Epizootic pneumonia of bighorn sheep following experimental exposure to Mycoplasma ovipneumoniae.

Directory of Open Access Journals (Sweden)

Thomas E Besser

Full Text Available Bronchopneumonia is a population limiting disease of bighorn sheep (Ovis canadensis. The cause of this disease has been a subject of debate. Leukotoxin expressing Mannheimia haemolytica and Bibersteinia trehalosi produce acute pneumonia after experimental challenge but are infrequently isolated from animals in natural outbreaks. Mycoplasma ovipneumoniae, epidemiologically implicated in naturally occurring outbreaks, has received little experimental evaluation as a primary agent of bighorn sheep pneumonia.In two experiments, bighorn sheep housed in multiple pens 7.6 to 12 m apart were exposed to M. ovipneumoniae by introduction of a single infected or challenged animal to a single pen. Respiratory disease was monitored by observation of clinical signs and confirmed by necropsy. Bacterial involvement in the pneumonic lungs was evaluated by conventional aerobic bacteriology and by culture-independent methods. In both experiments the challenge strain of M. ovipneumoniae was transmitted to all animals both within and between pens and all infected bighorn sheep developed bronchopneumonia. In six bighorn sheep in which the disease was allowed to run its course, three died with bronchopneumonia 34, 65, and 109 days after M. ovipneumoniae introduction. Diverse bacterial populations, predominantly including multiple obligate anaerobic species, were present in pneumonic lung tissues at necropsy.Exposure to a single M. ovipneumoniae infected animal resulted in transmission of infection to all bighorn sheep both within the pen and in adjacent pens, and all infected sheep developed bronchopneumonia. The epidemiologic, pathologic and microbiologic findings in these experimental animals resembled those seen in naturally occurring pneumonia outbreaks in free ranging bighorn sheep.

Epizootic pneumonia of bighorn sheep following experimental exposure to Mycoplasma ovipneumoniae.

Science.gov (United States)

Besser, Thomas E; Cassirer, E Frances; Potter, Kathleen A; Lahmers, Kevin; Oaks, J Lindsay; Shanthalingam, Sudarvili; Srikumaran, Subramaniam; Foreyt, William J

2014-01-01

Bronchopneumonia is a population limiting disease of bighorn sheep (Ovis canadensis). The cause of this disease has been a subject of debate. Leukotoxin expressing Mannheimia haemolytica and Bibersteinia trehalosi produce acute pneumonia after experimental challenge but are infrequently isolated from animals in natural outbreaks. Mycoplasma ovipneumoniae, epidemiologically implicated in naturally occurring outbreaks, has received little experimental evaluation as a primary agent of bighorn sheep pneumonia. In two experiments, bighorn sheep housed in multiple pens 7.6 to 12 m apart were exposed to M. ovipneumoniae by introduction of a single infected or challenged animal to a single pen. Respiratory disease was monitored by observation of clinical signs and confirmed by necropsy. Bacterial involvement in the pneumonic lungs was evaluated by conventional aerobic bacteriology and by culture-independent methods. In both experiments the challenge strain of M. ovipneumoniae was transmitted to all animals both within and between pens and all infected bighorn sheep developed bronchopneumonia. In six bighorn sheep in which the disease was allowed to run its course, three died with bronchopneumonia 34, 65, and 109 days after M. ovipneumoniae introduction. Diverse bacterial populations, predominantly including multiple obligate anaerobic species, were present in pneumonic lung tissues at necropsy. Exposure to a single M. ovipneumoniae infected animal resulted in transmission of infection to all bighorn sheep both within the pen and in adjacent pens, and all infected sheep developed bronchopneumonia. The epidemiologic, pathologic and microbiologic findings in these experimental animals resembled those seen in naturally occurring pneumonia outbreaks in free ranging bighorn sheep.

Cost evaluation of therapeutic drug monitoring of gentamicin at a teaching hospital in Malaysia

Directory of Open Access Journals (Sweden)

Ibrahim MI

2014-03-01

Full Text Available Background: Therapeutic drug monitoring (TDM makes use of serum drug concentrations as an adjunct to decision-making. Preliminary data in our hospital showed that approximately one-fifth of all drugs monitored by TDM service were gentamicin. Objective: In this study, we evaluated the costs associated with providing the service in patients with bronchopneumonia and treated with gentamicin. Methods: We retrospectively collected data from medical records of patients admitted to the Hospital Universiti Sains Malaysia over a 5-year period. These patients were diagnosed with bronchopneumonia and were on gentamicin as part of their treatment. Five hospitalisation costs were calculated; (i cost of laboratory and clinical investigations, (ii cost associated with each gentamicin dose, (iii fixed and operating costs of TDM service, (iv cost of providing medical care, and (v cost of hospital stay during gentamicin treatment. Results: There were 1920 patients admitted with bronchopneumonia of which 67 (3.5% had TDM service for gentamicin. Seventy-three percent (49/67 patients were eligible for final analysis. The duration of gentamicin therapy ranged from 3 to 15 days. The cost of providing one gentamicin assay was MYR25, and the average cost of TDM service for each patient was MYR104. The average total hospitalisation cost during gentamicin treatment for each patient was MYR442 (1EUR approx. MYR4.02. Conclusion: Based on the hospital perspective, in patients with bronchopneumonia and treated with gentamicin, the provision of TDM service contributes to less than 25% of the total cost of hospitalization.

Is survival improved by the use of NIV and PEG in amyotrophic lateral sclerosis (ALS? A post-mortem study of 80 ALS patients.

Directory of Open Access Journals (Sweden)

Christian Burkhardt

Full Text Available Non-invasive ventilation (NIV and percutaneous gastrostomy (PEG are guideline-recommended interventions for symptom management in amyotrophic lateral sclerosis (ALS. Their effect on survival is controversial and the impact on causes of death is unknown.To investigate the effect of NIV and PEG on survival and causes of death in ALS patients.Eighty deceased ALS patients underwent a complete post mortem analysis for causes of death between 2003 and 2015. Forty-two of these patients consented for genetic testing. Effects of NIV and PEG on survival and causes of death were analyzed in a multivariable Cox proportional hazard regression.Six patients, who requested assisted suicide causing drug-induced hypoxia, were excluded from final analysis. Respiratory failure was the main cause of death in 72 out of 74 patients. Fifteen out of 74 died of aspiration pneumonia 23/74 of bronchopneumonia and 8/74 of a combination of aspiration pneumonia and bronchopneumonia. Twenty died of hypoxia without concomitant infection, and six patients had pulmonary embolism alone or in combination with pneumonia. NIV (p = 0.01 and PEG (p<0.01 had a significant impact on survival. In patients using NIV bronchopneumonia was significantly more frequent (p <0.04 compared to non-NIV patients. This effect was even more pronounced in limb onset patients (p<0.002. Patients with C9orf72 hexanucleotide repeat expansions showed faster disease progression and shorter survival (p = 0.01.The use of NIV and PEG prolongs survival in ALS. This study supports current AAN and EFNS guidelines which recommend NIV and PEG as a treatment option in ALS. The risk of bronchopneumonia as cause of death may be increased by NIV.

Fallot's tetralogy in a European beaver (Castor fiber).

Science.gov (United States)

Wenger, Sandra; Gull, Jessica; Glaus, Tony; Blumer, Serafin; Wimmershoff, Julia; Kranjc, Asja; Steinmetz, Hanspeter; Hatt, Jean-Michel

2010-06-01

A 20-mo-old, female, 9-kg European beaver (Castor fiber) presented with apathy, reduced appetite of 3-day duration and a grade 5/6 systolic heart murmur. Thoracic radiographs revealed a diffuse broncho-interstitial pattern suspicious for bronchopneumonia. The echocardiographic findings of a hypertrophied right ventricle, ventricular septal defect with overriding aorta, and infundibular pulmonic stenosis were consistent with Fallot's tetralogy. Even though the bronchopneumonia rather than the congenital cardiac defect was considered of primary importance for the presenting clinical signs, the latter was relevant for the decision not to continue any medical treatment. Both disease processes were confirmed on necropsy. Fallot's tetralogy, European beaver, Castor fiber, heart murmur, ultrasound.

Pulmonary and systemic fungal infections in an Atlantic spotted dolphin and a Bryde's whale, Brazil.

Science.gov (United States)

Groch, Kátia R; Díaz-Delgado, Josué; Sacristán, Carlos; Oliveira, Denyiélim E; Souza, Gabriela; Sánchez-Sarmiento, Angélica M; Costa-Silva, Samira; Marigo, Juliana; Castilho, Pedro V; Cremer, Marta J; Rodrigues Hoffmann, Aline; Esperón, Fernando; Catão-Dias, José L

2018-03-22

We report the gross and microscopic findings and molecular identification of 2 cases of hyphate fungal infection in cetaceans from Brazil. The first case involved an adult male Atlantic spotted dolphin Stenella frontalis with localized pulmonary disease characterized by pyogranulomatous and necrotizing bronchopneumonia with intralesional hyphae. The second case involved an adult male Bryde's whale Balaenoptera edeni with orchitis, periorchitis, mesenteric lymphadenitis and pyogranulomatous bronchopneumonia with intralesional hyphae. PCR analysis from the dolphin's lung yielded Aspergillus fumigatus, and the fungus from the whale's mesenteric lymph node showed the greatest identity to Nanniziopsis obscura and Stagonosporopsis cucurbitacearum These cases represent the first reports of pulmonary aspergillosis by A. fumigatus in an Atlantic spotted dolphin and systemic mycosis by a possibly novel Onygenales in marine mammals.

101 an epidemic of adenovirus type·' bronchopneumonia in bantu

African Journals Online (AJOL)

1971-01-30

Jan 30, 1971 ... bovine plasma albumin (Armour) in Hanks' balanced salt solution. At the laboratory antibiotics were added and the speci- mens inoculated into tubes of HeLa and primary vervet kidney tissue cultures. These were maintained for 21 days, obs~rved for cytopathic changes and haemadsorbed with guinea-pig ...

Pneumonia - children - community acquired

Science.gov (United States)

Bronchopneumonia - children; Community-acquired pneumonia - children; CAP - children ... Viruses are the most common cause of pneumonia in infants and children. Ways your child can get CAP include: Bacteria and viruses living in the nose, sinuses, or mouth may spread ...

Natural history of ventricular septal defects in Nigerian children ...

African Journals Online (AJOL)

There were 2 (3.3%) deaths from bronchopneumonia and bacterial endocarditis. Conclusion. Spontaneous closure readily occurs in small-sized defects and muscular VSDs. However, most patients with moderate to large VSDs are confined to long-term medical management, highlighting the need for indigenous surgical ...

Cilia-associated bacteria in fatal Bordetella bronchiseptica pneumonia of dogs and cats

Science.gov (United States)

Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less well-studied. The objectives of this study were to identify the frequency of Bordetella bronchiseptica infection in fatal cases of bronchopneumonia in dogs and cats and to compare the diag...

Bordetella bronchiseptica and fatal pneumonia of dogs and cats

Science.gov (United States)

Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less well-studied. The objectives of this study were to identify the frequency of Bordetella bronchiseptica infection in fatal cases of bronchopneumonia in dogs and cats and to compare the diag...

Underlying congenital heart disease in Nigerian children with ...

African Journals Online (AJOL)

Background: Pneumonia is a common cause of childhood morbidity and mortality globally. Some congenital heart disease(CHD) may predispose their sufferer to bronchopneumonia. Objective: To evaluate the contribution of CHD to pneumonia in children seen in a tertiary hospital. Methods: Over a year, consecutive ...

Retrospective Study of Disease Incidence and Type of Pneumonia ...

African Journals Online (AJOL)

Dr Olaleye

with one or two aggregate bronchial associated lymphoid tissue (BALT). Table IV gives the histopathological diagnosis, bronchopneumonia was predominant with fibrinous (6) or suppurative (2) pattern, others were interstitial pneumonia (3), broncho-interstitial pneumonia with giant cells (8) and a collapsed lung. Table 3.

Effects of Pharmacologic Intervention on Oxygenation, Lung Water and Protein Leak in the Pseudomonas ARDS Procine Model

Science.gov (United States)

1993-07-01

they displayed varying degrees of congestion and edema, often with petechial or larger hemorrhages and more or less widespread bronchopneumonia in...Chemow, B. (1990) Circulating interleukin-1 and tumor necrosis factor in septic shock and experimental endotoxin fever . J. Infect. Dis., 161:79-84

Fluorescence-Based Reporter for Gauging Cyclic Di-GMP Levels in Pseudomonas aeruginosa

DEFF Research Database (Denmark)

Rybtke, Morten T.; Borlee, Bradley R.; Murakami, Keiji

2012-01-01

The increased tolerance toward the host immune system and antibiotics displayed by biofilm-forming Pseudomonas aeruginosa and other bacteria in chronic infections such as cystic fibrosis bronchopneumonia is of major concern. Targeting of biofilm formation is believed to be a key aspect in the dev...

Microbiology and pathology of fibrinous pericarditis in Danish slaughter pigs

DEFF Research Database (Denmark)

Buttenschøn, J.; Friis, N.F.; Aalbaek, B.

1997-01-01

. Parvovirus was found in one case in the pericardium and in two cases in the spleen. Forty-five cases mere subacute co chronic. The gross pathological examination showed that bronchopneumonia, chronic pleuritis and synovitis or a low grade arthritis occurred in most cases. Only the arthritic lesions...

Intoxication for lead

International Nuclear Information System (INIS)

Velez, Ruben Dario; Tamayo, Margarita Maria

1999-01-01

We present a case of a hospitalized girl with bronchopneumonia, who needed mechanic ventilation. Also she had a developmental delay and Burtons border in gums. Radiological studies showed dense transverse metaphiseal bands in long bones and hyperdensity in basal ganglia. We found high serum lead levels

Underlying congenital heart disease in Nigerian children with ...

African Journals Online (AJOL)

EB

2013-09-03

Sep 3, 2013 ... Abstract. Background: Pneumonia is a common cause of childhood morbidity and mortality globally. Some congenital heart disease. (CHD) may predispose their sufferer to bronchopneumonia. Objective: To evaluate the contribution of CHD to pneumonia in children seen in a tertiary hospital. Methods: Over ...

Community-acquired Pneumonia in Hospitalized Urban Young ...

African Journals Online (AJOL)

As part of a comprehensive hospital-based study of acute lower respiratory infections (ALRI) in under-five urban Nigerian children, we sought to identify the possible clinical and investigative correlates of lobar versus bronchopneumonia, and the possible determinants of mortality in community-acquired pneumonia. Over a ...

Case Report: Salmonella lung infection | Ohanu | International ...

African Journals Online (AJOL)

A case of an 84 year old man admitted because of fever, abdominal discomfort, weakness, past history of cough wheezing and abuse of prednisolone and Erythromycin. He had Bronchopneumonia and diabetes. Salmonella typhimurium was isolated from both his sputum and blood while stool was negative for salmonella.

[Study on the anti-NTHi infection of Hap recombinant protein in vivo].

Science.gov (United States)

Li, Wan-yi; Wang, Bao-ning; Zuo, Feng-qiong; Zeng, Wei; Feng, Feng; Kuang, Yu; Jiang, Zhong-hua; Li, Ming-yuan

2010-07-01

To observe the immune effect of Hap recombinant protein on murine model of bronchopneumonia infected with NTHi, and explore the mechanism about the anti-NTHi infection. The C57BL/6 mice intranasally immunized with purified Hap recombinant protein and CT-B were challenged by NTHi encased in agar beads. The immunifaction of anti-infection was observed through encocyte counting of BALF, bacteria detection of lung and the pathologyical change of lung tissue. In the challenge with NTHi experiment, the inflammatory exudation of the infected murine and pathological change of lung tissue was relieved by combined immunization of Hap recombinant protein and CT-B, and quantity of NTHi in lung of the infected murine was reduced obviously. The Hap recombinant protein also had good ability of anti-NTHi infection in the murine model of NTHi bronchopneumonia. This study could offer the oretical and experimental basis for development of new vaccine against NTHi.

Multidrug-resistant endemic clonal strain of Candida auris in India

NARCIS (Netherlands)

Chowdhary, A.; Kumar, V.; Sharma, C.; Prakash, A.; Agarwal, K.; Babu, R.; Dinesh, K.R.; Karim, S.; Singh, S.K.; Hagen, F.; Meis, J.F.G.M.

2014-01-01

Candida auris is a recently described rare agent of fungemia. It is notable for its antifungal resistance. A total of 15 C. auris isolates, originating from seven cases of fungemia, three cases of diabetic gangrenous foot, and one case of bronchopneumonia from a tertiary care hospital in south

Copper-measurement in a muscle-biopsy. A possible method for postmortem diagnosis of Menkes disease

DEFF Research Database (Denmark)

Tønnesen, T.; Müller-Schauenburg, G.; Damsgaard, Else

1986-01-01

A 5-month-old boy showed severe delay in mental and motor development. His hair was normal. He died at 18 months from bronchopneumonia. Autopsy of the brain revealed meningo-cerebral angiodysplasia with tortuous vessels at the surface of the brain. This raised a suspicion of Menkes disease...

Determinants of antibiotic prescription in paediatric patients: The ...

African Journals Online (AJOL)

... differences (p>0.05) in the prescription rates of the hospitals. The most commonly used antibiotics were beta-lactams (57.3%), aminoglycosides (28.3%) and co-trimoxazole (9.4%). Antibiotics were prescribed in all cases of bronchopneumonia, fever, sepsis and acute gastroenteritis. For malaria and undefined diagnoses, ...

cholangiopathy in a co-hort of hiv positive kenyan patients

African Journals Online (AJOL)

2013-12-01

Dec 1, 2013 ... seven had herpes zoster virus, one had broncho-pneumonia, ten had diarrhoea and thirty two had no infections. Seven patients .... computer and analysed using SPSS package. The results were expressed as mean .... with a history of any opportunistic infections (9). HAART administration accounts for the ...

Behmel syndrome with bilateral posterior ear lobule creases

African Journals Online (AJOL)

Rabah M. Shawky

2013-09-08

Sep 8, 2013 ... and died at the age of 13 months with bronchopneumonia, and the younger one is 7 months old with normal ... tissues predisposing to the development of embryonal tumors [2]. ... The older brother of the patient suffered delayed motor and .... and whether selective mutations influence the SGBS phenotype.

The Brachmann-De Lange Syndrome

African Journals Online (AJOL)

1974-05-04

May 4, 1974 ... to hospital because of failure to thrive, bronchopneumonia and kwashiorkor. The parents, 3 older sisters and 2 older brothers were physically and mentally normal. There was no history of significant family illness or exposure to drugs during pregnancy and the young parents were not related. The patient ...

Cornelia-de Lange syndrome in an Egyptian infant with unusual ...

African Journals Online (AJOL)

... metacarpophalengeal joints, bilateral short big toes, angulation of the lower part of the bones of right forearm and both legs with multiple skin folds. Also biochemical and X-ray evidence of rickets was detected mostly due to malnutrition and failure to thrive. The patient died at the age of 5 months with bronchopneumonia

Epizootic Pneumonia of Bighorn Sheep following Experimental Exposure to Mycoplasma ovipneumoniae

OpenAIRE

Besser, Thomas E.; Cassirer, E. Frances; Potter, Kathleen A.; Lahmers, Kevin; Oaks, J. Lindsay; Shanthalingam, Sudarvili; Srikumaran, Subramaniam; Foreyt, William J.

2014-01-01

BACKGROUND: Bronchopneumonia is a population limiting disease of bighorn sheep (Ovis canadensis). The cause of this disease has been a subject of debate. Leukotoxin expressing Mannheimia haemolytica and Bibersteinia trehalosi produce acute pneumonia after experimental challenge but are infrequently isolated from animals in natural outbreaks. Mycoplasma ovipneumoniae, epidemiologically implicated in naturally occurring outbreaks, has received little experimental evaluation as a primary agent o...

Parasites in harbour seals ( Phoca vitulina) from the German Wadden Sea between two Phocine Distemper Virus epidemics

Science.gov (United States)

Lehnert, K.; Raga, J. A.; Siebert, U.

2007-12-01

Parasites were collected from 107 harbour seals ( Phoca vitulina) found on the coasts of Schleswig-Holstein, Germany, between 1997 and 2000. The prevalence of the parasites and their associated pathology were investigated. Eight species of parasites, primarily nematodes, were identified from the examined organs: two anisakid nematodes ( Pseudoterranova decipiens (sensu lato) , Contracaecum osculatum (sensu lato)) from the stomach, Otostrongylus circumlitus (Crenosomatidae) and Parafilaroides gymnurus (Filaroididae) from the respiratory tract, one filarioid nematode ( Acanthocheilonema spirocauda) from the heart, two acanthocephalans, Corynosoma strumosum and C. semerme (Polymorphidae), from the intestine and an ectoparasite, Echinophthirius horridus (Anoplura, Insecta). Lungworm infection was the most prominent parasitological finding and secondary bacterial bronchopneumonia the most pathogenic lesion correlated with the parasites. Heavy nematode burdens in the respiratory tract were highly age-related and more frequent in young seals. A positive correlation was observed between high levels of pulmonary infection and severity of bronchopneumonia. The prevalence of lungworms in this study was higher than in seals that died during the 1988/1989 Phocine Distemper Virus epidemic, and the prevalence of acanthocephalans and heartworms had decreased compared to findings from the first die-off.

Susceptibility of Rocky Mountain bighorn sheep and domestic sheep to pneumonia induced by bighorn and domestic livestock strains of Pasteurella haemolytica.

Science.gov (United States)

Onderka, D K; Rawluk, S A; Wishart, W D

1988-10-01

Bighorn sheep were inoculated intratracheally with suspensions of nonhemolytic Pasteurella haemolytica biotype T (10(12) organisms) unique to wild bighorns, with beta-hemolytic P. haemolytica biotype T (10(12) organisms) isolated from clinically normal domestic sheep or intradermally with half a dose of a cattle vaccine containing P. haemolytica biotype A (10(5) organisms). The bighorn strain caused lobar necrotizing bronchopneumonia whereas both domestic livestock strains precipitated fatal septicemia and fibrinous bronchopneumonia. The serotypes given were T3, T4, T15 and A1 and these were recovered from lung lesions and other organs. In three trials, domestic sheep were inoculated intratracheally with suspensions of bighorn sheep pneumonic lungs, and two concentrations of the P. haemolytica bighorn strain (10(4) and 10(12) organisms). One of these sheep was inoculated intrabronchially. The domestic sheep experienced a transient fever and elevated white blood cell counts. After six days, none of the sheep had lung lesions and inoculated organisms could not be recovered. It is suggested that bighorn sheep are very susceptible to P. haemolytica from domestic livestock and should not be allowed in contact with sheep or cattle.

The first clinical liver transplantation of Brazil revisited.

Science.gov (United States)

Bacchella, T; Machado, M C C

2004-05-01

The first clinical orthotopic liver transplantation in Brazil was performed on August 5, 1968. The patient was awake after surgery and died on the seventh postoperative day due to subdural hematoma, bronchopneumonia, renal failure, and graft rejection. The report of this case is important to understand the evolution of clinical liver transplantation in Brazil, where this procedure is now routinely carried out in many medical centers.

Susceptibility of Rocky Mountain bighorn sheep and domestic sheep to pneumonia induced by bighorn and domestic livestock strains of Pasteurella haemolytica.

OpenAIRE

Onderka, D K; Rawluk, S A; Wishart, W D

1988-01-01

Bighorn sheep were inoculated intratracheally with suspensions of nonhemolytic Pasteurella haemolytica biotype T (10(12) organisms) unique to wild bighorns, with beta-hemolytic P. haemolytica biotype T (10(12) organisms) isolated from clinically normal domestic sheep or intradermally with half a dose of a cattle vaccine containing P. haemolytica biotype A (10(5) organisms). The bighorn strain caused lobar necrotizing bronchopneumonia whereas both domestic livestock strains precipitated fatal ...

Exposure of bighorn sheep to domestic goats colonized with Mycoplasma ovipneumoniae induces sub-lethal pneumonia

OpenAIRE

Besser, Thomas E.; Cassirer, E. Frances; Potter, Kathleen A.; Foreyt, William J.

2017-01-01

Background Bronchopneumonia is a population limiting disease of bighorn sheep (Ovis canadensis) that has been associated with contact with domestic Caprinae. The disease is polymicrobial but is initiated by Mycoplasma ovipneumoniae, which is commonly carried by both domestic sheep (O. aries) and goats (Capra aegagrus hircus). However, while previous bighorn sheep comingling studies with domestic sheep have resulted in nearly 100% pneumonia mortality, only sporadic occurrence of fatal pneumoni...

Inclusões intracitoplasmáticas hialinas na medular da adrenal de bovinos

Directory of Open Access Journals (Sweden)

L.P Mesquita

2011-02-01

Full Text Available Cytoplasmic inclusion bodies in adrenal medullary chromaffin cells have been described in various species including humans. These inclusions are believed to be related to certain infectious, toxic and neurodegenerative diseases. No reports concerning such adrenal inclusions have been described in bovines. Adrenal glands from twenty bovines were evaluated in a retrospective study. Seven of these exhibited inclusions - three cases of rabies, two cases of chronic suppurative bronchopneumonia, one case of chronic suppurative peritonitis, and one case of gangrenous mastitis. The inclusions were present in higher numbers especially in cases of rabies and also in one case of chronic suppurative bronchopneumonia. The inclusions were intracytoplasmic, eosinophilic, rounded, single or multiple, of various sizes, strongly stained by PAS and were present in higher numbers in the external layer of the adrenal medulla. The inclusions were negative when subjected to immunohistochemistry for detection of viral antigens in the cases of rabies. Although inclusion bodies were present in adrenal glands devoid of other histological alterations, they were more abundant in cases in which the adrenal gland had other alterations. The correlation between certain diseases and the development of inclusion bodies is not known, which highlights the importance of further studies on these inclusions in adrenal glands of bovines.

Immunoglobulin concentration in blood serum of postcolostral calves: Ratio between immunoglobulin level and appearance of enzootic pneumonia

Directory of Open Access Journals (Sweden)

Jonić Branko

2007-01-01

Full Text Available The timely supply of newborn calves with optimal quantities of colostrum has a key role in the process of immune protection in the early phase of their lives. Passively acquired antibodies can protect the digestive organs from infection caused by E.coli bacteria, and it seems also from the appearance of diseases of the respiratory tract. These examinations were performed on a cattle farm where bronchopneumonia was one of the most significant health problems, and a group of 39 calves were selected for the investigations. The calves were fed with their mothers’ colostrum after birth, and then with collective milk. Immunoglobulin concentration was determined in blood samples taken during the postcolostral period, with the method using zinc-sulphate. At the age of 40 days, the calves were administered a polyvalent inactivated vaccine, and revaccinated 20 days after that (Vibak, Veterinary Department Subotica. In 74.34% calves, the immunoglobulin G concentration ranged from 26 to 40 g/l. In 25.66% calves, the immunoglobulin concentration was lower, from 8 to 25 g/l. The calves found to have a lower concentration of immunoglobulin in blood contracted bronchopneumonia more frequently, and the outcome of the disease in some cases was mortality, even.

The Effect of Exclusive Breastfeeding on Hospital Stay and Morbidity due to Various Diseases in Infants under 6 Months of Age: A Prospective Observational Study

Directory of Open Access Journals (Sweden)

Amarpreet Kaur

2016-01-01

Full Text Available Background. Mother’s milk is the best for the babies. Protective and preventive role of breast milk was evaluated in this study by assessing the relation of type of feeding and duration of hospital stay or morbidity. Methods. This prospective study was conducted in a tertiary care hospital and 232 infants in the age group of 14 weeks to 6 months formed the sample. There are two groups of infants, that is, one for breastfed and one for top fed infants. Statistical analysis was done and results were calculated up to 95% to 99% level of significance to find effect of feeding pattern on hospital stay due to various diseases and morbidity. Results. Prolonged hospital stay, that is, >7 days, was lesser in breastfed infants and results were statistically significant in case of gastroenteritis (p value < 0.001, bronchopneumonia (p value = 0.0012, bronchiolitis (p value = 0.005, otitis media (p value = 0.003, and skin diseases (p value = 0.047. Lesser morbidity was seen in breastfed infants with gastroenteritis (p value 0.0414, bronchopneumonia (p value 0.03705, bronchiolitis (p value 0.036706, meningitis (p value 0.043, and septicemia (p value 0.04. Conclusions. Breastfed infants have shorter hospital stay and lesser morbidity in regard to various diseases as compared to top fed infants.

Two cases of bovine hypertrophic osteopathy (Marie-Bamberger's disease)

International Nuclear Information System (INIS)

Ravary, B.; Fecteau, G.

2002-01-01

Two cattle were presented with persistent lameness and Marie-Bamberger's disease was suspected because of the generalised deformity of the distal limbs. The diagnosis was confirmed after further tests (radiography, post-mortem and anatomopathological examinations). The first case was probably caused by a pulmonary infection. The cause of the second case could not be fully determined. The bony lesions characteristic of this condition result from stimulation of the osteogenic layer of the periosteum, and results from neoplasic lesions, pulmonary abscesses, bronchopneumonia, etc [it

Fatal pneumonia of bighorn sheep following association with domestic sheep.

Science.gov (United States)

Foreyt, W J; Jessup, D A

1982-04-01

During 1979-1980 acute fibrinopurulent bronchopneumonia resulted in high mortality or total loss of herds of bighorn sheep (Ovis canadensis) in California and Washington. Contact with domestic sheep occurred shortly before the onset of disease in each case. Circumstantial evidence indicated that the apparently healthy domestic sheep transmitted pathogenic bacteria to the bighorns, resulting in mortality. Pasteurella multocida and Corynebacterium pyogenes were isolated from pulmonary tissue of dead bighorns. The presence of domestic sheep may have been an important stress which initiated or compounded the disease.

Pneumonia in the immunocompetent patient.

Science.gov (United States)

Reynolds, J H; McDonald, G; Alton, H; Gordon, S B

2010-12-01

Pneumonia is an acute inflammation of the lower respiratory tract. Lower respiratory tract infection is a major cause of mortality worldwide. Pneumonia is most common at the extremes of life. Predisposing factors in children include an under-developed immune system together with other factors, such as malnutrition and over-crowding. In adults, tobacco smoking is the single most important preventable risk factor. The commonest infecting organisms in children are respiratory viruses and Streptoccocus pneumoniae. In adults, pneumonia can be broadly classified, on the basis of chest radiographic appearance, into lobar pneumonia, bronchopneumonia and pneumonia producing an interstitial pattern. Lobar pneumonia is most commonly associated with community acquired pneumonia, bronchopneumonia with hospital acquired infection and an interstitial pattern with the so called atypical pneumonias, which can be caused by viruses or organisms such as Mycoplasma pneumoniae. Most cases of pneumonia can be managed with chest radiographs as the only form of imaging, but CT can detect pneumonia not visible on the chest radiograph and may be of value, particularly in the hospital setting. Complications of pneumonia include pleural effusion, empyema and lung abscess. The chest radiograph may initially indicate an effusion but ultrasound is more sensitive, allows characterisation in some cases and can guide catheter placement for drainage. CT can also be used to characterise and estimate the extent of pleural disease. Most lung abscesses respond to medical therapy, with surgery and image guided catheter drainage serving as options for those cases who do not respond.

A retrospective study of 11 cases of lungworm (Didelphostrongylus hayesi) infection in opossums (Didelphis virginiana).

Science.gov (United States)

Lamberski, Nadine; Reader, J Rachel; Cook, Lizette F; Johnson, Eileen M; Baker, David G; Lowenstine, Linda J

2002-06-01

A juvenile, female North American opossum (Didelphis virginiana) died of verminous pneumonia caused by Didelphostrongylus haysei despite aggressive treatment with oral fenbendazole, corticosteroids, and antibiotics. This prompted a retrospective study of lungworm infection in opossums, during which 19 additional necropsy reports from opossums were reviewed. Including the subject of this report, a total of 11 (55%) of these cases included a diagnosis of lungworm infection. This diagnosis was considered to have contributed to death in eight out of the 11 cases (73%). Histologically, 10 of the 11 (91%) opossums had granulomatous bronchopneumonia with small to moderate numbers of adult nematodes in the airways and parenchyma. Four of the 11 (36%) opossums had free larvae within the parenchyma or terminal airways. Inflammation was usually associated with larvae, degenerating parasites, and nonintact adult nematodes. Superimposed bacterial pneumonia was evident in three animals, and sections of lung examined from all the opossums were characterized by moderate to severe smooth-muscle hyperplasia in airways, including terminal respiratory bronchioles and alveolar ducts. Nine animals had prominent medial smooth-muscle hyperplasia in small- and medium-sized arterioles. Lesions in other organs, particularly in liver, heart, and gastrointestinal tract, were frequently identified. Three animals had concomitant septicemia or bacterial bronchopneumonia (or both), which contributed to the cause of death. Seven animals had gastric nematodosis (Physaloptera sp.), although three of them had been treated with a 14-day course of fenbendazole.

Lung structure-respiratory function relationships in experimentally-induced bronchiolitis, bronchopneumonia and interstitial pneumonia in rats

Energy Technology Data Exchange (ETDEWEB)

Mauderly, J L; Madron, E de; Harkema, J R

1988-12-01

Histopathology and respiratory function of rats with three different types and distributions of lower lung inflammation were compared to better understand lung structure-function relationships. Rats were exposed 21 h/day for 7 days to 0.8 ppm ozone (O{sub 3}), sham-exposed as controls, or given 5 mg/kg bacterial endotoxin either intratracheally (ITE) or intraperitoneally (IPE). Respiratory function was measured 24 h after the end of treatment, than the rats were sacrificed and the distribution of inflammation was evaluated morphometrically. Chronic centriacinar inflammation with formation of new respiratory bronchioles caused an obstructive functional impairment in the O{sub 3} rats, which was clearly distinguished from the restrictive impairments resulting from acute inflammation in ITE and IPE rats. Only the magnitudes of changes related to the distribution of inflammation differentiated the ITE and IPE groups. Flow parameters previously thought sensitive to large airway resistance were changed in the O{sub 3} rats. Alveolar luminal inflammatory exudate affected quasistatic compliance more than septal inflammation in ITE and IPE rats. Quasistatic chord compliance was the most sensitive of three indices of pressure-volume relationships. The findings in this study improve the basis for interpreting respiratory function changes of rats. (author)

The origin of Pasteurella multocida impacts pathology and inflammation when assessed in a mouse model

DEFF Research Database (Denmark)

Pors, Susanne E.; Chadfield, Mark S.; Sorensen, Dorte B.

2016-01-01

dose dependent and consisted of exudative bronchopneumonia, abscess formation in liver and a lower bacterial load in lung and liver. Both isolates caused increased expression of MMP9 and TIMP1. In conclusion, evaluation and comparison of pathogenicity and host-pathogen interaction of P. multocida......) of an isolate from porcine pneumonia or fowl cholera showed marked differences between the two isolates. The avian isolate was highly pathogenic with severe signs of necrotizing pneumonia, liver necrosis and high bacterial load in lung and liver. Clinical signs and pathology related to the porcine isolate were...

Parasitism of wild Gouldian finches (Erythrura gouldiae) by the air-sac mite Sternostoma tracheacolum.

