had healed the animals tongue were assessed daily for the presence of radiation-induced mucositis (mucosal ulceration). Quantal data for the incidence of radiation-induced mucositis were analysed using logit analysis and dose modification factor (DMF) was obtained. There was a modest increase in the ED50 values

  15. Study on the Relationship between Plasma Homocysteine and Acute Cerebral Vascular Disease

    2000-01-01

    The levels of plasma homocysteine were determined by using high-performance liquid chromatographic method. It was found that plasma homocysteine levels were significantly higher in the patients with stroke than that in the controls. There was no correlation between plasma homocysteine levels and hypertension, smoking, concentrations of blood glucose or hypertriglyceridesemia. It was suggested that hyperhomocysteinemia may be an independent risk factor for acute cerebral vascular disease.

  16. [Clinical pathway management of acute exacerbations of chronic obstructive pulmonary disease based on state machine].

    Tan, Jian; Hao, Liwei; Cheng, Yuanxiong; Xu, Tongliang; Song, Yingnuo

    2014-04-01

    We propose a clinical pathway of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) based on state machine. Clinical event-driven response was utilized to control workflow execution of the AECOPD clinical pathway. By comparison with the traditional clinical pathway management, clinical numerical results showed that the proposed method was better in hospitalization days, average hospitalization expense and aberration rate, and better handled the variability in the AECOPD clinical pathway execution. PMID:24752111

  17. Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in patients with Crohn's Disease

    Reinshagen Max; Mason Richard A; Adler Guido; Spaniol Ulrike; Klaus Jochen; von Tirpitz C Christian

    2009-01-01

    Abstract Background Small intestinal bacterial overgrowth (SIBO) is characterized by excessive proliferation of colonic bacterial species in the small bowel. Potential causes of SIBO include fistulae, strictures or motility disturbances. Hence, patients with Crohn's Disease (CD) are especially predisposed to develop SIBO. As result, CD patients may experience malabsorption and report symptoms such as weight loss, watery diarrhea, meteorism, flatulence and abdominal pain, mimicking acute flare...

  18. Nitric Oxide Response to Acute Exercise in Patients with Coronary Artery Disease

    Kaya, Ayşem; Arat-Özkan, Alev; Köner, Özge; Balcı, Huriye; Abacı, Okay; Gürmen, Tevfik; Küçükoğlu, Serdar; Yiğit, Zerrin

    2010-01-01

    Nitric oxide (NO) has been identified as a vasodilatory substance released from the endothelium which decreases in the presence of atherosclerosis. This study aimed to evaluate the systemic NO response to acute exercise in untrained diabetic and nondiabetic patients with atherosclerotic coronary artery disease (CAD). This is a prospective, clinical study consisting of three groups. Group A (n=50) consisted of nondiabetic CAD patients,group B (n=20) consisting of diabetic, CAD patients and gro...

  19. Competitive PCR for quantification of minimal residual disease in acute lymphoblastic leukaemia

    Nyvold, C; Madsen, H O; Ryder, L P;

    2000-01-01

    A very precise and reproducible polymerase chain reaction (PCR) method was developed in order to quantify minimal residual disease (MRD) in children with acute lymphoblastic leukaemia (ALL). A clone-specific competitor was constructed by introducing a restriction site in a PCR product identical to...... at least one malignant cell in 10(5) normal cells. This method may be used for treatment stratification based on the early response to antileukaemic therapy. Udgivelsesdato: 2000-Jan-13...

  20. Phenyl-α-tert-Butyl Nitrone Reverses Mitochondrial Decay in Acute Chagas’ Disease

    Wen, Jian-jun; Bhatia, Vandanajay; Popov, Vsevolod L.; Garg, Nisha Jain

    2006-01-01

    In this study, we investigated the mechanism(s) of mitochondrial functional decline in acute Chagas’ disease. Our data show a substantial decline in respiratory complex activities (39 to 58%) and ATP (38%) content in Trypanosoma cruzi-infected murine hearts compared with normal controls. These metabolic alterations were associated with an approximately fivefold increase in mitochondrial reactive oxygen species production rate, substantial oxidative insult of mitochondrial membranes and respir...

  1. Role of damage control enterostomy in management of children with peritonitis from acute intestinal disease

    Ameh, Emmanuel A; Michael A Ayeni; Stephen A Kache; Philip M Mshelbwala

    2013-01-01

    Background: Intestinal anastomosis in severely ill children with peritonitis from intestinal perforation, intestinal gangrene or anastomotic dehiscence (acute intestinal disease) is associated with high morbidity and mortality. Enterostomy as a damage control measure may be an option to minimize the high morbidity and mortality. This report evaluates the role of damage control enterostomy in the treatment of these patients. Materials and Methods: A retrospective review of 52 children with acu...

  2. The Fecal Microbiome in Dogs with Acute Diarrhea and Idiopathic Inflammatory Bowel Disease

    Jan S. Suchodolski; Melissa E Markel; Garcia-Mazcorro, Jose F.; Unterer, Stefan; Heilmann, Romy M.; Scot E Dowd; Kachroo, Priyanka; Ivanov, Ivan; Minamoto, Yasushi; Dillman, Enricka M.; Steiner, Jörg M.; Cook, Audrey K.; Toresson, Linda

    2012-01-01

    Background Recent molecular studies have revealed a highly complex bacterial assembly in the canine intestinal tract. There is mounting evidence that microbes play an important role in the pathogenesis of acute and chronic enteropathies of dogs, including idiopathic inflammatory bowel disease (IBD). The aim of this study was to characterize the bacterial microbiota in dogs with various gastrointestinal disorders. Methodology/Principal Findings Fecal samples from healthy dogs (n = 32), dogs wi...

  3. Haemodialysis is an effective treatment in acute metabolic decompensation of maple syrup urine disease

    P.S. Atwal

    2015-09-01

    Full Text Available Acute metabolic decompensation in maple syrup urine disease can occur during intercurrent illness and is a medical emergency. A handful of reports in the medical literature describe the use of peritoneal dialysis and haemodialysis as therapeutic inventions. We report the only patient from our centre to have haemodialysis performed in this setting. Combined with dietary BCAA restriction and calorific support, haemodialysis allows rapid reduction in plasma leucine concentrations considerably faster than conservative methods.

  4. Endothelial-cell injury in cutaneous acute graft-versus-host disease.

    Dumler, J S; Beschorner, W. E.; Farmer, E R; Di Gennaro, K. A.; Saral, R; Santos, G. W.

    1989-01-01

    The presence of an erythematous skin rash and hemorrhagic complications in acute graft-versus-host disease (GVHD) suggest that the vasculature may be involved in the immunopathologic process. We reviewed endothelial and vascular histopathologic changes on light microscopy and on immunoperoxidase stained sections of skin biopsies obtained from 41 HLA-identical allogeneic marrow transplant recipients with at least grade 2 GVHD. Biopsies taken from 14 allogeneic HLA-identical bone marrow transpl...

  5. Pathophysiology, prevention, and treatment of acute graft-versus-host disease

    Abhinav Deol; Voravit Ratanatharathorn; Uberti, Joseph P.

    2011-01-01

    Abhinav Deol, Voravit Ratanatharathorn, Joseph P UbertiDepartment of Oncology, Blood and Marrow Stem Cell Transplant Program, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USAAbstract: Acute graft-versus-host disease (aGVHD) is an immunologically mediated inflammatory reaction, which continues to be a major cause of morbidity and mortality in patients undergoing allogeneic hematopoietic stem cell transplant. Although the occurrence and severity...

  6. PIXE analysis of trace elements in hair and their correlation with acute cerebrovascular diseases

    The PIXE (proton induced X-ray emission) technique has been used to analyze trace elements in more than 200 human hair samples from 60 patients with acute cerebrovascular diseases and 28 normal controls. Trace element differences in hair between the patients and the normal controls have been observed. A Van de Graaff accelerator and a Si(Li) semiconductor at Institute of Nuclear Science and Technology of Sichuan University were used. (author)

  7. Ultrasonographic diagnosis of acute pancreatitis caused by ruptured hydatid disease to the biliary system

    Ozcaglayan, O; Halefoglu, A M; Ozcaglayan, T; Sumbul, H A

    2014-01-01

    Acute pancreatitis is a rare complication of hydatic disease which occurs following the rupture of a cyst to the intrahepatic bile ducts. Herein, we report a case of a 34-year-old Turkish man, who presented with upper abdominal pain. In laboratory examination, amylase and lipase levels were elevated. Ultrasound examination showed a cystic hypoechoic mass lesion located in the right lobe of the liver with dilated intrahepatic bile ducts, and germinative membranes were detected originating from...

  8. Recurrent Acute Pancreatitis and Cholangitis in a Patient with Autosomal Dominant Polycystic Kidney Disease

    Kambiz Yazdanpanah; Navid Manouchehri; Elinaz Hosseinzadeh; Mohammad Hassan Emami; Mehdi Karami; Amir Hossein Sarrami

    2013-01-01

    Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder associated with multiple cyst formation in the different organs. Development of pancreatic cyst in ADPKD is often asymptomatic and is associated with no complication. A 38-year-old man with ADPKD was presented with six episodes of acute pancreatitis and two episodes of cholangitis in a period of 12 months. Various imaging studies revealed multiple renal, hepatic and pancreatic cysts, mild ectasia of pancreatic duct,...

  9. Role of free radicals in the pathogenesis of acute chest syndrome in sickle cell disease

    Farber Harrison W; Klings Elizabeth S

    2001-01-01

    Abstract Acute chest syndrome (ACS) of sickle cell disease (SCD) is characterized pathologically by vaso-occlusive processes that result from abnormal interactions between sickle red blood cells (RBCs), white blood cells (WBCs) and/or platelets, and the vascular endothelium. One potential mechanism of vascular damage in ACS is by generation of oxygen-related molecules, such as superoxide (O2-), hydrogen peroxide (H2O2), peroxynitrite (ONOO-), and the hydroxyl (•OH) radical. The present review...

  10. Acute phase response before treatment predicts radiation esophagitis in non-small cell lung cancer

    Background and purpose: Radiation esophagitis (RE) represents an inflammatory reaction to radiation therapy (RT). We hypothesized that aspects of the physiologic acute phase response (APR) predicts RE. Material and methods: We retrospectively analyzed 285 patients with non-small cell lung cancer (NSCLC) treated with definitive radiation. The primary analysis was the association of pretreatment lab values reflective of the APR with symptomatic (grade ⩾2) RE. Univariate and multivariate odds ratios (ORs) were calculated to test associations of clinical and pretreatment lab values with RE. Optimal cutpoints and multivariable risk stratification groupings were determined via recursive partitioning analysis. Results: Pretreatment platelet counts were higher and hemoglobin levels lower in patients who developed RE (P < 0.05). Based on these two pre-treatment risk factors, an APR score was defined as 0 (no risk factors), 1 (either risk factor), or 2 (both risk factors). APR score was significantly associated with RE in both univariate (OR = 2.3 for each point, 95% confidence interval [CI] 1.5–3.4, P = 0.001) and multivariate (OR = 2.1, 95% CI 1.3–3.4, P = 0.002) analyses. Conclusions: The APR score may represent a novel metric to predict RE. However, pending validation in an independent dataset, caution is advised when interpreting these results given their retrospective and thus exploratory nature

  11. Impact of graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantation for acute myeloid leukemia

    Baron, F; Labopin, M; Niederwieser, D;

    2012-01-01

    This report investigated the impact of graft-versus-host disease (GVHD) on transplantation outcomes in 1859 acute myeloid leukemia patients given allogeneic peripheral blood stem cells after reduced-intensity conditioning (RIC allo-SCT). Grade I acute GVHD was associated with a lower risk of...

  12. Distantiae transmission of Trypanosoma cruzi: a new epidemiological feature of acute Chagas disease in Brazil.

    Samanta Cristina das Chagas Xavier; André Luiz Rodrigues Roque; Daniele Bilac; Vitor Antônio Louzada de Araújo; Sócrates Fraga da Costa da Costa Neto; Elias Seixas Lorosa; Luiz Felipe Coutinho Ferreira da Silva; Ana Maria Jansen

    2014-01-01

    BACKGROUND: The new epidemiological scenario of orally transmitted Chagas disease that has emerged in Brazil, and mainly in the Amazon region, needs to be addressed with a new and systematic focus. Belém, the capital of Pará state, reports the highest number of acute Chagas disease (ACD) cases associated with the consumption of açaí juice. METHODOLOGY/PRINCIPAL FINDINGS: The wild and domestic enzootic transmission cycles of Trypanosoma cruzi were evaluated in the two locations (Jurunas and Va...

  13. Screening for Wilson disease in acute liver failure: a comparison of currently available diagnostic tests

    Korman, J.D.; Volenberg, I.; Balko, J.;

    2008-01-01

    Acute liver failure (ALF) due to Wilson disease (WD) is invariably fatal without emergency liver transplantation. Therefore, rapid diagnosis of WD should aid prompt transplant listing. To identify the best method for diagnosis of ALF due to WD (ALF-WD), data and serum were collected from 140 ALF...... patients (16 with WD), 29 with other chronic liver diseases and 17 with treated chronic WD. Ceruloplasmin (Cp) was measured by both oxidase activity and nephelometry and serum copper levels by atomic absorption spectroscopy. In patients with ALF, a serum Cp <20 mg/dL by the oxidase method provided a...

  14. Distantiae Transmission of Trypanosoma cruzi: A New Epidemiological Feature of Acute Chagas Disease in Brazil

    Xavier, Samanta Cristina das Chagas; Roque, André Luiz Rodrigues; Bilac, Daniele; de Araújo, Vitor Antônio Louzada; Neto, Sócrates Fraga da Costa; Lorosa, Elias Seixas; da Silva, Luiz Felipe Coutinho Ferreira; Jansen, Ana Maria

    2014-01-01

    Background The new epidemiological scenario of orally transmitted Chagas disease that has emerged in Brazil, and mainly in the Amazon region, needs to be addressed with a new and systematic focus. Belém, the capital of Pará state, reports the highest number of acute Chagas disease (ACD) cases associated with the consumption of açaí juice. Methodology/Principal Findings The wild and domestic enzootic transmission cycles of Trypanosoma cruzi were evaluated in the two locations (Jurunas and Val-...

