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Sample records for acute beryllium disease

  1. Chronic Beryllium Disease

    Science.gov (United States)

    ... Science Education & Training Home Conditions Chronic Beryllium Disease Chronic Beryllium Disease Make an Appointment Find a Doctor Ask a ... MD, MSPH, FCCP (February 01, 2016) What is chronic beryllium disease (CBD)? Chronic beryllium disease (CBD) is a disease ...

  2. Transgenic Mouse Model of Chronic Beryllium Disease

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, Terry

    2009-05-26

    Animal models provide powerful tools for dissecting dose-response relationships and pathogenic mechanisms and for testing new treatment paradigms. Mechanistic research on beryllium exposure-disease relationships is severely limited by a general inability to develop a sufficient chronic beryllium disease animal model. Discovery of the Human Leukocyte Antigen (HLA) - DPB1Glu69 genetic susceptibility component of chronic beryllium disease permitted the addition of this human beryllium antigen presentation molecule to an animal genome which may permit development of a better animal model for chronic beryllium disease. Using FVB/N inbred mice, Drs. Rubin and Zhu, successfully produced three strains of HLA-DPB1 Glu 69 transgenic mice. Each mouse strain contains a haplotype of the HLA-DPB1 Glu 69 gene that confers a different magnitude of odds ratio (OR) of risk for chronic beryllium disease: HLA-DPB1*0401 (OR = 0.2), HLA-DPB1*0201 (OR = 15), HLA-DPB1*1701 (OR = 240). In addition, Drs. Rubin and Zhu developed transgenic mice with the human CD4 gene to permit better transmission of signals between T cells and antigen presenting cells. This project has maintained the colonies of these transgenic mice and tested the functionality of the human transgenes.

  3. Chronic Beryllium Disease Prevention Program Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, S

    2012-03-29

    This document describes how Lawrence Livermore National Laboratory (LLNL) meets the requirements and management practices of federal regulation 10 CFR 850, 'Chronic Beryllium Disease Prevention Program (CBDPP).' This revision of the LLNL CBDPP incorporates clarification and editorial changes based on lessons learned from employee discussions, observations and reviews of Department of Energy (DOE) Complex and commercial industry beryllium (Be) safety programs. The information is used to strengthen beryllium safety practices at LLNL, particularly in the areas of: (1) Management of small parts and components; and (2) Communication of program status to employees. Future changes to LLNL beryllium activities and on-going operating experience will be incorporated into the program as described in Section S, 'Performance Feedback.'

  4. Chronic beryllium disease: Diagnosis and management

    Energy Technology Data Exchange (ETDEWEB)

    Rossman, M.D. [Hospital of the Univ. of Pennsylvania, Philadelphia, PA (United States)

    1996-10-01

    Chronic beryllium disease is predominantly a pulmonary granulomatosis that was originally described in 1946. Symptoms usually include dyspnea and cough. Fever, anorexia, and weight loss are common. Skin lesions are the most common extrathoracic manifestation. Granulomatous hepatitis, hypercalcemia, and kidney stones can also occur. Radiographic and physiologic abnormalities are similar to those in sarcoidosis. While traditionally the pathologic changes included granulomas and cellular interstitial changes, the hallmark of the disease today is the well-formed granuloma. Immunologic studies have demonstrated a cell-mediated response to beryllium that is due to an accumulation of CD4{sup +} T cells at the site of disease activity. Diagnosis depends on the demonstration of pathologic changes (i.e., granuloma) and evidence that the granuloma was caused by a hypersensitivity to beryllium (i.e., positive lung proliferative response to beryllium). Using these criteria, the diagnosis of chronic beryllium disease can now be made before the onset of clinical symptoms. Whether, with early diagnosis, the natural course of this condition will be the same as when it was traditionally diagnosed is not known. Currently, corticosteroids are used to treat patients with significant symptoms or evidence of progressive disease. 21 refs.

  5. Beryllium

    Science.gov (United States)

    Foley, Nora K.; Jaskula, Brian W.; Piatak, Nadine M.; Schulte, Ruth F.; Schulz, Klaus J.; DeYoung, John H.; Seal, Robert R.; Bradley, Dwight C.