Science.gov (United States)

Tidemann, S C; McOrist, S; Woinarski, J C; Freeland, W J

1992-01-01

Sixty-two percent of 26 wild caught Gouldian finches (Erythrura gouldiae) were infected with Sternostoma tracheacolum, a parasitic rhinonyssid mite. The intensity of infection was higher in adult finches than juveniles, and higher in juvenile females than juvenile males. Histopathological investigation of wild Gouldian Finches revealed bronchopneumonia and air sacculitis associated with mite infection. Although this mite may not have contributed to the decline of Gouldian finch populations in the wild during the past 20 yr, it may be suppressing the return of the finch to its former status.

Bronchiolitis from nitrous fumes

Energy Technology Data Exchange (ETDEWEB)

Darke, C S; Warrack, A J.N.

1958-01-01

Gases of low solubility (e.g., NO/sub 2/) may not irritate upper respiratory tract but may act insidiously on lower tract producing edema and bronchiolitis. Cases of bronchiolitis (1 resulting in death) from exposure to brown nitrous fumes are reported. There were no or slight symptoms at first but severe ones after about 1 wk. Pathology appears as acute pulmonary edema with damage and desquamation of alveolar epithelium particularly and that of respiratory bronchioles somewhat. Patchy atelectasis, bronchopneumonia and disruption of fibers in cell walls may also occur. Severe cases have obliteration of lumen (bronchiolitis obliterans) with extreme distress and death.

Clinical Characteristic and Outcome of Acute Lower Respiratory Tract Infection in Children with Congenital Heart Disease

Directory of Open Access Journals (Sweden)

Krystle Gabriela

2015-09-01

Full Text Available Background: Acute Lower Respiratory Tract Infection (ALRTI is the leading cause of deaths in children under 5 years of age worldwide, and has high morbidity and mortality in children with Congenital Heart Disease (CHD. The objective of this study was to obtain the incidence, clinical characteristic, and outcome of ALRTI children with CHD. Methods: A retrospective hospital-based study was conducted from January 2007–December 2011 to medical record of child patients with ALRTI and CHD in the Department of Child Health of Dr. Hasan Sadikin General Hospital, Bandung. The diagnosis of CHD was determined by echocardiography. The collected data was analyzed and presented in percentage shown in tables. Results : From 3,897 children who had ALRTI, there were 149 children with CHD (3.8%, with 11.4% of whom founded with recurrent episodes. This happened often in girls than boys with quite similar ratio of 1.37: 1.The majority of children (80% was under 1 year old of age, 72.5% with malnutrition, and 24.8% with severe malnutrition. Clinical symptoms mostly found were difficulty of breathing (98%, fever (85.2%, cough (75.2%, and runny nose (63.1%. The most common types of CHD were Patent Ductus Arteriosus (47.6%, followed by Ventricular Septal Defect (47%. Bronchopneumonia (86.6% was the common type of ALRTI. The length of stay was mostly less than 10 days (70.5%. From all the children 43.7% had complications, and 6.7% died. Conclusions: The ALRTI in children with CHD is not common and has good outcome. The majority for CHD lesions are Patent Ductus Arteriosus and Ventricular Septal Defect while for ALRTI is Bronchopneumonia.

Human transmissible spongiform encephalopathy: Case report

Directory of Open Access Journals (Sweden)

Duque Velásquez, Camilo

2014-07-01

Full Text Available We report the case of a 64 year-old woman with motor and cognitive deterioration that progressed rapidly during eight months. She was unsuccessfully treated with quinacrine, and died in a terminal status, by septic shock secondary to bronchopneumonia by broncho-aspiration. The brain was donated for research and the histopathological analysis showed spongiform changes, astrogliosis and prion protein (PrPRes deposits, confirmed by Western blot (WB. These features are considered characteristic of prion diseases, which are uncommon in Colombia. We highlight that its diagnosis was made for the first time in this country by the simultaneous use of immunohistochemistry and Western blot.

Pulmonary nocardiosis with osteomyelitis

International Nuclear Information System (INIS)

Bechet, R.; Granier, P.; Mourad, M.; Dufranc, A.; Adoue, D.

2007-01-01

We report a case of a 49-year-old female who developed a bronchopneumonia associated with atelectasis of the upper right lobe and back pain of bone origin. Bronchoscopy revealed an endobronchial mass at the origin of the right upper lobe bronchus. Scintigraphy showed three paravertebral spots of the seventh and eighth thoracic vertebrae, without any radiological modification. Culture of lung tissue obtained by trans-parietal punction under CT scan control became positive to Nocardia belonging to the pneumoniae complex. Positive diagnosis of pulmonary nocardiosis associated with two rare localizations was set, one was an endobronchial mass, the other was osteomyelitis of the posterior chest wall. The patient was treated with Trimethoprim ulfamethoxazole and recovered completely. (author)

Total lymphoid irradiation in refractory systemic lupus erythematosus

International Nuclear Information System (INIS)

Ben-Chetrit, E.; Gross, D.J.; Braverman, A.; Weshler, Z.; Fuks, Z.; Slavin, S.; Eliakim, M.

1986-01-01

In two patients with systemic lupus erythematosus, conventional therapy was considered to have failed because of persistent disease activity and unacceptable side effects. Both were treated with total lymphoid irradiation without clinical benefit, despite adequate immunosuppression as documented by markedly reduced numbers of circulating T lymphocytes and T-lymphocyte-dependent proliferative responses in vitro. The first patient developed herpes zoster, gram-negative septicemia, neurologic symptoms, and deterioration of lupus nephritis. The second patient developed massive bronchopneumonia, necrotic cutaneous lesions, and progressive nephritis and died 2 weeks after completion of radiotherapy. These observations, although limited to two patients, indicate that total lymphoid irradiation in patients with severe systemic lupus erythematosus should be regarded as strictly experimental

Congenital CMV with LAD type 1 and NK cell deficiency.

Science.gov (United States)

Rai, Narendra; Thakur, Neha

2013-08-01

We report a rare case of congenital cytomegalovirus (CMV) in a patient who was subsequently diagnosed as leukocyte adhesion defect type 1 with natural killer cell deficiency. The clinical course was complicated by severe CMV pneumonitis during the newborn period. Thereafter the infant suffered from recurrent skin infections without pus formation, otitis media, and bronchopneumonia since 3 months of age. The patient had congenital CMV infection as urine and blood plasma was positive for CMV from day 12 onward. Neutrophil chemotaxis studies showed a decrease in directed chemotaxis. Neutrophils were dyspoetic and nonfunctional lacking HLA DR, CD11c, and CD18. Lymphocytes were polyclonal but lacked CD56, CD16, and surface membrane immunoglobulin.

Acute exogenous lipoid pneumonia, on a fire eating

International Nuclear Information System (INIS)

Quintanilla-Gallo, Juvel; Jimenez-Navarrete, Manuel Fco.; Gourzong-Taylor, Charles

2006-01-01

A case of an adult 19 years of age, fire juggler and manipulator is presented. The young came in to the medical emergency service of the Hospital Dr. Rafael A. Calderon Guardia, because of a sudden episode of right thoracic pain and dyspnea. A right pleural effusion was documented and a round mass at the base of the left lung. A suggestive clinic of bronchopneumonia started after hours, it was localized first as community acquired pneumonia. Considering his work history and clinical characteristics, the case was reoriented and concluded that this is what the medical literature in English is called f ire-eater pneumonia , uncommon aspiration pneumonia which was a literature review. (author) [es

Leukocyte adhesion deficiency syndrome: report on the first case in Chile and South America

Directory of Open Access Journals (Sweden)

Rodrigo Vásquez-De Kartzow

Full Text Available CONTEXT: Adhesion molecule deficiency type 1 is a rare disease that should be suspected in any patient whose umbilical cord presents delay in falling off, and who presents recurrent severe infections. Early diagnostic suspicion and early treatment improve the prognosis. CASE REPORT: The case of a four-month-old boy with recurrent hospitalizations because of severe bronchopneumonia and several episodes of acute otitis media with non-purulent drainage of mucus and positive bacterial cultures is presented. His medical history included neonatal sepsis and delayed umbilical cord detachment. Laboratory studies showed marked leukocytosis with predominance of neutrophils and decreased CD11b and CD18. These were all compatible with a diagnosis of leukocyte adhesion deficiency type I [LAD type 1].

Ultrastructure of respiratory tract epithelium following irradiation or application of cytostatics

International Nuclear Information System (INIS)

Konradova, V.; Smelhaus, V.; Kanta, J.

1988-01-01

The ultrastructure was studied of the large bronchi epithelium in 3 patients with malignant tumors where signs of pulmonary fibrosis were found following irradiation and combined therapy. In 2 patients, pseudostratified cylindrical epithelium was observed with signs of pathological alteration, in the third patient an altered pseudostratified cylindrical epithelium with ultrastructural signs of commencing reconstructure into stratified squamous epithelium. The findings in the respiratory track epithelium of the patients were similar to those observed in a group of children with chronic or relapsing bronchitis and bronchopneumonia. The findings show marked disturbance of the ciliary border caused by reduction in the number of kinocilia which is associated with an impairment of the self-cleaning capacity of epithelium. (author). 1 tab., 10 refs

Distemper in raccoons and foxes suspected of having rabies

Science.gov (United States)

Habermann, R.T.; Herman, C.M.; Williams, F.P.

1958-01-01

1) Twenty-one raccoons and 3 red foxes were collected from areas where suspected rabies occurred. All were found to be nonrabid. 2) Distemper was diagnosed in 14 of the 21 raccoons by demonstrating intracytoplasmic and intranuclear inclusions in the brain and visceral tissues. Two of the 3 foxes were considered to have distemper; the clinical signs were typical and mouse inoculation tests were negative for rabies. 3) Deaths of the other 7 raccoons were attributed to: leishmaniasis 1, gastritis 1, bronchopneumonia 1, parasitism 2, car injury 1; 1 showed no significant lesions. The death of 1 fox was attributed to parasitism. 4) Distemper may be a frequent cause of death in raccoons and foxes, in epizootics which simulate rabies.

[FACTORS RELATED TO MORTALITY IN NECROTIZINGENTEROCOLITIS(NEC) IN NEONATES AND OLDER INFANTS

Science.gov (United States)

Ríos D , Hugo; Rivera M , Juan

1997-01-01

In order to determine the factors related to mortality in Necrotizing enterocolitis (NEC), medical records of neonates and older infants diagnosed of NEC in the Instituto de Salud del Niño between 1984 and 1993 were retrospectively reviewed. Only the cases with a reliable roentgenologic, surgical or pathologic diagnosis were included. Sixty cases (46 infants and 14 neonates) were found, with a higher incidence in males (37 males vs 23 females). Twenty six cases required surgical treatment. Overall mortality was 77%, with no significant differences between neonates and infants, nor between those who were operated or not. Moderate or severe malnutrition, diarrhea as an early clinical manifestations, bronchopneumonia, shock and poor nutricional management were found as factors related to mortality.

Disabling pansclerotic morphea of childhood with extracutaneous manifestations

Directory of Open Access Journals (Sweden)

Mahendra M Kura

2013-01-01

Full Text Available Disabling pansclerotic morphea (DPM of childhood is a rare generalized type of localized scleroderma (LS that is known to follow an aggressive course with pansclerotic lesions leading to severe joint contractures and consequent immobility. Mortality is due to complications of the disease such as bronchopneumonia, sepsis, or gangrene. There is no specific laboratory finding. Treatment protocols are still evolving for this severe recalcitrant disorder. Extracutaneous manifestations are rarely reported in DPM. We present the case of a 7-year-old girl with DPM with severe extracutaneous manifestations in the form of gastrointestinal and vascular disease, whose disease progressed rapidly. In spite of treatment with methotrexate, corticosteroids, and PUVA therapy, she ultimately succumbed to her illness due to sepsis.

Barbiturate ingestion in three adult captive tigers (Panthera tigris and concomitant fatal botulism of one : clinical communication

Directory of Open Access Journals (Sweden)

J. H. Williams

2011-05-01

Full Text Available Zoo animals, including tigers, have been reported to suffer from barbiturate intoxication, with pentabarbitone being most commonly recorded. Clinical signs range from mild ataxia to general anaesthesia with recovery over hours to days with several factors affecting hepatic barbiturate metabolism and tissue partitioning. Botulism is an often fatal intoxication in man, animals, birds and certain fish. The occurrence in carnivores is uncommon to rare, with only 2 reports found of botulism in felids. This report relates to 3 adult captive cohabiting tigers that simultaneously developed signs of abdominal discomfort, progressive ataxia, recumbency and comatose sleep resembling stage 2 anaesthesia, alternating with periods of distracted wakefulness and ataxic movements. These signs occurred 4 days after being fed the carcass of a horse that had ostensibly died of colic and not been euthanased. The male tiger that was the dominant animal in the feeding hierarchy was worst affected and had to be given intravenous fluids. The female that was lowest in hierarchy was unaffected. After 48-72 hours of treatment at the Onderstepoort Veterinary Academic Hospital the females could eat and made an uneventful recovery. The male tiger showed partial recovery but died during the night a few hours after drinking water on his return to the owner. Necropsy revealed severe oesophageal dilation and impaction with decaying grass; some of this material and water were present in the pharynx and trachea, and had been aspirated causing acute widespread bronchopneumonia. Colon content tested negative for common pesticides but, together with liver, tested positive for barbiturate. Serum taken on the day of admission had tested negative for barbiturate and the residual serum from the 3 animals later tested negative for botulinum toxin. Colon and oesophageal content from the male at necropsy were positive for Clostridium botulinum toxin type C by the mouse bioassay

Antimicrobial prophylaxis for major head and neck surgery in cancer patients: sulbactam-ampicillin versus clindamycin-amikacin.

Science.gov (United States)

Phan, M; Van der Auwera, P; Andry, G; Aoun, M; Chantrain, G; Deraemaecker, R; Dor, P; Daneau, D; Ewalenko, P; Meunier, F

1992-09-01

A total of 99 patients with head and neck cancer who were to undergo surgery were randomized in a prospective comparative study of sulbactam-ampicillin (1:2 ratio; four doses of 3 g of ampicillin and 1.5 g of sulbactam intravenously [i.v.] every 6 h) versus clindamycin (four doses of 600 mg i.v. every 6 h)-amikacin (two doses of 500 mg i.v. every 12 h) as prophylaxis starting at the induction of anesthesia. The two groups of evaluable patients (43 in the clindamycin-amikacin treatment group and 42 in the sulbactam-ampicillin treatment group) were comparable as far as age (mean, 57 years; range, 21 to 84 years), sex ratio (71 males, 28 females), weight (mean, 66 kg; range, 40 to 69 kg), indication for surgery (first surgery, 48 patients; recurrence, 37 patients), previous anticancer treatment (surgery, radiation therapy, chemotherapy), type of surgery, and stage of cancer. The overall infection rate (wound, bacteremia, and bronchopneumonia) within 20 days after surgery was 20 patients in each group. Wound infections occurred in 14 (33%) sulbactam-ampicillin-treated patients and 9 (21%) clindamycin-amikacin-treated patients (P = 0.19; not significant). The rates of bacteremia were 2 and 4%, respectively. The rates of bronchopneumonia were 14.3 and 23.2%, respectively (P was not significant). Most infections were polymicrobial, but strict anaerobes were recovered only from patients who received sulbactam-ampicillin. Antimicrobial treatment was required within 20 days after surgery for 42% of the sulbactam-ampicillin-treated patients and 44% of the clindamycin-amikacin-treated patients. By comparison with previous studies, we observed a decreased efficacy of antimicrobial prophylaxis in patients with head and neck cancer undergoing surgery because of the increased proportion of patients who were at very high risk for infection (extensive excision and plastic reconstruction in patients with recurrent stage III and IV cancers) and because of the longer duration of

The roentgenological study of measles pneumonia

International Nuclear Information System (INIS)

Shin, U.; Song, C. H.; Lee, H. Y.; Chung, H. K.; Joo, K. B.

1983-01-01

Measles is important infectious disease of pediatrics and pneumonia is the most commonest complication of measles. We have experienced 20 cases of pneumonia among 31 cases of measles in infant nursing home of Chae Chun during of December. 1981. The results a are as follows; 1. The incidence of measles pneumonia is 64.5%. 2. The patterns of pneumonic infiltration is : The pneumonia may have a bronchopneumonia (60%), Lobar pneumonia (15%), or combined form (35%). 3. Both lungs are involved by measles pneumonia: Right lung only (30%), Left lung only (5%), or Bilateral (65%). 4. Hilar lymphadenopathy (51.6%). Hilar lymphadenopathy with pneumonia (82.2%) and hilar lymphadenopathy without pneumonia (17.8%). 5. There is no pulmonary nodule which is noted frequently in atypical measles pneumonia as a seguale

[Clinical evaluations of flomoxef in respiratory tract infections].

Science.gov (United States)

Mikasa, K; Sawaki, M; Ako, H; Narita, N

1987-10-01

Flomoxef (FMOX, 6315-S), a new antibacterial drug, was administered to 9 cases with respiratory tract infections for a duration of 8 approximately 16 days at a daily dose of 2 g. Diagnosis of these patients were bronchopneumonia 5 cases, chronic bronchitis 3 cases and acute bronchitis 1 case. From transtracheal aspiration several organisms were isolated; Haemophilus influenzae was isolated in 3 cases, Streptococcus pneumoniae in 3 cases, H. influenzae plus Branhamella catarrhalis in 1 case, Streptococcus dysgalactiae plus Neisseria meningitidis in 1 case and Corynebacterium pseudodiphtheriticum in 1 case. The clinical efficacy was good in all 9 cases, the efficacy rate was 100%. All the bacteria were eliminated. Side effects were not observed. From these results, it appears that FMOX is a valuable drug in the treatment of respiratory tract infections.

Oleic acid-associated bronchiolitis obliterans-organizing pneumonia in beagle dogs.

Science.gov (United States)

Li, X; Botts, S; Morton, D; Knickerbocker, M J; Adler, R

2006-03-01

Accidental intra-airway exposure of dogs with pure oleic acid produced bronchiolitis obliterans and bronchopneumonia. Pulmonary changes included multifocal to coalescing necrosis of bronchioles and adjacent alveoli, hemorrhage, inflammation, and exudation of fibrin. Hyperplasia of bronchiolar and alveolar epithelial cells and proliferation of loose fibrovascular connective tissue formed polyps or plugs of variable size and shape. Polyps in the airways primarily consisted of fibroblasts with loose or myxoid stroma and were variably covered with attenuated epithelial cells. Some polyps had prominent vasculature, mixed inflammatory cell infiltration, and/or necrosis. Polyps or plugs variably effaced bronchioles and adjacent alveoli. The changes closely resembled human bronchiolitis obliterans-organizing pneumonia (BOOP). Controlled intra-airway delivery of oleic acid in dogs may be a potential animal model of obstructive pulmonary diseases such as BOOP or bronchiolitis obliterans.

Pneumonia due to Chlamydia pecorum in a Koala (Phascolarctos cinereus).

Science.gov (United States)

Mackie, J T; Gillett, A K; Palmieri, C; Feng, T; Higgins, D P

2016-11-01

Chlamydiosis is a common infectious disease of koalas (Phascolarctos cinereus), but Chlamydia spp. have not yet been demonstrated to cause pneumonia in these animals. A juvenile male koala died following an episode of respiratory disease. At necropsy examination, the lung tissue was consolidated. Microscopical lesions in the lung included pyogranulomatous bronchopneumonia, proliferation of bronchiolar and alveolar epithelium and interstitial fibrosis. Hyperplastic bronchiolar epithelial cells contained aggregates of small basophilic punctate organisms, which were confirmed as chlamydiae by transmission electron microscopy and immunohistochemistry. Real-time polymerase chain reaction identified these as Chlamydia pecorum. This report provides the best evidence to date of chlamydial infection causing pneumonia in a koala, and the first evidence that C. pecorum is capable of infecting the bronchiolar epithelium of the koala. Copyright © 2016 Elsevier Ltd. All rights reserved.

Postmortem findings in collared peccaries raised in captivity in northeastern Brazil

Directory of Open Access Journals (Sweden)

Jael S. Batista

2014-11-01

Full Text Available This study is a retrospective examination of diseases in collared peccaries that were diagnosed by the Veterinary Pathology Laboratory, Universidade Federal Rural do Semiárido. Necropsy and histological examination were performed from 2005 to 2010. Of the 50 necropsied collared peccaries, 24% died due to restraint and capture myopathy; 18% died from trauma; and the remainder was diagnosed with splenic hemangioma (6%, enterolithiasis (6%, gastritis (6%, gastric ulcer (4%, intestinal volvulus (4%, gastric volvulus (2%, mammary carcinoma (2%, polycystic kidney disease (2%, pyometra (2%, and suppurative bronchopneumonia (2%. Twelve animals remained undiagnosed, seven of which (14% were in advanced autolytic condition and five of which (10% had no gross or microscopic lesions that were compatible with disease. This paper describes illnesses that have not been reported in the collared peccary, focusing on their clinical and pathological aspects.

Absorbed dose assessment in newborns during x-ray examinations

Science.gov (United States)

Taipe, Patricia K.; Berrocal, Mariella J.; Carita, Raúl F.

2012-02-01

Often a newborn presents breathing problems during the early days of life, i.e. bronchopneumonia, wich are caused in most of cases, by aspirating a mixture of meconium and amniotic fluid. In these cases, it is necessary to make use of a radiograph, requested by the physician to reach a diagnosis. This paper seeks to evaluate the absorbed doses in neonates undergoing a radiograph. For this reason we try to simulate the real conditions in a X-ray room from Lima hospitals. With this finality we perform a simulation made according a questionnaire related to technical data of X-ray equipment, distance between the source and the neonate, and its position to be irradiated. The information obtained has been used to determine the absorbed dose by infants, using the MCNP code. Finally, the results are compared with reference values of international health agencies.

The development of pneumoconiosis and its final stages in miners of the Karvina district

Energy Technology Data Exchange (ETDEWEB)

Pochmon, O; Kratochvil, Z

1974-01-01

The authors studied 63 retired miners from the Ostrava- Karvina coal mines who had a complicated form of pneumoco niosis. They had been repeatedly hospitalized in the department for tuberculosis and respiratory diseases, mostly because of a complicated respiratory illness. Under conditions of the Ostrava-Karvina mines, pneumoco niosis develops rapidly in proportion to the dust pollution the miners are exposed to. In the above 63 miners pneumoconiosis was in an advanced stage (type B and C according to the Geneva classification). The disease progressed most rapidly (within 10 years) in the group of drifters. Chronic bronchitis was found in 44% of the patients, lung emphysema in 56%, cor pulmonale in 57% of cases. The gravest complications in retired miners with an advanced stage of pneumoconiosis were exacerbated chronic bronchitis and bronchopneumonia endangering the lives of the patients.

Paciente com paralisa cerebral coreoatetoide: evolução clínica pós-intervenção Patient with choreoathetoid cerebral palsy: post therapeutic intervention

Directory of Open Access Journals (Sweden)

Carolina Castelli Silvério

2010-04-01

cerebral palsy, three years and three months old on average, under speech therapy. Data related to staff classification (FOIS scale; dysphagia degree; bronchopneumonia, airway secretions and weight; food consistency; suggestive signs of tracheal aspiration. Data were collected in their medical records before and after therapeutic intervention. RESULTS: data related to FOIS scale indicated that before and after therapeutic intervention, the majority of the patients were in V level, with reduction in the second moment. Increase of the patients in the III and IV levels. After therapeutic intervention, there was reduction of the patients who had liquid foods, increase the use of Jelly-O and homogenic pasty. The severity of dysphagia was reduced as well as the incidence of bronchopneumonia and airway secretions, increase in weight and a reduction of suggestive signs of tracheal aspiration. CONCLUSION: speech and language therapy intervention, together with the work of a multidisciplinary dysphagia team, promotes better swallowing efficacy and security, with a decrease in suggestive signs of tracheal aspiration, bronchopneumonia and weight increase.

Pneumonia enzoótica em javalis (Sus scrofa Enzootic pneumonia in wild boars (Sus scrofa

Directory of Open Access Journals (Sweden)

Roselene Ecco

2009-06-01

presented reduced growth rate, anorexia, lethargy, cough and dyspnea, especially after they were moved. High body temperature (40ºC in average was verified in some animals. Auscultation revealed moderate pulmonary crepitation and stertors. Pulmonary gross lesions were typical of lobular bronchopneumonia. Lung lesions were characterized by ventral-cranial consolidation in the majority of the cases. The color of affected pulmonary areas varied from diffuse dark red to mosaic pattern (dark red lobule intercalate by grayish lobule or diffusely grayish. The majority of the lungs had mucopurulent exsudate in the bronchial lumen that also drained from the parenchyma cut surface. Upon microscopy, the changes were characterized by purulent and histiocytic bronchopneumonia with necrotic foci. In some animals, there was BALT hyperplasia associated with perivascular and peribronchial plasma cells and lymphocytes infiltration in most of these cases. Bordetella bronchiseptica and Streptococcus spp. were the most frequently isolated bacteria. Immunohistochemistry evaluation demonstrated Mycoplasma hyopneumoniae on the luminal surface of bronchial and bronchiolar epithelial cells, and the DNA of bacteria was detected by PCR. This is the first report of bronchopneumonia in wild boars associated with M. hyopneumoniae infection.

Pneumatisation of the maxillary sinus in normal and symptomatic children

International Nuclear Information System (INIS)

Odita, J.C.; Akamaguna, A.I.; Ugbodaga, C.I.; Ogisi, F.O.; Amu, O.D.

1986-01-01

The pattern of pneumatisation and normal width of the maxillary sinus in 191 Nigerian infants and children whose age range was 6 months to 14 years was determined. Fifty-four percent of children with no respiratory tract or sinus infection had opaque maxillary sinus. A figure of 44.5% was obtained amongst children with suspected bronchopneumonia. Only 41.5% of suspected cases of sinusitis, acute and chronic middle ear disease had opaque sinus. The highest rate of sinus opacity was seen in children under 2 years who were asymptomatic. The mean maximal width of normally aerated sinus was 8.74 mm for children under 2 years, 16.5 mm for 3-6 years, 21.5 mm for 7-11 years and 25 mm for children 12 years and above. We conclude that maxillary sinus opacity in our experience is an unreliable index for the diagnosis of sinusitis in children. (orig.)

Congenic tuberculosis. Presentation of clinical case

International Nuclear Information System (INIS)

David Calabria, Milena; Ojeda Leon, Paulina

2004-01-01

We are presenting the case of less than to 2 month old and premature infant, she had hyaline membrane disease and required mechanical ventilation during 6 days, at the first month. She presented a viral rhinopharyngitis symptomatology, perioral cyanosis with apnoea, and respiratory distress, the chest x-ray showed multiple bilateral hyperlucid images, mainly at the right side afterwards the patient presented intermittent fever of long evolution and initially received treatment for cavitary bronchopneumonia and sequel of mechanical ventilation, receiving multiple antimicrobial antibiotics, the mother had intermittent fevers since the sixth month of pregnancy and was hospitalized for suspected endometritis after delivery, she presented clinical impairment which evolved to sepsis and died in the ICU, the endometrial histopathology showed granulomas suggesting tuberculosis, due to long history of fevers in the baby and the genital tuberculosis in the mother a tuberculosis study was performed in the girl which resulted positive

'A one-sided affair': unilateral pulmonary oedema and the role of cardiac MRI in diagnosing premature coronary artery disease in a patient with Prader-Willi syndrome.

Science.gov (United States)

Jabbar, Avais; Khan, Jamal N; Singh, Anvesha; McCann, Gerry P

2013-05-22

There is no formal association between premature coronary artery disease (CAD) and Prader-Willi syndrome despite its association with hyperlipidaemia, diabetes mellitus and hypertension. A 36-year-old man with Prader-Willi syndrome presented with acute breathlessness. Inflammatory markers were borderline elevated and chest radiography demonstrated unilateral diffuse alveolar shadowing. Bronchopneumonia was diagnosed and despite treatment with multiple courses of antimicrobial therapy, there was minimal symptomatic and radiographical improvement. A diagnosis of unilateral pulmonary oedema was suspected. Echocardiography was non-diagnostic due to body habitus and coronary angiography was deemed inappropriate due to uncertainty in diagnosis, invasiveness and pre-existing chronic kidney disease. Therefore, cardiac magnetic resonance was performed, confirming severe triple-vessel CAD. This case demonstrates a presentation of heart failure with unilateral chest radiograph changes in a young patient with Prader-Willi syndrome and severe premature CAD detected by multiparametric cardiac magnetic resonance imaging.

Case report 402: Megakaryocytic myelosis with disseminated osteolysis and osteomyelosclerosis

International Nuclear Information System (INIS)

Herrera, A.; Rossner, A.; Grundmann, E.; Urbanitz, D.; Lingg, G.

1986-01-01

A case is presented of a 41-year-old man who was admitted because of anemia and a history of weakness, skeletal pain, night sweats and difficulty in sleeping. Abnormal hematological features and other laboratory studies were detailed. A skeletal surgery showed marked osteolysis affecting many long bones and the skull with evidence of intramedullary osteosclerosis. Several biopsy studies were obtained; the patient ultimately died of terminal bronchopneumonia, sepsis and uremia. A diagnosis of megakarycytic myelosis with disseminated osteolysis was made on the basis of all the features - both clinical, hematological, pathological and radiological. Biopsy studies were reported in detail as were the histological studies in the autopsy material. The various manifestations of myeloid metaplasia were considered and the different causes described. The differential diagnosis was stressed and the radiological and pathological considerations of this entity were discussed in detail with a thorough review of the literature. (orig.)

Pathological findings and probable causes of the death of Stejneger’s beaked whales (Mesoplodon stejnegeri) stranded in Japan from 1999 and 2011

Science.gov (United States)

TAJIMA, Yuko; MAEDA, Kaori; YAMADA, Tadasu K.

2014-01-01

One hundred and twenty stranding events of Stejneger’s beaked whales were reported in Japan between 1999 and 2011. The purpose of this study is to introduce pathological data and to discuss probable causes of death for 44 Stejneger’s beaked whales among them. The significant pathological findings were the pulmonary edema, parasitic granulomatous nephritis, emaciation, amyloidosis, suppurative bronchopneumonia and so on. The probable causes of death were categorized as noninfectious in 43 of the cases, which included drowning, starvation and secondary amyloidosis. One individual was diagnosed with septicemia, which was the only example of an infectious disease. Because we could not always perform advanced analyses, such as microbiology tests, biotoxin examinations or contaminant analyses, the finality of our findings may be impaired. However, the present study has broad implications on the causes of death of Stejneger’s beaked whales of the seas around Japan, which are valuable for the future studies and for the detection of emerging diseases. PMID:25328004

Pathological findings and probable causes of the death of Stejneger's beaked whales (Mesoplodon stejnegeri) stranded in Japan from 1999 and 2011.

Science.gov (United States)

Tajima, Yuko; Maeda, Kaori; Yamada, Tadasu K

2015-01-01

One hundred and twenty stranding events of Stejneger's beaked whales were reported in Japan between 1999 and 2011. The purpose of this study is to introduce pathological data and to discuss probable causes of death for 44 Stejneger's beaked whales among them. The significant pathological findings were the pulmonary edema, parasitic granulomatous nephritis, emaciation, amyloidosis, suppurative bronchopneumonia and so on. The probable causes of death were categorized as noninfectious in 43 of the cases, which included drowning, starvation and secondary amyloidosis. One individual was diagnosed with septicemia, which was the only example of an infectious disease. Because we could not always perform advanced analyses, such as microbiology tests, biotoxin examinations or contaminant analyses, the finality of our findings may be impaired. However, the present study has broad implications on the causes of death of Stejneger's beaked whales of the seas around Japan, which are valuable for the future studies and for the detection of emerging diseases.

High resolution CT of the lung

Energy Technology Data Exchange (ETDEWEB)

Itoh, Harumi (Kyoto Univ. (Japan). Faculty of Medicine)

1991-02-01

The emergence of computed tomography (CT) in the early 1970s has greatly contributed to diagnostic radiology. The brain was the first organ examined with CT, followed by the abdomen. For the chest, CT has also come into use shortly after the introduction in the examination of the thoracic cavity and mediastinum. CT techniques were, however, of limited significance in the evaluation of pulmonary diseases, especially diffuse pulmonary diseases. High-resolution CT (HRCT) has been introduced in clinical investigations of the lung field. This article is designed to present chest radiographic and conventional tomographic interpretations and to introduce findings of HRCT corresponding to the same shadows, with a summation of the significance of HRCT and issues of diagnostic imaging. Materials outlined are tuberculosis, pneumoconiosis, bronchopneumonia, mycoplasma pneumonia, lymphangitic carcinomatosis, sarcoidosis, diffuse panbronchiolitis, interstitial pneumonia, and pulmonary emphysema. Finally, an overview of basic investigations evolved from HRCT is given. (N.K.) 140 refs.

Acute-phase proteins: As diagnostic tool

Directory of Open Access Journals (Sweden)

Sachin Jain

2011-01-01

Full Text Available The varied reactions of the host to infection, inflammation, or trauma are collectively known as the acute-phase response and encompass a wide range of pathophysiological responses such as pyrexia, leukocytosis, hormone alterations, and muscle protein depletion combining to minimize tissue damage while enhancing the repair process. The mechanism for stimulation of hepatic production of acute-phase proteins is by proinflammatory cytokines. The functions of positive acute-phase proteins (APP are regarded as important in optimization and trapping of microorganism and their products, in activating the complement system, in binding cellular remnants like nuclear fractions, in neutralizing enzymes, scavenging free hemoglobin and radicals, and in modulating the host′s immune response. APP can be used as diagnostic tool in many diseases like bovine respiratory syncytial virus, prostate cancer, bronchopneumonia, multiple myeloma, mastitis, Streptococcus suis infection, starvation, or lymphatic neoplasia. Thus, acute-phase proteins may provide an alternative means of monitoring animal health.

How radiotherapy was historically used to treat pneumonia: could it be useful today?

Science.gov (United States)

Calabrese, Edward J; Dhawan, Gaurav

2013-12-13

X-ray therapy was used to treat pneumonia during the first half of the 20th century. Fifteen studies report that approximately 700 cases of bacterial (lobar and bronchopneumonia), sulfanilamide non-responsive, interstitial, and atypical pneumonia were effectively treated by low doses of X-rays, leading to disease resolution, based on clinical symptoms, objective disease biomarkers, and mortality incidence. The capacity of the X-ray treatment to reduce mortality was similar to serum therapy and sulfonamide treatment during the same time period. Studies with four experimental animal models (i.e., mice, guinea pig, cat, and dog) with bacterial and viral pneumonia supported the clinical findings. The mechanism by which the X-ray treatment acts upon pneumonia involves the induction of an anti-inflammatory phenotype that leads to a rapid reversal of clinical symptoms, facilitating disease resolution. The capacity of low doses of X-rays to suppress inflammatory responses is a significant new concept with widespread biomedical and therapeutic applications.

Experimental contact transmission of Pasteurella haemolytica from clinically normal domestic sheep causing pneumonia in Rocky Mountain bighorn sheep.

Science.gov (United States)

Onderka, D K; Wishart, W D

1988-10-01

Two Rocky Mountain bighorn lambs (Ovis canadensis canadensis) were held in captivity for 120 days before being housed with two domestic sheep. The lambs were clinically normal and had no Pasteurella spp. on nasal swab cultures. The domestic sheep were known to carry Pasteurella haemolytica biotype A in the nasal passages. After being in close contact for 19 days. P. haemolytica biotype A was cultured from nasal swabs of one of the bighorn lambs. By 26 days, both bighorn sheep developed coughs, were anorectic and became lethargic and nasal swabs yielded P. haemolytica biotype T, serotype 10. Twenty-nine days after contact, the lambs were necropsied and found to have extensive fibrinous bronchopneumonia. From affected tissues pure cultures of beta-hemolytic P. haemolytica biotype T, serotype 10 were grown. Both domestic sheep remained clinically normal and had no gross or microscopic lesions, but they carried the same P. haemolytica serotype in their tonsils. Behavioural observations gave no indication of stress in the bighorn lambs.