  15. Pharmacologic prophylaxis regimens for acute graft-versus-host disease: past, present and future.

    Ram, Ron; Storb, Rainer

    2013-08-01

    Abstract Acute graft-versus-host disease (GVHD) has compromised and continues to compromise the benefits associated with allogeneic hematopoietic cell transplant to cure malignant and non-malignant diseases. Pharmacologic interventions to prevent GVHD have emerged as a major objective of research in the immunology and transplant fields. A better understanding of the pathobiology behind the GVHD process has led the way to novel approaches and medications. Here we review the present arsenal of medications used to prevent GVHD, focusing on past experience and the current evidence, and discuss future potential targets. PMID:23278640

  16. Pathomorphological study of homopoietic organs in subjects dead from radiation disease after the Chernobyl power plant accident

    Hemopoietic organs (bone marrow, spleen, lymph nodes) of 27 subjects who died of acute radiation disease that ran a severe or an extremely grave course after the Chernobyl power lant accident were examined at the light optic and ultrastructural levels. The morphologic changes thatr could be traced can be classified within three periods: aplastic condition (2-3 weeks following the irradiation), initial signs of recovery (3-4 weeks after the irradiation), and active recovery (more than 4 weeks after the irradiation). A compensatory exlotension of the hemopoietic base at the expense of myeloid transformation of the fatty bone marrow of long tubular bones diaphyses was observed in the majority of cases

  17. Anaemia and other blood diseases induced by radiation

    The growing interest in the effects of radiation on blood formation is explained not only by the fact that haemopoietic tissue can be damaged in the event of accidents, but also by the fact that depression of medullary haemopoiesis is often a limiting factor in radiotherapy for various malignant diseases, in particular leukosis. The degree of cell alteration in the peripheral blood resulting from different types of exposure to ionizing radiation depends to a large extent on the lifetime of the cells since in irradiation it is primarily the balance between utilization and production of new cells that is disrupted. In animals that survive exposure to lethal doses of radiation a notable drop in the number of erythrocytes has been observed between the 10th and 30th days after irradiation. The most pronounced anaemia usually appears between the 15th and 20th days. In animals that do not survive a significant drop in the number of erythrocytes takes place the day before or the day on which death occurs. The decrease in the number of red blood cells is due mainly to a drop in their production, to increased destruction of erythrocytes and to haemorrhage

  18. Th Cell Gene Expression and Function in Response to Low Dose and Acute Radiation

    Daila S. Gridley, PhD

    2012-03-30

    FINAL TECHNICAL REPORT Supported by the Low Dose Radiation Research Program, Office of Science U.S. Department of Energy Grant No. DE-FG02-07ER64345 Project ID: 0012965 Award Register#: ER64345 Project Manager: Noelle F. Metting, Sc.D. Phone: 301-903-8309 Division SC-23.2 noelle.metting@science.doe.gov Submitted March 2012 To: https://www.osti.gov/elink/241.3.jsp Title: Th Cell Gene Expression and Function in Response to Low Dose and Acute Radiation PI: Daila S. Gridley, Ph.D. Human low dose radiation data have been derived primarily from studies of space and airline flight personnel, nuclear plant workers and others exposed occupationally, as well as victims in the vicinity of atomic bomb explosions. The findings remain inconclusive due to population inconsistencies and complex interactions among total dose, dose rate, radiation quality and age at exposure. Thus, safe limits for low dose occupational irradiation are currently based on data obtained with doses far exceeding the levels expected for the general population and health risks have been largely extrapolated using the linear-nonthreshold dose-response model. The overall working hypothesis of the present study is that priming with low dose, low-linear energy transfer (LET) radiation can ameliorate the response to acute high-dose radiation exposure. We also propose that the efficacy of low-dose induced protection will be dependent upon the form and regimen of the high-dose exposure: photons versus protons versus simulated solar particle event protons (sSPE). The emphasis has been on gene expression and function of CD4+ T helper (Th) lymphocytes harvested from spleens of whole-body irradiated C57BL/6 mice, a strain that provides the genetic background for many genetically engineered strains. Evaluations of the responses of other selected cells, tissues such as skin, and organs such as lung, liver and brain were also initiated (partially funded by other sources). The long-term goal is to provide information

  19. Radiosensitivity and clinical symptoms of the acute radiation syndrome in calves and young cattle

    38 calves, aged 2.5 to 4 months were exposed to bilateral whole-body X-ray treatment. Incident doses were between 1.80 Gy and 2.80 Gy. An incident dose in excess of 3.0 Gy has to be considered as Ldsub(100/30) for calves in the above age group, while incident doses between 2.2 Gy and 2.5 Gy are LDsub(50/30) and 1.8 Gy being LDsub(0/30). The clinical symptoms of the acute radiation syndrome were clearly phased in response to doses between 2.0 Gy and 4.0 Gy (primary, latency, main reaction, and recovery periods). Following the above doses, the death of the animals, occurred between the middle of the third and end of the fourth week after irradiation. The clinical symptoms are described in detail. Only the symptoms in the main reaction phase depend unambiguously on dosage. There were more frequent febrile rectal temperatures, higher incidence of bronchopneumonia, and disturbances of movement. The acute clinical symptoms gradually faded away in the phase of transition to recovery towards the end of the fourth week after irradiation. (author)

  20. Assessment of acute and late effects to high-LET radiation

    We have begun to reassess late tissue effects available from the Charged Particle Cancer Radiotherapy program at Berkeley. Our quantitative approach is limited in the analysis of these Phase I/II studies by not having equivalent patient numbers for each of the particle beams studied, by not having completely comparable follow-up times, by variations in the sizes of the fields compared, by variations in the skin scoring photographic documentation available from the patient charts, and by variations in the fractionation sizes, numbers and schedules. Despite these limitations, preliminary evidence demonstrates acute skin reactions with a shift to increasing lower dose per fraction per field for the maximum skin reactions of helium, carbon and neon ions compared to electrons. Comparisons with skin reactions from low-energy neutrons indicate that Bragg peak carbon ions (initial energy 308 MeV/nucleon) are slightly less effective than 7.5 MeV neutrons. Bragg peak neon ions (initial energy 670 MeV/nucleon) corrected for differences in reference radiation are slightly more effective than 7.5 MeV neutrons. Bragg peak silicon (initial energy 670 MeV/nucleon) result in an enhanced acute skin reaction, and a premature appearance of late effects that may indicate a significantly different mechanism of damage and/or repair

  1. Kikuchi-Fujimoto disease: an unusual association with acute renal failure

    Amanda Feliciano da Silva

    2010-12-01

    Full Text Available Kikuchi-Fujimoto disease, also known as histiocytic necrotizing lymphadenitis of unknown etiopathogenesis, is a self-limited disease which frequently appears as feverish lymphadenomegaly, thus creating the need for differential diagnosis with lymphoma, systemic lupus erythematosus (SLE, infectious mononucleosis, cat-scratch disease, and toxoplasmosis with lymphonodal impairment. However, there are cases in which it may evolve with complications such as aseptic meningitis, cerebellar ataxia, and aseptic myocarditis. We are presenting a case of a 24-year-old man who had an initial picture of arthralgia, evening fever and adenomegaly. Kikuchi disease was diagnosed through lymph node biopsy with immunohistochemistry and evolves with severe systemic manifestations, such as pericarditis with cardiac tamponade, pneumonitis, hepatitis, and acute kidney failure - the latter has not been reported in literature yet. There was significant improvement of the clinical picture with prednisone

  2. Adalimumab-induced acute interstitial lung disease in a patient with rheumatoid arthritis

    Olivia Meira Dias

    2014-01-01

    Full Text Available The use of immunobiological agents for the treatment of autoimmune diseases is increasing in medical practice. Anti-TNF therapies have been increasingly used in refractory autoimmune diseases, especially rheumatoid arthritis, with promising results. However, the use of such therapies has been associated with an increased risk of developing other autoimmune diseases. In addition, the use of anti-TNF agents can cause pulmonary complications, such as reactivation of mycobacterial and fungal infections, as well as sarcoidosis and other interstitial lung diseases (ILDs. There is evidence of an association between ILD and the use of anti-TNF agents, etanercept and infliximab in particular. Adalimumab is the newest drug in this class, and some authors have suggested that its use might induce or exacerbate preexisting ILDs. In this study, we report the first case of acute ILD secondary to the use of adalimumab in Brazil, in a patient with rheumatoid arthritis and without a history of ILD.

  3. An analysis of clinical characteristics of septic acute kidney injury by using criteria of Kidney Disease:Improving Global Outcomes

    臧芝栋

    2013-01-01

    Objective To evaluate the value of kidney Disease:Improving Global Outcomes(KDIGO) criteria in investigating clinical feature and prognosis of acute kidney injury(AKI) patients with sepsis in ICU.Methods

  4. Multiwavelength UV-IR laser system based on a-cut Nd : YVO4 - YVO4 composite vanadate crystals with σ-polarised radiation

    Lasing properties of a-cut Nd : YVO4 - YVO4 composite vanadate crystals are experimentally studied for the π and σ polarisations of radiation at the 4F3/2 - 4I11/2 transition. Polarisation dependences of the lasing characteristics of passively Q-switched Nd : YVO4 - YVO4 lasers with Cr4+ : YAG Q-switches are investigated. It is shown that the laser operates with the highest efficiency in the case of the σ-polarised radiation (minimum pulse duration shorter than 1.5 ns, maximum peak power up to 25 kW, maximum peak energy about 35 μJ at a slope efficiency up to 32 %). Frequency conversion to the second and fourth harmonics is demonstrated. Based on this study, a multiwavelength laser with bactericidal and therapeutic effects is developed for treatment of a wide spectrum of diseases.

  5. Influence of plasma GSH level on acute radiation mucositis of the oral cavity

    The purpose of the study was to see how pretreatment plasma GSH level influences the severity of acute radiation mucositis of the oral cavity during therapeutic irradiation in patients with oral cancer. Thirteen patients with squamous cell circinoma of the oral cavity form the subject material. Radical radiotherapy (60 Gy in 25 fractions over 5 weeks) was given using telecobalt. Pretreatment plasma GSH level was measured by Beutler's method. The normal tissue reaction during radiotherapy was monitored and graded. The GSH levels ranged from 10.6-90.5 μM/L (mean 30.6 μM/L). Those who had higher GSH levels developed less severe mucositis. The mean GSH levels in the groups with different severity of reactions were: Grade 2 (four patients) = 50.7 μM/L; Grade 3 (five patients) = 26.1 μM/L; Grade 4 (two patients) = 20.4 μM/L and Grade 5 (two patients) = 26.1 μM/L; Grade 4 (two patients) = 20.4 μM/L and Grade 5 (two patients) = 13.6 μM/L. Plasma GSH estimation has the potential to predict individual sensitivity to acute radiation mucositis and may particularly be useful in hyperfractionated regimes. The study also affirms the radioprotective role of GSH and suggests that this effect is either due to protection against membrane lipid perodixation (since GSH does not enter the cell freely) or DNA damage (fractionated radiotherapy may permit freer entry of GSH into cell). 26 refs., 1 fig., 2 tabs

  6. γ-Tocotrienol as a Promising Countermeasure for Acute Radiation Syndrome: Current Status.

    Singh, Vijay K; Hauer-Jensen, Martin

    2016-01-01

    The hazard of ionizing radiation exposure due to nuclear accidents or terrorist attacks is ever increasing. Despite decades of research, still, there is a shortage of non-toxic, safe and effective medical countermeasures for radiological and nuclear emergency. To date, the U.S. Food and Drug Administration (U.S. FDA) has approved only two growth factors, Neupogen (granulocyte colony-stimulating factor (G-CSF), filgrastim) and Neulasta (PEGylated G-CSF, pegfilgrastim) for the treatment of hematopoietic acute radiation syndrome (H-ARS) following the Animal Efficacy Rule. Promising radioprotective efficacy results of γ-tocotrienol (GT3; a member of the vitamin E family) in the mouse model encouraged its further evaluation in the nonhuman primate (NHP) model. These studies demonstrated that GT3 significantly aided the recovery of radiation-induced neutropenia and thrombocytopenia compared to the vehicle controls; these results particularly significant after exposure to 5.8 or 6.5 Gray (Gy) whole body γ-irradiation. The stimulatory effect of GT3 on neutrophils and thrombocytes (platelets) was directly and positively correlated with dose; a 75 mg/kg dose was more effective compared to 37.5 mg/kg. GT3 was also effective against 6.5 Gy whole body γ-irradiation for improving neutrophils and thrombocytes. Moreover, a single administration of GT3 without any supportive care was equivalent, in terms of improving hematopoietic recovery, to multiple doses of Neupogen and two doses of Neulasta with full supportive care (including blood products) in the NHP model. GT3 may serve as an ultimate radioprotector for use in humans, particularly for military personnel and first responders. In brief, GT3 is a promising radiation countermeasure that ought to be further developed for U.S. FDA approval for the ARS indication. PMID:27153057

  7. Studies of the ionizing radiation effects on the effluents acute toxicity due to anionic surfactants

    Several studies have shown the negative effects of surfactants, as detergents active substance, when discharged on biological sewage wastewater treatment plants. High toxicity may represent a lower efficiency for biological treatment. When surfactants are in aquatic environment they may induce a loss of grease revetment on birds (feather). Depending on the surfactant concentration, several damages to all biotic systems can happen. Looking for an alternative technology for wastewater treatment, efficient for surfactant removal, the present work applied ionizing radiation as an advanced oxidation process for affluents and effluents from Suzano Treatment Station. Such wastewater samples were submitted to radiation using an electron beam from a Dynamic Electron Beam Accelerator from Instituto de Pesquisas Energeticas e Nucleares. In order to assess this proposed treatment efficacy, it was performed acute toxicity evaluation with two test-organisms, the crustacean Daphnia similis and the luminescent bacteria Vibrio fischeri. The studied effluents were: one from a chemical industry (IND), three from sewage plant (affluents - GG, GM and Guaio) and the last biologically treated secondary effluent (EfF), discharged at Tiete river. The applied radiation doses varied from 3 kGy to 50 kGy, being 50 kGy enough for surfactant degradation contained at industrial effluent. For GG, GM and Guaio samples, doses of 6 kGy and 10 kGy were efficient for surfactant and toxicity reduction, representing an average removal that varied from 71.80% to 82.76% and toxicity from 30% to 91% for most the effluents. The final effluent was less toxic than the others and the radiation induced an average 11% removal for anionic surfactant. The industrial effluents were also submitted to an aeration process in order to quantify the contribution of surfactant to the whole sample toxicity, once it was partially removed as foam and several fractions were evaluated for toxicity. (author)

  8. γ-Tocotrienol as a Promising Countermeasure for Acute Radiation Syndrome: Current Status

    Vijay K. Singh

    2016-05-01

    Full Text Available The hazard of ionizing radiation exposure due to nuclear accidents or terrorist attacks is ever increasing. Despite decades of research, still, there is a shortage of non-toxic, safe and effective medical countermeasures for radiological and nuclear emergency. To date, the U.S. Food and Drug Administration (U.S. FDA has approved only two growth factors, Neupogen (granulocyte colony-stimulating factor (G-CSF, filgrastim and Neulasta (PEGylated G-CSF, pegfilgrastim for the treatment of hematopoietic acute radiation syndrome (H-ARS following the Animal Efficacy Rule. Promising radioprotective efficacy results of γ-tocotrienol (GT3; a member of the vitamin E family in the mouse model encouraged its further evaluation in the nonhuman primate (NHP model. These studies demonstrated that GT3 significantly aided the recovery of radiation-induced neutropenia and thrombocytopenia compared to the vehicle controls; these results particularly significant after exposure to 5.8 or 6.5 Gray (Gy whole body γ-irradiation. The stimulatory effect of GT3 on neutrophils and thrombocytes (platelets was directly and positively correlated with dose; a 75 mg/kg dose was more effective compared to 37.5 mg/kg. GT3 was also effective against 6.5 Gy whole body γ-irradiation for improving neutrophils and thrombocytes. Moreover, a single administration of GT3 without any supportive care was equivalent, in terms of improving hematopoietic recovery, to multiple doses of Neupogen and two doses of Neulasta with full supportive care (including blood products in the NHP model. GT3 may serve as an ultimate radioprotector for use in humans, particularly for military personnel and first responders. In brief, GT3 is a promising radiation countermeasure that ought to be further developed for U.S. FDA approval for the ARS indication.