    2017-12-19

    Beryllium is a mineral commodity that is used in a variety of industries to make products that are essential for the smooth functioning of a modern society. Two minerals, bertrandite (which is supplied domestically) and beryl (which is currently supplied solely by imports), are necessary to ensure a stable supply of high-purity beryllium metal, alloys, and metal-matrix composites and beryllium oxide ceramics. Although bertrandite is the source mineral for more than 90 percent of the beryllium produced globally, industrial beryl is critical for the production of the very high purity beryllium metal needed for some strategic applications. The current sole domestic source of beryllium is bertrandite ore from the Spor Mountain deposit in Utah; beryl is imported mainly from Brazil, China, Madagascar, Mozambique, and Portugal. High-purity beryllium metal is classified as a strategic and critical material by the Strategic Materials Protection Board of the U.S. Department of Defense because it is used in products that are vital to national security. Beryllium is maintained in the U.S. stockpile of strategic materials in the form of hot-pressed beryllium metal powder.Because of its unique chemical properties, beryllium is indispensable for many important industrial products used in the aerospace, computer, defense, medical, nuclear, and telecommunications industries. For example, high-performance alloys of beryllium are used in many specialized, high-technology electronics applications, as they are energy efficient and can be used to fabricate miniaturized components. Beryllium-copper alloys are used as contacts and connectors, switches, relays, and shielding for everything from cell phones to thermostats, and beryllium-nickel alloys excel in producing wear-resistant and shape-retaining high-temperature springs. Beryllium metal composites, which combine the fabrication ability of aluminum with the thermal conductivity and highly elastic modulus of beryllium, are ideal for

  6. Development of Biomarkers for Chronic Beryllium Disease in Mice

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, Terry

    2013-01-25

    Beryllium is a strategic metal, indispensable for national defense programs in aerospace, telecommunications, electronics, and weaponry. Exposure to beryllium is an extensively documented occupational hazard that causes irreversible, debilitating granulomatous lung disease in as much as 3 - 5% of exposed workers. Mechanistic research on beryllium exposure-disease relationships has been severely limited by a general lack of a sufficient CBD animal model. We have now developed and tested an animal model which can be used for dissecting dose-response relationships and pathogenic mechanisms and for testing new diagnostic and treatment paradigms. We have created 3 strains of transgenic mice in which the human antigen-presenting moiety, HLA-DP, was inserted into the mouse genome. Each mouse strain contains HLA-DPB1 alleles that confer different magnitude of risk for chronic beryllium disease (CBD): HLA-DPB1*0401 (odds ratio = 0.2), HLA-DPB1*0201 (odds ratio = 15), HLA-DPB1*1701 (odds ratio = 240). Our preliminary work has demonstrated that the *1701 allele, as predicted by human studies, results in the greatest degree of sensitization in a mouse ear swelling test. We have also completed dose-response experiments examining beryllium-induced lung granulomas and identified susceptible and resistant inbred strains of mice (without the human transgenes) as well as quantitative trait loci that may contain gene(s) that modify the immune response to beryllium. In this grant application, we propose to use the transgenic and normal inbred strains of mice to identify biomarkers for the progression of beryllium sensitization and CBD. To achieve this goal, we propose to compare the sensitivity and accuracy of the lymphocyte proliferation test (blood and bronchoalveolar lavage fluid) with the ELISPOT test in the three HLA-DP transgenic mice strains throughout a 6 month treatment with beryllium particles. Because of the availability of high-throughput proteomics, we will also identify

  7. 10 CFR Appendix A to Part 850 - Chronic Beryllium Disease Prevention Program Informed Consent Form

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Chronic Beryllium Disease Prevention Program Informed Consent Form A Appendix A to Part 850 Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Pt. 850, App. A Appendix A to Part 850—Chronic Beryllium Disease Prevention Program Informed...

  8. Measurement of Beryllium in Biological Samples by Accelerator Mass Spectrometry: Applications for Studying Chronic Beryllium Disease

    Energy Technology Data Exchange (ETDEWEB)

    Chiarappa-Zucca, M L; Finkel, R C; Martinelli, R E; McAninch, J E; Nelson, D O; Turtletaub, K W