Bronchial and pulmonary scintigraphy with radioactively marked aerosols

International Nuclear Information System (INIS)

Wuerstle, T.

1982-01-01

In 97 patients with bronchitis, bronchial asthma, tuberculosis, sarcoidosis, pneumoconiosis, or tumors the mucociliary clearance and/or deposit pattern after inhalation of radioactively marked aerosols (1 mCi 99m Tc sulfur colloid) was studied. Normal values of the mucociliary 30 min. clearance for the central bronchial/lung periphery are 21%/15%. There was a decreased clearance with bronchitis (11/8%), bronchial asthma, emphysema, tuberculosis, sarcoidosis, trachiobronchial amyloidosis, pleural scarring or interstitial pneumona. Increased clearance (29/19%) was shown with pneumoconiosis. The correlation of deposit pattern and disease, for example, bronchitis, bronchial asthma, bullous emphysema, pleural scarring, partial lung resection, bronchopneumonia, or bronchial restriction, is described. In comparison of aerosol scintigraphy to perfusion scintigraphy and ventilation with gaseous xenon, the aerosol scintigraphy is superior to xenon for certain indications. The aerosol particles, which are larger in comparison to xenon, settle easier by obstructions or flow variations and thereby give better clinical indications of regional differences. (orig.) [de

How Radiotherapy Was Historically Used To Treat Pneumonia: Could It Be Useful Today?

Science.gov (United States)

Calabrese, Edward J.; Dhawan, Gaurav

2013-01-01

X-ray therapy was used to treat pneumonia during the first half of the 20th century. Fifteen studies report that approximately 700 cases of bacterial (lobar and bronchopneumonia), sulfanilamide non-responsive, interstitial, and atypical pneumonia were effectively treated by low doses of X-rays, leading to disease resolution, based on clinical symptoms, objective disease biomarkers, and mortality incidence. The capacity of the X-ray treatment to reduce mortality was similar to serum therapy and sulfonamide treatment during the same time period. Studies with four experimental animal models (i.e., mice, guinea pig, cat, and dog) with bacterial and viral pneumonia supported the clinical findings. The mechanism by which the X-ray treatment acts upon pneumonia involves the induction of an anti-inflammatory phenotype that leads to a rapid reversal of clinical symptoms, facilitating disease resolution. The capacity of low doses of X-rays to suppress inflammatory responses is a significant new concept with widespread biomedical and therapeutic applications. PMID:24348219

[Alagille's syndrome in Cuba. A report of 9 cases].

Science.gov (United States)

Castañeda, C; Fragoso, T; Gra, B; Guerra, L; Castellanos, O; Trujillo, M E

1992-01-01

Alagille's syndrome or arteriohepatic dysplasia has been described in Cuba in nine patients between nine months and 12 years of age (8 males and one female). Among the clinical features we found five major abnormalities: chronic cholestasis with neonatal jaundice (9/9), peculiar facies (9/9), peripheral pulmonary artery hypoplasia associated with cardiac murmur (6/9), butter-fly-like arch defects (4/9), and posterior embryotoxon (6/7). Two children had a severe xanthomatosis. Laparoscopy showed green hepatomegaly depending on the degree of cholestasis, and only one patient had incipient signs of micronodular cirrhosis. Liver histology showed a paucity of interlobular bile ducts. Survival was of 60%. One patient survived more than 30 years. Four patients died of liver carcinoma (unique report in infants), broncho-pneumonia, acute renal failure, and sudden death respectively. Among the minor features were mental retardation (5/9), a peculiar voice (3/9), growth retardation observed in some of our patients. This is the first report on Alagille's syndrome in Latin America, because so far reports have come only from Europe and North America.

Triple synchronous cancers. A medical and ethical problem

International Nuclear Information System (INIS)

Debevec, L.; Cesar, R.; Kern, I.

2007-01-01

In a patient with suspicious synchronous multiple tumours, there are limited possibilities for effective therapy. Therefore, the decision for invasive diagnostics and precise staging of tumours is questionable, especially in elderly patients suitable only for symptomatic therapy. A 78-year-old man with hypertension and angina pectoris was admitted to the hospital due to syncope. Two primary lung tumours and a kidney tumour were detected by imaging investigation. The patient refused invasive diagnostics and left the hospital. After 19 months he was readmitted in an impaired clinical condition and subsequently died of bronchopneumonia. The autopsy revealed squamous cell carcinoma of the right upper lobe with metastases to regional lymph nodes and to the brain, small-cell carcinoma of the left upper lobe with metastases to regional lymph nodes and to the spleen, and clear-cell kidney carcinoma with multiple metastases to the lungs. All tumours were necrotizing, and therefore we assumed that any attempt at specific therapy would have been ineffective. In an elderly patient with advanced lung tumors and suspicious synchronous triple cancers, the ''wait and see'' option can be suitable. (author)

Nocardiosis in a Kidney-Pancreas Transplant

Directory of Open Access Journals (Sweden)

I. Fontana

2010-01-01

Full Text Available 34-year-old man with chronic renal and pancreas failure in complicated diabetic disease received a kidney-pancreas transplantation. On the 32nd postoperative day, an acute kidney rejection occurred and resolved with OKT3 therapy. The patient also presented refractory urinary infection by E. Fecalis and M. Morganii, and a focal bronchopneumonia in the right-basal lobe resolved with elective chemotherapy. During the 50th post-operative day, an intense soft tissue inflammation localized in the first left metatarsal-phalangeal articulation occurred (Figure 1 followed by an abscess with a cutaneous fistula and extension to the almost totality of foot area. The radiological exam revealed a small osteo-lacunar image localized in the proximal phalanx head of the first finger foot. From the cultural examination of the purulent material, N. Asteroides was identified. An amoxicillin-based treatment was started and continued for three months, with the complete resolution of infection This case is reported for its rarity in our casuistry, and for its difficult differential diagnosis with other potentially serious infections.

Mortality study for a decade: ischemic stroke in the elderly.

Directory of Open Access Journals (Sweden)

Javier J. García Zacarías

2014-09-01

Full Text Available Cerebrovascular diseases are among the top three causes of death in Cuba and the world, about 80 % of these patients belong to Ischemic Stroke. The objective of this paper is to describe the clinical and developmental profile of patients who died of Ischemic Stroke. A descriptive, prospective research, cross- sectional study was made, the sample included all deaths from ischemic stroke at the University Hospital "Camilo Cienfuegos" Sancti Spiritus, between January 1st, 2001 and December 31, 2010, and persons over 60 years of age with necropsy performed. Atherothrombotic stroke was the most frequent category, the highest mortality rates were observed in persons over 80 years of age and in females, hypertension, ischemic heart disease and transient ischemic attack were the main significant medical history; most patients were admitted in the stroke unit and died in Middle Progressive Care, cerebral edema and intracranial hypertension and hypostatic bronchopne umonia were complications and specific main causes of most frequent death. Value of cerebral edema and hypostatic bronchopneumonia as clinical complications and causes of death in patients investigated is confirmed.

Perinatal and infant mortality in urban slums under I.C.D.S. scheme.

Science.gov (United States)

Thora, S; Awadhiya, S; Chansoriya, M; Kaul, K K

1986-08-01

Perinatal and infant mortality during the year 1985 was analyzed through a prospective study conducted in 12 Anganwadis (total population of 13,054) located in slum areas of India's Jabalpur city. Overall, the infant mortality rate was 128.7/1000 live births and the perinatal mortality rate was 88.5/1000 live births. 58.5% of deaths occurred in the neonatal period. Causes of neonatal deaths included prematurity, respiratory distress syndrome, birth asphyxia, septicemia, and neonatal tetanus. Postneonatal deaths were largely attributable to dehydration from diarrhea, bronchopneumonia, malnutrition, and infectious diseases. All mortality rates were significantly higher in Muslims than among Hindus. Muslims accounted for 28% of the study population, but contributed 63% of stillbirths and 55% of total infant deaths. This phenomenon appears attributable to the large family size among Muslims coupled with inadequate maternal-child health care. The national neonatal and postneonatal mortality rates are 88/1000 and 52/1000, respectively. The fact that the neonatal mortality rate in the study area was slightly lower than the national average may reflect the impact of ICDS services.

Identification of titanium in human tissues: probable role in pathologic processes

International Nuclear Information System (INIS)

Moran, C.A.; Mullick, F.G.; Ishak, K.G.; Johnson, F.B.; Hummer, W.B.

1991-01-01

Six cases of titanium dioxide exposure involving lung, skin, and synovium are described, with a review of the literature. The patients, four men and two women, were between the ages of 22 and 65 years. The pulmonary changes were characterized by fibrosis and numerous macrophages with abundant deposition of a black pigment. Adjacent areas of bronchopneumonia were also observed. In the skin a severe necrotizing lesion involving the subcutaneous tissue with extension to the muscle was observed in one case and a nonspecific inflammatory response was observed in another; both cases showed abundant black pigment deposition. Electron microscopy and energy dispersive x-ray analysis demonstrated the presence of large quantities of titanium in the pigment granules. There may be a combination of black pigment deposition and fibrosis, necrosis, or a xanthomatous or granulomatous reaction, that, together with negative results on special staining and culture studies for organisms, should raise the suspicion of titanium-associated injury and prompt the study of the affected tissues by x-ray analysis for positive identification

Pathology and Epidemiology of Stillbirth in New Zealand Sea Lions (Phocarctos hookeri) From Enderby Island, Auckland Islands, 1998-2012.

Science.gov (United States)

Michael, S A; Chilvers, B L; Hunter, S A; Duignan, P; Roe, W

2016-11-01

Stillbirth is a small and often cryptic fraction of neonatal mortality in mammals including pinnipeds. As part of an investigation into the poor reproductive success of the endangered New Zealand sea lion (Phocarctos hookeri), archived tissues from 37 stillborn pups born on Enderby Island between 1998 and 2012 were examined using histopathological techniques. Apart from bronchopneumonia with neutrophilic infiltration in 4 cases, few inflammatory conditions were identified in stillborn pups. However, 27/32 (84%) stillborn pups had aspirated squames present in the respiratory tract, without meconium. It is unclear if this finding represents fetal distress during parturition or whether it is a normal finding for this species. Three pups lacked histological evidence of hepatic glycogen storage, which may indicate placental defects or maternal undernutrition. No evidence of infectious disease was found on histopathological analysis, consistent with the low seroprevalence in New Zealand of infections known to cause reproductive failure in other pinniped species. This study forms an important baseline for further examination of stillborn New Zealand sea lion pups, as pup mortality is investigated as a contributor to the species' decline. © The Author(s) 2016.

Pulmonary perfusion scintigraphy in children with chronic pulmonary damage: Preliminary results from application of the SPECT technique

International Nuclear Information System (INIS)

Lobo S, Gabriel; Ladron de Guevara H, David; Munoz G, Maria Angelica; Araya A, Fernando; Coll C, Claudia; Donoso R, Gilda; Jimenez J, Cesar; Perez R; Andres

2003-01-01

The aim was to describe lung perfusion SPECT (LPS) findings in children with chronic pulmonary damage. Material and Method: We revised 106 LPS of children (age:3.9 ± 3.3 yr) with chronic pulmonary damage, performed with a two headed gamma camera. The most common clinical diagnosis were adenovirus bronchopneumonia sequelae (ADV)(29%), unknown origin chronic pulmonary damage (UOPD) (21%), bronchopulmonary dysplasia (BPD)(15%), and chronic obstructed bronchitis (COB)(14%). Severity of pulmonary alterations were evaluated using a Score, which considered extent and type of lung involvement and differential pulmonary perfusion. Pattern of involvement and Score were correlated with diagnosis and gender. Results: Ninety one percent (96/106) of LPS were abnormal (62% boys). Fifty two (54%) showed bilateral alterations, being this finding (p:0.019) more frequent in boys. ADV group showed mainly a mixed bilateral pattern (35%), UOPD a focal unilateral pattern (32%), COB a diffuse unilateral pattern (33%), and BPD a normal pattern (25%). Miscellaneous and UOPD showed the highest score values, and BPD and COB the lowest ones. Conclusion: In this population, LPS is abnormal in high proportion, with some differential characteristics according gender and original diagnosis (au)

Diagnosis Infeksi Streptococcus suis serotipe-2 pada Babi Secara Serologi dengan Muramidase Released Protein (SEROLOGICALLY DIAGNOSE OF STREPTOCOCCUS SUIS SEROTYPE-2 INFECTION IN PIGS BASED ON MURAMIDASE RELEASED PROTEIN

Directory of Open Access Journals (Sweden)

Siti Isrina Oktavia Salasia

2016-01-01

Full Text Available Streptococcus suis is a bacterial pathogen causing disease of pigs that characterized by meningitis,bronchopneumonia, arthritis, pericarditis, polyserositis and septicaemia. S. suis especially serotype 2 caninfect human (zoonotic with a special symptom of meningitis. The aim of this research was to detect S.suis infection based on muramidase released protein (MRP, as an important virulence marker of S. suis.S. suis serotype 2 strain P171 with phenotype of MRP+EF+ was used in this research. The MRP antigen wasextracted using lysozyme and separated by using sodium dodecyl sulphate-polyacrylamide gel electrophoresis(SDS-PAGE. Balb/c mice were imunized with 136 kDa MRP to produce antibody against MRP. Theantibody was evaluated by using enzyme linkage immunosorbent assay (ELISA. The results of the researchshowed that the antibody against MRP with molecular weight of 136 kDa could be produced on Balb/Cmice with the highest absorbance of 3,889 and could be used to detect field sera from infected pigs with200x dilution using ELISA antigen capture. Antibody against MRP could detect serologically of S. suisinfection in pigs in Papua with 50% seropositivy by using ELISA antigen capture and 40% by using dot blot.

A case of kwashiorkor in a child with congenital hypothyroidism

Directory of Open Access Journals (Sweden)

Helena Aneke Tangkilisan

2001-12-01

Full Text Available A 12-year-old Indonesian girl with the body weight of 9.8 kg and length 78 cm was admitted to the Department of Child Health, Manado General Hospital with kwashiorkor and congenital hypothyroidism. The main complaint was edema starting 3 weeks before admission. Physical examination showed body weight for age (BW/A 14.3%, body weight for body length (BW/BL 66.0% and body length for age (BL/A 49.1%. On admission she looked severely ill, apathetic, with hypothermia and hypotonia. Almost all signs and symptoms of kwashiorkor and congenital hypothyroidism were found accompanied bronchopneumonia and dermatologic problems. Laboratory findings showed severe anemia, leukocytosis, hypoproteinemia, hyponatremia, hypokalemia, elevated thyroid stimulating hormone and low level of Thyroxine-4. Bone age equaled to a newborn baby bone age. There was no thyroid tissue on thyroid ultrasound examination. The patient was treated for severe protein energy malnutrition and ThyraxR. Problems of kwashiorkor could been solved well but not with the congenital hypothyroidism. She was discharged from hospital after 2 months treatment and till now at 14th year of age with her developmental milestones equals to that of 8 month old baby.

Clinical characteristics and computed tomography findings of pulmonary toxoplasmosis after hematopoietic stem cell transplantation.

Science.gov (United States)

Sumi, Masahiko; Norose, Kazumi; Hikosaka, Kenji; Kaiume, Hiroko; Takeda, Wataru; Kirihara, Takehiko; Kurihara, Taro; Sato, Keijiro; Ueki, Toshimitsu; Hiroshima, Yuki; Kuraishi, Hiroshi; Watanabe, Masahide; Kobayashi, Hikaru

2016-12-01

The prognosis of pulmonary toxoplasmosis, including disseminated toxoplasmosis involving the lungs, following hematopoietic stem cell transplantation (HSCT) is extremely poor due to the difficulties associated with early diagnosis and the rapidly progressive deterioration of multiorgan function. In our institution, we identified nine cases of toxoplasmosis, representing incidences of 2.2 and 19.6 % among all HSCT recipients and seropositive HSCT recipients, respectively. Of the patients with toxoplasmosis, six had pulmonary toxoplasmosis. Chest computed tomography (CT) findings revealed centrilobular, patchy ground-glass opacities (n = 3), diffuse ground-glass opacities (n = 2), ground-glass opacities with septal thickening (n = 1), and marked pleural effusion (n = 1). All cases died, except for one with suspected pulmonary toxoplasmosis who was diagnosed by a polymerase chain reaction assay 2 days after the onset of symptoms. In pulmonary toxoplasmosis, CT findings are non-specific and may mimic pulmonary congestion, atypical pneumonia, viral pneumonitis, and bronchopneumonia. Early diagnosis and treatment is crucial for overcoming this serious infectious complication. Pulmonary toxoplasmosis should be considered during differential diagnosis in a recipient with otherwise unexplained signs of infection and CT findings with ground-glass opacities, regardless of the distribution.

Fatal toxoplasmosis in an immunosuppressed domestic cat from Brazil caused by Toxoplasma gondii clonal type I

Directory of Open Access Journals (Sweden)

Hilda Fátima de Jesus Pena

Full Text Available Abstract The objective of the study was to report on a fatal case of feline toxoplasmosis with coinfection with the feline leukemia virus (FeLV. A domestic cat (Felis silvestris catus presented intense dyspnea and died three days later. In the necropsy, the lungs were firm, without collapse and with many white areas; moderate lymphadenomegaly and splenomegaly were also observed. The histopathological examination showed severe necrotic interstitial bronchopneumonia and mild necrotic hepatitis, associated with intralesional cysts and tachyzoites of Toxoplasma gondii that were positive by anti-T. gondii immunohistochemical (IHC evaluation. The bone marrow showed chronic myeloid leukemia and the neoplastic cells were positive by anti-FeLV IHC evaluation. DNA extracted from lungs was positive for T. gondii by PCR targeting REP-529. T. gondii was characterized by PCR-RFLP and by the microsatellites technique. ToxoDB-PCR-RFLP #10, i.e. the archetypal type I, was identified. Microsatellite analysis showed that the strain was a variant of type I with two atypical alleles. This was the first time that a T. gondii clonal type I genotype was correlated with a case of acute toxoplasmosis in a host in Brazil.

Bacterial and Pneumocystis Infections in the Lungs of Gene-Knockout Rabbits with Severe Combined Immunodeficiency

Directory of Open Access Journals (Sweden)

Jun Song

2018-03-01

Full Text Available Using the CRISPR/Cas9 gene-editing technology, we recently produced a number of rabbits with mutations in immune function genes, including FOXN1, PRKDC, RAG1, RAG2, and IL2RG. Seven founder knockout rabbits (F0 and three male IL2RG null (−/y F1 animals demonstrated severe combined immunodeficiency (SCID, characterized by absence or pronounced hypoplasia of the thymus and splenic white pulp, and absence of immature and mature T and B-lymphocytes in peripheral blood. Complete blood count analysis showed severe leukopenia and lymphocytopenia accompanied by severe neutrophilia. Without prophylactic antibiotics, the SCID rabbits universally succumbed to lung infections following weaning. Pathology examination revealed severe heterophilic bronchopneumonia caused by Bordetella bronchiseptica in several animals, but a consistent feature of lung lesions in all animals was a severe interstitial pneumonia caused by Pneumocystis oryctolagi, as confirmed by histological examination and PCR analysis of Pneumocystis genes. The results of this study suggest that these SCID rabbits could serve as a useful model for human SCID to investigate the disease pathogenesis and the development of gene and drug therapies.

Bacterial and Pneumocystis Infections in the Lungs of Gene-Knockout Rabbits with Severe Combined Immunodeficiency

Science.gov (United States)

Song, Jun; Wang, Guoshun; Hoenerhoff, Mark J.; Ruan, Jinxue; Yang, Dongshan; Zhang, Jifeng; Yang, Jibing; Lester, Patrick A.; Sigler, Robert; Bradley, Michael; Eckley, Samantha; Cornelius, Kelsey; Chen, Kong; Kolls, Jay K.; Peng, Li; Ma, Liang; Chen, Yuqing Eugene; Sun, Fei; Xu, Jie

2018-01-01

Using the CRISPR/Cas9 gene-editing technology, we recently produced a number of rabbits with mutations in immune function genes, including FOXN1, PRKDC, RAG1, RAG2, and IL2RG. Seven founder knockout rabbits (F0) and three male IL2RG null (−/y) F1 animals demonstrated severe combined immunodeficiency (SCID), characterized by absence or pronounced hypoplasia of the thymus and splenic white pulp, and absence of immature and mature T and B-lymphocytes in peripheral blood. Complete blood count analysis showed severe leukopenia and lymphocytopenia accompanied by severe neutrophilia. Without prophylactic antibiotics, the SCID rabbits universally succumbed to lung infections following weaning. Pathology examination revealed severe heterophilic bronchopneumonia caused by Bordetella bronchiseptica in several animals, but a consistent feature of lung lesions in all animals was a severe interstitial pneumonia caused by Pneumocystis oryctolagi, as confirmed by histological examination and PCR analysis of Pneumocystis genes. The results of this study suggest that these SCID rabbits could serve as a useful model for human SCID to investigate the disease pathogenesis and the development of gene and drug therapies. PMID:29593714

WHO Severe Acute Respiratory Infections (SARI) Definition often Underdiagnoses Serious Respiratory Viral Infections in Hospitalized Jordanian Children

Science.gov (United States)

Khuri-Bulos, Najwa; Piya, Bhinnata; Shehabi, Asem; Faouri, Samir; Williams, John V; Vermund, Sten; Halasa, Natasha B

2017-01-01

Abstract Background The World Health Organization (WHO) case definition of severe acute respiratory infections (SARI) is anyone with an acute respiratory infection with symptoms within 10 days of presentation, cough, fever, and hospitalization. This is used to standardize global influenza surveillance with the caveat not all cases will be captured. We sought to determine the proportion of hospitalized Jordanian children admitted with acute respiratory illnesses meeting the SARI definition. Methods We conducted 3-year viral surveillance study in children <2 years admitted with acute respiratory symptoms and/or fever into a large government hospital in Amman. Demographic and clinical data were collected. We tested nasal/throat swabs for 11 viruses using q-RT-PCR. We compared children who met SARI definition to non-SARI. Results We enrolled 3168 children. Table 1 compares those children who met SARI definition vs. those who did not. Figure 1 compares % of children who were virus-positive and met SARI definition. Table 1. N (%) SARI (n = 1198) Non-SARI (n = 1970) p-values Male 729 (60.9) 1183 (60.1) 0.655 Median Age 6.7 months 2.3 months 0.000 Underlying medical condition 160 (13.4) 215 (10.9) 0.039 Pneumonia 192 (16.0) 202 (10.3) 0.000 Sepsis 150 (12.5) 750 (38.1) 0.000 Bronchiolitis 169 (14.1) 378 (19.2) 0.000 Bronchopneumonia 656 (54.8) 364 (18.5) 0.000 ≤10-day duration 1198 (100) 1848 (93.8) 0.000 Cough 1198 (100) 1172 (59.5) 0.000 Fever 1198 (100) 649 (32.9) 0.000 Fever and Cough 1198 (100) 48 (2.4) 0.000 Virus positive 1076 (89.8) 1505 (76.4) 0.000 Rhinovirus 438 (36.6) 800 (40.6) 0.024 Adenovirus 201 (16.8) 274 (13.9) 0.028 Parainfluenza 1–3 75 (6.3) 100 (5.1) 0.157 Respiratory Syncytial Virus 635 (53.0) 762 (38.7) 0.000 Influenza A-C 61 (5.1) 58 (2.9) 0.002 Human Metapneumovirus 153 (12.8) 120 (6.1) 0.000 Conclusion Children who met the definition of SARI were more likely to be older, have an underlying medical condition, have the diagnoses of pneumonia and

Two years of surveillance of influenza a virus infection in a swine herd. Results of virological, serological and pathological studies.

Science.gov (United States)

Cappuccio, Javier; Dibarbora, Marina; Lozada, Inés; Quiroga, Alejandra; Olivera, Valeria; Dángelo, Marta; Pérez, Estefanía; Barrales, Hernán; Perfumo, Carlos; Pereda, Ariel; Pérez, Daniel R

2017-02-01

Swine farms provide a dynamic environment for the evolution of influenza A viruses (IAVs). The present report shows the results of a surveillance effort of IAV infection in one commercial swine farm in Argentina. Two cross-sectional serological and virological studies (n=480) were carried out in 2011 and 2012. Virus shedding was detected in nasal samples from pigs from ages 7, 21 and 42-days old. More than 90% of sows and gilts but less than 40% of 21-days old piglets had antibodies against IAV. In addition, IAV was detected in 8/17 nasal swabs and 10/15 lung samples taken from necropsied pigs. A subset of these samples was further processed for virus isolation resulting in 6 viruses of the H1N2 subtype (δ2 cluster). Pathological studies revealed an association between suppurative bronchopneumonia and necrotizing bronchiolitis with IAV positive samples. Statistical analyses showed that the degree of lesions in bronchi, bronchiole, and alveoli was higher in lungs positive to IAV. The results of this study depict the relevance of continuing long-term active surveillance of IAV in swine populations to establish IAV evolution relevant to swine and humans. Copyright © 2016 Elsevier Ltd. All rights reserved.

Abortion and premature birth in cattle following vaccination with Brucella abortus strain RB51.

Science.gov (United States)

Fluegel Dougherty, Amanda M; Cornish, Todd E; O'Toole, Donal; Boerger-Fields, Amy M; Henderson, Owen L; Mills, Ken W

2013-09-01

Brucella abortus RB51 is the vaccine strain currently licensed for immunizing cattle against brucellosis in the United States. Most cattle are vaccinated as heifer calves at 4-12 months of age. Adult cattle may be vaccinated in selected high-risk situations. Two herds of pregnant adult cattle in the brucellosis-endemic area of Wyoming were vaccinated with a standard label dose (1.0-3.4 × 10(10) organisms) of RB51. Reproductive losses in the vaccinated herds were 5.3% (herd A) and 0.6% (herd B) and included abortions, stillbirths, premature calves, and unbred cows (presumed early abortion). Brucella abortus was cultured from multiple tissues of aborted and premature calves (7/9), and from placenta. Isolates were identified as B. abortus strain RB51 by standard strain typing procedures and a species-specific polymerase chain reaction. Bronchopneumonia with intralesional bacteria and placentitis were observed microscopically. There was no evidence of involvement of other infectious or toxic causes of abortion. Producers, veterinarians, and laboratory staff should be alert to the risk of abortion when pregnant cattle are vaccinated with RB51, to potential human exposure, and to the importance of distinguishing field from vaccinal strains of B. abortus.

Mycoplasma pneumoniae pneumonia: CT features in 16 patients

Energy Technology Data Exchange (ETDEWEB)

Lee, Inho; Kim, Tae Sung; Yoon, Hye-Kyung [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea)

2006-03-15

The objective of this study was to assess the computed tomography (CT) features of Mycoplasma pneumoniae pneumonia. We retrospectively reviewed CT findings of 16 patients (M:F=9:7, age range 1-74 years, median 9 years) with serologically proven Mycoplasma pneumoniae pneumonia and with chest CT scan available. Two distinctive patterns of CT features of M. pneumoniae pneumonia were noted between the paediatric (age <18 years) and the adult (age {>=}18 years) groups. The pediatric group (n=11) showed lobar or segmental consolidation (100%) with frequent pleural effusion (82%) and regional lymphadenopathy (82%) and mild volume decrease of the involved lobe (73%), while four of the five adult patients showed diffuse and/or multifocal, centrilobular or peribronchovascular areas of ground-glass attenuation (80%) with a lobular distribution, and frequent thickening of interlobular septa (60%) and the bronchial walls (40%) were also detected at high-resolution CT. The CT finding of a lobar or segmental consolidation with a parapneumonic effusion seen in our children with M. pneumoniae pneumonia was similar to that of bacterial lobar pneumonia. In contrast, the CT findings noted in our adult patients consisted of a mixture of a bacterial bronchopneumonia pattern and a viral interstitial pneumonia pattern. (orig.)

Mycoplasma pneumoniae pneumonia: CT features in 16 patients

International Nuclear Information System (INIS)

Lee, Inho; Kim, Tae Sung; Yoon, Hye-Kyung

2006-01-01

The objective of this study was to assess the computed tomography (CT) features of Mycoplasma pneumoniae pneumonia. We retrospectively reviewed CT findings of 16 patients (M:F=9:7, age range 1-74 years, median 9 years) with serologically proven Mycoplasma pneumoniae pneumonia and with chest CT scan available. Two distinctive patterns of CT features of M. pneumoniae pneumonia were noted between the paediatric (age <18 years) and the adult (age ≥18 years) groups. The pediatric group (n=11) showed lobar or segmental consolidation (100%) with frequent pleural effusion (82%) and regional lymphadenopathy (82%) and mild volume decrease of the involved lobe (73%), while four of the five adult patients showed diffuse and/or multifocal, centrilobular or peribronchovascular areas of ground-glass attenuation (80%) with a lobular distribution, and frequent thickening of interlobular septa (60%) and the bronchial walls (40%) were also detected at high-resolution CT. The CT finding of a lobar or segmental consolidation with a parapneumonic effusion seen in our children with M. pneumoniae pneumonia was similar to that of bacterial lobar pneumonia. In contrast, the CT findings noted in our adult patients consisted of a mixture of a bacterial bronchopneumonia pattern and a viral interstitial pneumonia pattern. (orig.)

Síndrome neuranêmica. Discussão de um caso com caráter familial e evolução aguda, em jovem

Directory of Open Access Journals (Sweden)

Horacio Martins Canelas

1949-03-01

Full Text Available Les auteurs étudient un cas d'anémie pernicieuse compliquée par la dégenérescence combiné subaig de la moelle. La maladie a commentée en 1946, à 1'âge de 18 ans, par faiblesse des jambes et paresthésies des mains et des pieds. Un éxamen clinique realisé en Avril 1948, pourtant, n'a pas montré l'existence de signes somatiques objectifs. Seulement quatre mois plus tard (fin de Juillet, le malade a presenté tout à fait brusquement un syndrome clinique de section transverse de la moelle, dont l'anesthésie montait jusqu'à la limite de T3. II est décedé le 3 de Septembre, par bronchopneumonia À l'autopsie on a rencontré des lésions caracteristiques de la dégenérescence combinée de la moelle. Le malade était un arrieré mental et son père souffrait aussi d'anémie pernicieuse et dégenérescence subaig de la moelle. Les auteurs étudient les aspects héredo-familiales, le début précoce et l'évolution aig de la maladie.

Infecção por Chryseobacterium indologenes: relato de um caso Chryseobacterium indologenes infection: a case report

Directory of Open Access Journals (Sweden)

Renata de Souza Ferreira

2010-03-01

Full Text Available Relatamos um caso de infecção por Chryseobacterium indologenes, presente na cultura de aspirado traqueal em paciente sob ventilação mecânica invasiva, revisando os aspectos epidemiológicos, microbiológicos e o tratamento na unidade de terapia intensiva. Paciente do sexo masculino, 30 anos, internado com quadro de aplasia de medula idiopática e neutropenia febril foi transferido para a unidade de terapia intensiva com quadro de broncopneumonia e sepse grave de origem pulmonar. A maioria dos casos já relatados de pacientes com infecção por Chryseobacterium indologenes apresentavam patologias graves associadas e infecções polimicrobianas que podem dificultar a interpretação da efetividade da terapia antimicrobiana contra este agente.A case of Chryseobacterium indologenes infection is reported, identified in an invasive mechanic ventilation patient's tracheal aspiration material. Epidemiological, microbiological, and intensive care unit therapy aspects are discussed. The patient was a 30 years-old male, admitted with idiopathic medullary aplasia and febrile neutropenia, referred to the intensive care unit with severe bronchopneumonia and sepsis of pulmonary origin. Most of the previously reported Chryseobacterium indologenes infection cases were associated with severe diseases and polymicrobial infections which could make difficult interpreting antimicrobial therapy options against this agent.

Lung pathology in slaughtered sheep from the north of the department of Bolivar, Colombia

Directory of Open Access Journals (Sweden)

Jahnier Andrés Caicedo-Martínez

2017-09-01

Full Text Available The main objective of this study was to describe the lung lesions in slaughtered sheep. A cross-sectional descriptive study that included 26 sheep lungs without clinical signs of disease from the north of the department of Bolivar, Colombia, was carried out. The relative frequency of macroscopic and microscopic lung lesions, as well as the association between macroscopic lesions and body condition were established. Ninety-two percent of the sheep studied showed macroscopic and microscopic lesions. Thirty-two macroscopic lesions were found: pleuritis (34 %, interstitial pneumonia (32 %, embolic pneumonia (13 %, granulomatous pneumonia (6 %, emphysematous bulla (6 %, verminous pneumonia (3 %, suppurative bronchopneumonia (3 % and atelectasis (3 %. Pleuritis showed a highly significant relationship with body condition (p value <0.01. Forty-one microscopic lesions grouped as inflam-matory disorders (63 %, insufflation disturbances, i.e. emphysema and atelectasis (7 %, cell growth disorders (22 %, and microcirculatory disturbances (8 % were observed. Regarding microscopic lesion chronicity, acute (29 %, subacute (32 %, chronic (37 % and chronic-active (2 % lesions were found. This is the first study in Colombia that describes lung lesions in slaughtered sheep. This study concludes that most lesions associated with the respiratory complex are subclinical, and therefore, it is neces-sary to strengthen the use of diagnostic and control measures to reduce infection rate and economic losses.

Case report: clinical and postmortem findings in four cows with rib fracture.

Science.gov (United States)

Braun, Ueli; Warislohner, Sonja; Hetzel, Udo; Nuss, Karl

2017-02-06

Published reports of rib fractures in adult cattle are limited to the occurrence of chronic rib swellings caused by calluses, which are unremarkable from a clinical standpoint, whereas studies identifying clinical signs of rib fractures were not found in a literature search. This report describes the clinical and postmortem findings in four cows with rib fractures. The 13th rib was fractured in three cows and the 11th rib in the remaining cow; three fractures were on the right and one on the left side. Clinical and postmortem findings varied considerably, and percussion of the rib cage elicited a pain response in only one cow. One cow had generalised peritonitis because of perforation of the rumen by the fractured rib. One cow was recumbent because of pain and became a downer cow, and two other cows had bronchopneumonia, which was a sequel to osteomyelitis of the fracture site in one. In the absence of a history of trauma, the diagnosis of rib fracture based on clinical signs alone is difficult. Although rib fractures undoubtedly are very painful, the four cases described in this report suggest that they are difficult to diagnose in cattle because associated clinical signs are nonspecific.

Characteristics of patients hospitalized at an intensive care unit due to drug abuse

Directory of Open Access Journals (Sweden)

Flávia Antunes

2013-07-01

Full Text Available Objective. To characterize the clinical and demographic profile of patients hospitalized due to drug intoxication at an intensive care unit (ICU of a teaching hospital between 2004 and 2010. Methodology. In this descriptive study, information was collected from the hospitalized patients, as informed by a Toxicology Care Center (CAT in Paraná (Brazil. The clinical files were checked and information was collected about age, gender, toxic agents and intoxication circumstances, comorbidities and clinical outcomes. Results. Sixty-two patients were included in the study, with a mean age of 58 years and 77% male. Alcohol was the substance related to most hospitalizations (77%, followed by psychoactive drugs (14% and marihuana and crack (5% each. The main comorbidities were bronchopneumonia due to aspiration (37%, alcohol-related liver cirrhosis (24% and traumatic brain injury (19%. The most frequent intoxication circumstances were chronic abuse (79%, attemptive suicide (19% and acute abuse (4.9%. Thirty-nine percent of the patients died during hospitalization. Conclusion. The results show a concerning reality, as most of the patients are men of economically active age, who were intoxicated by a legal substance like alcohol, with a relevant number of deaths. Nurses need to pay particular attention to this health problem, in the context of which they play a fundamental role as educators with a view to the encouragement of healthy lifestyles.