  9. Pathophysiology, prevention, and treatment of acute graft-versus-host disease

    Abhinav Deol

    2011-03-01

    Full Text Available Abhinav Deol, Voravit Ratanatharathorn, Joseph P UbertiDepartment of Oncology, Blood and Marrow Stem Cell Transplant Program, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USAAbstract: Acute graft-versus-host disease (aGVHD is an immunologically mediated inflammatory reaction, which continues to be a major cause of morbidity and mortality in patients undergoing allogeneic hematopoietic stem cell transplant. Although the occurrence and severity of this disease may be devastating, there is a proven immunologically mediated antitumor activity that accompanies the disease process, which has a beneficial effect on outcome. Animal models of graft-versus-host disease (GVHD have given us a conceptual model that has allowed a better understanding of the pathophysiology and offers a framework for understanding the complex interactions between antigen-presenting cells, donor T-cells, and cytokines in the development of aGVHD. It has also given us a model that allows testing of various strategies for prevention and treatment. New, innovative approaches for treatment and prevention of aGVHD including better donor selection with the use of sophisticated human leukocyte antigen typing, use of T-cell depletion, reduced-intensity transplant regimens, and improved pharmacologic immunosuppression have improved outcomes by decreasing the incidence and severity of aGVHD. However, the limitation of these strategies is that effective treatment and prevention of aGVHD is often accompanied by a concomitant rise in relapses, graft failure and infections, and ultimately no improvement in overall survival. Investigators are working on understanding the difference between GVHD and graft versus tumor effect, as this would be the key in improving outcomes for our patients. In this review, we will discuss the pathophysiology of aGVHD along with the preventative and treatment strategies.Keywords: acute GVHD, GVHD, acute graft

  10. Cyclosporine and methotrexate-related pharmacogenomic predictors of acute graft-versus-host disease.

    Laverdière, Isabelle; Guillemette, Chantal; Tamouza, Ryad; Loiseau, Pascale; Peffault de Latour, Regis; Robin, Marie; Couture, Félix; Filion, Alain; Lalancette, Marc; Tourancheau, Alan; Charron, Dominique; Socié, Gérard; Lévesque, Éric

    2015-02-01

    Effective immunosuppression is mandatory to prevent graft-versus-host disease and to achieve a successful clinical outcome of hematopoietic stem cell transplantation. Here we tested whether germline single nucleotide polymorphisms in 20 candidate genes related to methotrexate and cyclosporine metabolism and activity influence the incidence of graft-versus-host disease in patients who undergo stem cell transplantation for hematologic disorders. Recipient genetic status of the adenosine triphosphate-binding cassette sub-family C1 and adenosine triphosphate-binding cassette sub-family C2 transporters, 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/ inosine monophosphate cyclohydrolase within the methotrexate pathway, and nuclear factor of activated T cells (cytoplasmic 1) loci exhibit a remarkable influence on severe acute graft-versus-host disease prevalence. Indeed, an increased risk of acute graft-versus-host disease was observed in association with single nucleotide polymorphisms located in 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/inosine monophosphate cyclohydrolase (hazard ratio=3.04; P=0.002), nuclear factor of activated T cells (cytoplasmic 1) (hazard ratio=2.69; P=0.004), adenosine triphosphate-binding cassette sub-family C2 (hazard ratio=3.53; P=0.0018) and adenosine triphosphate-binding cassette sub-family C1 (hazard ratio=3.67; P=0.0005). While donor single nucleotide polymorphisms of dihydrofolate reductase and solute carrier family 19 (member 1) genes are associated with a reduced risk of acute graft-versus-host disease (hazard ratio=0.32-0.41; P=0.0009-0.008), those of nuclear factor of activated T cells (cytoplasmic 2) are found to increase such risk (hazard ratio=3.85; P=0.0004). None of the tested single nucleotide polymorphisms was associated with the occurrence of chronic graft-versus-host disease. In conclusion, by targeting drug-related biologically relevant genes, this work emphasizes the potential role of

  11. Ethnic differences in mortality from acute rheumatic fever and chronic rheumatic heart disease in New Mexico, 1958-1982.

    Becker, T M; Wiggins, C L; Key, C. R.; Samet, J M

    1989-01-01

    To examine time trends and differences in mortality rates from acute rheumatic fever and chronic rheumatic heart disease in New Mexico's Hispanic, American Indian, and non-Hispanic white populations, we analyzed vital records data for 1958 through 1982. Age-adjusted mortality rates for acute rheumatic fever were low and showed no consistent temporal trends among the three ethnic groups over the study period. Age-adjusted and age-specific mortality rates for chronic rheumatic heart disease in ...

  12. Radiation-induced intracranial osteosarcoma after radiation for acute lymphocytic leukemia associated with Li-Fraumeni syndrome

    A 28-year-old man presented with osteosarcoma of the occipital bone 16 years after 24 Gy of craniospinal irradiation for acute lymphocytic leukemia. The tumor had both intra- and extra-cranial components. However, the affected skull appeared to be normal on imaging because of permeative infiltration by the tumor. Subtotal resection was achieved and the tumor was verified histologically as an osteosarcoma. The residual tumor soon showed remarkable enlargement and disseminated to the spinal cord. Both of the enlarged and disseminated tumor masses were treated by surgical intervention and chemotherapy. However, the patient deteriorated due to the tumor regrowth and died 11 months after the initial diagnosis. This patient had previously developed a leukemia, a colon cancer, a rectal cancer and a hepatocellular carcinoma. His brother also died of leukemia. The patient had a heterozygous TP53 germ-line mutation of codon 248 in the exon 7. In conclusion, we consider the present tumor to be a rare example of radiation-induced skull osteosarcoma in a member of the cancer-prone family with TP53 germ-line mutation which is associated with Li-Fraumeni syndrome. (author)

  13. Autologous bone marrow stromal cell transplantation as a treatment for acute radiation enteritis induced by a moderate dose of radiation in dogs.

    Xu, Wenda; Chen, Jiang; Liu, Xu; Li, Hongyu; Qi, Xingshun; Guo, Xiaozhong

    2016-05-01

    Radiation enteritis is one of the most common complications of cancer radiotherapy, and the development of new and effective measures for its prevention and treatment is of great importance. Adult bone marrow stromal stem cells (ABMSCs) are capable of self-renewal and exhibit low immunogenicity. In this study, we investigated ABMSC transplantation as a treatment for acute radiation enteritis. We developed a dog model of acute radiation enteritis using abdominal intensity-modulated radiation therapy in a single X-ray dose of 14 Gy. ABMSCs were cultured in vitro, identified via immunofluorescence and flow cytometry, and double labeled with CM-Dil and superparamagnetic iron oxide (SPIO) before transplantation, which took place 48 hours after abdominal irradiation in a single fraction. The dog model of acute radiation enteritis was transplanted with cultured ABMSCs labeled with CM-Dil and SPIO into the mesenteric artery through the femoral artery. Compared with untreated control groups, dogs treated with ABMSCs exhibited substantially longer survival time and improved relief of clinical symptoms. ABMSC transplantation induced the regeneration of the intestinal epithelium and the recovery of intestinal function. Furthermore, ABMSC transplantation resulted in elevated serum levels of the anti-inflammatory cytokine interleukin-11 (IL10) and intestinal radioprotective factors, such as keratinocyte growth factor, basic fibroblast growth factor-2, and platelet-derived growth factor-B while reducing the serum level of the inflammatory cytokine IL17. ABMSCs induced the regeneration of the intestinal epithelium and regulated the secretion of serum cytokines and the expression of radioprotective proteins and thus could be beneficial in the development of novel and effective mitigators of and protectors against acute radiation enteritis. PMID:26763584

  14. Rectal cancer and inflammatory bowel disease: natural history and implications for radiation therapy

    Purpose: There exists little information concerning the natural history of rectal cancer in patients with inflammatory bowel disease (IBD). In addition, the tolerance of pelvic irradiation in these patients is unknown. We analyzed the largest series of patients with IBD and rectal cancer in order to determine the natural history of the disease as well as the effect and tolerance of pelvic irradiation. Methods and Materials: A retrospective analysis of 47 patients with IBD and rectal cancer treated over a 34-year period (1960-1994) was performed. Thirty-five patients had ulcerative colitis and 12 patients had Crohn's disease. There were 31 male patients and 16 female patients. The stage (AJC) distribution was as follows: stage 0 in 5 patients, stage I in 13 patients, stage II in 7 patients, stage III in 13 patients, and stage IV in 9 patients. Surgical resection was performed in 44 patients. In two of these patients, preoperative pelvic irradiation was given followed by surgery. Twenty of these patients underwent postoperative adjuvant therapy (12 were treated with chemotherapy and pelvic irradiation and 8 with chemotherapy alone). Three patients were found to have unresectable disease and were treated with chemotherapy alone (2 patients) or chemotherapy and radiation therapy (RT) (1 patient). Radiation complications were graded using the RTOG acute and late effects scoring criteria. Follow-up ranged from 4 to 250 months (median 24 months). Results: The 5-year actuarial results revealed an overall survival (OS) of 42%, a disease-free survival (DFS) of 43%, a pelvic control rate (PC) of 67% and a freedom from distant failure (FFDF) of 47%. DFS decreased with increasing T stage with a 5-year rate of 86% for patients with Tis-T2 disease compared to 10% for patients with T3-T4 disease (p ) were noted in three patients (20%) receiving pelvic irradiation ± chemotherapy and these included two cases of grade 3 skin reactions and one case of grade 4 gastrointestinal

  15. Acute adaptive immune response correlates with late radiation-induced pulmonary fibrosis in mice

    The lung response to radiation exposure can involve an immediate or early reaction to the radiation challenge, including cell death and an initial immune reaction, and can be followed by a tissue injury response, of pneumonitis or fibrosis, to this acute reaction. Herein, we aimed to determine whether markers of the initial immune response, measured within days of radiation exposure, are correlated with the lung tissue injury responses occurring weeks later. Inbred strains of mice known to be susceptible (KK/HIJ, C57BL/6J, 129S1/SvImJ) or resistant (C3H/HeJ, A/J, AKR/J) to radiation-induced pulmonary fibrosis and to vary in time to onset of respiratory distress post thoracic irradiation (from 10–23 weeks) were studied. Mice were untreated (controls) or received 18 Gy whole thorax irradiation and were euthanized at 6 h, 1d or 7 d after radiation treatment. Pulmonary CD4+ lymphocytes, bronchoalveolar cell profile & cytokine level, and serum cytokine levels were assayed. Thoracic irradiation and inbred strain background significantly affected the numbers of CD4+ cells in the lungs and the bronchoalveolar lavage cell differential of exposed mice. At the 7 day timepoint greater numbers of pulmonary Th1 and Th17 lymphocytes and reduced lavage interleukin17 and interferonγ levels were significant predictors of late stage fibrosis. Lavage levels of interleukin-10, measured at the 7 day timepoint, were inversely correlated with fibrosis score (R = −0.80, p = 0.05), while serum levels of interleukin-17 in control mice significantly correlated with post irradiation survival time (R = 0.81, p = 0.04). Lavage macrophage, lymphocyte or neutrophil counts were not significantly correlated with either of fibrosis score or time to respiratory distress in the six mouse strains. Specific cytokine and lymphocyte levels, but not strain dependent lavage cell profiles, were predictive of later radiation-induced lung injury in this panel of inbred strains. The online version of this

  16. Radiation therapy for early stage Hodgkin's disease: Australasian patterns of care

    Purpose: Analysis of treatment outcome for Stage I-IIA supradiaphragmatic Hodgkin's disease treated solely by irradiation in Australia and New Zealand. Methods and Materials: Patients with supradiaphragmatic Hodgkin's disease only who were treated by irradiation alone with curative intent between 1969 to 1988 were retrospectively reviewed. Ten radiation oncology departments in Australia and New Zealand contributed patient data to the study. Patient, tumor, and treatment variables were recorded. Disease-free interval, survival, and complications were analyzed. Results: Eight hundred and twenty patients were reviewed. The median age was 29 years. There were 437 men and 383 women. The distribution of 310 clinically staged patients was 170 stage IA, 5 IB, and 135 IIA. Five hundred and ten patients received laparotomies, and pathologic staging was as follows: IA 214, IB 13, IIA 283. The 10-year acturial disease-free rate was 69% and overall survival rate was 79%. Increasing age, male sex, higher number of involved sites, the use of involved field irradiation, no staging laparotomy, and earlier year of treatment were significantly associated with an increased risk of relapse and lower survival. Actuarial 10-year survival following recurrence was 48%. Acute complications requiring interruption to treatment occurred in 46 patients (6%), but < 1% had their treatment permanently suspended. Actuarial complication rates at 10 years were: cardiac 2%, pulmonary 3% and thyroid 5%. There were 44 second malignancies including 10 non-Hodgkin's lymphomas, 3 leukemias, 7 lung, and 6 breast cancers. Mean delay to the development of a second cancer was 6 years. The 10-year actuarial rate of second malignancy was 5%. Conclusions: The Australasian experience of early stage Hodgkin's disease is consistent with the results in the published literature and confirms that irradiation produces a high cure rate with minimal toxicity

  17. Regulatory T Cells Contribute to the Inhibition of Radiation-Induced Acute Lung Inflammation via Bee Venom Phospholipase A₂ in Mice.

    Shin, Dasom; Lee, Gihyun; Sohn, Sung-Hwa; Park, Soojin; Jung, Kyung-Hwa; Lee, Ji Min; Yang, Jieun; Cho, Jaeho; Bae, Hyunsu

    2016-01-01

    Bee venom has long been used to treat various inflammatory diseases, such as rheumatoid arthritis and multiple sclerosis. Previously, we reported that bee venom phospholipase A₂ (bvPLA₂) has an anti-inflammatory effect through the induction of regulatory T cells. Radiotherapy is a common anti-cancer method, but often causes adverse effects, such as inflammation. This study was conducted to evaluate the protective effects of bvPLA₂ in radiation-induced acute lung inflammation. Mice were focally irradiated with 75 Gy of X-rays in the lung and administered bvPLA₂ six times after radiation. To evaluate the level of inflammation, the number of immune cells, mRNA level of inflammatory cytokine, and histological changes in the lung were measured. BvPLA₂ treatment reduced the accumulation of immune cells, such as macrophages, neutrophils, lymphocytes, and eosinophils. In addition, bvPLA₂ treatment decreased inflammasome-, chemokine-, cytokine- and fibrosis-related genes' mRNA expression. The histological results also demonstrated the attenuating effect of bvPLA₂ on radiation-induced lung inflammation. Furthermore, regulatory T cell depletion abolished the therapeutic effects of bvPLA₂ in radiation-induced pneumonitis, implicating the anti-inflammatory effects of bvPLA₂ are dependent upon regulatory T cells. These results support the therapeutic potential of bvPLA₂ in radiation pneumonitis and fibrosis treatments. PMID:27144583

  18. Circulating microbial products and acute phase proteins as markers of pathogenesis in lymphatic filarial disease.

    R Anuradha

    Full Text Available Lymphatic filariasis can be associated with development of serious pathology in the form of lymphedema, hydrocele, and elephantiasis in a subset of infected patients. Dysregulated host inflammatory responses leading to systemic immune activation are thought to play a central role in filarial disease pathogenesis. We measured the plasma levels of microbial translocation markers, acute phase proteins, and inflammatory cytokines in individuals with chronic filarial pathology with (CP Ag+ or without (CP Ag- active infection; with clinically asymptomatic infections (INF; and in those without infection (endemic normal [EN]. Comparisons between the two actively infected groups (CP Ag+ compared to INF and those without active infection (CP Ag- compared to EN were used preliminarily to identify markers of pathogenesis. Thereafter, we tested for group effects among all the four groups using linear models on the log transformed responses of the markers. Our data suggest that circulating levels of microbial translocation products (lipopolysaccharide and LPS-binding protein, acute phase proteins (haptoglobin and serum amyloid protein-A, and inflammatory cytokines (IL-1β, IL-12, and TNF-α are associated with pathogenesis of disease in lymphatic filarial infection and implicate an important role for circulating microbial products and acute phase proteins.