    2004-04-15

    A method using accelerator mass spectrometry (AMS) has been developed for quantifying attomoles of beryllium (Be) in biological samples. This method provides the sensitivity to trace Be in biological samples at very low doses with the purpose of identifying the molecular targets involved in chronic beryllium disease. Proof of the method was tested by administering 0.001, 0.05, 0.5 and 5.0 {micro}g {sup 9}Be and {sup 10}Be by intraperitoneal injection to male mice and removing spleen, liver, femurs, blood, lung, and kidneys after 24 h exposure. These samples were prepared for AMS analysis by tissue digestion in nitric acid, followed by further organic oxidation with hydrogen peroxide and ammonium persulfate and lastly, precipitation of Be with ammonium hydroxide, and conversion to beryllium oxide at 800 C. The {sup 10}Be/{sup 9}Be ratio of the extracted beryllium oxide was measured by AMS and Be in the original sample was calculated. Results indicate that Be levels were dose-dependent in all tissues and the highest levels were measured in the spleen and liver. The measured {sup 10}Be/{sup 9}Be ratios spanned 4 orders of magnitude, from 10{sup -10} to 10{sup -14}, with a detection limit of 3.0 x 10{sup -14}, which is equivalent to 0.8 attomoles of {sup 10}Be. These results show that routine quantification of nanogram levels of Be in tissues is possible and that AMS is a sensitive method that can be used in biological studies to understand the molecular dosimetry of Be and mechanisms of toxicity.

  9. Exposure and genetics increase risk of beryllium sensitisation and chronic beryllium disease in the nuclear weapons industry.

    Science.gov (United States)

    Van Dyke, Michael V; Martyny, John W; Mroz, Margaret M; Silveira, Lori J; Strand, Matt; Cragle, Donna L; Tankersley, William G; Wells, Susan M; Newman, Lee S; Maier, Lisa A

    2011-11-01

    Beryllium sensitisation (BeS) and chronic beryllium disease (CBD) are caused by exposure to beryllium with susceptibility affected by at least one well-studied genetic host factor, a glutamic acid residue at position 69 (E69) of the HLA-DPβ chain (DPβE69). However, the nature of the relationship between exposure and carriage of the DPβE69 genotype has not been well studied. The goal of this study was to determine the relationship between DPβE69 and exposure in BeS and CBD. Current and former workers (n=181) from a US nuclear weapons production facility, the Y-12 National Security Complex (Oak Ridge, Tennessee, USA), were enrolled in a case-control study including 35 individuals with BeS and 19 with CBD. HLA-DPB1 genotypes were determined by PCR-SSP. Beryllium exposures were assessed through worker interviews and industrial hygiene assessment of work tasks. After removing the confounding effect of potential beryllium exposure at another facility, multivariate models showed a sixfold (OR 6.06, 95% CI 1.96 to 18.7) increased odds for BeS and CBD combined among DPβE69 carriers and a fourfold (OR 3.98, 95% CI 1.43 to 11.0) increased odds for those exposed over an assigned lifetime-weighted average exposure of 0.1 μg/m(3). Those with both risk factors had higher increased odds (OR 24.1, 95% CI 4.77 to 122). DPβE69 carriage and high exposure to beryllium appear to contribute individually to the development of BeS and CBD. Among workers at a beryllium-using facility, the magnitude of risk associated with either elevated beryllium exposure or carriage of DPβE69 alone appears to be similar.

  10. Exposure and genetics increase risk of beryllium sensitisation and chronic beryllium disease in the nuclear weapons industry

    Energy Technology Data Exchange (ETDEWEB)

    Van Dyke, M. V. [National Jewish Health, Denver, CO (United States). Hollis Lab.; Colorado State Univ., Fort Collins, CO (United States); Martyny, John W. [National Jewish Health, Denver, CO (United States). Hollis Lab.; Colorado State Univ., Fort Collins, CO (United States); Univ. of Colorado Denver School of Medicine and Colorado School of Public Health, Denver, CO (United States); Mroz, M. M. [National Jewish Health, Denver, CO (United States). Hollis Lab.; Silveira, L. J. [National Jewish Health, Denver, CO (United States). Hollis Lab.; Strand, M. [National Jewish Health, Denver, CO (United States). Hollis Lab.; Cragle, D. L. [Oak Ridge Associated Univ., Oak Ridge, TN (United States); Tankersley, W. G. [Oak Ridge Associated Univ., Oak Ridge, TN (United States); Wells, S. M. [Oak Ridge Associated Univ., Oak Ridge, TN (United States); Newman, L. S. [Univ. of Colorado Denver School of Medicine and Colorado School of Public Health, Denver, CO (United States); Maier, L. A. [National Jewish Health, Denver, CO (United States). Hollis Lab.; Univ. of Colorado Denver School of Medicine and Colorado School of Public Health, Denver, CO (United States)