Radiologic and clinical findings of mycoplasma pneumonia in children

Energy Technology Data Exchange (ETDEWEB)

Choi, Yong Jin; Oh, Ki Keun [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

1987-06-15

Mycoplasma Pneumonia is a cause of primary atypical pneumonia, but it is asymptomatic mostly or may cause of only mild symptoms. School-aged children experienced high attack rate and manifestation if 'unusual pneumonia' are noted. So authors reviewed clinical and radiological features of 110 cases of serologically proven Mycoplasma pneumonia in hospitalized children between November 1984 and January 1987 retrospectively. The results were as follows ; 1. The sex distribution was 57:53 (1.1:1) in male to female ratio and 47% of them were 5 though 8 years old of age with peak incidence between 5 and 6 years old of age. 2. The symptoms were cough, fever, and sore throat in descending order of frequency and mean symptom duration before admission was 8.1 day. The prevalent season was earlier winter. 3. The radiologic findings were air-space consolidation with lobar, segmental distribution in 68%, interstitial infiltration in 12%, bronchopneumonia in 12%, chronic bronchitis pattern in 3.6%, normal in 4.5%, hilar LN enlargement in 37%, pleural effusion in 12%. 4. Radiologic resolution period was usually 10 days around (4-25 days) and after complete recovery, scarring change or calcification was not seen. 5. Extrapulmonary manifestations were uncommon but hepatitis, hematuria, skin rash, gastroenteritis, myocarditis, otitis media occurred. 6. With administration of tetracyclin and erythromycin, clinical and radiologic responses were promptly seen.

Ground-glass opacity in diffuse lung diseases: high-resolution computed tomography-pathology correlation

International Nuclear Information System (INIS)

Santos, Maria Lucia de Oliveira; Vianna, Alberto Domingues; Marchiori, Edson; Souza Junior, Arthur Soares; Moraes, Heleno Pinto de

2003-01-01

Ground-glass opacity is a finding frequently seen in high-resolution computed tomography examinations of the chest and is characterized by hazy increased attenuation of lung, however without blurring of bronchial and vascular margins. Due to its un specificity, association with other radiological, clinical and pathological findings must be considered for an accurate diagnostic interpretation. In this paper were reviewed 62 computed tomography examinations of patients with diffuse pulmonary diseases of 14 different etiologies in which ground-glass opacity was the only or the most remarkable finding, and correlated this findings with pathology abnormalities seen on specimens obtained from biopsies or necropsies. In pneumocystosis, ground-glass opacities correlated histologically with alveolar occupation by a foaming material containing parasites, in bronchiole alveolar cell carcinoma with thickening of the alveolar septa and occupation of the lumen by mucus and tumoral cells, in paracoccidioidomycosis with thickening of the alveolar septa, areas of fibrosis and alveolar bronchopneumonia exudate, in sarcoidosis with fibrosis or clustering of granulomas and in idiopathic pulmonary fibrosis with alveolar septa thickening due to fibrosis. Alveolar occupation by blood was found in cases of leptospirosis, idiopathic hemo siderosis, metastatic kidney tumor and invasive aspergillosis whereas oily vacuole were seen in lipoid pneumonia, proteinaceous and lipo proteinaceous material in silico proteinosis and pulmonary alveolar proteinosis, and edematous fluid in cardiac failure. (author)

Systemic equid alphaherpesvirus 9 in a Grant's zebra.

Science.gov (United States)

Moeller, Robert B; Crossley, Beate; Pipkin, Arlena; Li, Yanqiu; Balasuriya, Udeni B R

2018-04-01

A 2-y-old female Grant's zebra ( Equus quagga [ burchellii] boehmi) was presented with a clinical history of depression, anorexia, and weakness of 1-wk duration. Postmortem examination identified ulcers on the tongue and palate; a large abscess adjacent to the larynx; left lung consolidation; mild swelling, darkening, and congestion of the liver with accentuation of the lobular pattern; and edema and congestion of the distal small and large intestines. Histologic examination identified necrotizing bronchopneumonia, necrotizing hepatitis, nephritis, and enterocolitis. Eosinophilic intranuclear inclusions were detected in syncytial cells and degenerate bronchial epithelium in the lungs and in some hepatocytes associated with necrotic foci. Bacterial cultures of the lung, liver, and laryngeal abscess failed to detect any significant pathogen. Lung and liver tested positive for equine herpesvirus with neuropathogenic marker by real-time PCR. Subsequently, equine herpesvirus was isolated in tissue culture, and the entire viral DNA polymerase gene (ORF30) was sequenced. The zebra lung isolate had a very close nucleotide and amino acid sequence identity to equid alphaherpesvirus 9 (EHV-9; 99.6% and 99.8%, respectively) in contrast to the neuropathogenic T953 strain of EHV-1 (94.7% and 96.6%, respectively). Although zebras are considered the natural host for EHV-9, we document an unusual acute systemic, fatal EHV-9 infection in a 2-y-old Grant's zebra.

First report of Angiostrongylus vasorum and Hepatozoon from a red fox (Vulpes vulpes) from West Virginia, USA.

Science.gov (United States)

Kistler, Whitney M; Brown, Justin D; Allison, Andrew B; Nemeth, Nicole M; Yabsley, Michael J

2014-02-24

Angiostrongylus vasorum was identified in the lungs of a red fox (Vulpes vulpes) from West Virginia, United States (US), indicating a new geographical location for this metastrongylid nematode. The fox was euthanized and submitted for necropsy after displaying erratic behavior. We did not detect rabies virus or canine distemper virus from the fox. We observed bronchopneumonia associated with A. vasorum infection disseminated in both lungs. In addition, protozoal meronts were observed in the liver, spleen, and mesenteric lymph node, and were identified as Hepatozoon canis. Lymphoid depletion was also observed in the spleen and mesenteric lymph node. In addition to A. vasorum and H. canis infections, Eucoleus aerophilus eggs and adult worms were observed in the lungs of the fox. Severe lesions associated with A. vasorum infection were observed in the lungs and these were determined to be the likely cause of morbidity; however, synergistic effects among the multiple infections detected in this fox cannot be ruled out. This is the first report of an autochthonous A. vasorum infection in the US and from outside of Newfoundland Canada, the only place in North America where the parasite is known to be endemic. Additionally, this is the first report of a H. canis infection in a red fox from the US. Copyright © 2013 Elsevier B.V. All rights reserved.

[Major sickle cell syndromes and infections associated with this condition in children in Burkina Faso].

Science.gov (United States)

Douamba, Sonia; Nagalo, Kisito; Tamini, Laure; Traoré, Ismaël; Kam, Madibèlè; Kouéta, Fla; Yé, Diarra

2017-01-01

This study aims to investigate infections in children with major sickle cell syndrome. We conducted a monocentric descriptive retrospective hospital study in Ouagadougou, Burkina Faso, over a ten-year period. All children with major sickle cell syndrome (homozygous SS and double heterozygous SC, SD Punjab , Sβ thalassemic, SO Arab and SE) hospitalized for microbiologically confirmed infections were enrolled in the study. One hundred and thirty-three patients met our inclusion criteria. The SS phenotype accounted for 63.2% of cases and SC 36.8%. The frequency of infections was 21.8%. In 45.9% of cases, these affected children aged 0-5 years. The most frequent signs were osteoarticular pain (42.1%), cough (25.7%), abdominal pain (23.3%), pallor (43.6%). The major diagnoses were bronchopneumonia (31.6%), malaria (16.5%), osteomyelitis (12.8%) and septicemia (10.5%). The isolated pathogenic organisms were Streptococcus pneumoniae (35.5%) and Salmonella spp (33.3%). Third generation cephalosporins were the most commonly prescribed antibiotics. Gros mortality rate was 7.5%. Bacterial infections and malaria dominate the clinical picture of infections in children with major sickle cell syndrome at the at the Pediatrics University Hospital Center Charles De-Gaulle. This study highlights the importance of establishing a national program for the management of sickle-cell anemia, which could help prevent or reduce the occurrence of infections in children with sickle cell syndrome.

Radiologic and clinical findings of mycoplasma pneumonia in children

Energy Technology Data Exchange (ETDEWEB)

Choi, Yong Jin; Oh, Ki Keun [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

1987-06-15

Mycoplasma Pneumonia is a cause of primary atypical pneumonia, but it is asymptomatic mostly or may cause of only mild symptoms. School-aged children experienced high attack rate and manifestation if 'unusual pneumonia' are noted. So authors reviewed clinical and radiological features of 110 cases of serologically proven Mycoplasma pneumonia in hospitalized children between November 1984 and January 1987 retrospectively. The results were as follows ; 1. The sex distribution was 57:53 (1.1:1) in male to female ratio and 47% of them were 5 though 8 years old of age with peak incidence between 5 and 6 years old of age. 2. The symptoms were cough, fever, and sore throat in descending order of frequency and mean symptom duration before admission was 8.1 day. The prevalent season was earlier winter. 3. The radiologic findings were air-space consolidation with lobar, segmental distribution in 68%, interstitial infiltration in 12%, bronchopneumonia in 12%, chronic bronchitis pattern in 3.6%, normal in 4.5%, hilar LN enlargement in 37%, pleural effusion in 12%. 4. Radiologic resolution period was usually 10 days around (4-25 days) and after complete recovery, scarring change or calcification was not seen. 5. Extrapulmonary manifestations were uncommon but hepatitis, hematuria, skin rash, gastroenteritis, myocarditis, otitis media occurred. 6. With administration of tetracyclin and erythromycin, clinical and radiologic responses were promptly seen.

Radiologic Review of an Outbreak of the Pandemic (H1N1) 2009 Virus Infection at a University Hospital in Seoul, Korea

International Nuclear Information System (INIS)

Choi, Seung Hee; Kang, Eun Young; Kim, Yoon Kyung; Woo, Ok Hee; Yong, Hwan Seok; Oh, Yu Whan; Kim, Jang Su

2011-01-01

To assess the frequency of radiologic abnormalities and investigate the radiologic findings of patients with a pandemic (H1N1) 2009 virus infection at a University hospital in Seoul, Korea. In November 2009, 9,427 patients were tested for pandemic (H1N1) 2009 virus and 3,849 (41%) were positive. Among them, only 338 (9%) underwent chest radiographs and 13 (0.3%) received chest CT. Two radiologists retrospectively reviewed all the radiologic images. Among the 338 patients, 287 (85%) were normal and 51 (15%) showed abnormalities. The frequency of abnormalities was significantly higher in children (41/212=19%) than in adults (10/126=8%) (p = 0.005). Of them, 42 (82%) patients had airspace pneumonia, whereas the remaining patients showed a bronchopneumonia pattern. Unilateral (82%) involvement was more common than bilateral (18%) involvement. Among patients who received chest CT, 12 (92%) showed abnormalities, with bilateral (67%) and random (75%) involvement being more common. Ground-glass opacity (67%) and centrilobular nodules (58%) were the more common CT findings. Only a small number of patients were critically ill enough to undergo further radiologic evaluation as a result of pandemic (H1N1) 2009 virus infection, and most patients had normal chest radiographs. Unilateral airspace pneumonia was the most common abnormality in patients infected with pandemic (H1N1) 2009 virus.

Mortalidad extrahospitalaria en menores de 1 año

Directory of Open Access Journals (Sweden)

Felipa E. García García

1997-04-01

Full Text Available Se presenta un estudio retrospectivo de 40 niños menores de 1 año, fallecidos fuera de un centro hospitalario en el período comprendido de enero de 1989 a diciembre de 1990 en Ciudad de La Habana. La muerte natural apareció con mayor frecuencia y dentro de ella las bronconeumonías, cardiopatías y sepsis fueron las 3 primeras causas. El maltrato se presentó en el 40 % de los casos, y se comportó el intencional y la muerte por negligencia de igual forma con el 50 % respectivamente. No se identificó la muerte súbita, aunque sí se hallaron aspectos relacionados con ella, como la edad al morir, sexo y horario de defunciones.It is presented a retrospective study of 40 children under one year old, who died outside a hospital center from January, 1989 to December, 1990, in Havana City. Natural death was the most frequent, and within it bronchopneumonias, cardiopathies, and sepsis were the first three causes. Mistreatment was present in 40 % of the cases; whereas intentional mistreatment and death due to negligence behaved in the same way with 50 %, respectively. Sudden death was not identified, although some aspects connected with it such as age of death, sex, and time of decesse were found.

Clinical study of infectious diseases on aged A-bomb survivors in Hiroshima Welfare Home for aged A-bomb survivors

International Nuclear Information System (INIS)

Aisaka, Tadakazu; Orimen, Akio; Niimi, Masanobu; Simizu, Kiyoshi.

1978-01-01

Infections, especially urinary passage and respiratory infections of aged A-bomb survivers under special protective care was examined. Urinary passage infections have recently shown an increasing tendency. These infections are related to the factors such as their basic diseases and wearing napkins rather than a severe degree of protective care. In the case of respiratory infection, diseases such as influenza are observed rather in patients who can walk, but they tend to be aggravated in bedridden patients. It cannot be said that more urinary passage infections are observed in A-bomb survivers than non A-bomb survivers. Both urinary passage infection and respiratory infection tend to recur repeatedly. Aged A-bomb survivers show no significant difference of acquired immunity from that of non A-bomb survivers group. However, a maintenance of neutralizing antibody by vaccination of influenza in the former is worse than in the latter. Bedridden patients show a higher rate of infection to potential urinary passage diseases than patients who can walk, irrespective of sex. Moreover, bedridden patients have a large number of bacteria, but other significant host reaction couldn't be observed. In bedridden patients with potential urinary passage infection, a variety of bacteria, most of which are bacteria resistant to rutinely used broad spectrum antibiotics, is detected. As a main disease or a direct cause of death, pyelonephritis in women and bronchopneumonia are often observed. (Iwagami, H.)

Hyperlucent lung

International Nuclear Information System (INIS)

Jimenez-Gutierrez, Florana; Soto-Quiros, Manuel E.

2007-01-01

Unilateral hyperlucent lung is also known as Swyer-James Syndrome, Macleod Syndrome or lobular or unilateral emphysema. It is an uncommon disease characterized by lung or unilateral lobe hiperlucency associated to an air trapping upon expiration. As regards to etiology, this syndrome is considered to be an acquired disease that appears secondary to respiratory infections during the early years of life, probably bronchiolitis and/ or viral pneumonia. The clinical presentation varies among patients. Some of them are asymptomatic, others present a history of recurrent episodes of pulmonary infections from early years of life or present effort dyspnea. The diagnosis is usually made accidentally by a chest radiograph in a child with history of respiratory infections or in an adult during a routine chest x- ray in an asymptomatic person. It is important to differentiate this syndrome from other causes of unilateral pulmonary hiperlucency on conventional chest x-rays. Few cases of Swyer-James Syndrome in children have been reported, it is presented the clinical case of a patient who had a parainfluenza 3 bronchopneumonia when he was a month and eighteen days of age. The differential diagnosis of this syndrome should be done with other thoracic entities that diminish the radiological pulmonary unilateral density. A case of a child who is the bearer of hyperlucent lung is described. (author) [es

Ground-glass opacity in diffuse lung diseases: high-resolution computed tomography-pathology correlation; Opacidades em vidro fosco nas doencas pulmonares difusas: correlacao da tomografia computadorizada de alta resolucao com a anatomopatologia

Energy Technology Data Exchange (ETDEWEB)

Santos, Maria Lucia de Oliveira; Vianna, Alberto Domingues; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Souza Junior, Arthur Soares [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Disciplina de Radiologia; Moraes, Heleno Pinto de [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Patologia]. E-mail: edmarchiori@zipmail.com.br

2003-12-01

Ground-glass opacity is a finding frequently seen in high-resolution computed tomography examinations of the chest and is characterized by hazy increased attenuation of lung, however without blurring of bronchial and vascular margins. Due to its un specificity, association with other radiological, clinical and pathological findings must be considered for an accurate diagnostic interpretation. In this paper were reviewed 62 computed tomography examinations of patients with diffuse pulmonary diseases of 14 different etiologies in which ground-glass opacity was the only or the most remarkable finding, and correlated this findings with pathology abnormalities seen on specimens obtained from biopsies or necropsies. In pneumocystosis, ground-glass opacities correlated histologically with alveolar occupation by a foaming material containing parasites, in bronchiole alveolar cell carcinoma with thickening of the alveolar septa and occupation of the lumen by mucus and tumoral cells, in paracoccidioidomycosis with thickening of the alveolar septa, areas of fibrosis and alveolar bronchopneumonia exudate, in sarcoidosis with fibrosis or clustering of granulomas and in idiopathic pulmonary fibrosis with alveolar septa thickening due to fibrosis. Alveolar occupation by blood was found in cases of leptospirosis, idiopathic hemo siderosis, metastatic kidney tumor and invasive aspergillosis whereas oily vacuole were seen in lipoid pneumonia, proteinaceous and lipo proteinaceous material in silico proteinosis and pulmonary alveolar proteinosis, and edematous fluid in cardiac failure. (author)

Retroperitoneal unicentric Castleman's disease (giant lymph node hyperplasia: case report

Directory of Open Access Journals (Sweden)

Jaques Waisberg

Full Text Available CONTEXT AND OBJECTIVE: Castleman's disease, or giant lymph node hyperplasia, is a rare disorder of the lymphoid tissue that causes lymph node enlargement. It is considered benign in its localized form, but aggressive in the multicentric type. The definitive diagnosis is based on postoperative pathological findings. The aim here was to describe a case of retroperitoneal unicentric Castleman's disease in the retroperitoneum. CASE REPORT: A 61-year old white male with weight loss and listlessness presented with moderate arterial hypertension and leukopenia. Abdominal tomography revealed a 5 x 4 x 5 cm oval mass of low attenuation, with inner calcification and intense enhancement on intravenous contrast, located in the retroperitoneal region, between the left kidney and the aorta, at the renal hilus. Exploratory laparotomy revealed a non-pulsatile solid oval mass situated in the retroperitoneum, adjacent to the left renal hilus. The retroperitoneal lesion was removed in its entirety. Examination of frozen samples revealed benign lymph node tissue and histopathological examination of the surgical sample revealed hyaline-vascular giant lymph node hyperplasia (Castleman's disease. The patient was discharged on the 12th day without significant events. Two months after the operation, the patient was readmitted with severe cardiac insufficiency, acute renal failure and bronchopneumonia, which progressed to acute respiratory insufficiency, sepsis and death.

Radiologic and clinical findings of mycoplasma pneumonia in children

International Nuclear Information System (INIS)

Choi, Yong Jin; Oh, Ki Keun

1987-01-01

Mycoplasma Pneumonia is a cause of primary atypical pneumonia, but it is asymptomatic mostly or may cause of only mild symptoms. School-aged children experienced high attack rate and manifestation if 'unusual pneumonia' are noted. So authors reviewed clinical and radiological features of 110 cases of serologically proven Mycoplasma pneumonia in hospitalized children between November 1984 and January 1987 retrospectively. The results were as follows ; 1. The sex distribution was 57:53 (1.1:1) in male to female ratio and 47% of them were 5 though 8 years old of age with peak incidence between 5 and 6 years old of age. 2. The symptoms were cough, fever, and sore throat in descending order of frequency and mean symptom duration before admission was 8.1 day. The prevalent season was earlier winter. 3. The radiologic findings were air-space consolidation with lobar, segmental distribution in 68%, interstitial infiltration in 12%, bronchopneumonia in 12%, chronic bronchitis pattern in 3.6%, normal in 4.5%, hilar LN enlargement in 37%, pleural effusion in 12%. 4. Radiologic resolution period was usually 10 days around (4-25 days) and after complete recovery, scarring change or calcification was not seen. 5. Extrapulmonary manifestations were uncommon but hepatitis, hematuria, skin rash, gastroenteritis, myocarditis, otitis media occurred. 6. With administration of tetracyclin and erythromycin, clinical and radiologic responses were promptly seen

Conducta anestésica en un lactante con enfisema lobar congénito Behavior of anesthesia in an infant with congenital lobar emphysema

Directory of Open Access Journals (Sweden)

Raúl de Jesús Nápoles Smith

2012-02-01

Full Text Available Se presenta el caso clínico de un lactante con enfisema lobar congénito, tratado en el Hospital Infantil Sur de Santiago de Cuba con antecedentes de cuadros respiratorios recurrentes y varias hospitalizaciones previas. Inicialmente ingresó con bronconeumonía y disnea, por lo que se sospechó la presencia de un neumotórax, pero mediante estudios radiológicos se obtuvo el diagnóstico definitivo y se decidió aplicarle tratamiento quirúrgico. En el período intraoperatorio tuvo una complicación cardiovascular (bradicardia extrema, que fue tratada con las medidas adecuadas (oxígeno a 100 %, masaje cardíaco directo y sulfato de atropina, las cuales permitieron una evolución posoperatoria satisfactoria en la Unidad de Cuidados Intensivos Pediátricos.The case of an infant with congenital lobar emphysema is reported, who was treated in the Southern Children Hospital of Santiago de Cuba with history of recurrent respiratory symptoms and several previous hospitalizations. Initially he was admitted with bronchopneumonia and dyspnea, and the presence of pneumothorax was suspected, but a definitive diagnosis was obtained by radiological studies and surgical treatment was decided. In the intraoperative period he had a cardiovascular complication (extreme bradycardia, which was treated with appropriate measures (100 % oxygen, direct heart massage and atropine sulfate, which allowed a satisfactory postoperative course in the Pediatric Intensive Care Unit.

Sulphur Mustard Poisoning and Its Complications in Iranian Veterans

Directory of Open Access Journals (Sweden)

Beeta Balali-Mood

2009-09-01

Full Text Available Sulphur mustard is a chemical warfare agent, which was largelyused during the World War One and in Iraq-Iran conflict. It mayalso be used as a chemical terrorism agent. Therefore, medicalprofessions should have sufficient knowledge and be preparedfor medical intervention of any such chemical attack.Sulphur mustard exerts direct toxic effects on the eyes, skin,and respiratory tract, with subsequent systemic actions on thenervous, immunologic, hematologic, digestive, and reproductivesystems. It is an alkylating agent that affects DNA synthesis andthus, delayed complications have been considered since theWorld War One. Cases of malignancies in the target organs particularlyin hematopoietic, respiratory, and digestive systemswere reported. Common delayed respiratory complications includechronic bronchitis, bronchiectasis, frequent bronchopneumonia,and pulmonary fibrosis, all of which tend to deterioratewith time. Severe dry skin, delayed keratitis, and reduction ofnatural killer cells with subsequent increased risk of infectionsand malignancies are also among the most distressing long-termconsequences of sulphur mustard intoxication. However, despiteextensive research that has been conducted on Iranian veteransduring the past decades, major gaps continue to remain in thesulphur mustard literature. Immunological and neurological dysfunctionsand the relationship between exposure to sulphur mustardand mutagenicity, carcinogenicity, and teratogenicity areimportant fields that require further studies, particularly on Iranianveterans with chronic health problems caused by sulphurmustard poisoning. There is also a paucity of information on themedical management of acute and delayed toxic effects of sulphurmustard poisoning, a subject that greatly challenges themedical professions.

Babesia (Theileria) annae in a red fox (Vulpes vulpes) from Prince Edward Island, Canada.

Science.gov (United States)

Clancey, Noel; Horney, Barbara; Burton, Shelley; Birkenheuer, Adam; McBurney, Scott; Tefft, Karen

2010-04-01

A 4-6-mo-old female red fox (Vulpes vulpes) was presented to the Atlantic Veterinary College (AVC) Teaching Hospital, Prince Edward Island, Canada. On presentation, the fox was weak and had pale mucous membranes. A complete blood count and a serum biochemistry profile were performed. Blood smear examination revealed low numbers of erythrocytes containing centrally to paracentrally located, single, rarely multiple, approximately 1 x 2 microm, oval to round organisms with morphology similar to Babesia microti. Polymerase chain reaction testing and DNA sequencing of the Babesia species 18S rRNA gene were performed on DNA extracted from whole blood. Results were positive for a Babesia microti-like parasite genetically identical to Babesia (Theileria) annae. The fox was euthanized due to poor prognosis for recovery. Necropsy examination revealed multifocal to locally extensive subacute nonsuppurative meningoencephalitis, an eosinophilic broncho-pneumonia, a moderate diffuse vacuolar hepatopathy, and lesions associated with blunt trauma to the left abdominal region. This is the first reported case of a red fox in Canada infected with a piroplasm. It remains uncertain whether the presence of this hemoparasite in this fox was pathogenic or an incidental finding. The potential for competent vectors of Babesia species on Prince Edward Island, the potential for this Babesia microti-like parasite to infect other wild and domestic canids, and the significance of this parasite to the health of infected individuals are yet to be determined.

An investigation into beef calf mortality on five high-altitude ranches that selected sires with low pulmonary arterial pressures for over 20 years.

Science.gov (United States)

Neary, Joseph M; Gould, Daniel H; Garry, Franklyn B; Knight, Anthony P; Dargatz, David A; Holt, Timothy N

2013-03-01

Producer reports from ranches over 2,438 meters in southwest Colorado suggest that the mortality of preweaned beef calves may be substantially higher than the national average despite the selection of low pulmonary pressure herd sires for over 20 years. Diagnostic investigations of this death loss problem have been limited due to the extensive mountainous terrain over which these calves are grazed with their dams. The objective of the current study was to determine the causes of calf mortality on 5 high-altitude ranches in Colorado that have been selectively breeding sires with low pulmonary pressure (branding (6 weeks of age) in the spring to weaning in the fall (7 months of age). Clinical signs were recorded, and blood samples were taken from sick calves. Postmortem examinations were performed, and select tissue samples were submitted for aerobic culture and/or histopathology. On the principal study ranch, 9.6% (59/612) of the calves that were branded in the spring either died or were presumed dead by weaning in the fall. In total, 28 necropsies were performed: 14 calves (50%) had lesions consistent with pulmonary hypertension and right-sided heart failure, and 14 calves (50%) died from bronchopneumonia. Remodeling of the pulmonary arterial system, indicative of pulmonary hypertension, was evident in the former and to varying degrees in the latter. There is a need to better characterize the additional risk factors that complicate pulmonary arterial pressure testing of herd sires as a strategy to control pulmonary hypertension.

Histopathological findings in lungs of hawksbill turtles collected on the coasts of the states of Espírito Santo and Rio de Janeiro, Brazil

Directory of Open Access Journals (Sweden)

M.A. Silva

Full Text Available ABSTRACT The present work aimed to report the histopathological findings verified in lungs of hawksbill turtles (Eretmochelys imbricata retrieved from the coasts of the states of Espírito Santo and Rio de Janeiro, Brazil. Between the years 2010 and 2014, 29 E. imbricata individuals were found stranded on the coasts, already dead or dying during treatment. Lung samples of all specimens were collected during necropsies, fixed in 10% neutral buffered formalin, subjected to routine histological processing and classified histomorphologically. The findings revealed that 37.93% of the specimens presented lung lesions. Of these, 90.91% were rescued alive and 9.09% were found dead; 63.63% were females and 36.37% were males. The mean weight was 5.44 Kg and the mean length 39 cm, characterizing young individuals. The animals originated from São Francisco de Itabapoana - RJ, Aracruz - ES, São Mateus - ES, Guarapari - ES, Linhares - ES, Itapemirim - ES, and Anchieta - ES. Macroscopic analysis revealed presence of foam, hyperemia, nodules in the parenchyma, cyst and caseous material. Microscopic examination evidenced heterophilic bronchopneumonia, parasitic granulomatous pneumonia caused by spirorchiids, bacterial granulomatous pneumonia, fungal granulomatous pneumonia, and congestion. It was concluded that juvenile specimens of Eretmochelys imbricata, females and males, originated from the states of Espírito Santo and Rio de Janeiro and found stranded both alive or dead, have significant lung lesions, mainly inflammatory ones, associated or not with infectious agents.

The sensor kinase MprB is required for Rhodococcus equi virulence.

Science.gov (United States)

MacArthur, Iain; Parreira, Valeria R; Lepp, Dion; Mutharia, Lucy M; Vazquez-Boland, José A; Prescott, John F

2011-01-10

Rhodococcus equi is a soil bacterium and, like Mycobacterium tuberculosis, a member of the mycolata. Through possession of a virulence plasmid, it has the ability to infect the alveolar macrophages of foals, resulting in pyogranulomatous bronchopneumonia. The virulence plasmid has an orphan two-component system (TCS) regulatory gene, orf8, mutation of which completely attenuates virulence. This study attempted to find the cognate sensor kinase (SK) of orf8. Annotation of the R. equi strain 103 genome identified 23 TCSs encoded on the chromosome, which were used in a DNA microarray to compare TCS gene transcription in murine macrophage-like cells to growth in vitro. This identified six SKs as significantly up-regulated during growth in macrophages. Mutants of these SKs were constructed and their ability to persist in macrophages was determined with one SK, MprB, found to be required for intracellular survival. The attenuation of the mprB- mutant, and its complementation, was confirmed in a mouse virulence assay. In silico analysis of the R. equi genome sequence identified an MprA binding box motif homologous to that of M. tuberculosis, on mprA, pepD, sigB and sigE. The results of this study also show that R. equi responds to the macrophage environment differently from M. tuberculosis. MprB is the first SK identified as required for R. equi virulence and intracellular survival. Copyright © 2010 Elsevier B.V. All rights reserved.

[A South American tapir (Tapirus terrestris) with peritonitis].

Science.gov (United States)

van der Kolk, J H; van der Hage, M H

A 6-year-old male tapir was admitted because it had been anorexic for 1 day. On admission, the tapir weighed 160 kg. Its rectal temperature was 32.4 degrees C, its heart rate was 120 beats per minute, and its respiratory rate was 12 breaths per minute. The elasticity of the skin was diminished. Haematological evaluation upon admission revealed a haematocrit of 0.63 L.L-1., 6.0 G.L-1 leucocytes with 40 per cent band neutrophils. The concentrations of urea nitrogen and creatinine in plasma were raised (18.9 mmol L-1. and 475 mumol L-1., respectively). Severe combined acidosis was apparent; the venous pH was 6.965, the bicarbonate concentration was 13.7 mmol.L-1., and the venous pCO2 was 8.6 kPa. No strongyle eggs were isolated from faeces by flotation, but a faecal sample yielded a positive culture for Pseudomonas aeruginosa. Urinalysis revealed proteinuria and the presence of leucocytes and renal epithelial cells. Treatment with fluids, TMP/S (17.5 and 3.5 mg/kg body weight, twice a day, respectively), and clenbuterol (0.56 microgram/kg body weight, twice a day) intravenously was unsuccessful and the tapir died 4 days after hospitalization. At necropsy, peritonitis due to a colon infarct as well as chronic bronchopneumonia and renal tubulonecrosis were found. The antibiotic susceptibility of the bacteria isolated (Streptoc. sp., E. coli, and K. pneumoniae) from the tapir post-mortem was assessed.

A bighorn sheep die-off in southern Colorado involving a Pasteurellaceae strain that may have originated from syntopic cattle.

Science.gov (United States)

Wolfe, Lisa L; Diamond, Brandon; Spraker, Terry R; Sirochman, Michael A; Walsh, Daniel P; Machin, Chandra M; Bade, Donald J; Miller, Michael W

2010-10-01

We investigated a pasteurellosis epizootic in free-ranging bighorn sheep (Ovis canadensis) wherein a Pasteurellaceae strain carried by syntopic cattle (Bos taurus) under severe winter conditions appeared to contribute to pneumonia in affected bighorns. Twenty-one moribund or dead bighorn sheep were found on the "Fossil Ridge" herd's winter range, Colorado, USA, between 13 December 2007 and 29 February 2008. Eight carcasses examined showed gross or microscopic evidence of acute to subacute fibrinous bronchopneumonia. All eight carcasses yielded at least one β-hemolytic Mannheimia haemolytica biogroup 1(±(G)) strain, and seven also yielded a β-hemolytic Bibersteinia trehalosi biogroup 4 (CDS) strain; evidence of Pasteurella multocida, Mycoplasma ovipneumoniae, and parainfluenza 3 and bovine respiratory syncytial viruses was also detected. Isolates of β-hemolytic Manneimia haemolytica biogroup 1(G) from a bighorn carcass and a syntopic cow showed 99.5% similarity in genetic fingerprints; B. trehalosi biogroup 4(CDS) isolates were ≥94.9% similar to an isolate from a nearby bighorn herd. Field and laboratory observations suggested that pneumonia in affected bighorns may have been caused by a combination of pathogens including two pathogenic Pasteurellaceae strains--one likely of cattle origin and one likely of bighorn origin--with infections in some cases perhaps exacerbated by other respiratory pathogens and severe weather conditions. Our and others' findings suggest that intimate interactions between wild sheep and cattle should be discouraged as part of a comprehensive approach to health management and conservation of North American wild sheep species.

Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated?

Directory of Open Access Journals (Sweden)

Nelson Adami Andreollo

Full Text Available Objective: to analyse the indications and results of the total esophagogastrectomy in cancers of the distal esophagus and esophagogastric junction. Methods: twenty patients with adenocarcinomas were operated with a mean age of 55 ± 9.9 years (31-70 years, and 14 cases were male (60%. Indications were 18 tumors of the distal esophagus and esophagogastric junction (90% and two with invasion of gastric fundus (10% in patients with previous gastrectomy. Preoperative colonoscopy to exclude colonic diseases was performed in ten cases. Results: the surgical technique consisted of median laparotomy and left cervicotomy, followed by transhiatal esophagectomy associated with D2 lymphadenectomy. The reconstructions were performed with eight esophagocoloduodenoplasty and the others were Roux-en-Y esophagocolojejunoplasty to prevent the alkaline reflux. Three cases were stage I / II, while 15 cases (85% were stages III / IV, reflecting late diagnosis of these tumors. The operative mortality was 5 patients (25%: a mediastinitis secondary to necrosis of the transposed colon, abdominal cellulitis secondary to wound infection, severe pneumonia, an irreversible shock and sepsis associated with colojejunal fistula. Four patients died in the first year after surgery: 3 (15% were due to tumor recurrence and 1 (5% secondary to bronchopneumonia. The 5-year survival was 15%. Conclusion: the total esophagogastrectomy associated with esophagocoloplasty has high morbidity and mortality, requiring precise indication, and properly selected patients benefit from the surgery, with the risk-benefit acceptable, contributing to increased survival and improved quality of life

Óbitos em instituição asilar Deaths in nursing homes

Directory of Open Access Journals (Sweden)

Milton Luiz Gorzoni

2011-06-01

analysis. The collected data were gender, age, cause(s of death and underlying disease(s. The statistical analysis compared data between the two genders and two age ranges ( 75 years. RESULTS: There were 118 deaths in 2006 (mean age: 74.5 ± 15.2 years - 64 women (mean age: 78.4 ± 14.4 years old and 54 men (mean age: 69.8 ± 15.0 years old. Causes of death were sepsis (41 deaths, septic shock (25, bronchopneumonia (16, sudden death (11, multiple-organ failure (9 and other causes (16 deaths. The main underlying diseases were infections (63 deaths - bronchopneumonia (34, sepsis (12, urinary tract infection (7 infected pressure ulcers (7, osteomyelitis (2 and bile duct infection (1; immobility syndrome (42 deaths. The proportion of women older than 75 years showed statistical significance concerning the number of deaths. The sample did not show statistical significance regarding seasonality, causes of death or underlying disease(s when comparing infectious and noninfectious causes of death vs. men and women, aged older or younger than 75 years. CONCLUSION: Deaths in nursing homes were basically caused by a combination of immobility and infections that developed into sepsis.