  19. Biomarkers in the assessment of acute and chronic kidney diseases in the dog and cat.

    Cobrin, A R; Blois, S L; Kruth, S A; Abrams-Ogg, A C G; Dewey, C

    2013-12-01

    In both human and veterinary medicine, diagnosing and staging renal disease can be difficult. Measurement of glomerular filtration rate is considered the gold standard for assessing renal function but methods for its assessment can be technically challenging and impractical. The main parameters used to diagnose acute and chronic kidney disease include circulating creatinine and urea concentrations, and urine-specific gravity. However, these parameters can be insensitive. Therefore, there is a need for better methods to diagnose and monitor patients with renal disease. The use of renal biomarkers is increasing in human and veterinary medicine for the diagnosis and monitoring of acute and chronic kidney diseases. An ideal biomarker would identify site and severity of injury, and correlate with renal function, among other qualities. This article will review the advantages and limitations of renal biomarkers that have been used in dogs and cats, as well as some markers used in humans that may be adapted for veterinary use. In the future, measuring a combination of biomarkers will likely be a useful approach in the diagnosis of kidney disorders. PMID:24152019

  20. Risk factors associated with the introduction of acute clinical infectious bursal disease among Danish broiler chickens in 1998

    Flensburg, Mimi Folden; Ersbøll, Annette Kjær; Jørgensen, Poul Henrik

    2002-01-01

    The objective of the present study was to investigate risk factors associated with the introduction of acute clinical infectious bursal disease (IBD) among Danish broiler chickens in 1998. Data on 218 flocks were collected from hatcheries, abattoirs, farmers and veterinarians; 49 of the flocks had...... experienced acute clinical IBD (cases), 169 were unexposed (controls). The study was carried out using a case-control design. Cases were defined as the first flock on each premises to experience acute clinical IBD, and these were compared with non-diseased, non-IBD-vaccinated control flocks chosen randomly...

  1. Emergency preparedness of Research Center for Radiation medicine and its hospital to admit and treat the patients with signs of acute radiation sickness

    After the Chernobyl accident, the Research Center for Radiation Medicine (RCRM) was established in Kiev (Ukraine). Its main task was to maintain a high level of emergency preparedness and be ready to examine and treat patients who suffer as a result of hypothetical radiation accident. Based on the previous experience, this institution's specialists worked out new diagnostic criteria and drug treatment schemata for acute radiation sickness, created a database on 75 patients with this diagnosis and improved educational programmes for medical students and physicians working in the field of radiation medicine. RCRM collaborates fruitfully with western partners through the joint research projects and connects with the World Health Organisation's Radiation Emergency Medical Preparedness and Assistance Network centre. Collaboration with Kiev Center for Bone Marrow Transplantation allows RCRM to use aseptic wards having highly filtered air for the treatment of most severely irradiated patients. (authors)

  2. Higher sensitivity of LEC strain rat in radiation-induced acute intestinal death

    LEC strain rats (LEC rats), which have been known to develop hereditarily spontaneous fulminant hepatitis 4-5 months after birth, were highly sensitive to whole-body X-irradiation as compared to WKAH strain rats (WKAH rats). Radiation-induced acute intestinal death occurred at doses higher than 6.5 Gy in LEC rats, and at doses higher than 12.8 Gy in WKAH rats, respectively. By the probit analysis of survival data, it was shown that the LD50/7 value of LEC rats was estimated to be 7.03 Gy which was significantly lower than that (12.99 Gy) of WKAH rats. Histopathological examinations of small intestines from LEC rats 2 days after irradiation at the dose of 8.5 Gy showed severe epithelial death together with edema, whereas little or no significant changes were noted in intestinal epithelium of 8.5 Gy-irradiated WKAH rats. These results suggest that the radiosensitivity of LEC rats to ionizing radiation appears to be higher than that of other strains of rats

  3. Studies on the application of tryptophan metabolites as indicators of acute radiation damage and their modification

    It has been the aim of the investigations to continue earlier studies on the amplication of tryptophan metabolites as biochemical indicators after irradiation. These metabolites are of interest as they apparently indicate radiation effects in contrast to other metabolites like taurine and deoxycytidine in a dose range which leads to acute radiation sickness with the consequence of death. This assumption has been confirmed by the results of these studies. Measurements in the urine of rats demonstrate that the excretion of kynurenic acid and of xanthurenic acid as well as especially the ratio of kynurenic acid/anthranilic acid increases considerably in those animals which die some days later. The excretion of the surviving anilic acid increases considerably in those animals which die some days later. The excretion of the surviving animals is characteristical different. This abnormal excretion is induced by changes of specific, hepatic enzyme activities. The investigations have shown that the effects on the enzyme activities apppear not only after X-rays irradiation but also after neutrons. The studies, which have been performed with human material on the NAD-metabolism, demonstrate that with respect to the enzyme activities in the spleen as well as to the urinary excretion the same or similar effects, which have been found with animal experiments, can be expected. (orig.) 891 MG/orig. 892 CKA

  4. Histopathological comparison of topical therapy modalities for acute radiation proctitis in an experimental rat model

    Cagatay Korkut; Oktar Asoglu; Murat Aksoy; Yersu Kapran; Hatice Bilge; Nese Kiremit-Korkut; Mesut Parlak

    2006-01-01

    AIM: To evaluate the prevalent topical therapeutic modalities available for the treatment of acute radiation proctitis compared to formalin. METHODS: A total of 120 rats were used. Four groups (n = 30) were analyzed with one group for each of the following applied therapy modalities: control, mesalazine, formalin, betamethasone, and misoprostol. A single fraction of 17.5 Gy was delivered to each rat. The rats in control group rats were given saline, and the rats in the other three groups received appropriate enemas twice a day beginning on the first day after the irradiation until the day of euthanasia. On d 5, 10, and 15, ten rats from each group were euthanized and a pathologist who was unaware of treatment assignment examined the rectums using a scoring system. RESULTS: The histopathologic scores for surface epithelium, glands (crypts) and lamina propria stroma of the rectums reached their maximum level on d 10. The control and formalin groups had the highest and mesalazine had the lowest, respectively on d 10. On the 15th d, mesalazine, betamethasone, and misoprostol had the lowest scores of betamethasone. CONCLUSION: Mesalazine, betamethasone, and misoprostol are the best topical agents for radiation proctitis and formalin has an inflammatory effect and should not be used.

  5. Therapeutic effect of TPO and G-CSF on acute radiation sickness of monkeys

    Objective: The author describes the therapeutic effects of recombinant human thrombopoietin (rhTPO) and recombinant human granulocyte colony-stimulating factor (rhG-CSF) on acute radiation sickness in monkeys. Methods: rhTPO(10μg·kg-1·d-1, sc, on days 1-21 after TBI) or/and rhG-CSF (5μg·kg-1·d-1, sc, on days 1-21 after TBI) were administered to rhesus monkeys with 5.0 Gy X-irradiation. Results: rhTPO promoted platelet and reticulocyte recovery, resulting in less profound nadirs and a rapid recovery to normal levels. Platelet transfusion were not required in contrast to controls, while hemoglobin levels stabilized rapidly. TPO treatment did not influence neutrophil counts, rhG-CSF stimulated neutrophil regeneration and had no effect on platelet levels. Simultaneous administration of rhTPO and rhG-GSF were as effective as rhTPO alone in preventing thrombopenia, although the platelet level did not rise to the supranormal level seen with TPO alone. The neutrophils were greatly augmented in number, compared to G-CSF treatment alone, resulting in a less profound nadir and much earlier recovery, which was similarly observed for monocytes, CD11b+, CD16+ and CD56+ cell reconstitution. Conclusion: These data show that rhTPO and rhG-GSF are potent stimulators of hematopoiesis in monkeys with radiation sickness

  6. Whole acute toxicity removal from industrial and domestic effluents treated by electron beam radiation: emphasis on anionic surfactants

    Electron beam radiation has been applied to improve real industrial and domestic effluents received by Suzano wastewater treatment plant. Radiation efficacy has been evaluated as toxicity reduction, using two biological assays. Three sites were sampled and submitted for toxicity assays, anionic surfactant determination and electron beam irradiation. This paper shows the reduction of acute toxicity for both test-organisms, the marine bacteria Vibrio fischeri and the crustacean Daphnia similis. The raw toxic effluents exibitted from 0.6 ppm up to 11.67 ppm for anionic surfactant before being treated by the electron beam. Radiation processing resulted in reduction of the acute toxicity as well as surfactant removal. The final biological effluent was in general less toxic than other sites but the presence of anionic surfactants was evidenced

  7. Whole acute toxicity removal from industrial and domestic effluents treated by electron beam radiation: emphasis on anionic surfactants

    Moraes, M.C.F. E-mail: mariacristinafm@uol.com.br; Romanelli, M.F; Sena, H.C.; Pasqualini da Silva, G.; Sampa, M.H.O.; Borrely, S.I

    2004-10-01

    Electron beam radiation has been applied to improve real industrial and domestic effluents received by Suzano wastewater treatment plant. Radiation efficacy has been evaluated as toxicity reduction, using two biological assays. Three sites were sampled and submitted for toxicity assays, anionic surfactant determination and electron beam irradiation. This paper shows the reduction of acute toxicity for both test-organisms, the marine bacteria Vibrio fischeri and the crustacean Daphnia similis. The raw toxic effluents exibitted from 0.6 ppm up to 11.67 ppm for anionic surfactant before being treated by the electron beam. Radiation processing resulted in reduction of the acute toxicity as well as surfactant removal. The final biological effluent was in general less toxic than other sites but the presence of anionic surfactants was evidenced.

  8. Whole acute toxicity removal from industrial and domestic effluents treated by electron beam radiation: emphasis on anionic surfactants

    Moraes, M. C. F.; Romanelli, M. F.; Sena, H. C.; Pasqualini da Silva, G.; Sampa, M. H. O.; Borrely, S. I.

    2004-09-01

    Electron beam radiation has been applied to improve real industrial and domestic effluents received by Suzano wastewater treatment plant. Radiation efficacy has been evaluated as toxicity reduction, using two biological assays. Three sites were sampled and submitted for toxicity assays, anionic surfactant determination and electron beam irradiation. This paper shows the reduction of acute toxicity for both test-organisms, the marine bacteria Vibrio fischeri and the crustacean Daphnia similis. The raw toxic effluents exibitted from 0.6 ppm up to 11.67 ppm for anionic surfactant before being treated by the electron beam. Radiation processing resulted in reduction of the acute toxicity as well as surfactant removal. The final biological effluent was in general less toxic than other sites but the presence of anionic surfactants was evidenced.

  9. Recurrent acute pancreatitis and cholangitis in a patient with autosomal dominant polycystic kidney disease

    Kambiz Yazdanpanah

    2013-01-01

    Full Text Available Autosomal dominant polycystic kidney disease (ADPKD is an inherited disorder associated with multiple cyst formation in the different organs. Development of pancreatic cyst in ADPKD is often asymptomatic and is associated with no complication. A 38-year-old man with ADPKD was presented with six episodes of acute pancreatitis and two episodes of cholangitis in a period of 12 months. Various imaging studies revealed multiple renal, hepatic and pancreatic cysts, mild ectasia of pancreatic duct, dilation of biliary system and absence of biliary stone. He was managed with conservative treatment for each attack. ADPKD should be considered as a potential risk factor for recurrent acute and/or chronic pancreatitis and cholangitis.

  10. Non-psychotic mental disorders in persons who had acute radiation sickness as a result of the Chernobyl disaster (10 years after catastrophe)

    The description of non-psychotic mental disorders in the persons who had in 1986 acute radiation sickness of 1-3 severity degree as a result of the Chernobyl disaster was given on the basis of follow up study. Three principal syndromes were distinguished as following: cerebrasthenic, psychopathic-like ('characteropathia') and psycho organic. Principals of therapy of non-psychotic mental disorders in the persons who had been exposed to ionization radiation and suffered from acute radiation sickness are considered

  11. 2013 Space Radiation Standing Review Panel Status Review for: The Risk of Acute and Late Central Nervous System Effects from Radiation Exposure, The Risk of Acute Radiation Syndromes Due to Solar Particle Events (SPEs), The Risk Of Degenerative Tissue Or Other Health Effects From Radiation Exposure, and The Risk of Radiation Carcinogenesis

    2014-01-01

    The Space Radiation Standing Review Panel (from here on referred to as the SRP) was impressed with the strong research program presented by the scientists and staff associated with NASA's Space Radiation Program Element and National Space Biomedical Research Institute (NSBRI). The presentations given on-site and the reports of ongoing research that were provided in advance indicated the potential Risk of Acute and Late Central Nervous System Effects from Radiation Exposure (CNS) and were extensively discussed by the SRP. This new data leads the SRP to recommend that a higher priority should be placed on research designed to identify and understand these risks at the mechanistic level. To support this effort the SRP feels that a shift of emphasis from Acute Radiation Syndromes (ARS) and carcinogenesis to CNS-related endpoints is justified at this point. However, these research efforts need to focus on mechanisms, should follow pace with advances in the field of CNS in general and should consider the specific comments and suggestions made by the SRP as outlined below. The SRP further recommends that the Space Radiation Program Element continue with its efforts to fill the vacant positions (Element Scientist, CNS Risk Discipline Lead) as soon as possible. The SRP also strongly recommends that NASA should continue the NASA Space Radiation Summer School. In addition to these broad recommendations, there are specific comments/recommendations noted for each risk, described in detail below.