    2011-04-02

    Beryllium sensitisation (BeS) and chronic beryllium disease (CBD) are caused by exposure to beryllium with susceptibility affected by at least one well-studied genetic host factor, a glutamic acid residue at position 69 (E69) of the HLA-DPb chain (DPbE69). However, the nature of the relationship between exposure and carriage of the DPbE69 genotype has not been well studied. The goal of this study was to determine the relationship between DP{beta}E69 and exposure in BeS and CBD. Current and former workers (n=181) from a US nuclear weapons production facility, the Y-12 National Security Complex (Oak Ridge, Tennessee, USA), were enrolled in a case-control study including 35 individuals with BeS and 19 with CBD. HLA-DPB1 genotypes were determined by PCR-SSP. Beryllium exposures were assessed through worker interviews and industrial hygiene assessment of work tasks. After removing the confounding effect of potential beryllium exposure at another facility, multivariate models showed a sixfold (OR 6.06, 95% CI 1.96 to 18.7) increased odds for BeS and CBD combined among DP{beta}E69 carriers and a fourfold (OR 3.98, 95% CI 1.43 to 11.0) increased odds for those exposed over an assigned lifetime-weighted average exposure of 0.1 {micro}g/m{sup 3}. Those with both risk factors had higher increased odds (OR 24.1, 95% CI 4.77 to 122). DP{beta}E69 carriage and high exposure to beryllium appear to contribute individually to the development of BeS and CBD. Among workers at a beryllium-using facility, the magnitude of risk associated with either elevated beryllium exposure or carriage of DP{beta}E69 alone appears to be similar.

  11. 75 FR 80734 - Chronic Beryllium Disease Prevention Program

    Science.gov (United States)

    2010-12-23

    .... Background DOE has a long history of beryllium use because of the element's broad application to many nuclear operations and processes. Beryllium metal and ceramics are used in nuclear weapons as nuclear reactor moderators or reflectors and as nuclear reactor fuel element cladding. At DOE, beryllium operations have...

  12. Beryllium disease among construction trade workers at Department of Energy nuclear sites.

    Science.gov (United States)

    Welch, Laura S; Ringen, Knut; Dement, John; Bingham, Eula; Quinn, Patricia; Shorter, Janet; Fisher, Miles

    2013-10-01

    A medical surveillance program was developed to identify current and former construction workers at significant risk for beryllium related disease from work at the DOE nuclear weapons facilities, and to improve surveillance among beryllium exposed workers. Medical examinations included a medical history and a beryllium blood lymphocyte proliferation test (BeLPT). Stratified and multivariate logistic regression analyses were used to explore the risk of disease by age, race, trade, and reported work in buildings where beryllium was used. After adjusting for covariates, the risk of BeS was significantly higher among boilermakers, roofers, and sheet metal workers, as suggested in the stratified analyses. Workers identified as sensitized to beryllium were interviewed to determine whether they had been subsequently diagnosed with chronic beryllium disease. Between 1998 and December 31, 2010 13,810 workers received a BeLPT through the BTMed program; 189 (1.4%) were sensitized to beryllium, and 28 reported that they had had a compensation claim accepted for CBD. These data on former construction workers gives us additional information about the predictive value of the blood BeLPT test for detection of CBD in populations with lower total lifetime exposures and more remote exposures than that experienced by current workers in beryllium machining operations. Through this surveillance program we have identified routes of exposures to beryllium and worked with DOE site personnel to identity and mitigate those exposures which still exist, as well as helping to focus attention on the risk for beryllium exposure among current demolition workers at these facilities. Copyright © 2013 Wiley Periodicals, Inc.

  13. Target organ localization of memory CD4(+) T cells in patients with chronic beryllium disease.

    Science.gov (United States)

    Fontenot, Andrew P; Canavera, Scott J; Gharavi, Laia; Newman, Lee S; Kotzin, Brian L

    2002-11-01

    Chronic beryllium disease (CBD) is caused by exposure to beryllium in the workplace, and it remains an important public health concern. Evidence suggests that CD4(+) T cells play a critical role in the development of this disease. Using intracellular cytokine staining, we found that the frequency of beryllium-specific CD4(+) T cells in the lungs (bronchoalveolar lavage) of 12 CBD patients ranged from 1.4% to 29% (mean 17.8%), and these T cells expressed a Th1-type phenotype in response to beryllium sulfate (BeSO(4)). Few, if any, beryllium-specific CD8(+) T cells were identified. In contrast, the frequency of beryllium-responsive CD4(+) T cells in the blood of these subjects ranged from undetectable to 1 in 500. No correlation was observed between the frequency of beryllium-responsive bronchoalveolar lavage (BAL) CD4(+) T cells as detected by intracellular staining and lymphocyte proliferation in culture after BeSO(4) exposure. Staining for surface marker expression showed that nearly all BAL T cells exhibit an effector memory cell phenotype. These results demonstrate a dramatically high frequency and compartmentalization of antigen-specific effector memory CD4(+) cells in the lungs of CBD patients. These studies provide insight into the phenotypic and functional characteristics of antigen-specific T cells invading other inaccessible target organs in human disease.