Ocorrência de pneumonia associada à infecção por Mannheimia haemolytica em ovinos de Minas Gerais Occurrence of pneumonia associated to infection by Mannheimia haemolytica in sheep of Minas Gerais

Directory of Open Access Journals (Sweden)

Marina Rios de Araújo

2009-09-01

animals were not medicated and found dead. Grossly, the pulmonary findings were similar in all sheep. The pulmonary cranial lobes and the ventral portion of caudal lobes were consolidated and purulent exsudate streamed out of the airways. In the parenchyma of the cranial lobes there were white slightly prominent multifocal to coalescent areas with 0.2 to 0.5cm in diameter intercalated with dark red areas. Consolidated lesions occupied 70 to 80% of the lungs. Fibrinous pleuritis was observed in sheep 1, 2 and 3. Microscopically, the findings were fibrinopurulent bronchopneumonia with intense hyperemia, areas with intra-alveolar hemorrhage and thickening of interlobular septa with numerous neutrophils, cellular rests and scattering fibrin. Multifocal areas with liquefaction necrosis containing numerous bacterial colonies were observed in sheep 1, 2 and 3. In the cranial lobes of these sheep, there were areas with degenerated neutrophils forming clusters of basophilic cells with alongated nuclei ("oat cells" associated with bacterial colonies. The histological findings were characteristic of pneumonia caused by Mannheimia (M. haemolytica. Samples of the cranial lobes were sent for bacterial culture, and M. haemolytica was isolated and identified in all animals. This is the first report correlating pathological findings and the isolation of M. haemolytica as cause of bronchopneumonia in sheep in the country.

The influence of detoxification agents on the intensity of side effects caused by medium-high doses of methotrexate in children with acute lymphoblastic leukemia: Case series

Directory of Open Access Journals (Sweden)

Šumar Jovana S.

2014-01-01

Full Text Available Objective The treatment of childhood acute lymphoblastic leukemia (ALL in Serbia is conducted according to protocol ALL IC BMF-2009. The therapy includes the application of cytostatic drugs methotrexate and 6-mercaptopurine, and drug detoxifying Calcium Folinate. At the moment, 80% of affected children could be cured with current treatment, but resistance to the therapy and its toxic effects remain serious clinical problems. The aim of the study was to investigate the influence of detoxification agents (Calcium Folinate, silymarin and ursodeoxycholic acid on the side effects of methotrexate, applied in this protocol. Methods A modified acute toxicity form (GPOH was used for side effects monitoring. The research included children with either standard or intermediate risk ALL in the consolidation therapy phase, who were hospitalised at the Institute for Child and Youth Health Care of Vojvodina in Novi Sad during the period from July 2010 to February 2011. Results The most frequent side effect after 40 applications of methotrexate in ten children was bone marrow depression. Methotrexate caused: leukopenia in 10 patients, thrombocytopenia in 5 patients; after the use of folic acid, platelet count grew in 8 patients, leukocyte in 2 patients. Less frequent side effects: an increase serum transaminase activity, the state of fever, bronchopneumonia, diarrhoea with mild cramps and hypercalcaemia. Conclusion The application of Calcium Folinate, silymarin and ursodeoxycholic acid prevented the occurrence of severe adverse effects caused by medium-high doses of methotrexate. Observed adverse effects were of mild to moderate intensity, reversible and did not significantly disturb the quality of life in treated patients.

Isolation, characterization, antibiogram and pathology of Pasteurella multocida isolated from pigs

Directory of Open Access Journals (Sweden)

Mamta Tigga

2014-05-01

Full Text Available Aim: Isolation, characterization and antibiogram of Pasteurella multocida from diseased pigs of district Durg of Chhattisgarh, and to study pathological changes caused by swine pasteurellosis. Materials and Methods: An outbreak of swine pasteurellosis was suspected in pigs of Ruwabandha (Bhilai, Anjora, Somni, Tedesara, Tirgajhola villages of Durg district in Chhattisgarh, India during August and September of 2011. Nasal Swabs and blood samples from ailing pigs and heart blood and impression smears from morbid pigs were processed for detection and isolation of P. multocida by bacteriological methods. Detailed necropsy was conducted and gross and histopathological lesions were recorded. The test Isolates were subjected to antimicrobial sensitivity profile by disc-diffusion method. Results: The blood smears from heart blood and tissue impression smears revealed teaming of bipolar organisms indicating the presence of Pasteurella spp. The isolates obtained were subjected to Gram's staining for checking the purity and bipolar morphology and characterized biochemically. Gross lesions included severe acute pneumonia and haemorrhages in lungs, petechial haemorrhages on serous membranes and other visceral organs. On histopathological examination, lungs showed typical fibrinous bronchopneumonia, multifocal suppuration. All the isolates of P. multocida were 100% sensitive to Amoxicillin, Gentamicin, Enrofloxacin and showed100% resistance to Ceftizoxim and Cloxacillin. Conclusion: Gross and microscopic lesions in dead animals are of great diagnostic value and are of characteristic of P. multocida infection. Cultural, morphological and biochemical characters are useful to rule out the causative agent as P. multocida. Antibiotic sensitivity pattern of the isolates should routinely be carried out for knowing the antibiotic resistance trends in an endemic area.

Infección hospitalaria en recién nacidos ingresados en un servicio de cuidados intensivos neonatales Nosocomial infection in newborns admitted in a neonatal intensive care service

Directory of Open Access Journals (Sweden)

Luis Ricardo Manet Lahera

2010-09-01

Full Text Available Se efectuó un estudio descriptivo y transversal de los 48 recién nacidos ingresados por infecciones hospitalarias en el Servicio de Cuidados Intensivos Neonatales del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso " de Santiago de Cuba durante el 2005. La mayoría de los pacientes (85,5 % presentó sepsis connatal y la infección más común fue la bacteriemia, seguida de las bronconeumonías. El cultivo de secreciones endotraqueales constituyó la muestra de mayor positividad y entre los microorganismos aislados con mayor frecuencia figuraron las klebsiellas y los estafilococos coagulasa positiva. Quedó confirmado que los antibióticos menos efectivos contra los gérmenes grampositivos resultaron ser la penicilina y la ceftriaxona; y contra los gramnegativos, los aminoglucósidos.A descriptive and cross-sectional study of 48 newborns admitted due to nosocomial infections in the Neonatal Intensive Care Service of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba during 2005 was carried out. Most of the patients (85,5% presented sepsis at birth and the most common infection was bacteriemia, followed by bronchopneumonias. The culture of endotracheal secretions constituted the sample of more positivity and among the isolated microorganisms with more frequency there were the Klebsiella and the positive coagulasa estaphylococcus. It was confirmed that the less effective antibiotics against the Gram-positive germs turned out to be penicillin and ceftriaxone; and against the Gram-negative, the aminoglycoside.

Fatal canine distemper infection in a pack of African wild dogs in the Serengeti ecosystem, Tanzania.

Science.gov (United States)

Goller, Katja V; Fyumagwa, Robert D; Nikolin, Veljko; East, Marion L; Kilewo, Morris; Speck, Stephanie; Müller, Thomas; Matzke, Martina; Wibbelt, Gudrun

2010-12-15

In 2007, disease related mortality occurred in one African wild dog (Lycaon pictus) pack close to the north-eastern boundary of the Serengeti National Park, Tanzania. Histopathological examination of tissues from six animals revealed that the main pathologic changes comprised interstitial pneumonia and suppurative to necrotizing bronchopneumonia. Respiratory epithelial cells contained numerous eosinophilic intracytoplasmic inclusion bodies and multiple syncytial cells were found throughout the parenchymal tissue, both reacting clearly positive with antibodies against canine distemper virus (CDV) antigen. Phylogenetic analysis based on a 388 nucleotide (nt) fragment of the CDV phosphoprotein (P) gene revealed that the pack was infected with a CDV variant most closely related to Tanzanian variants, including those obtained in 1994 during a CDV epidemic in the Serengeti National Park and from captive African wild dogs in the Mkomazi Game Reserve in 2000. Phylogenetic analysis of a 335-nt fragment of the fusion (F) gene confirmed that the pack in 2007 was infected with a variant most closely related to one variant from 1994 during the epidemic in the Serengeti National Park from which a comparable fragment is available. Screening of tissue samples for concurrent infections revealed evidence of canine parvovirus, Streptococcus equi subsp. ruminatorum and Hepatozoon sp. No evidence of infection with Babesia sp. or rabies virus was found. Possible implications of concurrent infections are discussed. This is the first molecular characterisation of CDV in free-ranging African wild dogs and only the third confirmed case of fatal CDV infection in a free-ranging pack. Copyright © 2010 Elsevier B.V. All rights reserved.

Scrub typhus caused by Orientia tsutsugamushi Kawasaki-related genotypes in Shandong Province, northern China.

Science.gov (United States)

Zhang, Luyan; Bi, Zhenwang; Kou, Zengqiang; Yang, Huili; Zhang, Aihua; Zhang, Shoufeng; Meng, Xiangpeng; Zheng, Li; Zhang, Meng; Yang, Hui; Zhao, Zhongtang

2015-03-01

Orientia tsutsugamushi, the causative agent of scrub typhus, is an obligate intracellular bacterium and characterized by dramatic genetic diversity. To elucidate the genotypes of O. tsutsugamushi populating in patients in Shandong Province, a new epidemic zone in China, we sequenced partial of the 56-kDa type-specific antigen gene (TSA) and identified the genotypes of 43 O. tsutsugamushi samples from human patients confirmed with scrub typhus from 2010 to 2013. All of the 43 sequences are in the same clade, 39 of them are in one branch and the other four sequences, nominated as SH1002, SH1306, SH1309, and SH1307 are in four separate branches. To clarify the clinical characterizations caused by Kawasaki-related genotypes, we studied the clinical profiles of these 43 scrub typhus patients. Most patients (88.1%) were farmers lived in rural areas. They presented with fever (100.0%), headache (79.1%), dizziness (32.6%), generalized myalgia (48.8%), fatigue (53.5%), anorexia (53.5%), facial flushing (23.3%), conjunctival congestion (11.6%), skin rashes (58.1%) and lymphadenopathy (23.3%). Eschar (97.7%) was quite common in patients, which provided doctors with a luminous clue for diagnosis of scrub typhus. Thrombocytopenia was seen in 23.1% of patients, and three patients (7.0%) had bronchopneumonia. There was no death report in Shandong Province during the study period. The present study provides beneficial data for clinical, serological, and molecular diagnosis of scrub typhus infections, and also provides foundations for subsequent studies. Copyright © 2015 Elsevier B.V. All rights reserved.

Determinants of antibiotic prescription in paediatric patients: The case of two hospitals in Maputo, Mozambique

Directory of Open Access Journals (Sweden)

L G S Monteiro

2017-10-01

Full Text Available Background. The need for healthcare in paediatric patients is often due to respiratory diseases, acute diarrhoea and viral fever, which suggests a limited need for the use of antibiotics. Objectives. To identify the determinants of antibiotic prescription in hospitalised paediatric patients in Mozambique. Methods. A cross-sectional study was conducted between January and June 2015. A total of 454 medical prescriptions and clinical records of children aged 0 - 14 years from Hospital Central de Maputo (HCM and Hospital Geral de Mavalane (HGM were analysed. Results. Antibiotics were used in 97.6% of the patients, with no significant differences (p>0.05 in the prescription rates of the hospitals. The most commonly used antibiotics were beta-lactams (57.3%, aminoglycosides (28.3% and co-trimoxazole (9.4%. Antibiotics were prescribed in all cases of bronchopneumonia, fever, sepsis and acute gastroenteritis. For malaria and undefined diagnoses, antibiotics were prescribed 97.8% and 99.3% of cases, respectively. It was clear that most severe clinical conditions (odds ratio (OR 9.06; 1.13 - 12.14 and age <5 years (OR 5.47;1.54 - 7.60 were treated with antibiotics. Conclusion. The prescription of antibiotics for paediatric patients at both HCM and HGM was largely influenced by patients’ clinical condition and age. It showed that physicians used an empirical approach, in the absence of laboratory tests, often leading to unnecessary antibiotic treatments with negative causative effects. Physicians should be encouraged to use an evidence-based approach for managing the cases correctly.

The host defense peptide beta-defensin 1 confers protection against Bordetella pertussis in newborn piglets.

Science.gov (United States)

Elahi, Shokrollah; Buchanan, Rachelle M; Attah-Poku, Sam; Townsend, Hugh G G; Babiuk, Lorne A; Gerdts, Volker

2006-04-01

Innate immunity plays an important role in protection against respiratory infections in humans and animals. Host defense peptides such as beta-defensins represent major components of innate immunity. We recently developed a novel porcine model of pertussis, an important respiratory disease of young children and infants worldwide. Here, we investigated the role of porcine beta-defensin 1 (pBD-1), a porcine defensin homologue of human beta-defensin 2, in conferring protection against respiratory infection with Bordetella pertussis. In this model, newborn piglets were fully susceptible to infection and developed severe bronchopneumonia. In contrast, piglets older than 4 weeks of age were protected against infection with B. pertussis. Protection was associated with the expression of pBD-1 in the upper respiratory tract. In fact, pBD-1 expression was developmentally regulated, and the absence of pBD-1 was thought to contribute to the increased susceptibility of newborn piglets to infection with B. pertussis. Bronchoalveolar lavage specimens collected from older animals as well as chemically synthesized pBD-1 displayed strong antimicrobial activity against B. pertussis in vitro. Furthermore, in vivo treatment of newborn piglets with only 500 mug pBD-1 at the time of challenge conferred protection against infection with B. pertussis. Interestingly, pBD-1 displayed no bactericidal activity in vitro against Bordetella bronchiseptica, a closely related natural pathogen of pigs. Our results demonstrate that host defense peptides play an important role in protection against pertussis and are essential in modulating innate immune responses against respiratory infections.

Comparison of Passively Transferred Antibodies in Bighorn and Domestic Lambs Reveals One Factor in Differential Susceptibility of These Species to Mannheimia haemolytica-Induced Pneumonia ▿

Science.gov (United States)

Herndon, Caroline N.; Shanthalingam, Sudarvili; Knowles, Donald P.; Call, Douglas R.; Srikumaran, Subramaniam

2011-01-01

Mannheimia haemolytica consistently causes fatal bronchopneumonia in bighorn sheep (BHS; Ovis canadensis) under natural and experimental conditions. Leukotoxin is the primary virulence factor of this organism. BHS are more susceptible to developing fatal pneumonia than the related species Ovis aries (domestic sheep [DS]). In BHS herds affected by pneumonia, lamb recruitment is severely impaired for years subsequent to an outbreak. We hypothesized that a lack of maternally derived antibodies (Abs) against M. haemolytica provides an immunologic basis for enhanced susceptibility of BH lambs to population-limiting pneumonia. Therefore, the objective of this study was to determine the titers of Abs directed against M. haemolytica in the sera of BH and domestic lambs at birth through 12 weeks of age. Results revealed that BH lambs had approximately 18-fold lower titers of Ab against surface antigens of M. haemolytica and approximately 20-fold lower titers of leukotoxin-neutralizing Abs than domestic lambs. The titers of leukotoxin-neutralizing Abs in the serum and colostrum samples of BH ewes were approximately 157- and 50-fold lower than those for domestic ewes, respectively. Comparatively, the higher titers of parainfluenza 3 virus-neutralizing Abs in the BH lambs ruled out the possibility that these BHS had an impaired ability to passively transfer Abs to their lambs. These results suggest that lower levels of leukotoxin-neutralizing Abs in the sera of BH ewes, and resultant low Ab titers in their lambs, may be a critical factor in the poor lamb recruitment in herds affected by pneumonia. PMID:21613459

Comparison of passively transferred antibodies in bighorn and domestic lambs reveals one factor in differential susceptibility of these species to Mannheimia haemolytica-induced pneumonia.

Science.gov (United States)

Herndon, Caroline N; Shanthalingam, Sudarvili; Knowles, Donald P; Call, Douglas R; Srikumaran, Subramaniam

2011-07-01

Mannheimia haemolytica consistently causes fatal bronchopneumonia in bighorn sheep (BHS; Ovis canadensis) under natural and experimental conditions. Leukotoxin is the primary virulence factor of this organism. BHS are more susceptible to developing fatal pneumonia than the related species Ovis aries (domestic sheep [DS]). In BHS herds affected by pneumonia, lamb recruitment is severely impaired for years subsequent to an outbreak. We hypothesized that a lack of maternally derived antibodies (Abs) against M. haemolytica provides an immunologic basis for enhanced susceptibility of BH lambs to population-limiting pneumonia. Therefore, the objective of this study was to determine the titers of Abs directed against M. haemolytica in the sera of BH and domestic lambs at birth through 12 weeks of age. Results revealed that BH lambs had approximately 18-fold lower titers of Ab against surface antigens of M. haemolytica and approximately 20-fold lower titers of leukotoxin-neutralizing Abs than domestic lambs. The titers of leukotoxin-neutralizing Abs in the serum and colostrum samples of BH ewes were approximately 157- and 50-fold lower than those for domestic ewes, respectively. Comparatively, the higher titers of parainfluenza 3 virus-neutralizing Abs in the BH lambs ruled out the possibility that these BHS had an impaired ability to passively transfer Abs to their lambs. These results suggest that lower levels of leukotoxin-neutralizing Abs in the sera of BH ewes, and resultant low Ab titers in their lambs, may be a critical factor in the poor lamb recruitment in herds affected by pneumonia.

Development and characterization of a caprine aerosol infection model of melioidosis.

Directory of Open Access Journals (Sweden)

Carl Soffler

Full Text Available Infection with Burkholderia pseudomallei causes the disease melioidosis, which often presents as a serious suppurative infection that is typically fatal without intensive treatment and is a significant emerging infectious disease in Southeast Asia. Despite intensive research there is still much that remains unknown about melioidosis pathogenesis. New animal models of melioidosis are needed to examine novel aspects of pathogenesis as well as for the evaluation of novel therapeutics. The objective of the work presented here was to develop a subacute to chronic caprine model of melioidosis and to characterize the progression of disease with respect to clinical presentation, hematology, clinical microbiology, thoracic radiography, and gross and microscopic pathology. Disease was produced in all animals following an intratracheal aerosol of 10(4 CFU delivered, with variable clinical manifestations indicative of subacute and chronic disease. Bronchointerstitial pneumonia was apparent microscopically by day 2 and radiographically and grossly apparent by day 7 post infection (PI. Early lesions of bronchopneumonia soon progressed to more severe bronchointerstitial pneumonia with pyogranuloma formation. Extrapulmonary dissemination appeared to be a function of pyogranuloma invasion of pulmonary vasculature, which peaked around day 7 PI. Histopathology indicated that leukocytoclastic vasculitis was the central step in dissemination of B. pseudomallei from the lungs as well as in the establishment of new lesions. While higher doses of organism in goats can produce acute fatal disease, the dose investigated and resulting disease had many similarities to human melioidosis and may warrant further development to provide a model for the study of both natural and bioterrorism associated disease.

Filaroidosis infection in an immunocompetent adult dog from France

Directory of Open Access Journals (Sweden)

Cervone M.

2018-03-01

Full Text Available A dog from Paris (France was referred with a 2-week history of dry cough, intermittent acute onset of dyspnoea, and acute abdominal pain. A generalised bronchoalveolar infiltrate with a patchy distribution was observed at chest x-rays and computed tomography (CT scans. Negative results were obtained through several faecal examinations for cardiorespiratory nematodes by using the Baermann technique and at two blood analysis with a commercially available test for the detection of A. vasorum antigen (the first one at the first visit and second one at the control visit, one month later. PCR methods for the identification of A. vasorum and C. vulpis were also accomplished. At the control visit, nematode L1s were found during direct microscopic examination of bronchoalveolar lavage fluid (BALF. Thus, a different antigen-based assay for the detection of A. vasorum was performed with a positive result. Moreover, based on morphology, isolated larvae were identified as Filaroides hirthi. The dog was treated with fenbendazole (50 mg/kg per os once daily for two consecutive weeks. After five months, the dog was referred again for the intermittent acute onset of dyspnoea and was found to be still positive for F. hirthi larvae at BALF examination. A 15-day treatment regimen with fenbendazole in combination with three subcutaneous injections of ivermectin (0.4 mg/kg, once every two weeks, was then performed. No larvae were detected at two BALF microscopical examinations performed one month apart. Results from this case report underline the importance of including F. hirthi infections in the differential diagnosis of dog bronchopneumonia.

Genomic analysis of influenza A virus from captive wild boars in Brazil reveals a human-like H1N2 influenza virus.

Science.gov (United States)

Biondo, Natalha; Schaefer, Rejane; Gava, Danielle; Cantão, Mauricio E; Silveira, Simone; Mores, Marcos A Z; Ciacci-Zanella, Janice R; Barcellos, David E S N

2014-01-10

Influenza is a viral disease that affects human and several animal species. In Brazil, H1N1, H3N2 and 2009 pandemic H1N1 A(H1N1)pdm09 influenza A viruses (IAV) circulate in domestic swine herds. Wild boars are also susceptible to IAV infection but in Brazil until this moment there are no reports of IAV infection in wild boars or in captive wild boars populations. Herein the occurrence of IAV in captive wild boars with the presence of lung consolidation lesions during slaughter was investigated. Lung samples were screened by RT-PCR for IAV detection. IAV positive samples were further analyzed by quantitative real-time PCR (qRRT-PCR), virus isolation, genomic sequencing, histopathology and immunohistochemistry (IHC). Eleven out of 60 lungs (18.3%) were positive for IAV by RT-PCR and seven out of the eleven were also positive for A(H1N1)pdm09 by qRRT-PCR. Chronic diffuse bronchopneumonia was observed in all samples and IHC analysis was negative for influenza A antigen. Full genes segments of H1N2 IAV were sequenced using Illumina's genome analyzer platform (MiSeq). The genomic analysis revealed that the HA and NA genes clustered with IAVs of the human lineage and the six internal genes were derived from the H1N1pdm09 IAV. This is the first report of a reassortant human-like H1N2 influenza virus infection in captive wild boars in Brazil and indicates the need to monitor IAV evolution in Suidae populations. Copyright © 2013 Elsevier B.V. All rights reserved.

[Satisfactory evolution of a patient diagnosed in childhood with Bruton's disease].

Science.gov (United States)

Román Jiménez, María Guadalupe; Yamazaki Nakashimada, Marco Antonio; Blancas Galicia, Lizbeth

2010-01-01

Bruton's agammaglobulinemia is a primary immunodeficiency with a disease onset during the first months of age, when the maternal serum immunoglobulin levels decrease. It is characterized by recurrent infections and agammaglobulinemia. We report the case of a 6-year-old male patient with third-degree consanguinity, product of a third pregnancy and complete immunization scheme. He had a history of oral candidiasis at the age of 3 months, chicken pox at the age of 7 months, and two episodes of complicated bronchopneumonia at the age of 1 year and 6 years. He was admitted to the hospital because of fever and cough. Examination of the chest showed rales and right basilar hypoventilation, and a blood cell count revealed leukocytosis and neutrophilia. The diagnosis of pneumonia was made. He was treated with IV antibiotics. Serum immunoglobulins were reported to be low (IgM 55 mg/dL, IgA 0.9 mg/dL, and IgG 199 mg/dL). With these findings the clinical diagnosis of X-linked agammaglobulinemia (ALX) was concluded. A molecular test was performed fining a BTK gene confirming the diagnosis of Bruton's disease. Therapy with intravenous IgG was started every 21 days. During his evolution, he presented three episodes of rhinosinusitis, one of suppurative otitis media, and four events of pneumonia that required 37 days of hospitalization. After hospital discharge, the patient was free of infections and he returned to his daily activities. In cases of recurrent and severe respiratory infections in children, we must consider primary immunodeficiency disease in the differential diagnosis, mainly antibiotic deficiency. Early diagnosis and treatment improves the survival and quality of life in these patients.

Lungworm seroprevalence in free-ranging harbour seals and molecular characterisation of marine mammal MSP

Directory of Open Access Journals (Sweden)

Sophia Arlena Ulrich

2016-04-01

Full Text Available Harbour seals (Phoca vitulina are frequently infected with the lungworms Otostrongylus circumlitus and Parafilaroides gymnurus. The infection is often accompanied by secondary bacterial infections and can cause severe bronchopneumonia and even death in affected animals. Hitherto, the detection of lungworm infections was based on post mortem investigations from animals collected within stranding networks and a valid detection method for live free-ranging harbour seals was not available. Recently, an ELISA was developed for detecting lungworm antibodies in harbour seal serum, using major sperm protein (MSP of the bovine lungworm, Dictyocaulus viviparus as recombinant diagnostic antigen. To determine lungworm seroprevalence in free-ranging harbour seals, serum was taken from four different seal age groups (n = 313 resulting in an overall prevalence of 17.9% (18.9% of males, 16.7% of females. 0.7% of harbour seals up to six weeks of age were seropositive, as were 89% of seals between six weeks and six months, 53.6% between six and 18 months and 24.2% of seals over 18 months of age. In the 18 months and over age group, seropositive animals showed statistically significant reductions in body weight (P = 0.003 and length (P < 0.001. Sera from lungworm infected harbour seals in rehabilitation (n = 6 revealed that duration of antibody persistence may be similar to that of lungworm infected cattle, but further studies are needed to confirm this. Phylogenetic analyses of MSP sequences of different marine and terrestrial mammal parasitic nematodes revealed that lungworm MSP of the genus Dictyocaulus (superfamily Trichostrongyloidea is more closely related to metastrongylid marine mammal lungworms than to trichostrongylid nematodes of terrestrial hosts.

Analysis of perfusion defects by causes other than acute pulmonary thromboembolism on contrast-enhanced dual-energy CT in consecutive 537 patients

International Nuclear Information System (INIS)

Kim, Bo Hyun; Seo, Joon Beom; Chae, Eun Jin; Lee, Hyun Joo; Hwang, Hye Jeon; Lim, Chaehun

2012-01-01

Objective: To assess causes, incidence and patterns of perfusion defects (PDs) on dual-energy perfusion CT angiography (DECTA) in clinically suspected acute pulmonary thromboembolisms (PTE). Materials and methods: Consecutive 537 patients who underwent DECTA for suspicion of PTE were retrospectively reviewed. After excluding patients with possible PTE or unsatisfactory perfusion map quality, 299 patients with 1697 lobes were included. The DECTA (Somatom Definition, Siemens) was performed at 140 kV and 80 kV. Color-coded perfusion images were obtained with a lung PBV application of the workstation software (Syngo Dual Energy). The presence, incidence, three patterns of PDs (wedge-shaped, heterogeneous, and regionally homogeneous), pulmonary diseases, and the matchedness between the PD and the disease extent were studied. Results: 315 of 1697 lobes (18.6%) in 156 of 299 patients (81.3%) showed PDs. Among them, 51 (3%), 257 (15.1%), and 7 (0.4%) lobes had PDs due to vascular, nonvascular, and unidentifiable causes, respectively. Vascular causes include: pulmonary arterial (PA) hypertension (0.7%), extrinsic occlusion of PA by fibrosis (0.6%), PA hypoplasia (0.6%), vasculitis (0.5%), cancer mass compressing PA, venous occlusion, AVM, and pulmonary angiosarcoma. Most of PDs were wedge-shaped and well-matched. Nonvascular causes include: mosaic attenuation (4.1%), emphysema (3.2%), interstitial fibrosis (1.6%), bronchitis (1.4%), GGO (1.2%), cellular bronchiolitis (1%), bronchiectasis, airway obstruction, compensaroty lung hyperinflation, air trapping, cor-pulmonale, bronchopneumonia, physiologic decreased ventilation, and segmental bronchial atresia. Most of PDs showed heterogeneous pattern and were not matched. Conclusions: Various vascular and nonvascular diseases cause PDs on DECTA. Each disease shows different pattern of PD depending on pathophysiology and physiologic compensation.

[Clinical studies of flomoxef in the field of pediatrics].

Science.gov (United States)

Ito, S; Mayumi, M; Mikawa, H

1987-08-01

Flomoxef (FMOX, 6315-S), a newly synthesized antibiotic which belongs to the oxacephem group, was clinically evaluated for its efficacy and safety in 17 patients with ages ranging from 1 month to 9 year-8-month who had bacterial infections. The results obtained were summarized as follows. 1. A pharmacokinetic study following 20 mg/kg FMOX administration by intravenous bolus injection showed that the half-life of FMOX (beta phase) was 39.8 minutes and the urinary excretion of FMOX in the first 6 hours was 76.5%. 2. FMOX was administered to 3 patients with pneumonia, 8 patients with bronchopneumonia, 2 patients with tonsillitis, 2 patients with pyelonephritis, one patient each with cervical lymphadenitis, and pustulosis associated with severe varicella at daily dosage levels of 61.9 approximately 87.2 mg/kg, divided into 3 or 4 administrations by intravenous bolus injection or by 30 minutes drip infusion. The clinical results of these 17 patients were as follows; excellent: 14 patients, good: 2 patients, poor: 1 patient. The efficacy rate was 94.1%. 3. No clinical adverse reaction was observed in any of the 17 patients. Neutropenia, eosinophilia, a slight elevation of GPT and slight elevations of GOT & GPT were observed in 1, 1, 1, and 2 patients, respectively. No abnormality in coagulation system was observed in any of 10 evaluable patients. 4. MICs of FMOX against 13 strains isolated from patients were as follows. MIC against 2 out of 3 strains of Streptococcus pneumoniae was 0.20 micrograms/ml and that of the remaining 1 strain was 0.39 micrograms/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Pediatric visceral leishmaniasis in Albania: a retrospective analysis of 1,210 consecutive hospitalized patients (1995-2009.

Directory of Open Access Journals (Sweden)

Raida Petrela

Full Text Available BACKGROUND: Little information is available about infantile visceral leishmaniasis (VL in Albania as regards incidence, diagnosis and management of the disease. METHODOLOGY/PRINCIPAL FINDINGS: Demographic data, clinical and laboratory features and therapeutic findings were considered in children admitted to University Hospital of Tirana from 1995 to 2009, and diagnosed as having VL. The diagnosis was based on bone-marrow microscopy/culture in 77.5% of patients, serology in 16.1%, and ex juvantibus in 6.4%. A total of 1,210 children were considered, of whom 74% came from urbanized areas. All patients were in the age range 0-14 years, with a median of 4 years. Hepatosplenomegaly was recorded in 100%, fever in 95.4% and moderate to severe anemia in 88% of cases. Concomitant conditions were frequent: 84% had bronchopneumonia; diarrhea was present in 27%, with acute manifestations in 5%; 3% had salmonellosis. First-line therapy was meglumine antimoniate for all patients, given at the standard Sb(v dosage of 20 mg/kg/day for 21 to 28 days. Two children died under treatment, one of sepsis, the other of acute renal impairment. There were no cases of primary unresponsiveness to treatment, and only 8 (0.67% relapsed within 6-12 months after therapy. These patients have been re-treated with liposomal amphotericin B, with successful cure. CONCLUSIONS: Visceral leishmaniasis in pediatric age is relatively frequent in Albania; therefore an improvement is warranted of a disease-specific surveillance system in this country, especially as regards diagnosis. Despite recent reports on decreased responses to antimonial drugs of patients with Mediterranean VL, meglumine antimoniate treatment appears to be still highly effective in Albania.

A SUBCHRONIC INHALATION STUDY OF FISCHER 344 RATS EXPOSED TO 0, 0.4, 1.4 OR 4.0 PPM ACROLEIN

International Nuclear Information System (INIS)

KUTZMAN, R.S.

1981-01-01

Fischer 344 rats were exposed to 0.0, 0.4, 1.4, or 4.0 ppm acrolein for 62 days. The major objective of the study was to relate the results of a series of pulmonary function tests to biochemical and pathological alterations observed in the lung. Cytological and reproductive potential endpoints were also assessed after acrolein exposure. Rats were exposed to acrolein for 6 hours/day, 5 days/week for 62 days. Mortality was observed only in the 4.0 ppm chamber where 32 of 57 exposed males died; however, none of the 8 exposed females died. Most of the mortality occurred within the first 10 exposure days. Histologic examination indicated that the animals died of acute bronchopneumonia. The surviving males and females exposed to 4.0 ppm acrolein gained weight at a significantly slower rate than control animals. The growth of both sexes in the 0.4 and 1.4 ppm groups was similar to that of their respective controls. Histopathologic examination of animals after 62 days of exposure revealed bronchiolar epithelial necrosis and sloughing, bronchiolar edema with macrophages, and focal pulmonary edema in the 4.0 ppm group. These lesions were, in some cases, associated with edema of the trachea and peribronchial lymph nodes, and acute rhinitis which indicated an upper respiratory tract effect of acrolein. Of particular interest was the variability of response between rats in the 4.0 ppm group, some not affected at all while others were moderately affected. Intragroup variability in toxicity was also apparent in the 1.4 ppm exposure group where only 3 of 31 animals examined had lesions directly related to acrolein exposure. Extra respiratory organs appeared unaffected

Mycoplasma ovipneumoniae can predispose bighorn sheep to fatal Mannheimia haemolytica pneumonia.

Science.gov (United States)

Dassanayake, Rohana P; Shanthalingam, Sudarvili; Herndon, Caroline N; Subramaniam, Renuka; Lawrence, Paulraj K; Bavananthasivam, Jegarubee; Cassirer, E Frances; Haldorson, Gary J; Foreyt, William J; Rurangirwa, Fred R; Knowles, Donald P; Besser, Thomas E; Srikumaran, Subramaniam

2010-10-26

Mycoplasma ovipneumoniae has been isolated from the lungs of pneumonic bighorn sheep (BHS). However experimental reproduction of fatal pneumonia in BHS with M. ovipneumoniae was not successful. Therefore the specific role, if any, of M. ovipneumoniae in BHS pneumonia is unclear. The objective of this study was to determine whether M. ovipneumoniae alone causes fatal pneumonia in BHS, or predisposes them to infection by Mannheimia haemolytica. We chose M. haemolytica for this study because of its isolation from pneumonic BHS, and its consistent ability to cause fatal pneumonia under experimental conditions. Since in vitro culture could attenuate virulence of M. ovipneumoniae, we used ceftiofur-treated lung homogenates from pneumonic BHS lambs or nasopharyngeal washings from M. ovipneumoniae-positive domestic sheep (DS) as the source of M. ovipneumoniae. Two adult BHS were inoculated intranasally with lung homogenates while two others received nasopharyngeal washings from DS. All BHS developed clinical signs of respiratory infection, but only one BHS died. The dead BHS had carried leukotoxin-positive M. haemolytica in the nasopharynx before the onset of this study. It is likely that M. ovipneumoniae colonization predisposed this BHS to fatal infection with the M. haemolytica already present in this animal. The remaining three BHS developed pneumonia and died 1-5 days following intranasal inoculation with M. haemolytica. On necropsy, lungs of all four BHS showed lesions characteristic of bronchopneumonia. M. haemolytica and M. ovipneumoniae were isolated from the lungs. These results suggest that M. ovipneumoniae alone may not cause fatal pneumonia in BHS, but can predispose them to fatal pneumonia due to M. haemolytica infection. Copyright © 2010 Elsevier B.V. All rights reserved.