  12. Protracted Oxidative Alterations in the Mechanism of Hematopoietic Acute Radiation Syndrome

    Nikolai V. Gorbunov

    2015-02-01

    Full Text Available The biological effects of high-dose total body ionizing irradiation [(thereafter, irradiation (IR] are attributed to primary oxidative breakage of biomolecule targets, mitotic, apoptotic and necrotic cell death in the dose-limiting tissues, clastogenic and epigenetic effects, and cascades of functional and reactive responses leading to radiation sickness defined as the acute radiation syndrome (ARS. The range of remaining and protracted injuries at any given radiation dose as well as the dynamics of post-IR alterations is tissue-specific. Therefore, functional integrity of the homeostatic tissue barriers may decline gradually within weeks in the post-IR period culminating with sepsis and failure of organs and systems. Multiple organ failure (MOF leading to moribundity is a common sequela of the hemotapoietic form of ARS (hARS. Onset of MOF in hARS can be presented as “two-hit phenomenon” where the “first hit” is the underlying consequences of the IR-induced radiolysis in cells and biofluids, non-septic inflammation, metabolic up-regulation of pro-oxidative metabolic reactions, suppression of the radiosensitive hematopoietic and lymphoid tissues and the damage to gut mucosa and vascular endothelium. While the “second hit” derives from bacterial translocation and spread of the bacterial pathogens and inflammagens through the vascular system leading to septic inflammatory, metabolic responses and a cascade of redox pro-oxidative and adaptive reactions. This sequence of events can create a ground for development of prolonged metabolic, inflammatory, oxidative, nitrative, and carbonyl, electrophilic stress in crucial tissues and thus exacerbate the hARS outcomes. With this perspective, the redox mechanisms, which can mediate the IR-induced protracted oxidative post-translational modification of proteins, oxidation of lipids and carbohydrates and their countermeasures in hARS are subjects of the current review. Potential role of ubiquitous

  13. Neonatal herpes simplex virus type-1 central nervous system disease with acute retinal necrosis.

    Fong, Choong Yi; Aye, Aye Mya Min; Peyman, Mohammadreza; Nor, Norazlin Kamal; Visvaraja, Subrayan; Tajunisah, Iqbal; Ong, Lai Choo

    2014-04-01

    We report a case of neonatal herpes simplex virus (HSV)-1 central nervous system disease with bilateral acute retinal necrosis (ARN). An infant was presented at 17 days of age with focal seizures. Cerebrospinal fluid polymerase chain reaction was positive for HSV-1 and brain magnetic resonance imaging showed cerebritis. While receiving intravenous acyclovir therapy, the infant developed ARN with vitreous fluid polymerase chain reaction positive for HSV-1 necessitating intravitreal foscarnet therapy. This is the first reported neonatal ARN secondary to HSV-1 and the first ARN case presenting without external ocular or cutaneous signs. Our report highlights that infants with neonatal HSV central nervous system disease should undergo a thorough ophthalmological evaluation to facilitate prompt diagnosis and immediate treatment of this rapidly progressive sight-threatening disease. PMID:24378951

  14. Particle-induced pulmonary acute phase response may be the causal link between particle inhalation and cardiovascular disease

    Saber, Anne T.; Jacobsen, Nicklas R.; Jackson, Petra;

    2014-01-01

    Inhalation of ambient and workplace particulate air pollution is associated with increased risk of cardiovascular disease. One proposed mechanism for this association is that pulmonary inflammation induces a hepatic acute phase response, which increases risk of cardiovascular disease. Induction of...... epidemiological studies. In this review, we present and review emerging evidence that inhalation of particles (e.g., air diesel exhaust particles and nanoparticles) induces a pulmonary acute phase response, and propose that this induction constitutes the causal link between particle inhalation and risk of...... cardiovascular disease. Increased levels of acute phase mRNA and proteins in lung tissues, bronchoalveolar lavage fluid and plasma clearly indicate pulmonary acute phase response following pulmonary deposition of different kinds of particles including diesel exhaust particles, nanoparticles, and carbon nanotubes...

  15. Frequency and clinical relevance of human bocavirus infection in acute exacerbations of chronic obstructive pulmonary disease

    Felix C Ringshausen

    2009-02-01

    Full Text Available Felix C Ringshausen1, Ai-Yui M Tan1, Tobias Allander2, Irmgard Borg1, Umut Arinir1, Juliane Kronsbein1, Barbara M Hauptmeier1, Gerhard Schultze-Werninghaus1, Gernot Rohde11Clinical Research Group “Significance of viral infections in chronic respiratory diseases of children and adults,” University Hospital Bergmannsheil, Department of Internal Medicine III–Pneumology, Allergology and Sleep Medicine, Bochum, Germany; 2Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, and Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, SwedenObjective: Human bocavirus (HBoV is a recently discovered parvovirus associated with acute respiratory tract infections in children. The objective of the present study was to determine the frequency and clinical relevance of HBoV infection in adult patients with acute exacerbation of chronic obstructive pulmonary disease (AE-COPD.Methods: We retrospectively tested 212 COPD patients, 141 (66.5% with AE-COPD and 71 (33.5% with stable disease, of whom nasal lavage and induced sputum had been obtained for the presence of HBoV deoxyribonucleic acid (DNA. The specificity of positive polymerase chain reaction results was confirmed by sequencing.Results: Two hundred two of 212 patients for whom PCR results were available both for nasal lavage and induced sputum samples were eligible for data analysis. HBoV DNA was detected in three patients (1.5%. Of those, only one patient had AE-COPD. Thus, the frequency of HBoV infection demonstrated to be low in both AE-COPD (0.8% and stable COPD (2.9%. HBoV was found in two sputum and one nasal lavage sample in different patients, respectively. Sequencing revealed >99% sequence identity with the reference strain.Conclusion: HBoV detection was infrequent. Since we detected HBoV in both upper and lower respiratory tract specimens and in AE-COPD as well as stable disease, a major role of HBoV infection in adults with AE-COPD is unlikely

  16. Tolerance, immunocompetence, and secondary disease in fully allogeneic radiation chimeras

    The aim of this study was to ascertain the extent to which secondary disease and mortality in fully allogeneic chimeras (C57BL leads to CBA) is caused (if at all) by a delayed graft-versus-host reaction. Adult CBA males were thymectomized, irradiated, and reconstituted with T-lymphocyte-depleted C57BL or CBA bone marrow cells (BMC), followed three weeks after irradiation by implantation under the kidney capsule of thymic lobes from C57BL or CBA fetal or adult donors. These mice were observed for the development of secondary disease for periods in excess of 250 days, and they were examined at 5 weeks or 4 months for T lymphocyte reactivity and tolerance to alloantigens, using the cell-mediated lympholysis assay (CML). The following results were obtained. First, removal of T lymphocytes with anti-Thy 1 antibody and complement from allogeneic bone marrow did not prevent wasting and eventual death, although it prolonged the lifespan of mice substantially. Second, T lymphocytes generated from bone marrow-derived precursor cells became tolerant of the histocompatibility antigens of the thymus donor strain but remained normally reactive to third-party antigens. Third, allogeneic radiation chimeras did not survive as well as animals reconstituted with syngeneic cells, even when they were demonstrably tolerant in CML. Fourth, C57BL BMC maturing in a CBA host equipped with a C57BL thymus graft did not become tolerant of host antigens, indicating that extra-thymic tolerance does not occur in fully allogeneic--as opposed to semiallogeneic--chimeras. It is argued that the function of B lymphocytes and/or accessory cells is impaired in fully allogeneic radiation chimeras, and that the mortality observed was directly related to the resulting immunodeficiency. The relevance of the results described in this paper to clinical bone marrow transplantation is discussed

  17. Plasma levels of microRNA in chronic kidney disease: patterns in acute and chronic exercise.

    Van Craenenbroeck, Amaryllis H; Ledeganck, Kristien J; Van Ackeren, Katrijn; Jürgens, Angelika; Hoymans, Vicky Y; Fransen, Erik; Adams, Volker; De Winter, Benedicte Y; Verpooten, Gert A; Vrints, Christiaan J; Couttenye, Marie M; Van Craenenbroeck, Emeline M

    2015-12-15

    Exercise training is an effective way to improve exercise capacity in chronic kidney disease (CKD), but the underlying mechanisms are only partly understood. In healthy subjects (HS), microRNA (miRNA or miR) are dynamically regulated following exercise and have, therefore, been suggested as regulators of cardiovascular adaptation to exercise. However, these effects were not studied in CKD before. The effect of acute exercise (i.e., an acute exercise bout) was assessed in 32 patients with CKD and 12 age- and sex-matched HS (study 1). miRNA expression in response to chronic exercise (i.e., a 3-mo exercise training program) was evaluated in 40 CKD patients (study 2). In a subgroup of study 2, the acute-exercise induced effect was evaluated at baseline and at follow-up. Plasma levels of a preselected panel miRNA, involved in exercise adaptation processes such as angiogenesis (miR-126, miR-210), inflammation (miR-21, miR-146a), hypoxia/ischemia (miR-21, miR-210), and progenitor cells (miR-150), were quantified by RT-PCR. Additionally, seven miRNA involved in similar biological processes were quantified in the subgroup of study 2. Baseline, studied miRNA were comparable in CKD and HS. Following acute exercise, miR-150 levels increased in both CKD (fold change 2.12 ± 0.39, P = 0.002; and HS: fold change 2.41 ± 0.48 P = 0.018, P for interaction > 0.05). miR-146a acutely decreased in CKD (fold change 0.92 ± 0.13, P = 0.024), whereas it remained unchanged in HS. Levels of miR-21, miR-126, and miR-210 remained unaltered. Chronic exercise did not elicit a significant change in the studied miRNA levels. However, an acute exercise-induced decrease in miR-210 was observed in CKD patients, only after training (fold change 0.76 ± 0.15). The differential expression in circulating miRNA in response to acute and chronic exercise may point toward a physiological role in cardiovascular adaptation to exercise, also in CKD. PMID:26475583

  18. Asthma is a risk factor for acute chest syndrome and cerebral vascular accidents in children with sickle cell disease

    Scott Paul J; Zacharisen Michael C; Lynn John; Nordness Mark E; Kelly Kevin J

    2005-01-01

    Abstract Background Asthma and sickle cell disease are common conditions that both may result in pulmonary complications. We hypothesized that children with sickle cell disease with concomitant asthma have an increased incidence of vaso-occlusive crises that are complicated by episodes of acute chest syndrome. Methods A 5-year retrospective chart analysis was performed investigating 48 children ages 3–18 years with asthma and sickle cell disease and 48 children with sickle cell disease alone....

  19. Comparison of conformal and intensity modulated radiation therapy techniques for treatment of pelvic tumors. Analysis of acute toxicity

    This retrospective analysis reports on the comparative outcome of acute gastrointestinal (GI) and genitourinary (GU) toxicities between conformal radiation therapy (CRT) and intensity modulated radiation therapy (IMRT) techniques in the treatment of patients with pelvic tumors. From January 2002 to December 2008, 69 patients with pelvic tumors underwent whole pelvic CRT and 65 underwent whole pelvic IMRT to treat pelvic lymph nodes and primary tumor regions. Total dose to the whole pelvis ranged from 50 to 50.4 Gy in 25 to 28 daily fractions. Chemotherapy (CT) regimen, when employed, was based upon primary tumor. Acute GI and GU toxicities were graded by RTOG/EORTC acute radiation morbidity criteria. Absence of GI symptoms during radiotherapy (grade 0) was more frequently observed in the IMRT group (43.1% versus 8.7; p < 0.001) and medication for diarrhea (Grade 2) was more frequently used in the CRT group (65.2% versus 38.5%; p = 0.002). Acute GI grade 1 and 3 side effects incidence was similar in both groups (18.5% versus 18.8%; p = 0.95 and 0% versus 7.2%; p = 0.058, respectively). Incidence of GU toxicity was similar in both groups (grade 0: 61.5% versus 66.6%, p = 0.54; grade 1: 20% versus 8.7%, p = 0.06; grade 2: 18.5% versus 23.5%, p = 0.50 and grade 3: 0% versus 1.5%, p > 0.99). This comparative case series shows less grade 2 acute GI toxicity in patients treated with whole pelvic IMRT in comparison with those treated with CRT. Incidence of acute GU toxicity was similar in both groups

  20. Asthma is a risk factor for acute chest syndrome and cerebral vascular accidents in children with sickle cell disease

    Scott Paul J

    2005-01-01

    Full Text Available Abstract Background Asthma and sickle cell disease are common conditions that both may result in pulmonary complications. We hypothesized that children with sickle cell disease with concomitant asthma have an increased incidence of vaso-occlusive crises that are complicated by episodes of acute chest syndrome. Methods A 5-year retrospective chart analysis was performed investigating 48 children ages 3–18 years with asthma and sickle cell disease and 48 children with sickle cell disease alone. Children were matched for age, gender, and type of sickle cell defect. Hospital admissions were recorded for acute chest syndrome, cerebral vascular accident, vaso-occlusive pain crises, and blood transfusions (total, exchange and chronic. Mann-Whitney test and Chi square analysis were used to assess differences between the groups. Results Children with sickle cell disease and asthma had significantly more episodes of acute chest syndrome (p = 0.03 and cerebral vascular accidents (p = 0.05 compared to children with sickle cell disease without asthma. As expected, these children received more total blood transfusions (p = 0.01 and chronic transfusions (p = 0.04. Admissions for vasoocclusive pain crises and exchange transfusions were not statistically different between cases and controls. SS disease is more severe than SC disease. Conclusions Children with concomitant asthma and sickle cell disease have increased episodes of acute chest syndrome, cerebral vascular accidents and the need for blood transfusions. Whether aggressive asthma therapy can reduce these complications in this subset of children is unknown and requires further studies.

  1. Pulmonary fibrosis following pneumonia due to acute Legionnaires' disease. Clinical, ultrastructural, and immunofluorescent study.

    Chastre, J; Raghu, G; Soler, P; Brun, P; Basset, F; Gibert, C

    1987-01-01

    During a recent nosocomial outbreak, 20 critically ill patients with acute Legionnaires' disease were admitted to the intensive care unit of Hopital Bichat, Paris. Pulmonary specimens were obtained at surgery or immediately after death in 12 patients and were examined by light, immunofluorescent, and electron microscopy. Five of these 12 patients showed evidence of pulmonary fibrosis. In all of these five patients, infection with Legionella pneumophila was evidenced by bacteriologic methods, and other diseases known to cause fibrosis were excluded. The condition of four patients deteriorated rapidly with respiratory failure, and they died with pulmonary fibrosis. Only one patient finally recovered but was left with pulmonary sequelae. Two distinctive morphologic patterns were observed, one in which interstitial fibrosis was predominant and one in which intra-alveolar organization and fibrosis were also present. The alveolar epithelial lining and the basement membranes were disrupted in all patients, as evidenced by ultrastructural observations and by immunofluorescent studies showing gaps in the distribution of type 4 collagen and laminin. Types 1 and 3 collagen accumulated in areas corresponding to thickened interstitium and intra-alveolar fibrosis. Thus, some patients who survive the acute pneumonia of Legionnaires' disease may develop pulmonary fibrosis, and this process may lead to functional impairment or death despite prompt and appropriate treatment. PMID:3539546

  2. Neuron-specific enolase in cerebrospinal fluid and plasma of patients with acute ischemic brain disease

    Selaković Vesna M.

    2003-01-01

    Full Text Available The objective of this research was to determine the dynamics of change of neuron-specific enolase concentration in patients with acute ischemic brain disease in cerebrospinal fluid and plasma. The study included 103 patients, their mean age 58-66 years. The control group consisted of 16 patients, of matching age and sex, with radicular lesions of discal origin, subjected to diagnostic radiculography. Concentration of neuron-specific enolase was measured by a flouroimmunometric method. The results showed that the concentration of neuron-specific enolase in cerebrospinal fluid and plasma of patients with brain ischemic disease within first seven days significantly increased compared to the control. The highest increase of concentration was established in brain infarction, somewhat lower in reversible ischemic attack, and the lowest in transient ischemic attack. Maximal concentration was established on the 3rd-4th day upon the brain infarction. Neuron-specific enolase concentration in cerebrospinal fluid and plasma may be an indicator of pathophysiological processes in the acute phase of brain ischemia and is significant in early diagnostics and therapy of the disease.