  14. Defense programs beryllium good practice guide

    Energy Technology Data Exchange (ETDEWEB)

    Herr, M.

    1997-07-01

    Within the DOE, it has recently become apparent that some contractor employees who have worked (or are currently working) with and around beryllium have developed chronic beryllium disease (CBD), an occupational granulomatous lung disorder. Respiratory exposure to aerosolized beryllium, in susceptible individuals, causes an immunological reaction that can result in granulomatous scarring of the lung parenchyma, shortness of breath, cough, fatigue, weight loss, and, ultimately, respiratory failure. Beryllium disease was originally identified in the 1940s, largely in the fluorescent light industry. In 1950, the Atomic Energy Commission (AEC) introduced strict exposure standards that generally curtailed both the acute and chronic forms of the disease. Beginning in 1984, with the identification of a CBD case in a DOE contractor worker, there was increased scrutiny of both industrial hygiene practices and individuals in this workforce. To date, over 100 additional cases of beryllium-specific sensitization and/or CBD have been identified. Thus, a disease previously thought to be largely eliminated by the adoption of permissible exposure standards 45 years ago is still a health risk in certain workforces. This good practice guide forms the basis of an acceptable program for controlling workplace exposure to beryllium. It provides (1) Guidance for minimizing worker exposure to beryllium in Defense Programs facilities during all phases of beryllium-related work, including the decontamination and decommissioning (D&D) of facilities. (2) Recommended controls to be applied to the handling of metallic beryllium and beryllium alloys, beryllium oxide, and other beryllium compounds. (3) Recommendations for medical monitoring and surveillance of workers exposed (or potentially exposed) to beryllium, based on the best current understanding of beryllium disease and medical diagnostic tests available. (4) Site-specific safety procedures for all processes of beryllium that is likely to

  15. A role for cell adhesion in beryllium-mediated lung disease

    Energy Technology Data Exchange (ETDEWEB)

    Hong-geller, Elizabeth [Los Alamos National Laboratory

    2008-01-01

    Chronic beryllium disease (CBD) is a debilitating lung disorder in which exposure to the lightweight metal beryllium (Be) causes the accumulation of beryllium-specific CD4+ T cells in the lung and formation of noncaseating pulmonary granulomas. Treatment for CBD patients who exhibit progressive pulmonary decline is limited to systemic corticosteroids, which suppress the severe host inflammatory response. Studies in the past several years have begun to highlight cell-cell adhesion interactions in the development of Be hypersensitivity and CBD. In particular, the high binding affinity between intercellular adhesion molecule 1 (I-CAM1) on lung epithelial cells and the {beta}{sub 2} integrin LFA-1 on migrating lymphocytes and macrophages regulates the concerted rolling of immune cells to sites of inflammation in the lung. In this review, we discuss the evidence that implicates cell adhesion processes in onset of Be disease and the potential of cell adhesion as an intervention point for development of novel therapies.

  16. Low Prevalence of Chronic Beryllium Disease Among Workers at aNuclearWeaponsResearchandDevelopmentFacility

    Science.gov (United States)

    Arjomandi, Mehrdad; Seward, James; Gotway, Michael B.; Nishimura, Stephen; Fulton, George P.; Thundiyil, Josef; King, Talmadge E.; Harber, Philip; Balmes, John R.