Antimicrobial susceptibility, serotypes and genotypes of Pasteurella multocida isolates associated with swine pneumonia in Taiwan.

Science.gov (United States)

Yeh, Jih-Ching; Lo, Dan-Yuan; Chang, Shao-Kuang; Chou, Chi-Chung; Kuo, Hung-Chih

2017-09-21

Pasteurella multocida (PM) can cause progressive atrophic rhinitis and suppurative bronchopneumonia in pigs. The present study performed antimicrobial susceptibility testing and serotype and genotype identification on the 62 PM strains isolated from the lungs of diseased pigs with respiratory symptoms. Antimicrobial susceptibility testing examined 13 antimicrobial agents (amoxicillin, cefazolin, doxycycline, flumequine, enrofloxacin, florfenicol, kanamycin, lincomycin, Linco-Spectin (lincomycin and spectinomycin), erythromycin, tylosin, tilmicosin and tiamulin). Antimicrobial resistance ratios were over 40% in all of the antimicrobial agents except for cefazolin. The highest levels of resistance (100%) were found for kanamycin, erythromycin and tylosin. The majority of isolated strains was serotype D:L6 (n=35) followed by A:L3 (n=17). Comparison of the antimicrobial resistance levels between the two serotypes showed that the antimicrobial resistance rates were higher in D:L6 than in A:L3 for all the tested antimicrobials except for tylosin and tilmicosin. For PM with erm (B), erm (T) or erm (42), the results showed no significant difference compared with non-resistance gene strains in phenotype. Pulsed-field gel electrophoresis genotyping using Apa I restriction digestion of the genomic DNA demonstrated that there were 17 distinct clusters with a similarity of 85% or more, and the genotyping result was similar to that of serotyping. The results of the present study demonstrated that the PM isolated from diseased pigs in Taiwan was resistant to multiple antimicrobials, and the distribution of antimicrobial resistance was associated with pulsotype and serotype. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Forensic intoxication with clobazam: HPLC/DAD/MSD analysis.

Science.gov (United States)

Proença, Paula; Teixeira, Helena; Pinheiro, João; Marques, Estela P; Vieira, Duarte Nuno

2004-07-16

Clobazam (Castillium, Urbanil), a benzodiazepine often used as an anxiolytic and in the treatment of epilepsy, is considered a relatively safe drug. The authors present a fatal case with a 49-year-old female, found dead at home. She had been undergoing psychiatric treatment and was a chronic alcoholic. The autopsy findings were unremarkable, except for multivisceral congestion, steatosis and a small piece of a plastic blister pack in the stomach. Bronchopneumonia, bronchitis and bronchiolitis were also diagnosed. Anhigh-performance liquid chromatography (HPLC)/diode array detector (DAD)/mass spectrometry detection (MSD) with electrospray method was developed in order to detect, confirm and quantify clobazam in the post-mortem samples. In the chromatographic separation, a reversed-phase column C18 (2.1 x 150 mm, 3.5 microm) was used with a mobile phase of methanol and water, at a 0.25 ml/min flow rate. Carbonate buffer (pH 10.5) and 20 microl of prazepam (100 microg/ml) as internal standard were added to the samples. A simple and reliable liquid-liquid extraction method for the determination of clobazam in post-mortem samples was described. Calibration curves for clobazam were performed in blood, achieving linearity between 0.01 and 10 microg/ml and a detection limit of 1.0 ng/ml. The clobazam concentration found in post-mortem blood was 3.9 microg/ml, higher than the reported therapeutic concentration (0.1-0.4 microg/ml). The simultaneous acquisition by photodiode array detection and mass spectrometry detection results allowed benzodiazepines to be identified with sufficient certainty. An examination of all the available information suggested that death resulted from respiratory depression due to clobazam toxicity.

Human Metapneumovirus Infection in Jordanian Children: Epidemiology and Risk Factors for Severe Disease

Science.gov (United States)

Schuster, Jennifer E.; Khuri-Bulos, Najwa; Faouri, Samir; Shehabi, Asem; Johnson, Monika; Wang, Li; Fonnesbeck, Christopher; Williams, John V.; Halasa, Natasha

2016-01-01

Background Human metapneumovirus (HMPV) is a leading cause of acute respiratory tract infection (ARTI) in young children. Our objectives were to define HMPV epidemiology and circulating strains and determine markers of severe disease in Jordanian children. Methods We conducted a prospective study March 16, 2010-March 31, 2013 using quantitative RT-PCR to determine the frequency of HMPV infection among children <2 years old admitted with fever and/or acute respiratory illness to a major government hospital in Amman, Jordan. Results HMPV was present in 273/3168 (8.6%) of children presenting with ARTI. HMPV A2, B1, and B2, but not A1, were detected during the 3-year period. HMPV-infected children were older and more likely to be diagnosed with bronchopneumonia than HMPV-negative children. HMPV-infected children with lower respiratory tract infection (LRTI) had higher rates of cough and shortness of breath than children with LRTI infected with other or no identifiable viruses. Symptoms and severity were not different between children with HMPV only compared with HMPV co-infection. Children with HMPV subgroup A infection were more likely to require supplemental oxygen. In a multivariate analysis, HMPV subgroup A and age <6 months were independently associated with supplemental oxygen requirement. Conclusions HMPV is a leading cause of acute respiratory tract disease in Jordanian children <2 years old. HMPV A and young age were associated with severe disease. Ninety percent of HMPV-infected hospitalized children were full-term and otherwise healthy, in contrast to high-income nations; thus, factors contributing to disease severity likely vary depending on geographic and resource differences. PMID:26372450

Autopsy-proven causes of death in lungs of patients immunocompromised by secondary interstitial pneumonia Causas de óbito por pneumonia intersticial secundária em autópsias pulmonares de pacientes imunocomprometidos

Directory of Open Access Journals (Sweden)

Alberto Antonio Terrabuio Junior

2007-02-01

Full Text Available PURPOSE: To present the more frequent associations found in autopsies of immunocompromised patients who developed secondary interstitial pneumonia as well as the risk of death (odds ratio in having specific secondary interstitial pneumonia according to the cause of immunocompromise. METHOD: From January 1994 to March 2004, 17,000 autopsies were performed at Hospital das Clínicas, São Paulo University Medical School. After examining the pathology report review, we selected 558 of these autopsies (3.28% from patients aged 15 years or more with primary underlying diseases who developed radiologically diffuse infiltrates of the lung during their hospital course and died after secondary interstitial pneumonia (bronchopneumonia, lobar pneumonia, interstitial pneumonia, diffuse alveolar damage, pulmonary recurrence of underlying disease, drug-induced lung disease, cardiogenic pulmonary edema, or pulmonary embolism. Histology slides were reviewed by experienced pathologists to confirm or not the presence of secondary interstitial pneumonia. Statistical analysis included the Fisher exact test to verify any association between histopathology and the cause of immunocompromise; a logistic regression was used to predict the risk of death for specific histological findings for each of the independent variables in the model. RESULTS: Secondary interstitial pneumonia was histologically represented by diffuse interstitial pneumonitis ranging from mild nonspecific findings (n = 213 to a pattern of diffuse alveolar damage (n = 273. The principal causes of immunocompromise in patients with diffuse alveolar damage were sepsis (136 cases, neoplasia (113 cases, diabetes mellitus (37 cases, and transplantation (48 cases. A high risk of death by pulmonary edema was found for patients with carcinoma of colon. Similarly, in patients with lung cancer or cachexia, A high risk of death by bronchopneumonia (OR = 3.6; OR = 2.6, respectively was found. Pulmonary

Repouso da junção neuromuscular no tratamento de crises miastênicas e colinérgicas Management of the myasthenic and cholinergic crisis by neuromuscular junction rest

Directory of Open Access Journals (Sweden)

J. Lamartine de Assis

1968-06-01

second group, in addition to this management, were submitted to prolonged curarization by galamine (Flaxedil by intramuscular injection; all of them presented an initial curare supersensitivity which always decreased shortly. In both methods the reinstitution of the drug therapy was progressive. The respirator weanned of progressively and the patients were kept under observation for adequate ventilation. The doses were variable but subsequent doses of antimyasthenic medications were determined by clinical findings and response to the tensilon or prostigmine tests. The doses were increased or decreased accordingly in each individual case, rapid changes of drug doses to perfect adjustment being undesirable in this transition period. Partial or temporary remission occurred in some patients. Others were able to sustain satisfactory ventilation for a long period or definitively. Most of the crisis improved and most of the patients benefited from the therapeutic method of the neuromuscular junction rest. There was a remarkable reduction in the mortality rate from the crisis. One patient had a thymoma which was malignant; in spite of this the evolution of this case has been good after the treatment. Those patients who had immediate good response to the treatment of the crisis had a favorable fellow up, even a complete remission. Respiratory infections were very common in spite of all cares. Culture of tracheal secretions and wound exsudates were made. Bactericidal and broad-spectrum antibiotics were used, depending of the laboratory report cf patient's sensitivity. Physiotherapy besides other prophylactic measures was used against bronchopneumonia. Atelectasis was a common complication in the crisis and all efforts to prevent it were made, including daily clinical examination of pulmonary conditions, Vt,, blood pressure and bed side chest films. The routine use of atropine sulfate promoved inspissation of bronchial secretions, plugging of the bronchi, and attendant atelectasis

Evaluación clínica temprana del tratamiento de neumonías y bronconeumonías en Terapia Intensiva Cardiovascular / Early clinical assessment of pneumonia and bronchopneumonia treatment in a Cardiovascular Intensive Care Unit

Directory of Open Access Journals (Sweden)

Andrés M. Rodríguez Acosta

2015-08-01

Full Text Available Introducción: Las infecciones nosocomiales son frecuentes. La neumonía nosocomial es la segunda más común entre este tipo de infecciones y es la primera en la Unidad de Terapia Intensiva, donde alcanza una incidencia de 10 a 20 %.Objetivo: Determinar el efecto de la evaluación clínica evolutiva desde 48 - 72 horas de iniciado el tratamiento antimicrobiano.Método: Se realizó una investigación descriptiva, prospectiva de corte longitudinal, en 57 pacientes (muestreo incidental con diagnóstico de cardiopatía isquémica dolo-rosa, que desarrollaron neumonía o bronconeumonía nosocomial e ingresaron en la Unidad de Terapia Intensiva Cardiovascular del hospital “Dr. Celestino Hernández Ro-bau”, desde el 3 de enero al 31 de diciembre de 2013.Resultados: La categorización clínica inicial favoreció el diagnóstico de 50 neumonías y bronconeumonías precoces y 7 graves. La evaluación evolutiva desde las 48 - 72 ho-ras identificó la evolución no satisfactoria en 6 (12 % de las neumonías nosocomiales precoces y en 4 (57,1 % de las graves.Conclusiones: La evaluación clínica evolutiva temprana es útil para detectar la res-puesta al tratamiento antimicrobiano de las neumonías nosocomiales y actuar en consecuencia.

Tratamiento con azlocillin y amikacina en sepsis neonatal por staphylococcus haemolyticus multirresistente

Directory of Open Access Journals (Sweden)

María Espino Hernández

2000-03-01

Full Text Available El estafilococo coagulasa negativa es actualmente un importante patógeno nosocomial y agente causal de infección en el neonato. Cepas multirresistentes comúnmente aisladas de recién nacidos sometidos a cuidados intensivos dificultan la terapéutica, por lo que se hace necesario el empleo de combinaciones antibióticas que garanticen un efecto antibacteriano más eficiente. Se presentan los resultados obtenidos en un paciente con bronconeumonía adquirida por Staphylococcus haemolyticus multirresistente y que fue sometido a tratamiento combinado de azlocillin y amikacina. Se estudió el patrón de resistencia de la cepa para 30 antibióticos por métodos de difusión y dilución, así como la efectividad in vitro de la combinación antibiótica aplicada por el método del «tablero de ajedrez». Se observó en los resultados in vitro una marcada potencialización de la actividad aminoglucosídica por la presencia del antibiótico beta-lactámico, resultado que se correspondió con una excelente respuesta in vivo.Negative-coagulase Staphyloccocus, is at present time an important nosocomial pathogen and a causal agent of neonatal infection. Multirresistant strains commonly isolated from newborn under intensive care, make difficult treatment, so it is necessary use of antibiotic combination to assure a more efficient antibacterial effect. We present results obtained in a patient presenting with acquired bronchopneumonia from multirresistant Staphylococcus haemolyticus who received a combination of Azlocillin and Amikacin. Resistance pattern to this strain was studied by diffusion and dilution methods, as well as in vitro effectiveness of antibiotic combination, applied by "Chequerboard" method. In in vitro results, we found a significant potentiation of aminoglucoside activity by presence of Beta-lactamic antibiotic, result corresponding to an in vivo excellent response.

Abdomen agudo quirúrgico en el anciano

Directory of Open Access Journals (Sweden)

Jesús M Valdés Jiménez

2002-04-01

Full Text Available Se presenta un estudio descriptivo retrospectivo de 156 enfermos mayores de 65 años, con diagnóstico de abdomen agudo quirúrgico (AAQ, operados en el Hospital Clinicoquirúrgico «Manuel Fajardo» e ingresados en la Unidad de Cuidados Intermedios Polivalente, durante el trienio comprendido entre 1995 y 1998. Las causas más frecuentes del síndrome fueron la oclusión intestinal (58,9 %, la colecistitis aguda (13,5 % y la úlcera péptica gastroduodenal perforada (10,9 %. Las enfermedades asociadas de mayor prevalencia eran la cardiopatía isquémica (62,2 % y la hipertensión arterial (48,7 %. La mortalidad aumentó con el avance de la edad, y alcanzó el 70,4 % en los mayores de 85 años. Entre las complicaciones predominaron la infección de la herida quirúrgica (12,8 % y la bronconeumonía (5,8 %. La principal causa de muerte fue la sepsis (10,3 %A descriptive and retrospective study of 156 patients over 65 with diagnosis of acute surgical abdomen (ASA that were operated on at "Manuel Fajardo" Clinical and Surgical Hospital and admitted at the Polyvalent Intermediate Care Unit, from 1995 to 1998, was conducted. The most common causes of the syndrome were intestinal occlusion (58.9 %, acute cholecystitis (13.5 % and the gastroduodenal perforated peptic ulcer (10.9 %. The associated diseases of highest prevalence were ischemic heart disease (62.2 % and arterial hypertension (48.7 %. Mortality increased with age and amounted to 70.4 % in patients over 85. The infection of the surgical wound (12.8 % and bronchopneumonia (5.8% prevailed among the complications. Sepsis (10.3 % was the main cause of death

Traumatic brain injury in England and Wales: prospective audit of epidemiology, complications and standardised mortality

Science.gov (United States)

Lawrence, T; Bouamra, O; Woodford, M; Lecky, F; Hutchinson, P J

2016-01-01

Objectives To provide a comprehensive assessment of the management of traumatic brain injury (TBI) relating to epidemiology, complications and standardised mortality across specialist units. Design The Trauma Audit and Research Network collects data prospectively on patients suffering trauma across England and Wales. We analysed all data collected on patients with TBI between April 2014 and June 2015. Setting Data were collected on patients presenting to emergency departments across 187 hospitals including 26 with specialist neurosurgical services, incorporating factors previously identified in the Ps14 multivariate logistic regression (Ps14n) model multivariate TBI outcome prediction model. The frequency and timing of secondary transfer to neurosurgical centres was assessed. Results We identified 15 820 patients with TBI presenting to neurosurgical centres directly (6258), transferred from a district hospital to a neurosurgical centre (3682) and remaining in a district general hospital (5880). The commonest mechanisms of injury were falls in the elderly and road traffic collisions in the young, which were more likely to present in coma. In severe TBI (Glasgow Coma Score (GCS) ≤8), the median time from admission to imaging with CT scan is 0.5 hours. Median time to craniotomy from admission is 2.6 hours and median time to intracranial pressure monitoring is 3 hours. The most frequently documented complication of severe TBI is bronchopneumonia in 5% of patients. Risk-adjusted W scores derived from the Ps14n model indicate that no neurosurgical unit fell outside the 3 SD limits on a funnel plot. Conclusions We provide the first comprehensive report of the management of TBI in England and Wales, including data from all neurosurgical units. These data provide transparency and suggests equity of access to high-quality TBI management provided in England and Wales. PMID:27884843

Proteinosis alveolar pulmonar Pulmonary alveolar proteinosis

Directory of Open Access Journals (Sweden)

Concepción Sánchez Infante

2011-12-01

Full Text Available La proteinosis alveolar pulmonar es una enfermedad respiratoria crónica, caracterizada por alteración en el metabolismo del surfactante, lo que determina su acumulación anormal en el espacio alveolar. Es una enfermedad extremadamente rara. Se han reportado solamente 500 casos en la literatura. Se describió por primera vez en 1958. Se presenta un caso de proteinosis alveolar pulmonar en un lactante de 2 meses, con desnutrición proteico energética, que ingresa por dificultad respiratoria e hipoxemia, y, con imágenes radiológicas de tipo retículo-nodulillar, en vidrio deslustrado, en el cual se plantea inicialmente el diagnóstico de bronconeumonía. Ante la evolución desfavorable y no respuesta al tratamiento, se realizó un estudio para descartar enfermedades pulmonares crónicas. El paciente fallece y se confirma el diagnóstico por anatomía patológica. Se realiza una revisión del tema.The pulmonary alveolar proteinosis is a chronic respiratory disease characterized by surfactant metabolism alteration determining its abnormal accumulation in the alveolar space. It is a disease very rare and in literature only 500 cases have been reported; it was described for the first time in 1958. This is a case presentation of pulmonary alveolar proteinosis in an infant aged 2 months with energetic protein malnutrition admitted due to respiratory difficulty and hypoxemia and with radiologic images of the reticulonodulillary, in frosting glass, where initially is made the diagnosis of bronchopneumonia. In the face of unfavorable evolution and no response to treatment, a study was conducted to rule out chronic pulmonary diseases. Patient died confirming the diagnosis according to the pathologic anatomy. A review on subject is carried out.

Morbilidad geriátrica en el Hospital Provincial Clinicoquirúrgico Docente "Saturnino Lora" de Santiago de Cuba Geriatric morbidity in "Saturnino Lora" Provincial Clinical Surgical Teaching Hospital of Santiago de Cuba

Directory of Open Access Journals (Sweden)

Graciela Trinidad Tejera Ibarra

2012-12-01

Full Text Available Se realizó un estudio retrospectivo, descriptivo y transversal de 130 pacientes mayores de 65 años, seleccionados a través del método aleatorio simple durante su ingreso en la Sala de Geriatría del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, de junio a diciembre del 2011, con vistas a identificar las principales causas de morbilidad en estos ancianos. En la serie la mayoría de los integrantes correspondieron al sexo masculino, con predominio del grupo etario de 65-69 años, y se destacaron las enfermedades respiratorias como originarias de morbilidad, fundamentalmente la bronconeumonía, seguidas en menor frecuencia de las afecciones cardiovasculares y las neoplásicas, de las cuales sobresalieron, con un número superior de afectados, la hipertensión arterial y el cáncer de pulmón, respectivamente. Se calculó la tasa de prevalencia para expresar la morbilidad y como unidad de resumen estadístico se empleó el porcentaje.A retrospective, descriptive and cross-sectional study was conducted in 130 patients older than 65 years, selected through simple random method during their admission to the Geriatrics Department of "Saturnino Lora" Provincial Clinical Surgical Teaching Hospital of Santiago de Cuba, from June to December 2011, in order to identify the main causes of morbidity in these elderly. In the series most of the patients were male with prevalence of the age group of 65-69 years, and respiratory diseases as cause of morbidity, mainly bronchopneumonia, followed by a lesser frequency of cardiovascular and neoplastic diseases predominated, of them hypertension and lung cancer prevailed with a higher number of patients, respectively. Rate of prevalence was estimated to express the morbidity and as statistical summary unit, percentage was used.

[Prevalence and clinical characteristics of coronavirus NL63 infection in children hospitalized for acute lower respiratory tract infections in Changsha].

Science.gov (United States)

Zhang, Fei; Zhang, Bing; Xie, Zhi-Ping; Gao, Han-Chun; Zhao, Xin; Zhong, Li-Li; Zhou, Qiong-Hua; Hou, Yun-De; Duan, Zhao-Jun

2012-04-01

The main objective of this study was to explore the prevalence and clinical characteristics of human coronavirus NL63 infection in hospitalized children with acute lower respiratory tract infection (ALRTI) in Changsha. Nasopharyngeal aspirates (NPA) samples were collected from 1185 hospitalized children with ALRTI at the People's Hospital of Hunan province, between September 2008 and October 2010. Reverse transcriptase polymerase chain reaction (RT-PCR) was employed to screen for coronavirus NL63, which is a 255 bp fragment of a part of N gene. All positive amplification products were confirmed by sequencing and compared with those in GenBank. The overall frequency of coronavirus NL63 infection was 0.8%, 6 (60%) out of the coronavirus NL63 positive patients were detected in summer, 2 in autumn, 1 in spring and winter, respectively. The patients were from 2 months to two and a half years old. The clinical diagnosis was bronchopneumonia (60%), bronchiolitis (30%), and acute laryngotracheal bronchitis (10%). Four of the 10 cases had critical illness, 4 cases had underlying diseases, and 7 cases had mixed infection with other viruses. The homogeneity of coronavirus NL63 with those published in the GenBank at nucleotide levels was 97%-100%. Coronavirus NL63 infection exists in hospitalized children with acute lower respiratory tract infection in Changsha. Coronavirus NL63 infections are common in children under 3 years of age. There is significant difference in the infection rate between the boys and the girls: the boys had higher rate than the girls. The peak of prevalence of the coronavirus NL63 was in summer. A single genetic lineage of coronavirus NL63 was revealed in human subjects in Changsha. Coronavirus NL63 may also be one of the lower respiratory pathogen in China.

STREPTOCOCCUS PHOCAE IN MARINE MAMMALS OF NORTHEASTERN PACIFIC AND ARCTIC CANADA: A RETROSPECTIVE ANALYSIS OF 85 POSTMORTEM INVESTIGATIONS.

Science.gov (United States)

Taurisano, Nicole D; Butler, Brian P; Stone, Diana; Hariharan, Harry; Fields, Paul J; Ferguson, Hugh W; Haulena, Martin; Cotrell, Paul; Nielsen, Ole; Raverty, Stephen

2018-01-01

:  Streptococcus phocae is a pathogen of marine mammals, although its pathogenicity remains poorly understood. Recovery of this bacterium from asymptomatic carriers suggests that it is an opportunistic pathogen. We investigated the role of S. phocae in naturally occurring disease and its significance as a pathogen based on postmortem investigations. Between 2007 and 2012, 1,696 whole carcasses, tissue samples, or both were submitted from the northeastern Pacific and Arctic Canada for diagnostic testing. Streptococcus phocae was cultured from phocids ( n=66), otariids ( n=12), harbor porpoises ( Phocoena phocoena; n=5), and sea otters ( Enhydra lutris; n=2). Pathologic manifestations of S. phocae-associated disease included localized, as well as systemic, inflammatory lesions with common findings of suppurative bronchopneumonia ( n=17) and bacteremia ( n=27). Lung lesions were frequently culture-positive for S. phocae, suggesting commensal colonization of the oropharynx with subsequent opportunistic infection of the respiratory tract during tissue injury, coinfection, immunosuppression, or other debilitating conditions. The presence of a positive spleen culture, and interpretations at necropsy and histopathology, were used to determine the presence of S. phocae bacteremia. Less frequent lesions that were culture positive for S. phocae included abscesses ( n=9), meningitis ( n=7), and cellulitis ( n=1). The majority of cases with S. phocae lesions featured pre-existing conditions that presumably contributed to some degree of debilitation or immunosuppression, including emaciation ( n=29), liver mercury accumulation ( n=29), trauma ( n=22), severe pulmonary or cardiovascular nematodiasis ( n=9), concurrent bacterial or viral infections ( n=8), or sarcocystosis ( n=6). These findings suggest that S. phocae could be characterized as an opportunistic pathogen, associated with debilitating conditions in stranded and rehabilitating marine mammals. Wildlife investigators

Clinical features and phylogenetic analysis of Coxsackievirus A9 in Northern Taiwan in 2011

Directory of Open Access Journals (Sweden)

Huang Yi-Chuan

2013-01-01

Full Text Available Abstract Background Coxsackievirus A9 (CA9 was one of the most prevalent serotype of enteroviral infections in Taiwan in 2011. After several patient series were reported in the 1960s and 1970s, few studies have focused on the clinical manifestations of CA9 infections. Our study explores and deepens the current understanding of CA9. Methods We analyzed the clinical presentations of 100 culture-proven CA9-infected patients in 2011 by reviewing their medical records and depicted the CA9 phylogenetic tree. Results Of the 100 patients with culture-proven CA9 infections, the mean (SD age was 4.6 (3.4 years and the male to female ratio was 1.9. For clinical manifestations, 96 patients (96% had fever and the mean (SD duration of fever was 5.9 (3.4 days. Sixty one patients (61% developed a skin rash, and the predominant pattern was a generalized non-itchy maculopapular rash without vesicular changes. While most patients showed injected throat, oral ulcers were found in only 19 cases (19%, among whom, 6 were diagnosed as herpangina. Complicated cases included: aseptic meningitis (n=8, bronchopneumonia (n=6, acute cerebellitis (n=1, and polio-like syndrome (n=1. Phylogenetic analysis for current CA9 strains is closest to the CA9 isolate 27-YN-2008 from the border area of mainland China and Myanmar. Conclusions The most common feature of CA9 during the 2011 epidemic in Taiwan is generalized febrile exanthema rather than herpangina or hand, foot, and mouth disease. Given that prolonged fever and some complications are possible, caution should be advised in assessing patients as well as in predicting the clinical course.

Prevalence of DF508, G551D, G542X, and R553X mutations among cystic fibrosis patients in the North of Brazil

Directory of Open Access Journals (Sweden)

Araújo F.G. de

2005-01-01

Full Text Available Cystic fibrosis (CF is the most common genetic disease among Caucasians and is rare among sub-Saharan Africans. The Brazilian population is not ethnically homogeneous but it is the result of three-way ethnic admixture of Europeans, Africans and Amerindians in varying proportions, depending on the region. In the present study, we investigated 33 patients who had been diagnosed and are currently under treatment for CF at the University Hospital João de Barros Barreto, Belém, Pará State. The molecular analysis for G542X, G551D and R553X mutations was performed by PCR followed by RFLP using BstNI, HincII and MboI, respectively, in polyacrylamide gel eletrophoresis and stained with AgNO3. ThedeltaF508 mutation (a deletion of 3 bp was only analyzed by polyacrylamide gel electrophoresis and stained with AgNO3. Each sample was analyzed for regions of interest in the CFTR gene using amplified by PCR and specific primers. The deltaF508 and G551D mutations presented frequencies of 22.7 and 3%, respectively. In 74.3% of the remaining patients, none of the mutations investigated was found. The present study characterized in a sample of patients with an established clinical diagnosis of CF (asthma, repeated bronchopneumonia, disorders of nutritional status, etc. the most frequent mutation ( deltaF508 in the North region of Brazil and is also the first report of the G551D mutation. In spite of the wide spectrum of CF mutations and the heterogeneous ethnic origin of the Amazon population, the molecular diagnosis is a helpful additional tool for the diagnosis and treatment of CF patients.

Interaction between Mycoplasma hyopneumoniae and Swine Influenza Virus

Science.gov (United States)

Thacker, Eileen L.; Thacker, Brad J.; Janke, Bruce H.

2001-01-01

An experimental respiratory model was used to investigate the interaction between Mycoplasma hyopneumoniae and swine influenza virus (SIV) in the induction of pneumonia in susceptible swine. Previous studies demonstrated that M. hyopneumoniae, which produces a chronic bronchopneumonia in swine, potentiates a viral pneumonia induced by the porcine reproductive and respiratory syndrome virus (PRRSV). In this study, pigs were inoculated with M. hyopneumoniae 21 days prior to inoculation with SIV. Clinical disease as characterized by the severity of cough and fever was evaluated daily. Percentages of lung tissue with visual lesions and microscopic lesions were assessed upon necropsy at 3, 7, 14, and 21 days following SIV inoculation. Clinical observations revealed that pigs infected with both SIV and M. hyopneumoniae coughed significantly more than pigs inoculated with a single agent. Macroscopic pneumonia on necropsy at days 3 and 7 was greatest in both SIV-infected groups, with minimal levels of pneumonia in the M. hyopneumoniae-only-infected pigs. At 14 days post-SIV inoculation, pneumonia was significantly more severe in pigs infected with both pathogens. However, by 21 days postinoculation, the level of pneumonia in the dual-infected pigs was similar to that of the M. hyopneumoniae-only-infected group, and the pneumonia in the pigs inoculated with only SIV was nearly resolved. Microscopically, there was no apparent increase in the severity of pneumonia in pigs infected with both agents compared to that of single-agent-challenged pigs. The results of this study found that while pigs infected with both agents exhibited more severe clinical disease, the relationship between the two pathogens lacked the profound potentiation found with dual infection with M. hyopneumoniae and PRRSV. These findings demonstrate that the relationship between mycoplasmas and viruses varies with the individual agent. PMID:11427564

Traumatic brain injury in England and Wales: prospective audit of epidemiology, complications and standardised mortality.

Science.gov (United States)

Lawrence, T; Helmy, A; Bouamra, O; Woodford, M; Lecky, F; Hutchinson, P J

2016-11-24

To provide a comprehensive assessment of the management of traumatic brain injury (TBI) relating to epidemiology, complications and standardised mortality across specialist units. The Trauma Audit and Research Network collects data prospectively on patients suffering trauma across England and Wales. We analysed all data collected on patients with TBI between April 2014 and June 2015. Data were collected on patients presenting to emergency departments across 187 hospitals including 26 with specialist neurosurgical services, incorporating factors previously identified in the Ps14 multivariate logistic regression (Ps14 n ) model multivariate TBI outcome prediction model. The frequency and timing of secondary transfer to neurosurgical centres was assessed. We identified 15 820 patients with TBI presenting to neurosurgical centres directly (6258), transferred from a district hospital to a neurosurgical centre (3682) and remaining in a district general hospital (5880). The commonest mechanisms of injury were falls in the elderly and road traffic collisions in the young, which were more likely to present in coma. In severe TBI (Glasgow Coma Score (GCS) ≤8), the median time from admission to imaging with CT scan is 0.5 hours. Median time to craniotomy from admission is 2.6 hours and median time to intracranial pressure monitoring is 3 hours. The most frequently documented complication of severe TBI is bronchopneumonia in 5% of patients. Risk-adjusted W scores derived from the Ps14 n model indicate that no neurosurgical unit fell outside the 3 SD limits on a funnel plot. We provide the first comprehensive report of the management of TBI in England and Wales, including data from all neurosurgical units. These data provide transparency and suggests equity of access to high-quality TBI management provided in England and Wales. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Exposure of bighorn sheep to domestic goats colonized with Mycoplasma ovipneumoniae induces sub-lethal pneumonia.

Directory of Open Access Journals (Sweden)

Thomas E Besser

Full Text Available Bronchopneumonia is a population limiting disease of bighorn sheep (Ovis canadensis that has been associated with contact with domestic Caprinae. The disease is polymicrobial but is initiated by Mycoplasma ovipneumoniae, which is commonly carried by both domestic sheep (O. aries and goats (Capra aegagrus hircus. However, while previous bighorn sheep comingling studies with domestic sheep have resulted in nearly 100% pneumonia mortality, only sporadic occurrence of fatal pneumonia was reported from previous comingling studies with domestic goats. Here, we evaluated the ability of domestic goats of defined M. ovipneumoniae carriage status to induce pneumonia in comingled bighorn sheep.In experiment 1, three bighorn sheep naïve to M. ovipneumoniae developed non-fatal respiratory disease (coughing, nasal discharge following comingling with three naturally M. ovipneumoniae-colonized domestic goats. Gross and histological lesions of pneumonia, limited to small areas on the ventral and lateral edges of the anterior and middle lung lobes, were observed at necropsies conducted at the end of the experiment. A control group of three bighorn sheep from the same source housed in isolation during experiment 1 remained free of observed respiratory disease. In experiment 2, three bighorn sheep remained free of observed respiratory disease while comingled with three M. ovipneumoniae-free domestic goats. In experiment 3, introduction of a domestic goat-origin strain of M. ovipneumoniae to the same comingled goats and bighorn sheep used in experiment 2 resulted in clinical signs of respiratory disease (coughing, nasal discharge in both host species. At the end of experiment 3, gross and histological evidence of pneumonia similar to that observed in experiment 1 bighorn sheep was observed in both affected bighorn sheep and domestic goats.M. ovipneumoniae strains carried by domestic goats were transmitted to comingled bighorn sheep, triggering development of

Exposure of bighorn sheep to domestic goats colonized with Mycoplasma ovipneumoniae induces sub-lethal pneumonia.

Science.gov (United States)

Besser, Thomas E; Cassirer, E Frances; Potter, Kathleen A; Foreyt, William J

2017-01-01

Bronchopneumonia is a population limiting disease of bighorn sheep (Ovis canadensis) that has been associated with contact with domestic Caprinae. The disease is polymicrobial but is initiated by Mycoplasma ovipneumoniae, which is commonly carried by both domestic sheep (O. aries) and goats (Capra aegagrus hircus). However, while previous bighorn sheep comingling studies with domestic sheep have resulted in nearly 100% pneumonia mortality, only sporadic occurrence of fatal pneumonia was reported from previous comingling studies with domestic goats. Here, we evaluated the ability of domestic goats of defined M. ovipneumoniae carriage status to induce pneumonia in comingled bighorn sheep. In experiment 1, three bighorn sheep naïve to M. ovipneumoniae developed non-fatal respiratory disease (coughing, nasal discharge) following comingling with three naturally M. ovipneumoniae-colonized domestic goats. Gross and histological lesions of pneumonia, limited to small areas on the ventral and lateral edges of the anterior and middle lung lobes, were observed at necropsies conducted at the end of the experiment. A control group of three bighorn sheep from the same source housed in isolation during experiment 1 remained free of observed respiratory disease. In experiment 2, three bighorn sheep remained free of observed respiratory disease while comingled with three M. ovipneumoniae-free domestic goats. In experiment 3, introduction of a domestic goat-origin strain of M. ovipneumoniae to the same comingled goats and bighorn sheep used in experiment 2 resulted in clinical signs of respiratory disease (coughing, nasal discharge) in both host species. At the end of experiment 3, gross and histological evidence of pneumonia similar to that observed in experiment 1 bighorn sheep was observed in both affected bighorn sheep and domestic goats. M. ovipneumoniae strains carried by domestic goats were transmitted to comingled bighorn sheep, triggering development of pneumonia. However

Enfermedad ectasiante de la aorta abdominal: Morbilidad y mortalidad

Directory of Open Access Journals (Sweden)

Lilia E Chércoles Cazate

1996-06-01

Full Text Available Se presentó la experiencia de 10 años de trabajo (1983 a 1992, durante los cuales se atendieron 388 pacientes en el Hospital Provincial Docente "Saturnino Lora" de Santiago de Cuba, con el diagnóstico principal o asociado de aneurisma de la aorta abdominal. En el período analizado ingresaron en angiología y cirugía vascular 98 pacientes, 176 en medicina y 8 en otros servicios. Fallecieron a su llegada al cuerpo de guardia 106 por rotura del aneurisma o disección aórtica. Predominó el sexo masculino y la procedencia urbana. La hipertensión arterial fue la afección asociada más frecuente en los operados y la cardiopatía isquémica en los no operados. En los operados electivos, la complicación inmediata que más ocurrencia tuvo fue la trombosis de una rama de la prótesis y en los urgentes el sangramiento; mientras que en las mediatas, los operados electivos presentaron bronconeumonía y en los urgentes, anemia e íleo paralíticoThe experience of ten years of work (1983-1992 was presented. During that period, 388 patients with the main of associated diagnosis of abdominal aortic aneurysm were managed at the "Saturnino Lora" Provincial Educational Hospital, at Santiago de Cuba. In the decade analyzed, 98 patients entered in angiology and vascular surgery, 176 patients entered in medicine, and 8 in other services. In arriving to the emergency room, 106 subjects deceased due to aneurystic rupture or aortic dissection. Masculine sex and urban origin were prevailing. Arterial hypertension was the disease most frequently associated in the operated patients, and ischemic cardiac disease, among the non operated. In the elective operated patients, the immediate complication with the highest occurrence was the thrombosis of a branch of the prosthesis, and bleeding in the urgent cases, while in the mediate complications, the elective operated patients presented bronchopneumonia, and the urgent cases had anemia and paralytic ileus

Amiloidose renal em cão Shar-Pei: Relato de Caso Renal amyloidosis in a Shar-Pei dog: A case report

Directory of Open Access Journals (Sweden)

J.L. Reis Jr.