  3. Role of Tyrosine Isomers in Acute and Chronic Diseases Leading to Oxidative Stress - A Review.

    Molnár, Gergő A; Kun, Szilárd; Sélley, Eszter; Kertész, Melinda; Szélig, Lívia; Csontos, Csaba; Böddi, Katalin; Bogár, Lajos; Miseta, Attila; Wittmann, István

    2016-01-01

    Oxidative stress plays a major role in the pathogenesis of a variety of acute and chronic diseases. Measurement of the oxidative stress-related end products may be performed, e.g. that of structural isomers of the physiological para-tyrosine, namely meta- and ortho-tyrosine, that are oxidized derivatives of phenylalanine. Recent data suggest that in sepsis, serum level of meta-tyrosine increases, which peaks on the 2(nd) and 3(rd) days (pglucose product in non-diabetic septic cases (pRats were fed a standard high cholesterol-diet, and were given para-tyrosine or vehicle orally. High-cholesterol feeding lead to a significant increase in aortic wall meta-tyrosine content and a decreased vasorelaxation of the aorta to insulin and the glucagon-like peptide-1 analogue, liraglutide, that both could be prevented by administration of para-tyrosine. Concluding, these data suggest that meta- and ortho-tyrosine are potential markers of oxidative stress in acute diseases related to oxidative stress, and may also interfere with insulin action in septic humans. Competition of meta- and ortho-tyrosine by supplementation of para-tyrosine may exert a protective role in oxidative stress-related diseases. PMID:26785996

  4. Serum levels of matrix metalloproteinases -1,-2,-3 and -9 in thoracic aortic diseases and acute myocardial ischemia

    Argiriadou Helena

    2009-11-01

    Full Text Available Abstract Background Matrix metalloproteinases (MMPs constitute a family of zinc-dependent proteases (endopeptidases whose catalytic action is the degradation of the extracellular matrix components. In addition, they play the major role in the degradation of collagen and in the process of tissue remodeling. The present clinical study investigated blood serum levels of metalloproteinases- 1, -2, -3 and -9 in patients with acute and chronic aortic dissection, thoracic aortic aneurysm and acute myocardial ischemia compared to healthy individuals. Methods The blood serum levels of MMP-1, -2, -3 and -9 were calculated in 31 patients with acute aortic dissection, 18 patients with chronic aortic dissection, 18 patients with aortic aneurysm and in 13 patients with acute myocardial ischemia, as well as in 15 healthy individuals who served as the control group. Serum MMP levels were measured by using an ELISA technique. Results There were significantly higher levels of MMP-3 in patients with acute myocardial ischemia as compared to acute aortic dissection (17.33 ± 2.03 ng/ml versus 12.92 ± 1.01 ng/ml, p Conclusion Measurement of serum MMP levels in thoracic aortic disease and acute myocardial ischemia is a simple and relatively rapid laboratory test that could be used as a biochemical indicator of aortic disease or acute myocardial ischemia, when evaluated in combination with imaging techniques.

  5. Effects of radiation therapy for Hodgkin's disease in a child with ataxia telangiectasia: a clinical, biological and pathologic study

    Stage I lymphocyte-predominant Hodgkin's disease was diagnosed in a 44-month-old girl. Although immune deficiency was suspected and IgA deficiency demonstrated, the diagnosis of an ataxia-telangiectasia (AT)-like syndrome was not confirmed until eight weeks later when results of studies on the radiosensitivity of cultured skin fibroblasts were available. The child had none of the usual physical stigmata of AT. Severe acute radiation damage followed the treatment of this child with standard doses of radiation therapy. Clinical, pathologic, and radiobiologic correlations are drawn. The diagnosis of a malignant lymphoma disorder in children under the age of five should alert clinicians to the possibility of immune deficiency and, even in the absence of classical physical signs, to AT in particular. Suggestions for the management of future similar cases are put forward

  6. Clofarabine and Cytarabine in Treating Patients With Acute Myeloid Leukemia With Minimal Residual Disease

    2013-05-07

    Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; 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); Recurrent Adult Acute Myeloid Leukemia

  7. Dietary patterns and their association with acute coronary heart disease: Lessons from the REGARDS Study

    Al Suwaidi, Jassim

    2015-01-01

    Shikany et al used data from 17,418 participants in the REGARDS study, a national, population-based, longitudinal study of white and black adults aged ≥ 45 years, enrolled between 2003–2007. They examined 536 acute coronary heart disease events at follow-up (median 5.8 years) in relation to five dietary patterns (Convenience, Plant-based, Sweets, Southern, and Alcohol and Salad). After adjustment for baseline variables, the highest consumers of the Southern pattern experienced a 56% higher ha...

  8. Acute exudative polymorphous vitelliform maculopathy in a patient with Lyme disease.

    Singh, Ravi S J; Tran, Lac H; Kim, Judy E

    2013-01-01

    Acute exudative polymorphous vitelli-form maculopathy (AEPVM) is a rare condition of unclear etiology that has been seen in association with respiratory and viral infections. It has also been reported as a paraneoplastic phenomenon in older individuals. The authors report the first case of AEPVM associated with Lyme disease with over 3.5 years of follow-up. Multimodality serial imaging suggested the lesions began as multiple serous detachments followed by accumulation of photoreceptor outer segments in the subretinal space that gradually resolved over time and gave rise to the characteristic fundus findings at various stages. PMID:24044715

  9. Role of free radicals in the pathogenesis of acute chest syndrome in sickle cell disease

    Farber Harrison W

    2001-07-01

    Full Text Available Abstract Acute chest syndrome (ACS of sickle cell disease (SCD is characterized pathologically by vaso-occlusive processes that result from abnormal interactions between sickle red blood cells (RBCs, white blood cells (WBCs and/or platelets, and the vascular endothelium. One potential mechanism of vascular damage in ACS is by generation of oxygen-related molecules, such as superoxide (O2-, hydrogen peroxide (H2O2, peroxynitrite (ONOO-, and the hydroxyl (•OH radical. The present review summarizes the evidence for alterations in oxidant stress during ACS of SCD, and the potential contributions of RBCs, WBCs and the vascular endothelium to this process.

  10. Development of a positive psychology intervention for patients with acute cardiovascular disease

    Julia K. Boehm

    2011-09-01

    Full Text Available The management of depression and other negative psychological states in cardiac patients has been a focus of multiple treatment trials, though such trials have not led to substantial improvements in cardiac outcomes. In contrast, there has been minimal focus on interventions to increase positive psychological states in cardiac patients, despite the fact that optimism and other positive states have been associated with superior cardiovascular outcomes. Our objective was to develop an 8-week, phone-based positive psychology intervention for patients hospitalized with acute cardiac disease (acute coronary syndrome or decompensated heart failure. Such an intervention would consist of positive psychology exercises adapted for this specific population, and it would need to be feasible for practitioners and patients in real-world settings. By adapting exercises that were previously validated in healthy individuals, we were able to generate a positive psychology telemedicine intervention for cardiac patients that focused on optimism, kindness, and gratitude. In addition, we successfully created a companion treatment manual for subjects to enhance the educational aspects of the intervention and facilitate completion of exercises. Finally, we successfully performed a small pilot trial of this intervention, and found that the positive psychology intervention appeared to be feasible and well-accepted in a cohort of patients with acute cardiac illness. Future studies should further develop this promising intervention and examine its impact on psychological and medical outcomes in this vulnerable population of cardiac patients.

  11. Endothelial-cell injury in cutaneous acute graft-versus-host disease.

    Dumler, J. S.; Beschorner, W. E.; Farmer, E. R.; Di Gennaro, K. A.; Saral, R.; Santos, G. W.

    1989-01-01

    The presence of an erythematous skin rash and hemorrhagic complications in acute graft-versus-host disease (GVHD) suggest that the vasculature may be involved in the immunopathologic process. We reviewed endothelial and vascular histopathologic changes on light microscopy and on immunoperoxidase stained sections of skin biopsies obtained from 41 HLA-identical allogeneic marrow transplant recipients with at least grade 2 GVHD. Biopsies taken from 14 allogeneic HLA-identical bone marrow transplant recipients who never developed GVHD were used as controls. Sections were evaluated for evidence of immunologic vascular injury using the rank file analysis of histologic features, expression of HLA-DR antigen, and the distribution of fibrin and factor VIII-related antigen (F VIII RAg). Patients with acute GVHD had significantly greater intimal lymphocytic infiltrates, perivascular nuclear dust deposition, perivascular F VIII Rag extravasation and deposition and vascular proliferation than controls. We find significantly greater endothelial injury in GVHD patients, which may represent primary immunologic injury to the vasculature. The clinical findings in acute GVHD probably result from cumulative endothelial as well as epithelial injury. Images Figure 1 Figure 2 Figure 3 PMID:2596572

  12. Methanobactin reverses acute liver failure in a rat model of Wilson disease.

    Lichtmannegger, Josef; Leitzinger, Christin; Wimmer, Ralf; Schmitt, Sabine; Schulz, Sabine; Kabiri, Yaschar; Eberhagen, Carola; Rieder, Tamara; Janik, Dirk; Neff, Frauke; Straub, Beate K; Schirmacher, Peter; DiSpirito, Alan A; Bandow, Nathan; Baral, Bipin S; Flatley, Andrew; Kremmer, Elisabeth; Denk, Gerald; Reiter, Florian P; Hohenester, Simon; Eckardt-Schupp, Friedericke; Dencher, Norbert A; Adamski, Jerzy; Sauer, Vanessa; Niemietz, Christoph; Schmidt, Hartmut H J; Merle, Uta; Gotthardt, Daniel Nils; Kroemer, Guido; Weiss, Karl Heinz; Zischka, Hans

    2016-07-01

    In Wilson disease (WD), functional loss of ATPase copper-transporting β (ATP7B) impairs biliary copper excretion, leading to excessive copper accumulation in the liver and fulminant hepatitis. Current US Food and Drug Administration- and European Medicines Agency-approved pharmacological treatments usually fail to restore copper homeostasis in patients with WD who have progressed to acute liver failure, leaving liver transplantation as the only viable treatment option. Here, we investigated the therapeutic utility of methanobactin (MB), a peptide produced by Methylosinus trichosporium OB3b, which has an exceptionally high affinity for copper. We demonstrated that ATP7B-deficient rats recapitulate WD-associated phenotypes, including hepatic copper accumulation, liver damage, and mitochondrial impairment. Short-term treatment of these rats with MB efficiently reversed mitochondrial impairment and liver damage in the acute stages of liver copper accumulation compared with that seen in untreated ATP7B-deficient rats. This beneficial effect was associated with depletion of copper from hepatocyte mitochondria. Moreover, MB treatment prevented hepatocyte death, subsequent liver failure, and death in the rodent model. These results suggest that MB has potential as a therapeutic agent for the treatment of acute WD. PMID:27322060

  13. Preliminary clinical findings on NEUMUNE as a potential treatment for acute radiation syndrome

    5-androstenediol (5-AED) has been advanced as a possible countermeasure for treating the haematological component of acute radiation syndrome (ARS). It has been used in animal models to stimulate both innate and adaptive immunity and treat infection and radiation-induced immune suppression. We here report on the safety, tolerability and haematologic activity of 5-AED in four double-blinded, randomized, placebo-controlled studies on healthy adults including elderly subjects. A 5-AED injectable suspension formulation (NEUMUNE) or placebo was administered intramuscularly as either a single injection, or once daily for five consecutive days at doses of 50, 100, 200 or 400 mg. Subjects (n = 129) were randomized to receive NEUMUNE (n = 95) or the placebo (n = 34). NEUMUNE was generally well-tolerated; the most frequent adverse events were local injection site reactions (n = 104, 81%) that were transient, dose-volume dependent, mild to moderate in severity, and that resolved over the course of the study. Blood chemistries revealed a transient increase (up to 28%) in creatine phosphokinase and C-reactive protein levels consistent with intramuscular injection and injection site irritation. The blood concentration profile of 5-AED is consistent with a depot formulation that increases in disproportionate increments following each dose. NEUMUNE significantly increased circulating neutrophils (p < 0.001) and platelets (p < 0.001) in the peripheral blood of adult and elderly subjects. A dose-response relationship was identified. Findings suggest that parenteral administration of 5-AED in aqueous suspension may be a safe and effective means to stimulate innate immunity and alleviate neutropenia and thrombocytopenia associated with ARS.

  14. Preliminary clinical findings on NEUMUNE as a potential treatment for acute radiation syndrome

    Stickney, Dwight R; Groothuis, Jessie R; Ahlem, Clarence; Kennedy, Mike; Miller, Barry S; Onizuka-Handa, Nanette; Schlangen, Karen M; Destiche, Daniel; Reading, Chris; Garsd, Armando; Frincke, James M [Harbor Biosciences, 9171 Towne Centre Drive, Suite 180, San Diego, CA 92122 (United States)

    2010-12-01

    5-androstenediol (5-AED) has been advanced as a possible countermeasure for treating the haematological component of acute radiation syndrome (ARS). It has been used in animal models to stimulate both innate and adaptive immunity and treat infection and radiation-induced immune suppression. We here report on the safety, tolerability and haematologic activity of 5-AED in four double-blinded, randomized, placebo-controlled studies on healthy adults including elderly subjects. A 5-AED injectable suspension formulation (NEUMUNE) or placebo was administered intramuscularly as either a single injection, or once daily for five consecutive days at doses of 50, 100, 200 or 400 mg. Subjects (n = 129) were randomized to receive NEUMUNE (n = 95) or the placebo (n = 34). NEUMUNE was generally well-tolerated; the most frequent adverse events were local injection site reactions (n = 104, 81%) that were transient, dose-volume dependent, mild to moderate in severity, and that resolved over the course of the study. Blood chemistries revealed a transient increase (up to 28%) in creatine phosphokinase and C-reactive protein levels consistent with intramuscular injection and injection site irritation. The blood concentration profile of 5-AED is consistent with a depot formulation that increases in disproportionate increments following each dose. NEUMUNE significantly increased circulating neutrophils (p < 0.001) and platelets (p < 0.001) in the peripheral blood of adult and elderly subjects. A dose-response relationship was identified. Findings suggest that parenteral administration of 5-AED in aqueous suspension may be a safe and effective means to stimulate innate immunity and alleviate neutropenia and thrombocytopenia associated with ARS.

  15. Solar Radiation and Vitamin D: Mitigating Environmental Factors in Autoimmune Disease

    Schwalfenberg, Gerry K.

    2012-01-01

    This paper looks at the environmental role of vitamin D and solar radiation as risk reduction factors in autoimmune disease. Five diseases are considered: multiple sclerosis, type 1 diabetes, rheumatoid arthritis, autoimmune disease of the thyroid, and inflammatory bowel disease. Clinical relevant studies and factors that may indicate evidence that autoimmune disease is a vitamin D-sensitive disease are presented. Studies that have resulted in prevention or amelioration of some autoimmune dis...