2001-08-01

Full Text Available O presente relato descreve os achados clínicos e anatomopatológicos de um caso de amiloidose renal em um cão macho de nove anos da raça Shar-Pei. O animal apresentava quadro clínico de esporotricose e de insuficiência renal e exames positivos para erlichiose e leishmaniose. No dia anterior ao óbito, o cão apresentou apatia, desidratação e anúria. À necropsia foram observados inúmeros pontos milimétricos esbranquiçados localizados no córtex renal e hepatização do lobo diafragmático esquerdo. O achado histológico mais importante foi deposição de material eosinofílico, amorfo e acelular localizado nos tufos glomerulares que se corou positivamente pelo vermelho congo (amilóide. Observaram-se nefrite supurada multifocal, espessamento da cápsula de Bowman e broncopneumonia supurada crônica, com fibrose intensa. A origem da amiloidose, no presente caso, poderia ser hereditária, assemelhando-se à amiloidose familiar descrita em cães da raça Shar-Pei, ou ser devida à inflamação supurada crônica e/ou leishmaniose.The clinical and pathological findings of a case of renal amyloidosis in a nine-year-old male Shar-Pei dog were described. Clinically, there were signs of sporotrichosis and renal insufficiency, besides being positive to leishmaniasis and ehrlichiosis. On the day before death, the animal became apathetic, dehydrated and anuric. On gross examination, there were several whitish millimetric spots seen widespread in both renal cortices and consolidation of the left diaphragmatic pulmonary lobe. The most important microscopic finding was a deposition of amorphous acellular material on the glomerular tufts which stained positively by congo red stain. Other changes were multifocal suppurative nephritis, thickening of the Bowman capsule and chronic suppurative bronchopneumonia. The origin of the amyloidosis in this case could be hereditary, being similar to familiar amyloidosis described in Shar-Pei breed, or due to

Pathology and pathogenesis of disseminated visceral coccidiosis in cranes.

Science.gov (United States)

Novilla, Meliton N; Carpenter, James W

2004-06-01

Disseminated visceral coccidiosis (DVC) caused by Eimeria spp. was recognized as a disease entity in captive sandhill cranes (Grus canadensis) and whooping cranes (Grus americana) in the late 1970s. While most avian species of Eimeria inhabit the intestinal tract of its host, the crane eimerians, Eimeria reichenowi and Eimeria gruis, invade and multiply systemically and complete their development in both digestive and respiratory tracts. In DVC, cranes, especially chicks, may succumb to acute infections resulting in hepatitis, bronchopneumonia, myocarditis, splenitis, and enteritis. Cranes may also develop chronic, subclinical infections characterized by granulomatous nodules in various organs and tissues. This paper reviews the pathology and pathogenicity of natural and experimental DVC in sandhill and whooping cranes. Naturally infected birds appeared clinically normal, but progressive weakness, emaciation, greenish diarrhea, and recumbency before death were observed in birds administered doses > or = 10 x 10(3) sporulated oocysts per os. At necropsy, naturally infected birds had nodules in the mucosa of the oral cavity and the esophagus, and in thoracic and abdominal viscera. Experimentally infected birds necropsied less than 7 days after infection (a.i.) had no gross lesions. Birds examined later had hepatosplenomegaly, liver mottling, lung congestion and consolidation with frothy fluid in airways, and turgid intestinal tracts with hyperemic mucosa. From 28 days a.i., grossly visible granulomatous nodules were seen in the esophagus, heart, liver, cloaca, and eyelids. By light microscopy, the basic host response was a granulomatous inflammation with non-suppurative vasculitis affecting many organs and tissues. With time, multifocal aggregates of mononuclear cells, many laden with asexual coccidial stages, increased in size and number. Widespread merogony resulted in morbidity and death, particularly in birds administered 20 x 10(3) sporulated oocysts

Clinical and molecular investigation of a canine distemper outbreak and vector-borne infections in a group of rescue dogs imported from Hungary to Switzerland.

Science.gov (United States)

Willi, Barbara; Spiri, Andrea M; Meli, Marina L; Grimm, Felix; Beatrice, Laura; Riond, Barbara; Bley, Tim; Jordi, Rolf; Dennler, Matthias; Hofmann-Lehmann, Regina

2015-07-16

Canine distemper virus (CDV) is a major pathogen of dogs and wild carnivores worldwide. In Switzerland, distemper in domestic dogs is rarely reported. In recent years, the import of dogs from Eastern Europe to Switzerland has steadily increased. In the present study, we describe a distemper outbreak in 15 rescue dogs that were imported from Hungary to Switzerland by an animal welfare organisation. The data on vaccination and medical history were recorded (14 dogs), and the samples were collected to investigate CDV and vector-borne infections (13 dogs) and canine parvovirus infection (12 dogs). The dogs were monitored for six months. One dog was euthanised directly after import. Thirteen dogs showed clinical signs after arrival, i.e., diarrhoea (57 %), coughing (43 %) and nasal and/or ocular discharge (21 %); radiographic findings that were compatible with bronchopneumonia were present in four dogs. CDV infection was diagnosed in 11 dogs (85 %); 10 dogs (91 %) tested PCR-positive in conjunctival swabs. Vector-borne infections (Babesia spp., Leishmania infantum, Dirofilaria immitis) were found in 4 dogs (31 %). Three dogs were hospitalized, and six dogs received ambulatory therapy for up to two months until recovery. None of the dogs developed neurological disease. CDV shedding was detected for a period of up to four months. Because dogs were put under strict quarantine until CDV shedding ceased, CDV did not spread to any other dogs. The CDV isolates showed 99 % sequence identity in the HA gene among each other and belonged to the Arctic-like lineage of CDV. The present study highlights the imminent risks of spreading contagious viral and vector-borne infections through the non-selective import of sick dogs and dogs with incomplete vaccination from Eastern Europe. CDV shedding was detected for several months after the cessation of clinical signs, which emphasised the roles of asymptomatic carriers in CDV epidemiology. A long-term follow-up using sensitive PCR and

Feasibility of full and rapid neuromuscular blockade recovery with sugammadex in myasthenia gravis patients undergoing surgery – a series of 117 cases

Directory of Open Access Journals (Sweden)

Vymazal T

2015-10-01

Full Text Available Tomas Vymazal,1 Martina Krecmerova,1 Vladimír Bicek,1 Robert Lischke2 1Department of Anaesthesiology and ICM, 2nd Faculty of Medicine, 23rd Surgical Department of 1st Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic Purpose: Myasthenia gravis (MG is an autoimmune disease interfering with neuromuscular transmission. Patients are at risk of postoperative residual curarization (PORC if nondepolarizing muscle relaxants are used. Clinically inapparent insufficient muscle strength may result in hypoventilation and postoperative bronchopneumonia. We describe a cohort of 117 cases in which sugammadex was used in MG patients undergoing surgery with muscle relaxation with rocuronium.Methods and patients: We anesthetized 117 patients with MG using rocuronium and sugammadex as neuromuscular blockade reversal agent. One hundred five patients underwent surgical thymectomy and 12 underwent cholecystectomy (five laparotomic and seven laparoscopic. We measured time from sugammadex administration to recovery and to extubation, using the TOF-Watch® (series of four consecutive electrical impulses [the train-of-four] >0.9. We tracked peripheral capillary oxygen saturation (SpO2 <95%, elevation of partial pressure of carbon dioxide (pCO2 >10% above baseline, number of reintubations within the first 48 hours, and number of pneumonias within 120 hours, postoperatively. Results were processed as average, minimum, and maximum values.Results: The period needed to reach train-of-four of 0.9 following sugammadex administration was on average 117 seconds (minimum of 105 seconds/maximum of 127 seconds and differed within deviation <10%. The time to extubation following sugammadex administration was on average 276 seconds (minimum of 251 seconds/maximum of 305 seconds and differed minimally among patients as well. We observed no SpO2 <95%, no pCO2 elevation >10% above a baseline, no emergent reintubation within the

Correlação diagnóstica anatomoclínica. Aferição retrospectiva do diagnóstico clínico em necrópsias Correlation between anatomo-clinical diagnosis and retrospective assessment of clinical diagnosis in post mortms

Directory of Open Access Journals (Sweden)

Marcos Célio de Almeida

1989-08-01

Full Text Available Analisaram-se retrospectivamente 200 necrópsias, correlacionando-se os diagnósticos clínicos e anatomopatológicos. Foram consideradas 20 entidades nosológicas para confronto. Os diagnósticos não formulados em vida, embora observados na necrópsia (falso negativo, e que apresentaram os maiores percentuais em relação aos respectivos totais de achados necroscópicos, foram: pielonefrite aguda (100%, embolia pulmonar (87,50%, aneurisma dissecante da aorta (66,66% e broncopneumonia (58,16%. Os diagnósticos formulados em vida que não tiveram confirmação pela necrópsia (falso positivo, e que apresentaram os maiores percentuais em relação aos respectivos totais dos diagnósticos clínicos, foram: tuberculose (69,50%, paracoccidioidomicose (57,14%, septicemia (53,13% e doença de Chagas (44,44%. Houve concordância diagnóstica em 97 (48,50% dos 200 casos. Em 19 (9,50% deles o desacordo diagnóstico, se antes verificado, poderia ter implicado alterações do prognóstico. Enfatiza-se a importância da necrópsia para uma adequada correlação anatomoclínica e discute-se os achados em relação a estudos prévios.The post mortem findings in 200 autopsies were compared with the clinical diagnoses. Twenty diseases were analysed with respect to clinico-pathological correlation. In relation to the respective totals the diseases most frequently missed clinically were (false negative pyelonephrites (100%, pulmonary embolus (87.50% and bronchopneumonia (58.16%. In relation to the respective totals the clinical diagnoses less frequently confirmed (false positive were tuberculosis (69.56%, paracoccidioidomycosis (57.14%, sepsis (53.13% and Chagas'disease (44.44%. There was clinico-pathological agreement in 97 autopsies (48.50%. In 19 cases (9.50% if the diagnostic error had been detected during life this probably would have changes the prognosis. The findings are discussed in the light of previous studies. The importance of routine post

Histopathological and immunohistochemical findings of swine with spontaneous influenza A infection in Brazil, 2009-2010

Directory of Open Access Journals (Sweden)

Tatiane T.N. Watanabe

2012-11-01

Full Text Available Swine influenza (SI is caused by the type A swine influenza virus (SIV. It is a highly contagious disease with a rapid course and recovery. The major clinical signs and symptoms are cough, fever, anorexia and poor performance. The disease has been associated with other co-infections in many countries, but not in Brazil, where, however, the first outbreak has been reported in 2011. The main aim of this study was to characterize the histological features in association with the immunohistochemical (IHC results for influenza A (IA, porcine circovirus type 2 (PCV2 and porcine reproductive and respiratory syndrome virus (PRRSV in lung samples from 60 pigs submitted to Setor de Patologia Veterinária at the Universidade Federal do Rio Grande do Sul (SPV-UFRGS, Brazil, during 2009-2010. All of these lung samples had changes characterized by interstitial pneumonia with necrotizing bronchiolitis, never observed previously in the evaluation of swine lungs in our laboratory routine. Pigs in this study had showed clinical signs of a respiratory infection. Swine samples originated from Rio Grande do Sul 31 (52%, Santa Catarina 14 (23%, Paraná 11 (18%, and Mato Grosso do Sul 4 (7%. Positive anti-IA IHC labelling was observed in 45% of the cases, which were associated with necrotizing bronchiolitis, atelectasis, purulent bronchopneumonia and hyperemia. Moreover, type II pneumocyte hyperplasia, alveolar and bronchiolar polyp-like structures, bronchus-associated lymphoid tissue (BALT hyperplasia and pleuritis were the significant features in negative anti-IA IHC, which were also associated with chronic lesions. There were only two cases with positive anti-PCV2 IHC and none to PRRSV. Therefore, SIV was the predominant infectious agent in the lung samples studied. The viral antigen is often absent due to the rapid progress of SI, which may explain the negative IHC results for IA (55%; therefore, IHC should be performed at the beginning of the disease. This study

Surgical solution of subglottic stenosis graded III by Cotton in a child

International Nuclear Information System (INIS)

Sebova, I.; Sittel, Ch.

2017-01-01

The solution of laryngotracheal (LT) stenoses of a higher degree in children is a serious problem. Sometimes they arise due to iatrogenic trauma caused by long-term intubation through surface pressure of the intubation tube in the ring cartilage area. 50% of inborn LT stenoses are connected with systematic congenital developmental defects. The case history describes a case of a boy 5.5 years old born prematurely as the first one of twins and immediately after birth he had to be intubed due to the breathing problems. His twin had exited. The patient spent 41 days on pulmonary ventilation, survived sepsis, newborn jaundice, anaemia, then bronchopulmonary dysplasia and central hypotonic syndrome were found. The first attempt with extubation after the treatment was unsuccessful. Besides the pulmonary findings subglottic stenosis of insignificant grade was stated and the 3-month-old child underwent planned tracheostomy. Subsequently the child went through surgical treatment of retinopathy in the prematured and scrotal hernia on both sides. In the course of several years he suffered from recurrence of acute respiratory tract inflammation, incl. bronchopneumonia, the respiratory tract was colonised by pathogenic chronic microflora. The child was repeatedly examined with the endoscope, granulations in the area of tracheostomy were removed. Though the finding in the larynx - persisting narrowing - has been considered unimportant for several years, in spite of this some further unsuccessful attempts with decannulation of the child followed. In the meantime the patient was followed up as a long-time cannula patient at DORLK LF UK and DFNsP in Bratislava, his tracheostomy cannulas were exchanged. At the age of 5 surgical treatment of subglottic stenosis graded III by Cotton in the child was proposed. In February 2016 partial cricotracheal resection (PCTR) was performed applying LT Mold at the Clinic for Ear, Nose and Throat Disorders, Plastic Surgery at the City Hospital in

Defining syndromes using cattle meat inspection data for syndromic surveillance purposes: a statistical approach with the 2005-2010 data from ten French slaughterhouses.

Science.gov (United States)

Dupuy, Céline; Morignat, Eric; Maugey, Xavier; Vinard, Jean-Luc; Hendrikx, Pascal; Ducrot, Christian; Calavas, Didier; Gay, Emilie

2013-04-30

The slaughterhouse is a central processing point for food animals and thus a source of both demographic data (age, breed, sex) and health-related data (reason for condemnation and condemned portions) that are not available through other sources. Using these data for syndromic surveillance is therefore tempting. However many possible reasons for condemnation and condemned portions exist, making the definition of relevant syndromes challenging.The objective of this study was to determine a typology of cattle with at least one portion of the carcass condemned in order to define syndromes. Multiple factor analysis (MFA) in combination with clustering methods was performed using both health-related data and demographic data. Analyses were performed on 381,186 cattle with at least one portion of the carcass condemned among the 1,937,917 cattle slaughtered in ten French abattoirs. Results of the MFA and clustering methods led to 12 clusters considered as stable according to year of slaughter and slaughterhouse. One cluster was specific to a disease of public health importance (cysticercosis). Two clusters were linked to the slaughtering process (fecal contamination of heart or lungs and deterioration lesions). Two clusters respectively characterized by chronic liver lesions and chronic peritonitis could be linked to diseases of economic importance to farmers. Three clusters could be linked respectively to reticulo-pericarditis, fatty liver syndrome and farmer's lung syndrome, which are related to both diseases of economic importance to farmers and herd management issues. Three clusters respectively characterized by arthritis, myopathy and Dark Firm Dry (DFD) meat could notably be linked to animal welfare issues. Finally, one cluster, characterized by bronchopneumonia, could be linked to both animal health and herd management issues. The statistical approach of combining multiple factor analysis with cluster analysis showed its relevance for the detection of syndromes

Niveles de inmunoglobulinas IgA e IgM en recién nacidos y correlación con infección congénita

Directory of Open Access Journals (Sweden)

Rafael Ferrer Montoya

1998-03-01

Full Text Available Se realizó un estudio analítico y prospectivo en 600 recién nacidos, de los niveles sanguíneos de IgM e IgA y su relación con el riesgo de infección congénita. Se encontró elevada la IgM en 10 neonatos (1,7 % y la IgA en 18 (3 %. Se halló una buena correlación (OR y significancia estadística de IgM e IgA elevadas en los neonatos cuyas madres tuvieron líquido amniótico caliente y/o fétido, ruptura de las membranas de más de 24 horas y fiebre intraparto. También hubo una buena correlación (OR y significancia estadística de las Igs elevadas en neonatos con bronconeumonía y sepsis generalizada congénita. De los cultivos bacteriológicos existió una buena correlación (OR y significancia estadística en el hemocultivo y exudado faríngeo y las Igs elevadas y el residuo gástrico con la IgM elevada. Las bacterias grampositivas y gramnegativas aisladas en los neonatos tuvieron buena correlación (OR y significancia estadística, excepto para la IgA en las bacterias gramnegativas. Los 4 neonatos fallecidos por infección congénita tuvieron IgM elevadas.A prospective analytical study of IgM and IgA inmunoglobulin levels of 600 neonates and their correlation with congenital infection risks was made. 10 neonates (1.7 % presented a high IgM level whereas 18 (3 % had a raised IgA level. A good correlation (OR and statistical significance of raised IgA and IgM levels were found in newborns of mothers who had had hot and/or fetid amniotic fluid; ruptured membranes for over 24 hours and intralabor fever. Good correlation and statistical significance of high Igs were also present in neonates affected by bronchopneumonia and general congenital sepsis. As to the bacteriological cultures, good correlation and statistical significance was found in hemoculture and pharyngeal exudate, as well as raised Igs levels, and gastric residues with high IgM level. Gram-positive and gram-negative bacteria isolated from newborns presented good correlation

A severe connatal form of Pelizaeus Merzbacher disease in a Czech boy caused by a novel mutation (725C>A, Ala242Glu) at the 'jimpy(msd) codon' in the PLP gene.

Science.gov (United States)

Seeman, Pavel; Paderova, Katerina; Benes, Vladimir; Sistermans, Erik A

2002-02-01

Pelizaeus Merzbacher disease (PMD) is an X-linked recessive disorder of the central nervous system myelination caused by mutations involving the proteolipid protein gene (PLP). Early nystagmus and developmental delay, progressive pyramidal, cerebellar and dystonic signs as well as white matter changes in brain MRI are typical for PMD. The PLP gene can be affected by two major types of mutations. A duplication of the whole PLP gene is the most common mutation and results usually in the milder classical phenotype, whereas point mutations in PLP gene often result in the rarer and more severe connatal form of PMD. The PLP protein is a higly conserved across species and is identical in human, mouse and rat. We describe a 13-year-old Czech boy with an early and severe developmental delay. His maternal uncle died at the age of one year and was also early and severely psychomotoricly retarded. The patient was the first child of healthy unrelated parents born after an uneventful pregnancy and delivery in 1988. Hyperbilirubinemia and bronchopneumonia and early stridor complicated his neonatal period. Diffuse hypotonia, nystagmus, psychomotor retardation, visual and hearing impairment have been observed in the patient since the age of 6 weeks. White matter abnormalities, cortical and periventricular atrophy were detected by MRI at the age of 6 and 11 years, respectively. Despite these signs and results an accurate clinical diagnosis was unclear until the age of 11 years. Last neurological examination in 1999 showed no nystagmus anymore, but extremely dystrophic limbs, truncal deformation, due to severe scoliosis, tetraplegia with hyperreflexia in C5C7 and areflexia L2S2 and positive pyramidal signs. The boy had no visual or speech contact. DNA tests followed the clinical suspicion for PMD. At first, duplication of PLP gene was excluded by quantitative comparative PCR. Direct sequencing of PLP gene detected a novel mutation in exon 6, a missense mutation 725C-->A (Ala242Glu

Ingesta oral do paciente hospitalizado com disfagia orofaríngea neurogênica Oral Intake of hospitalized patient with neurogenic oropharyngeal dysphagia

Directory of Open Access Journals (Sweden)

Carolina Castelli Silvério

2010-12-01

Full Text Available OBJETIVO: verificar a evolução na ingesta oral e a ocorrência de broncopneumonias (BCP em pacientes hospitalizados com disfagia orofaríngea neurogênica, após atuação fonoaudiológica. MÉTODOS: 50 pacientes adultos, divididos em grupos: I: 31 pacientes pós-acidente vascular encefálico; II: sete pacientes pós-traumatismo crânio-encefálico; III: 12 pacientes com demência. Foram levantadas as informações antes e após a atuação fonoaudiológica: nível da Functional Oral Intake Scale (FOIS, ocorrência de BCP; número de atendimentos fonoaudiológicos e motivo de interrupção destes. RESULTADOS: houve aumento significativo dos níveis da escala FOIS e redução do percentual de ocorrência de BCP nos três grupos estudados. Nos grupos pós-AVE e demência a interrupção da fonoterapia ocorreu devido à alta hospitalar, enquanto que no grupo pós-TCE devido à alta fonoaudiológica. CONCLUSÃO: os pacientes deste estudo demonstraram avançar das consistências alimentares na ingesta oral, e redução da ocorrência de BCP, após a intervenção fonoaudiológica com relação à disfagia.PURPOSE: to investigate the development in oral intake and the incidence of bronchopneumonia (BCP in hospitalized patients with neurogenic oropharyngeal dysphagia, after speech and language therapy intervention. METHODS: 50 adult patients, divided in three groups: I: 31 post stroke patients; II: seven brain injury patients ; III: 12 dementia patients. Data collected before and after the speech and language therapy intervention were: staff classification in Functional Oral Intake Scale (FOIS, incidence of BCP, number of therapies and reason for their interruption. RESULTS: significant increase in the levels of FOIS scale and reduction in incidence of pneumonia in the three studied groups. In the post stroke and dementia groups the reason for therapy interruption was hospital discharge, and in the group of brain injury the reason was speech and

[Reconstructive surgery of the mitral and tricuspid valves with a Cosgrove-Edwards flexible ring].

Science.gov (United States)

Pugliese, P; Pantani, P; Lusa, A M; Nuti, R; Bongiovanni, M; Conti, F; Biasi, C; Pigini, F; Palmisano, D

2000-04-01

Mitral and tricuspid valve asymmetric annular dilation represents the most important mechanism which produces insufficiency. Recent computerized in vitro and in vivo three-dimensional models have been developed in order to better understand the competing factors (annular dilation, displacement of papillary muscles, left and right ventricular geometry). The leading cause of mitral and tricuspid competence is a sphincteric action of both annuli, during systole and diastole, the loss of which produces asymmetric dilation and therefore the absence of cusp coaptation. The Cosgrove-Edwards dynamic ring corrects, alone or in combination with other procedures on the valves, this patho-anatomic feature in a physiological way by restoring the normal annular dimensions and the sphincteric movements during the cardiac cycle. Between June 1998 and May 1999, 30 adult patients underwent mitral (n = 20, Group I) or tricuspid valve repair (n = 10, Group II). Regurgitation was due to a degenerative disease in 13 Group I patients and to ischemic (n = 3), congenital (n = 2) or dilated cardiomyopathy (n = 2) in the others. In Group II the leading cause of insufficiency was functional regurgitation in 7 patients and organic in 3. Associated procedures were carried out in 4 Group I patients and in all Group II patients. Regurgitation was evaluated by transesophageal echocardiography before, during and 3 months after operation. The maximal regurgitant area (MRA) and the grade of insufficiency were evaluated using the equation: MRA 2 4 7 10 cm2 = 4+. The operative mortality was 0%. One Group I patient died 3 months after operation due to bronchopneumonia. No patient was reoperated on for plasty failure in both groups during the follow-up. Mitral insufficiency was absent (grade 0) in 17 Group I patients and mild (grade 1+) in 3 at the end of operation. At 3-month postoperative transesophageal echocardiographic control mitral insufficiency was absent in 14 patients, mild (1+) in 4 and

Revascularização do miocárdio sem circulação extracorpórea em pacientes acima de 75 anos: análise dos resultados imediatos Myocardial revascularization without extracorporeal circulation in patients over 75 years of age: analysis of immediate results

Directory of Open Access Journals (Sweden)

Rodrigo Milani

2005-01-01

7.54±2.69%. The total number of distal anastomoses was 639. Seven (3.62% patients died, 3 due to bronchopneumonia, 1 due to mediastinitis, 1 due to metabolic causes, 1 due to cardiogenic shock, and another died suddenly after refixation of a sternal dehiscence. Reoperation due to bleeding, orotracheal reintubation, and prolonged mechanical ventilation were factors associated with an increase in mortality. CONCLUSION: The surgery adopted for myocardial revascularization was associated with a low mortality rate, a low complication index, and a short length of stay at the hospital.

Indicadores da evolução do paciente com paralisia cerebral e disfagia orofaríngea após intervenção terapêutica Evolution indicators of patients with cerebral palsy and oropharyngeal dysphagia after therapeutic intervention

Directory of Open Access Journals (Sweden)

Carolina Castelli Silvério

2009-01-01

Full Text Available OBJETIVO: Verificar a evolução na função de alimentação e estabilidade clínica de crianças com paralisia cerebral tetraparética espástica após intervenção terapêutica. MÉTODOS: Foram levantados em prontuário médico, antes e após a terapia, os dados de classificação da funcionalidade da alimentação (escala FOIS e grau de disfagia, consistências alimentares e sinais sugestivos de penetração e/ou aspiração laringotraqueal de 36 crianças com paralisia cerebral espástica. RESULTADOS: A maioria dos sujeitos alimentava-se com preparo especial, antes e após a intervenção, ocorrendo restrição de sólidos e líquidos no segundo momento. Houve diminuição da severidade da disfagia, redução de broncopneumonias e hipersecretividade pulmonar, aumento do peso e diminuição dos sinais sugestivos de penetração e/ou aspiração laringotraqueal, exceto recusa alimentar e cianose. CONCLUSÃO: A intervenção fonoaudiológica, em conjunto com a equipe multidisciplinar em disfagia, promove maior funcionalidade da deglutição e diminuição dos sinais sugestivos de penetração e/ou aspiração traqueal, além de maior estabilidade clínica.PURPOSE: To verify the evolution in nutrition and clinical stability of children with spastic tetraparetic cerebral palsy, after therapeutic intervention. METHODS: Data from before and after the therapeutic process were raised from the medical records of 36 children with spastic cerebral palsy, regarding classification of functional oral intake (FOIS scale and degree of dysphagia, food consistency, and suggestive signs of penetration and/or tracheal aspiration. RESULTS: Most subjects were fed with special preparation, before and after intervention, with restrictions to solid and liquid foods in the second instance. It was observed decrease of the severity of dysphagia, reduction of the incidence of bronchopneumonia and pulmonary hypersecretion, weight increase, and reduction of suggestive

Diagnostic pitfalls in a young Romanian ranger with an acute psychotic episode

Directory of Open Access Journals (Sweden)

Nagy EE

2016-05-01

battery of other autoimmune encephalitis markers showed negative. A complex program of treatment was applied, including antibiotics, beginning with ceftazidime and ciprofloxacin – for suspected aspiration bronchopneumonia – and thereafter with ceftriaxone. A gradual improvement was noticed and the treatment continued at the Infectious Disease Clinic. Finally, the patient was discharged with a doxycycline, antidepressant, and anxiolytic maintenance treatment. On his first and second control (days 44 and 122 from the disease onset, the patient was stable with no major complaints, Borrelia seropositivity was confirmed both for IgM and IgG while the cerebrospinal fluid also showed reactivity for IgG on immunoblot. On the basis of the putative occupational risk, acute psychotic episode, and the success of antibiotic therapy, we registered this case as a late neuroborreliosis with atypical appearance.Keywords: Borrelia burgdorferi, neuroborreliosis, neuropsychiatric symptoms, encephalitis, anti-NMDAR

Síndrome de Alagille Alagille syndrome

Directory of Open Access Journals (Sweden)

Yuri Betancourt Guerra

2013-03-01

Full Text Available El síndrome de Alagille es un trastorno genético cuya manifestación fundamental es una colestasis crónica producida por una hipoplasia de las vías biliares intrahepáticas, y se asocia a malformaciones congénitas cardiacas, renales y esqueléticas en pacientes con un fenotipo peculiar. Tiene una frecuencia de aparición de 1 por cada 100 000 nacidos vivos. La lesión histológica está dada por una reducción en la relación entre el número de conductos biliares y el de los espacios porta. Tiene una mortalidad global de un 20 %, y los pacientes pueden llegar a necesitar transplante hepático para su supervivencia. Se describe un paciente de 6 años de edad, femenina, que ingresa a los 23 días de nacida en el Hospital Pediátrico "Dr. Eduardo Agramonte Piña" por bronconeumonía, pero durante su estancia en el hospital se detecta síndrome colestásico dado por íctero y acolia, además de estenosis pulmonar y facies característica. Se realiza biopsia hepática compatible con síndrome de Alagille. El caso fue evaluado y se diagnostica la enfermedad por la presencia de criterios diagnósticos. Evoluciona de forma estable, con seguimiento por consulta externa hasta los 6 años, cuando ingresa en el Hospital Pediátrico "William Soler" para transplante hepático.Alagille syndrome is a genetic disorder and its main manifestation is chronic cholestasis caused by intrahepatic bile duct hypoplasia. It is associated with cardiac, renal and skeletal congenital malformations with peculiar phenotypes. It can occur in one per 100 000 livebirths. The histological lesions are caused by a reduction of the ratio of the number of bile ducts and the number of porta spaces. The global mortality rate of the disease is 20 % and the patients may need some hepatic transplantation for survival. Here is the case of a 6 years-old girl who was admitted to "Dr Eduardo Agramonte Piña" hospital when she was 23-days-old because she had bronchopneumonia, but during

Melioidosis in Malaysia: A Review of Case Reports.

Science.gov (United States)

Kingsley, Paul Vijay; Leader, Mark; Nagodawithana, Nandika Suranjith; Tipre, Meghan; Sathiakumar, Nalini

2016-12-01

Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. We sought to review case reports of melioidosis from Malaysia. We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome. Overall, 67 cases were reported with 29 (43%) deaths; the median age was 44 years, and a male preponderance (84%) was noted. Forty-one cases (61%) were bacteremic, and fatal septic shock occurred in 13 (19%) within 24-48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54%) was the most common risk factor. Twenty-six cases (39%) had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36%) was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%). Other types of clinical presentations were less common-genitourinary (n = 5), neurological (n = 5), osteomyelitis/septic arthritis (n = 4) and skin (n = 2); five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21%) was the most common followed by liver (18%); abscesses of the spleen and lung were the third most common (12% each). Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age) with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of parotid abscess was reported among

Hyperlucent lung; Pulmon hiperlucente

Energy Technology Data Exchange (ETDEWEB)

Jimenez-Gutierrez, Florana; Soto-Quiros, Manuel E [Hospital Nacional de Ninos, Servicio de Neumologia, apartado 1654-1000, San Jose (Costa Rica)

2007-10-15

Unilateral hyperlucent lung is also known as Swyer-James Syndrome, Macleod Syndrome or lobular or unilateral emphysema. It is an uncommon disease characterized by lung or unilateral lobe hiperlucency associated to an air trapping upon expiration. As regards to etiology, this syndrome is considered to be an acquired disease that appears secondary to respiratory infections during the early years of life, probably bronchiolitis and/ or viral pneumonia. The clinical presentation varies among patients. Some of them are asymptomatic, others present a history of recurrent episodes of pulmonary infections from early years of life or present effort dyspnea. The diagnosis is usually made accidentally by a chest radiograph in a child with history of respiratory infections or in an adult during a routine chest x- ray in an asymptomatic person. It is important to differentiate this syndrome from other causes of unilateral pulmonary hiperlucency on conventional chest x-rays. Few cases of Swyer-James Syndrome in children have been reported, it is presented the clinical case of a patient who had a parainfluenza 3 bronchopneumonia when he was a month and eighteen days of age. The differential diagnosis of this syndrome should be done with other thoracic entities that diminish the radiological pulmonary unilateral density. A case of a child who is the bearer of hyperlucent lung is described. (author) [Spanish] El pulmon hiperlucente unilateral tambien se ha denominado Sindrome de Swyer-James, Sindrome de Macleod o enfisema lobular o unilateral. Es una enfermedad poco frecuente que se caracteriza por una hiperclaridad pulmonar o lobar unilateral asociada a un atrapamiento aereo en la espiracion. En cuanto a la etiologia, existe evidencia que se atribuye a una enfermedad adquirida que aparece tras una infeccion pulmonar durante la infancia, probablemente una bronquiolitis o una neumonia viral. El cuadro clinico es variable: algunos pacientes se encuentran asintomaticos, otros con

Melioidosis in Malaysia: A Review of Case Reports

Science.gov (United States)

Kingsley, Paul Vijay; Leader, Mark; Nagodawithana, Nandika Suranjith; Tipre, Meghan; Sathiakumar, Nalini

2016-01-01

Background Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis. Objective We sought to review case reports of melioidosis from Malaysia. Methods We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome. Results Overall, 67 cases were reported with 29 (43%) deaths; the median age was 44 years, and a male preponderance (84%) was noted. Forty-one cases (61%) were bacteremic, and fatal septic shock occurred in 13 (19%) within 24–48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54%) was the most common risk factor. Twenty-six cases (39%) had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36%) was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%). Other types of clinical presentations were less common—genitourinary (n = 5), neurological (n = 5), osteomyelitis/septic arthritis (n = 4) and skin (n = 2); five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21%) was the most common followed by liver (18%); abscesses of the spleen and lung were the third most common (12% each). Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age) with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of

Penetrating abdomino-thoracic injuries: report of four impressive, spectacular and representative cases as well as their challenging surgical management.

Science.gov (United States)

Eder, Frank; Meyer, Frank; Huth, Christof; Halloul, Zuhir; Lippert, Hans

2011-03-01

towels, removed after 2 days), suture of the diaphragm, and pleural drainage. 4. A man was stabbed in the left thorax, resulting in pneumothorax and lesions of the diaphragm and left third of the transversal colon, and the neck, resulting in lesions of the pharynx and internal jugular vein. These injuries were approached with left thoracic drainage and suture of the colon and diaphragm lesions. Subsequent right thoracotomy was required to treat right pleural empyema caused by bronchopneumonia as a consequence of blunt thoracic trauma. In addition, the patient required relaparotomy to drain an abscess within the Douglas space and Billroth II gastric resection to control recurrent Forrest-Ia bleeding. Penetrating abdomino-thoracic injuries demand immediate life-saving measures, transfer to a trauma centre, appropriate resuscitative care, prompt diagnosis, and surgical intervention by an interdisciplinary team of abdominal, vascular, and cardiac surgeons. If these measures are provided, outcomes are maximized, mortality is minimized, and permanent damage can be avoided.

Melioidosis in Malaysia: A Review of Case Reports.

Directory of Open Access Journals (Sweden)

Paul Vijay Kingsley

2016-12-01

Full Text Available Melioidosis is a tropical infectious disease associated with significant mortality due to early onset of sepsis.We sought to review case reports of melioidosis from Malaysia.We conducted a computerized search of literature resources including PubMed, OVID, Scopus, MEDLINE and the COCHRANE database to identify published case reports from 1975 to 2015. We abstracted information on clinical characteristics, exposure history, comorbid conditions, management and outcome.Overall, 67 cases were reported with 29 (43% deaths; the median age was 44 years, and a male preponderance (84% was noted. Forty-one cases (61% were bacteremic, and fatal septic shock occurred in 13 (19% within 24-48 hours of admission; nine of the 13 cases were not specifically treated for melioidosis as confirmatory evidence was available only after death. Diabetes mellitus (n = 36, 54% was the most common risk factor. Twenty-six cases (39% had a history of exposure to contaminated soil/water or employment in high-risk occupations. Pneumonia (n = 24, 36% was the most common primary clinical presentation followed by soft tissue abscess (n = 22, 33%. Other types of clinical presentations were less common-genitourinary (n = 5, neurological (n = 5, osteomyelitis/septic arthritis (n = 4 and skin (n = 2; five cases had no evidence of a focus of infection. With regard to internal foci of infection, abscesses of the subcutaneous tissue (n = 14, 21% was the most common followed by liver (18%; abscesses of the spleen and lung were the third most common (12% each. Seven of 56 males were reported to have prostatic abscesses. Mycotic pseudoaneurysm occurred in five cases. Only one case of parotid abscess was reported in an adult. Of the 67 cases, 13 were children (≤ 18 years of age with seven deaths; five of the 13 were neonates presenting primarily with bronchopneumonia, four of whom died. Older children had a similar presentation as adults; no case of parotid abscess was reported among

Intoxicação natural por Amaranthus spinosus (Amaranthaceae em ovinos no Sudeste do Brasil Amaranthus spinosus (Amaranthaceae poisoning in sheep in southern Brazil

Directory of Open Access Journals (Sweden)

Paulo Vargas Peixoto

2003-12-01

streaks extending from cortex to medulla, and congestion. Histologically there was a severe acute tubular nephrosis, dispersed foci of coagulative necrosis in the liver, areas of coagulative necrosis in the myocardium and acute incipient interstitial pneumonia as well as secondary bronchopneumonia. Myocardial coagulative necrosis observed in seven sheep was attributed to hyperkalemia secondary to renal insufficiency. No references to spontaneous A. spinosus poisoning in sheep was found in the literature. Attempt to reproduce the poisoning by administration of the plant to sheep was insuccessful, probably because A. spinosus used was not from fertilized areas.

[Detection and clinical analysis of acute lower respiratory tract infection with human coronaviruses in children in Beijing area 2007-2015].

Science.gov (United States)

Qian, Yi; Xie, Zhengde; Ren, Lili; Liu, Chunyan; Xiao, Yan; Xu, Baoping; Yang, Yan; Qian, Suyun; Geng, Rong; Shen, Kunling

2015-09-01

To investigate human coronaviruses (HCoVs) infection in children with acute lower respiratory tract infection(ALRTI)and to explore the clinical features of ALRTI caused by HCoVs in children. Totally 4 371 children with clinical diagnosis of ALRTI during the period from March 2007 to February 2015 seen in Beijing Children's Hospital were recruited into this study. Patients were divided into 4 groups by age, including 1 890 cases in respiratory viruses including HCoVs (including HCoV-OC43, HCoV-229E, HCoV-NL63 and HCoV-HKU1), respiratory syncytial virus (RSV) and so on. Clinical features of ALRTI with single HCoVs infection were analyzed and compared with hospitalized ALRTI cases with single RSV infection in the same period. (1) Totally 2 895 cases were positive for at least one virus in this study in 4 371 ALRTI patients (positive rate 66.23%), in which 147 cases were positive for HCoVs infection (positive rate 3.36%). (2) Positive rates of HCoVs in each year from 2007 to 2014 were 6.11%, 3.79%, 4.69%, 4.31%, 2.38% 2.10%, 0.77% and 2.65%, respectively. The mean positive rates of HCoVs for each month from January to December were 2.53%, 2.12%, 3.63%, 6.68%, 1.53%, 3.77%, 3.92%, 3.00%, 2.15%, 5.26%, 3.01% and 2.80%. (3) Detection results of each subtypes of HCoVs in total 4 371 pediatric ALRTI patients were: 48 cases positive for HCoV-OC43(1.10%), 32 cases positive for HCoV-229E(0.73%), 25 cases positive for HCoV-NL63 (0.57%), 27 cases positive for HCoV-HKU1 (0.62%). (4) Positive rates of HCoVs infection in infection of HCoVs in this study, of which 12 cases were diagnosed as bronchopneumonia, 3 cases developed acute laryngeal obstruction, 2 cases had acute bronchial asthma attack. Common clinical manifestations included cough (14 cases), gasping (13 cases), dyspnea (9 cases), fever (6 cases), hoarseness (4 cases), laryngeal stridor (4 cases) and abnormality on chest X-ray (including fuzzy lung texture, patchy shadow and consolidation) (12 cases). (6) There were no

Infecção de prótese vascular em cirurgia da aorta torácica: revisão da experiência e relato de caso tratado por técnica não convencional Vascular prosthesis infection in thoracic aorta surgery: review of the experience and a case report illustrating treatment with an unconventional technique

Directory of Open Access Journals (Sweden)

Ronaldo Ducceschi Fontes

2004-03-01

Full Text Available Relatamos o caso de uma paciente de 37 anos de idade, que há cinco anos havia sido submetida à operação de Bental-de Bono em nosso serviço e retornou com dor de forte intensidade no toráx, sendo diagnosticada dissecção aguda de aorta do tipo III e tratada clinicamente. Um ano após esse episódio houve expansão dessa dissecção e a paciente foi submetida à cirurgia com interposição de prótese de dacron em aorta descendente. No pós-operatório imediato houve broncopneumonia esquerda e a paciente recebeu alta em boas condições e afebril. Após um mês da alta, retornou com febre e toxemia. Com diagnóstico de empiema pleural, foi submetida à toracotomia exploradora que não confirmou esse diagnóstico, havendo apenas intenso espessamento pleural. Quatro meses após a toracotomia exploradora, foram isolados Klebsiella pneumoniae e Enterobacter sp na hemocultura. A ressonância magnética revelou imagens compatíveis com infecção peri-prótese. Com esse quadro clínico e laboratorial foi indicada a remoção do enxerto e derivação axilo-bifemoral. A operação foi realizada com sucesso, a paciente recebeu alta em boas condições e continua fazendo controle ambulatorial e, atualmente, encontra-se com 57 meses de evolução sem complicações. São discutidos os métodos empregados para o diagnóstico e tratamento da infecção de prótese na cirurgia da aorta torácica.We report the case of a 37-year-old-female patient who had undergone a Bentall procedure at our service and returned with intense chest pain and acute aortic dissection type III, which was diagnosed and clinically treated. One year after this episode, this dissection expanded, and the patient underwent surgery with interposition of a Dacron graft in the descending aorta. In the immediate postoperative period, the patient experienced left bronchopneumonia and was discharged afebrile and in good condition. One month after discharge, she returned with fever and

Análisis de la morbilidad y mortalidad en recién nacidos con peso inferior a 1500 g Analysis of morbidity and mortality in newborns weighing less than 1500 g

Directory of Open Access Journals (Sweden)

Yanett Sarmiento Portal

2009-12-01

in Pinar del Río Province. METHODS: An analytical, prospective, longitudinal and observational research in Neonatal Intensive Care Unit (NICU of this hospital between January and December, 2007. Group included all live neonates weighing less than 1500 g admitted in NICU during the established period and sample included 52 neonates. Variables like sex, gestational age, weight, and intrauterine growth, the need of mechanic ventilation, complications and survival were analyzed. In SPSS 12 was created a database. Variables were analyzed by conceptual method. RESULTS: There was predominance of male sex (53,9%, gestational ages was between 27 and 29,6 weeks (44,2% and uterine growth with a suitable weight according gestational age (84,6%. Hyaline membrane disease (55,8% and metabolic disorders (50% are the more frequent morbidities. The 59,6% of newborns needed mechanic ventilation and bronchopneumonia was the leading cause of death in 40% of cases. Survival rate was of 90,4%.

Efeito da continuidade da fisioterapia respiratória até a alta hospitalar na incidência de complicações pulmonares após esofagectomia por câncer Effect of sustained respiratory care until hospital discharge on the incidence of pulmonary complications following esophagectomy for cancer

Directory of Open Access Journals (Sweden)

Adriana Claudia Lunardi

2008-01-01

higher tobacco consumption than ICUg ones (35.7±17.6 vs 26.1±18.4 packs-year, p<0.05, there were 20% less pulmonary complications in this group when compared to the ICU group (10% vs 30%, p<0.05: lesser incidence (75% of pleural effusion and 50% less of bronchopneumonia. DISg also had undergone a shorter time (less 4.5 days with pleural drain on (p<0.05. These findings suggest chest physical therapy care all along hospital stay until discharge may reduce pulmonary complications after esophagectomy for cancer.

Toward a standardized investigation protocol in sudden unexpected deaths in infancy in South Africa: a multicenter study of medico-legal investigation procedures and outcomes.

Science.gov (United States)

du Toit-Prinsloo, Lorraine; Dempers, Johan; Verster, Janette; Hattingh, Christa; Nel, Hestelle; Brandt, V D; Jordaan, Joyce; Saayman, Gert

2013-09-01

done in a total of 14 (0.5 %) cases. Discrepancies were present in the extent of the macroscopic post-mortem examinations, as well as the type and extent of the ancillary investigations performed. The investigations were completed in 2,583 of the cases. The majority of these infants died from natural disease processes [1,976 infants (76.5 %)]. Bronchopneumonia was the leading cause of natural deaths at all the mortuaries [674 cases (26.1 %)]. SIDS was diagnosed in only 224 cases (8.7 %) and in 383 (14.8 %) cases, where a full post-mortem examination with ancillary investigations was conducted; the cause of death was recorded as "unascertained." This study indicated that the admission criteria (to medico-legal mortuaries) and the investigative process/protocols in cases of SUDI differ greatly among 5 of the largest academic medical institutions in South Africa. Establishing and implementing standardized admission criteria (to medico-legal mortuaries) and implementing uniform investigative and autopsy protocols would appear to be an essential prerequisite to gain better understanding of the mystery of SIDS in South Africa.

Analysis of epidemiological and clinical characteristics of patients admitted diagnosed with acute ischemic cerebrovascular event in internal medicine services and neurology of the Hospital Mexico in March 2013 to March 2014

International Nuclear Information System (INIS)

Araya Gonzalez, Manuel Alberto

2014-01-01

transformation was documented in 6% of cases. 70% of patients were performed Doppler ultrasound of neck vessels. Without injuries 82%, 9% with obstruction between 50-70% and 9% with over 70% lumen obstruction. Echocardiography was performed in 54% of cases and 76% was obtained left ventricular hypertrophy, left atrial dilation 37% and 2% intramural thrombus. With respect to functionality 81% of patients had no or minimal dependence upon admission, to the time of discharge 74% have had moderated to severe disability, 12% mild and only 14% had no disability or this was minimal. 51% of patients have presented one or more complications during hospitalization, the 5 most frequent have been: bronchopneumonia 25%, bronchial aspiration and urinary tract infection 19%, 16% cognitive impairment and 10% cardiac arrhythmias. The average overall stay has been 13 days. Internal medicine has been 14± days and in neurology has been 12 ± days. The mortally rate has been 19% while 71% of patients were discharged to home and 10% were moved to the medical center. (author) [es

Pathogenicity of Rhodococcus equi in mice, isolated from environment, human and horse clinical samples Patogenicidade atogenicidade em camundongos de isolados clí- clínicos, nicos, ambientais e humanos de Rhodococcus equi

Directory of Open Access Journals (Sweden)

Mateus M. Costa

2006-09-01

Full Text Available Rhodococcus equi is a facultative intracellular pathogen associated with bronchopneumonia, mesenteric lymphadenitis and enterocolitis in foals. Although R. equi is likely to be found in every horse-breeding farm, the clinical disease is unrecognized in most of them. Capsule components, equi factor, micolic acid and some products encoded by the large 85-90Kb plasmid were described as virulence factors. However, the pathogenesis of R. equi infections and the sensibility of foals are not completely understood. The aim of this study was evaluate the virulence of R. equi isolated from human, horses and environment for mices. Nine strains carrying the 85-90Kb plasmid isolated from foal clinical specimens, one from immunodeficient human patient and six plasmidless strains (four isolated from feces, one from pasture and one from immunodeficient human patient were inoculated in cyclophosphamide immunossuppressed mice. The pathological changes and viability of R. equi cells in the liver of mice was verified after the 3rd, 6th an 10th day after inoculation for horse and environmental isolates and for R. equi isolates from human patients on the 1st, 3rd and 6th day. During the necropsy procedures, infiltrate of macrophages and pyogranulomatous lesions were detected after the sixth pos-inoculation day in the liver and spleen. In horse isolates, only plasmid positive strains were virulent, but in human isolates both strains (plasmid positive e plasmid negative were virulent. Both groups of the immunossupressed mice inoculated with R. equi isolated from environment showed pathological changes. All R. equi strains were unable to kill non imunossuppressed mice.Rhodococ-cus equi é um patógeno intracelular facultativo associado com broncopneumonia, linfadenite mesentérica e enterocolite em potros. Apesar do patógeno ser amplamente distribuído no ambiente equino, a doença não é encontrada em todos os criatórios. Componentes capsulares, "fator equi", �

Tumores primarios de la pared torácica Primary tumors of the thorax wall

Directory of Open Access Journals (Sweden)

Bárbaro Agustín Armas Pérez

2011-09-01

conducted to analyze the results of surgical treatment in 22 patients (sample with primary tumors of the thorax wall during 15 years (from January,1993 to December, 2008 in the services of general surgery and orthopedics of the "Amalia Simoni" Hospital of the Camagüey province. Results: there was a slight predominance of female sex and the age group from 17 to 44 years (mean, 39.4, the predominant comorbid disease was the high blood pressure, the right hemithorax was the more involved and the ribs from 1 to 4 were the more injured with predominance of benign affections including the osteochondroma. The treatment more applied was the surgical resection and the postoperative complication predominant was the bronchopneumonia. The tumor relapse rate was high but not always due to cancer. The were 4 deceased due to advanced malignant disease without perioperative deaths. Conclusions: results were compared to other reports with coincidence points in different features but also differing and try to unify criteria to improve diagnosis y the results of treatment of these patients. Most of patients were without complications and the tumor relapse was over the expected. The tumor resection always must to be wide. Global result was satisfactory.

Síndrome antissintetase anti-Jo-1 Anti-Jo-1 antisynthetase syndrome

Directory of Open Access Journals (Sweden)

Samuel Katsuyuki Shinjo

2010-10-01

. Clinical-laboratory and demographic data were obtained from medical files. All patients fulfilled the Bohan and Peter criteria (1975 and presented anti-Jo-1, articular, muscle and lung involvement. Eighteen patients with anti-Jo-1 ASS were analyzed. RESULTS: The mean age at disease onset was 39.9 ± 15.7 years and average disease duration was 9.7 ± 7.0 years. All subjects were white, and 94.4% were female. Constitutional symptoms occurred in 50 % of cases. There was cutaneous and gastrointestinal tract involvement in 66.6% and 55.6% of cases, respectively. No cases manifested neurologic or cardiac involvement. Half of the patients showed incipient pneumopathy, ground-glass opacities and basal pulmonary fibrosis. There was one case of tuberculosis, three of herpes zoster and one of non-Hodgkin lymphoma. One death occurred due to sepsis shock (hospital bronchopneumonia. All patients received prednisone (1mg/kg/day and 12 (66.7% participants received methyl prednisolone pulse therapy (1g/day, 3 days. Various immunosuppressants were used as corticosteroid tapers, depending on tolerance, side effects and/or refractoriness. Although disease relapse (clinical and/or laboratory occurred in 87.5% of cases, 12 out of 16 patients (75% were in disease remission at study endpoint. CONCLUSION: In the present study, almost all patients were white females and the disease relapse rate was high.

Doenças de ovinos diagnosticadas no Laboratório de Anatomia Patológica Animal da Universidade Federal de Mato Grosso do Sul (1996-2010 Sheep diseases diagnosed at the Laboratory of Animal Pathology, Federal University of Mato Grosso do Sul, Brazil (1996-2010

Directory of Open Access Journals (Sweden)

Thiago L. Almeida

2013-01-01

compile data and perform retrospective studies to provide important insight for professionals. A prevalence study from January 1996 to December 2010 was carried out in the archives of Laboratório de Anatomia Patológica Animal (LAP, Universidade Federal de Mato Grosso do Sul (UFMS. Laboratório de Bacteriologia, UFMS, and Setor de Patologia Veterinária at Universidade Federal do Rio Grande do Sul helped on the diagnostic of pulmonary mannheimiosis and scrapie respectively. The reports for sheep were reviewed and grouped into conclusive and inconclusive ones. The conclusive cases were classified according to the etiology of the disease. In the period, 331 exams (3.97% were done. Sixty-four experimental cases and materials from other states or countries (19.3% were excluded. Remaining cases (267, eighty-seven (32.6% were inconclusive and 180 (67.4% were considered conclusive reports, were classified according to the etiology: 60 (33.3% infectious and parasitary diseases; 45 (25% were poisonings and toxi-infections; 41 (22.8% were summarized as "injuries without apparent cause"; 22 (12.2% cases of metabolic and nutritional diseases; 10 (5.6% were classified as "other disorders" and 2 (1.1% case of neoplasms. Haemonchosis, fibrinonecrotic or fibrinopurulent pleuropneumonia, bronchopneumonia and pneumonia, poisonings by Brachiaria spp. and copper poisoning were the most prevalent diseases in sheep. Two cases of scrapie have been diagnosed in this period.

Alterações histopatológicas pulmonares em pacientes com insuficiência respiratória aguda: um estudo em autopsias Pulmonary histopathological alterations in patients with acute respiratory failure: an autopsy study

Directory of Open Access Journals (Sweden)

Alexandre de Matos Soeiro

2008-02-01

patients with acute respiratory failure (ARF and determine whether underlying diseases and certain associated risk factors increase the incidence of these histopathological patterns. METHODS: Final autopsy reports were reviewed, and 3030 autopsies of patients > 1 year of age with an underlying disease and associated risk factors were selected. All had developed diffuse infiltrates and died of ARF-related pulmonary alterations. RESULTS: The principal pulmonary histopathological alterations resulting in immediate death were diffuse alveolar damage (DAD, pulmonary edema, lymphocytic interstitial pneumonia (LIP and alveolar hemorrhage. The principal underlying diseases were AIDS, bronchopneumonia, sepsis, liver cirrhosis, pulmonary thromboembolism, acute myocardial infarction (AMI, cerebrovascular accident, tuberculosis, cancer, chronic kidney failure and leukemia. The principal associated risk factors were as follows: age > 50 years; arterial hypertension; congestive heart failure; chronic obstructive pulmonary disease; and diabetes mellitus. These risk factors and AIDS correlated with a high risk of developing LIP; these same risk factors, if concomitant with sepsis or liver cirrhosis, correlated with a risk of developing DAD; thromboembolism and these risk factors correlated with a risk of developing alveolar hemorrhage; these risk factors and AMI correlated with a risk of developing pulmonary edema. CONCLUSION: Pulmonary findings in patients who died of ARF presented four histopathological patterns: DAD, pulmonary edema, LIP and alveolar hemorrhage. Underlying diseases and certain associated risk factors correlated positively with specific histopathological findings on autopsy.

Tratamento cirúrgico das bronquiectasias. Revisão de 34 casos

Directory of Open Access Journals (Sweden)

Aurora Lino

1997-07-01

treatment relies on surgical ressection. In the period between 1988 and 1995, 34 patients with bronchiectasis, 17 women and 17 men, with mean age of 43,8±17,9 years, underwent surgery. Indications for surgery were as follows: failure of medical treatment in 17 patients (50%, who presented with recurrent bronchopulmonary infections; occurrence of complications, such as hemoptysis and/or blood stained sputum, in 15 patients (44%; pulmonary mass lesion of uncertain etiology in 2 patients (5,8%. We were able to determine the etiology in 23 patients: bronchopneumonia in childhood and/or adolescence in 12 patients, sequelae to pulmonary tuberculosis in 10 patients and aspiration of a foreign body in one case. Sputum production, cough, hemoptysis and/or blood stained sputum were the most frequent symptoms. Anatomycal involvement of the lesions was documented by CT scan, in 26 patients, I 0 of whom also underwent bronchography. In 8 patients bronchography alone was performed. In all patients except one, lesions were unilateral and preferentially located in the LIL, RSL and RML. Before surgery, pulmonary function changes, were predominantly of the obstructive type (14 patients or 41 %.The following surgical procedures were done: 4 pneumectomys, 23 lobectomys (5 associated with segmental ressections, 4 segmentec-tomys and 3 bilobectomys. Post surgical mortality was null and morbidity was 20% (7 patients. In post-surgical follow-up, during 6-24 month period, 20 patients (58,8% remained asymptomatic, 11 (32,3% showed substantial clinical improvement without deterioration of their respiratory function and in 3 (8,8% surgical ressection was not beneficial. Palavras-chave: bronquiectasias, tratamento cirúrgico, avaliação funcional respiratória, : Key-words, bronchiectasis, surgical treatment, pulmonary function testing

Implante transapical de endoprótese valvada balão-expansível em posição aórtica sem circulação extracorpórea Off-pump transapical balloon-expandable aortic valve endoprosthesis implantation

Directory of Open Access Journals (Sweden)

Diego Felipe Gaia

2009-06-01

ão.OBJECTIVE: The aortic valve replacement is a routine procedure, and involves replacement of the native valve/prosthesis. In most of the patients who undergo such procedure the risk is acceptable, but in some cases, such risk can justify contraindication. The minimally invasive transcatheter aortic valve implantation without cardiopulmonary bypass (CPB has been shown to be viable, with lower morbidity and mortality. The aim of this study was to develop a catheter-mounted aortic bioprosthesis for implantation without CPB. METHODS: After developing in animals, three patients with high EuroSCORE underwent implantation. Case 1: patients with bioprosthesis dysfunction; Case 2: severe aortic stenosis; Case 3: dysfunction of aortic bioprosthesis. After minithoracotomy and under echocardiographic and fluoroscopic control, a balloon catheter was placed on aortic position and inflated. After, a second balloon with valved endoprosthesis was positioned and released under high ventricular rate. Echocardiographic and angiographic controls were performed and the patients were referred to ICU. RESULTS: In the first case, implantation without CPB was possible with appropriate results. The patient evolved with improvement of ventricular function. After, this patient developed bronchopneumonia, tracheoesophageal fistula and died due to mediastinitis. Autopsy confirmed proper valve positioning and leaflets preservation. The second case showed the device migration after inflation of the balloon, with the need for urgent median sternotomy, CPB and conventional valve replacement. This patient evolved well and was discharged from the ICU on the 14th postoperative day without complications. This patient developed respiratory infection, septic shock and died on the 60th postoperative day. The patient from the third case underwent successful implantation. CONCLUSION: The off-pump transapical implantation of catheter-mounted bioprosthesis was shown to be a feasible procedure. Technical details and learning

支气管结核误诊为肺癌七例临床分析%Clinical Analysis of 7 Patients with Bronchial Tuberculosis Misdiagnosed as Having Lung Cancer

Institute of Scientific and Technical Information of China (English)

陈凤; 胥进

2017-01-01

having bronchial lung cancer, and 1 was misdiagnosed as having bronchopneumonia combined with pulmonary tuberculosis.Misdiagnosed time was 1-12 months.Patients'' conditions did not obviously improve after corresponding treatment for misdiagnosed diseases.Bronchial tuberculosis was confirmed after bronchovideoscopy, repeated bronchial mucosal histopathologic examination under fiberoptic bronchoscopy and brushing smear for finding acid fast bacilli.The 7 patients received treatments such as anti-tuberculosis routine therapy, which included 1 patient with surgical resection and 1 with stent placement.Symptoms of the 7 patients were relieved after treatment for 1 month, and rechecking chest X-ray or CT showed that lesions were absorbed compared with those before treatment.The patients were discharged after hospitalization for 1-5 months, and anti-tuberculosis therapy was continued after discharging.Conclusion Bronchial tuberculosis is easily misdiagnosed as lung cancer because of atypically clinical manifestations, and similar manifestations to lung cancer by X-ray and CT examinations.Patients with similar manifestations to the patients in this study should give bronchovideoscopy, repeated bronchial mucosal histopathologic examination under fiberoptic bronchoscopy and brushing smear for finding acid fast bacilli in time in order to confirm the diagnosis as early as possible.

Perfil de internações hospitalares por doenças respiratórias em crianças e adolescentes da cidade de São Paulo, 2000-2004 Perfil de internaciones hospitalares por enfermedades respiratorias en niños y adolescentes de la ciudad de São Paulo, 2000-2004 Hospital admissions due to respiratory diseases in children and adolescents of São Paulo city, 2000-2004

Directory of Open Access Journals (Sweden)

Renata Martins de T Natali

2011-12-01

described. RESULTS: Pneumonia and bronchopneumonia (51%, asthma (18% and acute and chronical diseases from upper airways (10% accounted for most of the admissions. Children up to five years are most frequently hospitalized, regardless of the specific cause. Among adolescents, the main causes of hospitalization were respiratory diseases that affects mainly the interstitial lung (0.1% and the necrotic and suppurative diseases of lower airways (0.2%. From the age of six to ten years, admissions for acute and chronic diseases from upper airways (10% were predominant. The peak of morbidity occurs in early autumn. There was a trend towards increasing hospital admissions for respiratory illnesses during the analyzed period. CONCLUSIONS: The distribution of hospital admissions for respiratory diseases in children and adolescents is dependent on age and season. The younger the age the greater the number of hospital admissions.

Sorotipagem de amostras de Streptococcus suis isoladas de suínos em granjas dos Estados de São Paulo, Minas Gerais e Paraná Serotyping of Streptococcus suis strains isolated from pigs in the States of São Paulo, Minas Gerais e Paraná, Brazil

Directory of Open Access Journals (Sweden)

Keila J.R. Pagnani

2002-01-01

-aglutinação, para a sorotipagem das amostras de S. suis. A sorotipagem das 51 amostras isoladas mostraram os seguintes resultados: 30 (58,8% foram classificadas como sorotipo 2, 11 (21,6% das amostras como sorotipo 3, sete (13,72% como sorotipo 7, duas (3,92% como sorotipo 1 e uma amostra como pertencente ao sorotipo14 (1,96%. Este é o primeiro relato do isolamento de um grande número de amostras de S. suis no Brasil, de casos típicos de processos infecciosos causados por esta bactéria. Também foi realizada a sorotipagem dos isolados, mostrando uma alta prevalência do sorotipo 2, quando comparada com a dos demais sorotipos encontrados.Streptococcus suis infection in swine is common in all countries where hog production is well developed. This infection has been associated with bronchopneumonia, meningitis, arthritis, pericarditis, myocarditis, endocarditis, fibrinous polyserositis, septicaemia, rhinitis, and abortion. Streptococcus suis has also been described as a pathogen for ruminants and humans. In Brazil there are several clinical evidences about the existence of S. suis disease in pigs affecting more than 50% of farms in States of São Paulo, Minas Gerais and Paraná. In the present research 51 strains of S. suis isolated from piggeries of the States of São Paulo, Minas Gerais and Paraná were collected from different pathologies such as septicaemia, meningitis, arthritis and pneumonia and been recovered either in pure culture or as the predominant organism from porcine tissues. Culture of specimens was carried out on 5% bovine blood agar plates incubated at 37°C for 24 hr. For the biochemical identification the a-hemolytic colonies of all capsulated isolates were submitted to various conventional tests, such as hydrolysis of arginine, Voges-Proskauer Test, and production of acid from various carbohydrates (inulin, salicin, trehalose, lactose, sucrose, sorbitol, mannitol and glycerol. The strains were also tested for their ability to grow in the presence of 6,5% Na

C3. Pneumonias da comunidade num serviço de Pneumologia

Directory of Open Access Journals (Sweden)

Sandra André

2003-11-01

, sendo a ausência de resposta clínica o motivo mais frequente (6.As principais complicações foram: derrame pleural parapneumónico -4; Empiema -1; Pneumotórax -1; Pneumonia necrotizante -4.A baixa rentabilidade diagnóstica pode dever-se à realização de exames microbiológicos após início de antibioterapia. A duração do internamento parece estar relacionada com o tempo de antibioterapia e com a presença de complicações. O padrão radiológico não se correlaciona com o tempo de internamento. : Community-acquired pneumonia (CAP is a frequent cause of hospital admission and its characterization is important to standardize medical procedures.The aim of this study was to evaluate the clinical, laboratorial and radiological presentation features of CAP, its microbiological diagnosis, management, clinical evolution and major complications.We aimed to studied prospectively patients admitted in our Pneumology Department between 2002 June and 2003 May with CAP diagnosis, using a special designed protocol. 23 patients (15 men and 8 women were admitted. 43,5% were active smokers.Average stay length was 14,0±8,0 days. 43,5% of patients had associated pathology.Evolution of symptoms before admission was 5,4±2,8 days. Sputum production, thoracic pain, dyspnoea and fever were the most often presentation symptoms. 73,4% of patients was hypoxemic. The most sensitive laboratorial data were elevated white blood count, SR or PCR.About radiological presentation: bilateral involvement -9; unilateral d”1 lobe – 12, > lobe –2; pleural effusion associated -6; cavitation -4; atelectasis -1. Bronchopneumonia pattern was the most prevalent (56,5%.Microbiological diagnosis was attempted in 39%.Empirical antibiotic regimen was started in all patients. First choice antibiotics were: cephalosporin+macrolide – 6; amoxycillin/ clavulanate -3; levofloxacin -2; macrolide -3; other regiments with macrolide -4. Patients with

Analysis of epidemiological and clinical characteristics of patients admitted diagnosed with acute ischemic cerebrovascular event in internal medicine services and neurology of the Hospital Mexico in March 2013 to March 2014; Analisis de las caracteristicas epidemiologicas y clinicas de los pacientes ingresados con diagnostico de evento cerebrovascular isquemico agudo en los servicios de medicina interna y neurologia del Hospital Mexico de marzo 2013 a marzo 2014

Energy Technology Data Exchange (ETDEWEB)

Araya Gonzalez, Manuel Alberto

2014-07-01

transformation was documented in 6% of cases. 70% of patients were performed Doppler ultrasound of neck vessels. Without injuries 82%, 9% with obstruction between 50-70% and 9% with over 70% lumen obstruction. Echocardiography was performed in 54% of cases and 76% was obtained left ventricular hypertrophy, left atrial dilation 37% and 2% intramural thrombus. With respect to functionality 81% of patients had no or minimal dependence upon admission, to the time of discharge 74% have had moderated to severe disability, 12% mild and only 14% had no disability or this was minimal. 51% of patients have presented one or more complications during hospitalization, the 5 most frequent have been: bronchopneumonia 25%, bronchial aspiration and urinary tract infection 19%, 16% cognitive impairment and 10% cardiac arrhythmias. The average overall stay has been 13 days. Internal medicine has been 14± days and in neurology has been 12 ± days. The mortally rate has been 19% while 71% of patients were discharged to home and 10% were moved to the medical center. (author) [Spanish] Expedientes de 100 pacientes internos fueron revisados con el diagnostico de evento cerebrovascular isquemico, en los servicios de neurologia y medicina interna del Hospital Mexico desde marzo del 2013 hasta marzo del 2014. Del total de pacientes 46 eran hombres y 54 eran mujeres. La edad promedio en general era de 69 anos, para los hombres ha sido de 66 anos y para las mujeres de 71. Pacientes de todas las provincias fueron ingresados, principalmente de San Jose con un 56% y Alajuela con un 19%. El manejo intrahospitalario segun especialidad fue distribuido en 60% medicina interna y 40% neurologia. Los factores de riesgo mas frecuentemente encontrados han sido: hipertension arterial 85%, diabetes mellitus 40%, tabaquismo 35%, dislipidemia 35%. El sobrepeso fue observado en 23% de los pacientes y la obesidad en 22%. En cuanto a las manifestaciones clinicas iniciales documentadas en la primera exploracion fisica, las 6

Clonidina como droga adjuvante no tratamento da síndrome de abstinência alcoólica em unidade de terapia intensiva: relato de caso Clonidina como droga coadyuvante en el tratamiento de la síndrome de abstinencia alcohólica en unidad de terapia intensiva: relato de un caso Clonidine as adjuvant therapy for alcohol withdrawal syndrome in intensive care unit: case report

Directory of Open Access Journals (Sweden)

Leandro Gobbo Braz

2003-12-01

alta de la UTI. CONCLUSIONES: La droga escogida para el tratamiento del síndrome de abstinencia alcohólico es el benzodiazepínico. No obstante, en el presente relato, solamente el uso coadyuvante de clonidina consiguió proporcionar tratamiento adecuado al paciente.BACKGROUND AND OBJECTIVES: Sedation of patients with past history of alcohol and drug abuse in Intensive Care Units (ICU is a challenge due to the high incidence of sedative drugs tolerance and withdrawal syndromes. This report aimed at describing a case of a young patient admitted to the ICU who developed alcohol withdrawal syndrome and tolerance to sedatives, resolved only after clonidine administration. CASE REPORT: Male patient, 18 years old, alcohol, tobacco, cocaine and marijuana abuser, victim of firearm accident, who was admitted to the ICU in the first post-enterectomy day, after gastric content aspiration during tracheal re-intubation. Clinical evolution was: vasoactive drugs up to the 4th day; bilateral bronchopneumonia with pleural effusion and need for artificial ventilation up to the 15th day. Initial sedation scheme was the association of midazolam and fentanyl. As from the 4th day, patient presented with several psychomotor agitation episodes, even after the association of lorazepam in the 6th day. In the 9th day, patient received the largest doses but remained agitated. Dexmedetomidine was associated, which has decreased other drug doses in 35% and has improved agitation. In the 12th day, midazolam and dexmedetomidine were replaced by propofol infusion with worsening of agitation. In the 13th day, clonidine was associated to the sedation scheme with total resolution of agitation. Propofol was withdrawn in the 14th day, fentanyl was maintained and midazolam infusion was restarted, with doses 75% and 65% lower as compared to peak doses of such drugs. Patient was extubated in the 15th day and was discharged from ICU. CONCLUSIONS: Benzodiazepines should remain the drugs of choice for the