  16. Mitochondrion-Permeable Antioxidants to Treat ROS-Burst-Mediated Acute Diseases.

    Zhang, Zhong-Wei; Xu, Xiao-Chao; Liu, Ting; Yuan, Shu

    2016-01-01

    Reactive oxygen species (ROS) play a crucial role in the inflammatory response and cytokine outbreak, such as during virus infections, diabetes, cancer, cardiovascular diseases, and neurodegenerative diseases. Therefore, antioxidant is an important medicine to ROS-related diseases. For example, ascorbic acid (vitamin C, VC) was suggested as the candidate antioxidant to treat multiple diseases. However, long-term use of high-dose VC causes many side effects. In this review, we compare and analyze all kinds of mitochondrion-permeable antioxidants, including edaravone, idebenone, α-Lipoic acid, carotenoids, vitamin E, and coenzyme Q10, and mitochondria-targeted antioxidants MitoQ and SkQ and propose astaxanthin (a special carotenoid) to be the best antioxidant for ROS-burst-mediated acute diseases, like avian influenza infection and ischemia-reperfusion. Nevertheless, astaxanthins are so unstable that most of them are inactivated after oral administration. Therefore, astaxanthin injection is suggested hypothetically. The drawbacks of the antioxidants are also reviewed, which limit the use of antioxidants as coadjuvants in the treatment of ROS-associated disorders. PMID:26649144

  17. Acute Sickle Hepatic Crisis after Liver Transplantation in a Patient with Hb SC Disease

    J. H. Gillis

    2015-01-01

    Full Text Available Acute sickle hepatic crisis (ASHC has been observed in approximately 10% of patients with sickle cell disease. It occurs predominantly in patients with homozygous (Hb SS sickle cell anemia and to a lesser degree in patients with Hb SC disease, sickle cell trait, and Hb S beta thalassemia. Patients commonly present with jaundice, right upper quadrant pain, nausea, low-grade fever, tender hepatomegaly, and mild to moderate elevations in serum AST, ALT, and bilirubin. We describe the case of a patient with a history of hemoglobin SC disease and cirrhosis caused by hepatitis C presenting approximately 1 year after liver transplantation with an ASHC. The diagnosis was confirmed by liver biopsy. Our patient was treated with RBC exchange transfusions, IV hydration, and analgesia and made a complete recovery. Only a limited number of patients with sickle cell disease have received liver transplants, and, to our knowledge, this is the first case of ASHC after transplantation in a patient with Hb SC disease.

  18. Outcomes of patients calling emergency medical services for suspected acute cardiovascular disease

    Schoos, Mikkel Malby; Sejersten, Maria; Baber, Usman;

    2015-01-01

    Adequate health care is increasingly dependent on prehospital systems and cardiovascular (CV) disease remains the most common cause for hospital admission. However the prevalence of CV dispatches of emergency medical services (EMS) is not well reported and survival data described in clinical trials...... and registries are subject to selection biases. We aimed to describe the prevalence and prognosis of acute CV disease and the effect of invasive treatment, in an unselected and consecutive prehospital cohort of 3,410 patients calling the national emergency telephone number from 2005 to 2008 with...... follow-up in 2013. Individual-level data from national registries were linked to the dedicated EMS database of primary ambulance dispatches supported by physician-manned emergency units. Outcome data were obtained from the Central Population Registry, the National Patient Registry, and the National...

  19. First presentation of Addison's disease as hyperkalaemia in acute kidney injury.

    Maki, Sara; Kramarz, Caroline; Maria Heister, Paula; Pasha, Kamran

    2016-01-01

    Addison's disease is a rare endocrine disorder that frequently presents with non-specific symptoms, but may deteriorate rapidly into life-threatening Addisonian crisis if left untreated. Diagnosis can be difficult in patients without a suggestive medical history. We describe a case of a 37-year-old man who was admitted with acute kidney injury and hyperkalaemia, resistant to treatment with insulin/dextrose and calcium gluconate. On clinical examination, he was found to be hyperpigmented; a subsequent random serum cortisol of 49 nmol/L affirmed the preliminary diagnosis of Addison's disease. The patient's hyperkalaemia improved on treatment with hydrocortisone, and a follow-up morning adrenocorticotropic hormone of 1051 ng/L confirmed the diagnosis. PMID:27170604

  20. The Role of Intestinal Microbiota in Acute Graft-versus-Host Disease

    Yuanyuan Chen

    2015-01-01

    Full Text Available The mammalian intestinal microbiota is a complex ecosystem that plays an important role in host immune responses. Recent studies have demonstrated that alterations in intestinal microbiota composition are linked to multiple inflammatory diseases in humans, including acute graft-versus-host disease (aGVHD. aGVHD is one of the major obstacles in allogeneic hematopoietic stem cell transplantation (allo-HSCT, characterized by tissue damage in the gastrointestinal (GI tract, liver, lung, and skin. Here, we review the current understanding of the role of intestinal microbiota in the control of immune responses during aGVHD. Additionally, the possibility of using probiotic strains for potential treatment or prevention of aGVHD will be discussed.

  1. Acute Chest Syndrome in Sickle Cell Disease Patients Post Caesarean Delivery

    YM Zhang

    2016-02-01

    Full Text Available Sickle cell disease (SCD is the most common inherited disease worldwide and is associated with anaemia and intermittent painful crisis. Pregnant women who are affected are known to have increased maternal and fetal mortality and morbidity. Acute chest syndrome (ACS is an uncommon but serious complication in pregnant women with SCD that can lead to death. We present two cases of patients with SCD, both of whom had severe ACS within 24 hours post Caesarean section. By accurate diagnosis and appropriate management by a multidisciplinary team, both mothers and fetuses had excellent outcomes. It is suggested that prompt recognition of ACS in a pregnant woman with SCD and collaborative medical and obstetric management are essential to optimize maternal and fetal outcomes.

  2. Follow-up of delayed health consequences of acute radiation exposure. Lessons to be learned from their medical management

    While the use of radioactive materials around the world offers a wide range of benefits in medicine, industry and research, safety precautions are essential to limit the exposure of persons to harmful radiation. When the quantity of radioactive material employed is substantial, as when radioactive sources are used for radiotherapy in medicine or for industrial radiography, extreme care is necessary to prevent accidents that may lead to severe health consequences for the individuals involved. Despite the fact that the precautions to be taken are clearly established, accidents with radiation sources continue to occur, albeit infrequently. The IAEA, as part of its 'Safety of Radiation Sources' and 'Emergency Response' subprogrammes, follows up severe accidents of this kind. In so doing, the IAEA attempts to document both the circumstances leading to the accident and the subsequent medical treatment in order to define the lessons to be learned from these events. The overall objective is to provide information that will be of benefit to organizations with responsibilities for radiation protection, the safety of radiation sources and the medical management of radiation accidents. The International Atomic Energy Agency has issued a number of publications on radiation accidents which have occurred in the past 15 years, reporting on the causes, radiation safety aspects and medical management of those affected particularly in the acute phase following an accident. These reports cover the accidents in Chernobyl, Ukraine (the Republic of the former Soviet Union) and Goiania (Brazil), and those in El Salvador, Vietnam, Belarus, Israel, Estonia, Costa Rica, Georgia, Russian Federation, Turkey, Peru and Panama. In 1998 the IAEA published three Safety Reports, co-sponsored by the World Health Organization, aimed at disseminating medical information on the recognition and treatment of radiation injuries, planning the medical response to radiation accidents and occupational health

  3. A STUDY OF PROFILE AND PATTERNS OF “JOINT INVOLVEMENT” IN UNDER 15 YEARS AGE GROUP CHILDREN WITH ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE

    Bhavani Shankar; Ramu

    2015-01-01

    CONTEXT (BACKGROUND): Acute Rheumatic fever / Rheumatic Heart disease is the most common acquired childhood heart disease diagnosis made in India. Poly Arthritis is one of the common manifestations of the disease and making it one among many differential diagnoses for sub - acute arthritis. AIMS & OBJECTIVES: To study the profile and patterns ...

  4. Seven-year national survey of Kawasaki disease and acute rheumatic fever.

    Taubert, K A; Rowley, A H; Shulman, S T

    1994-08-01

    To assess the frequency of hospital encoded diagnoses of acute rheumatic fever (ARF) and Kawasaki disease (KD), the two leading causes of acquired heart disease in children in the United States, we performed a survey of the medical record departments of United States children's hospitals and of general hospitals that have at least 400 beds and a pediatric ward. With a simple questionnaire, data were gathered for the years 1984 through 1990 by ICD.9CM codes, with a 58% response rate. About 8000 diagnoses of KD and 6000 diagnoses of ARF were encoded during the study period. Encoded diagnoses of both KD and ARF showed yearly fluctuations in the earlier years (1984 through 1987). For KD there was a general trend toward increasing numbers after 1986. These data are consistent with increased physician awareness and diagnosis of KD. For ARF a gradual decline was observed between 1986 and 1990. About 80% of ARF diagnoses were reported from general hospitals. The much smaller pool of encoded diagnoses of ARF at the children's hospitals showed a 56% increase from 1985 to 1986. These data suggest that the highly publicized increase in cases of acute rheumatic fever in the United States during the mid-1980s may reflect focal rather than nationwide increased activity and that nationally the number of diagnoses of ARF actually may have continued to decline gradually from 1984 through 1990. PMID:7970970

  5. Relationship between oxygen free radicals, cytokines, cortisol and stress complications in patients with acute cerebrovascular disease

    Objective: To investigate the relationship between oxygen free radicals, cytokines, cortisol and stress complications in patients with acute cerebrovascular disease (ACVD). Methods: Serum levels of superoxide dismutases (SOD), malonaldehyde (MDA) (with biochemistry) interleukin-6 (IL-6), tumor necrosis factor (TNF-α) and cortisol (with RIA) were measured in 32 patients with acute cerebrovascular disease (ACVD) plus stress complications and 48 patients without stress complications as well as 36 controls. Results: Serum SOD contents in non-stressed group were higher than those in stressed group (P<0.05) but lower than those of the controls (P<0.05). However the levels of MDA, IL-6, TNF-α and cortisol were highest in the stressed group and lowest in the controls (all P<0.05). Conclusion: Oxygen free radicals, IL-6, TNF-α and cortisol were involved in stress complications in patients with ACVD. Monitoring the levels of serum SOD, MDA, IL-6, TNF-α and cortisol could be useful for predicting stress complications and evaluating the therapeutic effect. (authors)

  6. Acute and chronic disease associated with naturally occurring T-2 mycotoxicosis in sheep.

    Ferreras, M C; Benavides, J; García-Pariente, C; Delgado, L; Fuertes, M; Muñoz, M; García-Marín, J F; Pérez, V

    2013-02-01

    A flock of approximately 1,000 sheep were exposed intermittently to food contaminated with T-2 toxin (T-2), a potent type-A trichothecene mycotoxin produced primarily by Fusarium sporotrichioides and Fusarium poae. In the acute stage of the intoxication, affected sheep developed anorexia, decreased water consumption, ruminal atony, soft faeces and apathy. One hundred and ninety of the exposed sheep died. The main gross lesions observed in animals dying during the acute disease were rumenitis and ulcerative abomasitis, depletion of lymphocytes in lymphoid organs, necrosis of the exocrine pancreas, myocarditis and intense oedema of the skin and brain. Sheep developing the chronic stage of disease showed weight loss and reproductive inefficiency and the main pathological features observed in animals dying during this stage were gastrointestinal inflammation, myocardial fibrosis and necrotic and suppurative lesions in the oral cavity. Opportunistic infections (e.g. mycotic mastitis or parasitic pneumonia) were also identified in these animals. Increased serum concentrations of lactate dehydrogenase and creatine kinase were observed, most likely related to heart lesions. T-2 toxins were detected in all samples of the diet of these animals that were analyzed. The changes in the sheep reported here are similar to those described previously in experimental studies. Lesions observed in the present animals suggest an additional cardiotoxic effect of T-2 in sheep. PMID:22819015

  7. Increased Serum Phospholipase A2 Activity in Advanced Chronic Liver Disease as an Expression of the Acute Phase Response

    Mario Pirisi

    1993-01-01

    Full Text Available Phospholipase A2 (PLA2 modifications were investigated in patients with acute and chronic liver diseases, PLA2 variations were related to indices of liver function as well as to parameters of the acute phase response. Serum PLA2 activity modifications were f1uorimetrically measured in 105 patients affected by acute and chronic liver diseases or extra-hepatic diseases. One-way ANOV A demonstrated a significant difference among groups (F= 4.53, P<0.001; Bonferroni’s test for pairwise comparisons showed that patients with hepatocellular carcinoma had higher mean values than subjects with benign extra-hepatic diseases (p<0.0 I and mild chronic liver disease (p<0.0S J. Multiple regression analysis, performed choosing PLA2 as the dependent variable and blood urea nitrogen, C-reacti ve protein, alkaline phosphatase and al-fetoprotein as predictor variables was significant (multiple R= 0.7056, multiple R2= 0.4978, F= 15.36, P= <0.0001. The standardized regression coefficients found to be significant were those of Creactive protein, blood urea nitrogen and al-fetoprotein. In conclusion, in patients with chronic liver disease, serum PLA2 activity increases parallel to disease severity and accompanies the expression of proteins of the acute phase response that. like PLA2 activity, increase in serum while liver synthesis declines.

  8. An acute graft-versus-host disease activity index to predict survival after hematopoietic cell transplantation with myeloablative conditioning regimens

    Leisenring, Wendy M.; Martin, Paul J.; Petersdorf, Effie W.; Regan, Anne E.; Aboulhosn, Nada; Stern, Jean M.; Aker, Saundra N.; Salazar, Raymond C.; McDonald, George B.

    2006-01-01

    Algorithms for grading acute graft-versus-host disease (GVHD) are inaccurate in assessing mortality risk. We developed a method to predict mortality by using data from 386 patients with acute GVHD. From the onset of GVHD to day 100, GVHD manifestations were scored for the skin, liver, and upper and lower gastrointestinal tract, and data were recorded for immunosuppressive treatment, performance, and fever. Logistic regression models predicting nonrelapse mortality (NRM) at day 200 were develo...

  9. Non-invasive mechanical ventilation in acute respiratory failure due to chronic obstructive pulmonary disease: correlates for success.

    Ambrosino, N; Foglio, K; Rubini, F.; Clini, E.; Nava, S.; M. Vitacca

    1995-01-01

    BACKGROUND--Non-invasive mechanical ventilation is increasingly used in the treatment of acute respiratory failure in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to identify simple parameters to predict the success of this technique. METHODS--Fifty nine episodes of acute respiratory failure in 47 patients with COPD treated with non-invasive mechanical ventilation were analysed, considering each one as successful (78%) or unsuccessful (22%) according t...

  10. Follicular Mucinosis in a Male Adolescent with a History of Acute Myelogenous Leukemia and Graft-versus-Host Disease.

    Jefferson, Julie; Taube, Janis; Grossberg, Anna

    2016-01-01

    Although many cases of follicular mucinosis are idiopathic, numerous others are associated with mycosis fungoides or, rarely, other neoplastic or inflammatory disorders. There are only three reported cases, all in adults, of follicular mucinosis arising in association with acute myelogenous leukemia, two of which involved mycosis fungoides-associated follicular mucinosis, including one case in which the patient had a preceding bone marrow transplant. We present the first reported case of follicular mucinosis arising in an adolescent with acute myelogenous leukemia and acute graft-versus-host disease after an allogeneic bone marrow transplantation. PMID:26645410

  11. The Hematopoietic Syndrome of the Acute Radiation Syndrome in Rhesus Macaques: A Systematic Review of the Lethal Dose Response Relationship.

    MacVittie, Thomas J; Farese, Ann M; Jackson, William

    2015-11-01

    Well characterized animal models that mimic the human response to potentially lethal doses of radiation are required to assess the efficacy of medical countermeasures under the criteria of the U.S. Food and Drug Administration "animal rule." Development of a model requires the determination of the radiation dose response relationship and time course of mortality and morbidity across the hematopoietic acute radiation syndrome. The nonhuman primate, rhesus macaque, is a relevant animal model that may be used to determine the efficacy of medical countermeasures to mitigate major signs of morbidity and mortality at selected lethal doses of total body irradiation. A systematic review of relevant studies that determined the dose response relationship for the hematopoietic acute radiation syndrome in the rhesus macaque relative to radiation quality, dose rate, and exposure uniformity has never been performed. The selection of data cohorts was made from the following sources: Ovid Medline (1957-present), PubMed (1954-present), AGRICOLA (1976-present), Web of Science (1954-present), and U.S. HHS REPORT (2002 to present). The following terms were used: Rhesus, total body-irradiation, total body x irradiation, TBI, irradiation, gamma radiation, hematopoiesis, LD50/60, Macaca mulatta, whole-body irradiation, nonhuman primate, NHP, monkey, primates, hematopoietic radiation syndrome, mortality, and nuclear radiation. The reference lists of all studies, published and unpublished, were reviewed for additional studies. The total number of hits across all search sites was 3,001. There were a number of referenced, unpublished, non-peer reviewed government reports that were unavailable for review. Fifteen studies, 11 primary (n = 863) and four secondary (n = 153) studies [n = 1,016 total nonhuman primates (NHP), rhesus Macaca mulatta] were evaluated to provide an informative and consistent review. The dose response relationships (DRRs) were determined for uniform or non-uniform total

  12. Biochemical indices of blood serum of cows with acute radiation sickness due to nuclear fission products. [/sup 235/U

    Yakovleva, V.P.; Burov, N.I

    1977-01-01

    Fission products of /sup 235/U were given to cows daily for 4 days. The animals developed the intestinal form of acute radiation sickness and did not survive longer than 20 days. Blood samples were taken at intervals and determinations were made on activity of transaminases and alkaline phosphatase, serum carbohydrates, cholesterol, lecithin, total lipids, K, Na, and Fe. Results showed an increase in enzyme activity, increase in carbohydrate levels, decrease in lipids and electrolytes, and weight loss. (HLW)

  13. Clinical analysis of patients with acute radiation syndrome due to total body irradiation or total lymphatic irradiation

    Objective: To study the severity of iatrogenic acute radiation syndrome, treatment, hematopoietic recovery and related complications in patients subjected to total body irradiation (TBI) or total lymphatic irradiation (TLI) prior to hematopoietic stem cell transplantation. Methods: 100 tumor patients (91 with leukemia and 9 with other tumors), after receiving 500∼1000 cGy (in an average of 738.6 cGy) of TBI or TLI with super high dose chemotherapy as conditioning regimen during the process of hemopoietic stem cell transplantation, developed severe or even extremely severe, mainly bone marrow form acute radiation syndrome. Results: The patients' white blood cell count once dropped to (0∼0.15) x 109/L, platelet count fell to (1∼17) x 109/L, bone marrow was depleted with only a few non-hemopoietic cells and rare hemopoietic cells, and a high risk of complicating with infection and hemorrhage was observed. Treated with a variety of measures including protective isolation, supportive care, administration of growth factors such as GM-CSF or G-CSF, blood component transfusion and effective antibiotics, 92 cases restored their normal hemopoiesis, while 8 cases died of infection or hemorrhage. The clinical course of these patients indicated that a majority of the patients with severe and extremely severe, iatrogenic acute radiation syndrome involving bone marrow could restore their normal hemopoiesis, and hemopoietic stem cell transplantation played an important role in the treatment. Conclusion: Hemopoietic stem cell transplantation and administration of growth factors are very useful for the treatment of acute radiation syndrome

  14. The UK Compensation Scheme for radiation-linked diseases

    The UK Compensation Scheme for Radiation-linked Diseases has operated since 1982. Originally started by BNFL and its trades' unions, the Scheme has now expanded to include the great majority of the UK's nuclear operators and their unions. The Scheme offers an alternative dispute resolution system to court action and, as such, offers the benefits of speed of resolution and generosities in the assessment of cases and payment of compensation at relatively low levels of causation probability. The Scheme uses an excess relative risk model, based on the BEIR V Report, to calculate causation probabilities for claimants. Cases with 'special factors' which might complicate or confound the Scheme's technical basis can be referred to an independent Expert Panel for determination. In cases that qualify for compensation payments, the value of compensation is agreed with the claimant using similar procedures to those which might be used for a successful legal case. The value of the final settlement is then adjusted according to a scale dependent on the causation probability value. The Scheme is directed by bodies constituted from the participating employers and trades' unions and is managed on a day-to-day basis by an independent Executive Secretary. To date the Compensation Scheme has considered over 970 cases, 90 of which have qualified for compensation payments. (author)

  15. Prediction of radiation induced liver disease using artificial neural networks

    The objective of this study was to evaluate the efficiency of predicting radiation induced liver disease (RILD) with an artificial neural network (ANN) model. From August 2000 to November 2004, a total of 93 primary liver carcinoma (PLC) patients with single lesion and associated with hepatic cirrhosis of Child-Pugh grade A, were treated with hypofractionated three-dimensional conformal radiotherapy (3DCRT). Eight out of 93 patients were diagnosed RILD. Ninety-three patients were randomly divided into two subsets (training set and verification set). In model A, the ratio of patient numbers was 1:1 for training and verification set, and in model B, the ratio was 2:1. The areas under receiver-operating characteristic (ROC) curves were 0.8897 and 0.8831 for model A and B, respectively. Sensitivity, specificity, accuracy, positive prediction value (PPV) and negative prediction value (NPV) were 0.875 (7/8), 0.882 (75/85), 0.882 (82/93), 0.412 (7/17) and 0.987 (75/76) for model A, and 0.750 (6/8), 0.800 (68/85), 0.796 (74/93), 0.261 (6/23) and 0.971 (68/70) for model B. ANN was proved high accuracy for prediction of RILD. It could be used together with other models and dosimetric parameters to evaluate hepatic irradiation plans. (author)

  16. Early corticosteroid administration in experimental radiation-induced heart disease

    The ability of dexamethasone (DEX) to reduce the severity of the late stage of radiation-induced heart disease (RIHD) was assessed in 25 New Zealand white rabbits. Ten rabbits served as unirradiated controls (CONT). In Group A, seven rabbits received intravenous DEX prior to irradiation and every 24 hours for three consecutive days. DEX was not administered to the eight rabbits in Group B. At 100 days postirradiation, the severity of the late state was determined by microscopic examination (MICRO) for myocardial fibrosis and determination of myocardial hydroxyproline content (MHP). Myocardial fibrosis was evident in groups A (40%) and B (80%) while none was present in CONT by MICRO. One rabbit in Group B with no fibrosis by MICRO had abnormally increased MHP. MHP was significantly increased in Groups A and B, as compared to CONT (p < 0.01). In addition to less fibrosis by MICRO, Group A demonstrated a significant reduction of MHP when compared to Group B (p < 0.05). Determination of MHP may be superior to MICRO in the detection of the late stage of RIHD. Also, early DEX administration appears to reduce myocardial collagen content (fibrosis) in this experimental model

  17. Acute coronary syndrome (ACS) registry--leading the charge for National Cardiovascular Disease (NCVD) Database.

    Chin, S P; Jeyaindran, S; Azhari, R; Wan Azman, W A; Omar, I; Robaayah, Z; Sim, K H

    2008-09-01

    Coronary artery disease is one of the most rampant non-communicable diseases in the world. It begins indolently as a fatty streak in the lining of the artery that soon progresses to narrow the coronary arteries and impair myocardial perfusion. Often the atherosclerotic plaque ruptures and causes sudden thrombotic occlusion and acute ST-elevation myocardial infarction (STEMI), non-ST-elevation MI (NSTEMI) or unstable angina (UA). This phenomenon is called acute coronary syndrome (ACS) and is the leading cause of death not only in Malaysia but also globally. In order for us to tackle this threat to the health of our nation we must arm ourselves with reliable and accurate information to assess current burden of disease resources available and success of current strategies. The acute coronary syndrome (ACS) registry is the flagship of the National Cardiovascular Disease Database (NCVD) and is the result of the dedicated and untiring efforts of doctors and nurses in both public and private medical institutions and hospitals around the country, ably guided and supported by the National Heart Association, the National Heart Foundation, the Clinical Research Centre and the Ministry of Health of Malaysia. Analyses of data collected throughout 2006 from 3422 patients with ACS admitted to the 12 tertiary cardiac centres and general hospitals spanning nine states in Malaysia in this first report has already revealed surprising results. Mean age of patients was 59 years while the most consistent risk factor for STEMI was active smoking. Utilization of medications was high generally. Thirty-day mortality for STEMI was 11%, for NSTEMI 8% and UA 4%. Thrombolysis (for STEMI only) reduced in-hospital and 30-day mortality by nearly 50%. Percutaneous coronary intervention or PCI also reduced 30-day mortality for patients with non-ST elevation MI and unstable angina. The strongest determinants of mortality appears to be Killip Class and age of the patient. Fewer women received

  18. Acute and late toxicity in prostate cancer patients treated by dose escalated intensity modulated radiation therapy and organ tracking

    To report acute and late toxicity in prostate cancer patients treated by dose escalated intensity-modulated radiation therapy (IMRT) and organ tracking. From 06/2004 to 12/2005 39 men were treated by 80 Gy IMRT along with organ tracking. Median age was 69 years, risk of recurrence was low 18%, intermediate 21% and high in 61% patients. Hormone therapy (HT) was received by 74% of patients. Toxicity was scored according to the CTC scale version 3.0. Median follow-up (FU) was 29 months. Acute and maximal late grade 2 gastrointestinal (GI) toxicity was 3% and 8%, late grade 2 GI toxicity dropped to 0% at the end of FU. No acute or late grade 3 GI toxicity was observed. Grade 2 and 3 pre-treatment genitourinary (GU) morbidity (PGUM) was 20% and 5%. Acute and maximal late grade 2 GU toxicity was 56% and 28% and late grade 2 GU toxicity decreased to 15% of patients at the end of FU. Acute and maximal late grade 3 GU toxicity was 8% and 3%, respectively. Decreased late ≥ grade 2 GU toxicity free survival was associated with higher age (P = .025), absence of HT (P = .016) and higher PGUM (P < .001). GI toxicity rates after IMRT and organ tracking are excellent, GU toxicity rates are strongly related to PGUM

  19. A Nonhuman Primate Model of Human Radiation-Induced Venocclusive Liver Disease and Hepatocyte Injury

    Background: Human liver has an unusual sensitivity to radiation that limits its use in cancer therapy or in preconditioning for hepatocyte transplantation. Because the characteristic veno-occlusive lesions of radiation-induced liver disease do not occur in rodents, there has been no experimental model to investigate the limits of safe radiation therapy or explore the pathogenesis of hepatic veno-occlusive disease. Methods and Materials: We performed a dose-escalation study in a primate, the cynomolgus monkey, using hypofractionated stereotactic body radiotherapy in 13 animals. Results: At doses ≥40 Gy, animals developed a systemic syndrome resembling human radiation-induced liver disease, consisting of decreased albumin, elevated alkaline phosphatase, loss of appetite, ascites, and normal bilirubin. Higher radiation doses were lethal, causing severe disease that required euthanasia approximately 10 weeks after radiation. Even at lower doses in which radiation-induced liver disease was mild or nonexistent, latent and significant injury to hepatocytes was demonstrated by asialoglycoprotein-mediated functional imaging. These monkeys developed hepatic failure with encephalopathy when they received parenteral nutrition containing high concentrations of glucose. Histologically, livers showed central obstruction via an unusual intimal swelling that progressed to central fibrosis. Conclusions: The cynomolgus monkey, as the first animal model of human veno-occlusive radiation-induced liver disease, provides a resource for characterizing the early changes and pathogenesis of venocclusion, for establishing nonlethal therapeutic dosages, and for examining experimental therapies to minimize radiation injury

  20. A Nonhuman Primate Model of Human Radiation-Induced Venocclusive Liver Disease and Hepatocyte Injury

    Yannam, Govardhana Rao [Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska (United States); Han, Bing [Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi' an Jiaotong University, Xi' an, Shaanxi (China); Setoyama, Kentaro [Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Yamamoto, Toshiyuki [Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska (United States); Ito, Ryotaro; Brooks, Jenna M. [Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Guzman-Lepe, Jorge [Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Department of Pathology, Children' s Hospital of Pittsburgh, Pittsburgh, Pennsylvania (United States); Galambos, Csaba [Department of Pathology, Children' s Hospital of Pittsburgh, Pittsburgh, Pennsylvania (United States); Fong, Jason V. [Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); Deutsch, Melvin; Quader, Mubina A. [Department of Radiation Oncology, Children' s Hospital of Pittsburgh, Pittsburgh, Pennsylvania (United States); Yamanouchi, Kosho [Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York (United States); Marion Bessin Liver Research Center, Albert Einstein College of Medicine, Bronx, New York (United States); Kabarriti, Rafi; Mehta, Keyur [Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, New York (United States); Soto-Gutierrez, Alejandro [Department of Pathology, Children' s Hospital of Pittsburgh, Pittsburgh, Pennsylvania (United States); McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (United States); and others

    2014-02-01

    Background: Human liver has an unusual sensitivity to radiation that limits its use in cancer therapy or in preconditioning for hepatocyte transplantation. Because the characteristic veno-occlusive lesions of radiation-induced liver disease do not occur in rodents, there has been no experimental model to investigate the limits of safe radiation therapy or explore the pathogenesis of hepatic veno-occlusive disease. Methods and Materials: We performed a dose-escalation study in a primate, the cynomolgus monkey, using hypofractionated stereotactic body radiotherapy in 13 animals. Results: At doses ≥40 Gy, animals developed a systemic syndrome resembling human radiation-induced liver disease, consisting of decreased albumin, elevated alkaline phosphatase, loss of appetite, ascites, and normal bilirubin. Higher radiation doses were lethal, causing severe disease that required euthanasia approximately 10 weeks after radiation. Even at lower doses in which radiation-induced liver disease was mild or nonexistent, latent and significant injury to hepatocytes was demonstrated by asialoglycoprotein-mediated functional imaging. These monkeys developed hepatic failure with encephalopathy when they received parenteral nutrition containing high concentrations of glucose. Histologically, livers showed central obstruction via an unusual intimal swelling that progressed to central fibrosis. Conclusions: The cynomolgus monkey, as the first animal model of human veno-occlusive radiation-induced liver disease, provides a resource for characterizing the early changes and pathogenesis of venocclusion, for establishing nonlethal therapeutic dosages, and for examining experimental therapies to minimize radiation injury.