    2012-01-01

    Objective To study the prevalence of beryllium sensitization (BeS) and chronic beryllium disease (CBD) in a cohort of workers from a nuclear weapons research and development facility. Methods We evaluated 50 workers with BeS with medical and occupational histories, physical examination, chest imaging with high-resolution computed tomography (N = 49), and pulmonary function testing. Forty of these workers also underwent bronchoscopy for bronchoalveolar lavage and transbronchial biopsies. Results The mean duration of employment at the facility was 18 years and the mean latency (from first possible exposure) to time of evaluation was 32 years. Five of the workers had CBD at the time of evaluation (based on histology or high-resolution computed tomography); three others had evidence of probable CBD. Conclusions These workers with BeS, characterized by a long duration of potential Be exposure and a long latency, had a low prevalence of CBD. PMID:20523233

  17. Low Prevalence of Chronic Beryllium Disease among Workers at a Nuclear Weapons Research and Development Facility

    Energy Technology Data Exchange (ETDEWEB)

    Arjomandi, M; Seward, J P; Gotway, M B; Nishimura, S; Fulton, G P; Thundiyil, J; King, T E; Harber, P; Balmes, J R

    2010-01-11

    To study the prevalence of beryllium sensitization (BeS) and chronic beryllium disease (CBD) in a cohort of workers from a nuclear weapons research and development facility. We evaluated 50 workers with BeS with medical and occupational histories, physical examination, chest imaging with HRCT (N=49), and pulmonary function testing. Forty of these workers also underwent bronchoscopy for bronchoalveolar lavage (BAL) and transbronchial biopsies. The mean duration of employment at the facility was 18 yrs and the mean latency (from first possible exposure) to time of evaluation was 32 yrs. Five of the workers had CBD at the time of evaluation (based on histology or HRCT); three others had evidence of probable CBD. These workers with BeS, characterized by a long duration of potential Be exposure and a long latency, had a low prevalence of CBD.

  18. Low prevalence of chronic beryllium disease among workers at a nuclear weapons research and development facility.

    Science.gov (United States)

    Arjomandi, Mehrdad; Seward, James; Gotway, Michael B; Nishimura, Stephen; Fulton, George P; Thundiyil, Josef; King, Talmadge E; Harber, Philip; Balmes, John R

    2010-06-01

    To study the prevalence of beryllium sensitization (BeS) and chronic beryllium disease (CBD) in a cohort of workers from a nuclear weapons research and development facility. We evaluated 50 workers with BeS with medical and occupational histories, physical examination, chest imaging with high-resolution computed tomography (N = 49), and pulmonary function testing. Forty of these workers also underwent bronchoscopy for bronchoalveolar lavage and transbronchial biopsies. The mean duration of employment at the facility was 18 years and the mean latency (from first possible exposure) to time of evaluation was 32 years. Five of the workers had CBD at the time of evaluation (based on histology or high-resolution computed tomography); three others had evidence of probable CBD. These workers with BeS, characterized by a long duration of potential Be exposure and a long latency, had a low prevalence of CBD.

  19. Technical Basis for PNNL Beryllium Inventory

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Michelle Lynn

    2014-07-09

    The Department of Energy (DOE) issued Title 10 of the Code of Federal Regulations Part 850, “Chronic Beryllium Disease Prevention Program” (the Beryllium Rule) in 1999 and required full compliance by no later than January 7, 2002. The Beryllium Rule requires the development of a baseline beryllium inventory of the locations of beryllium operations and other locations of potential beryllium contamination at DOE facilities. The baseline beryllium inventory is also required to identify workers exposed or potentially exposed to beryllium at those locations. Prior to DOE issuing 10 CFR 850, Pacific Northwest Nuclear Laboratory (PNNL) had documented the beryllium characterization and worker exposure potential for multiple facilities in compliance with DOE’s 1997 Notice 440.1, “Interim Chronic Beryllium Disease.” After DOE’s issuance of 10 CFR 850, PNNL developed an implementation plan to be compliant by 2002. In 2014, an internal self-assessment (ITS #E-00748) of PNNL’s Chronic Beryllium Disease Prevention Program (CBDPP) identified several deficiencies. One deficiency is that the technical basis for establishing the baseline beryllium inventory when the Beryllium Rule was implemented was either not documented or not retrievable. In addition, the beryllium inventory itself had not been adequately documented and maintained since PNNL established its own CBDPP, separate from Hanford Site’s program. This document reconstructs PNNL’s baseline beryllium inventory as it would have existed when it achieved compliance with the Beryllium Rule in 2001 and provides the technical basis for the baseline beryllium inventory.

  20. Analysis of HLA-DP association with beryllium disease susceptibility in pooled exposed populations

    Energy Technology Data Exchange (ETDEWEB)

    Cesare Saltini, Massimo Amicosante

    2009-12-19

    Berylliosis or Chronic Beryllium Disease is a chronic granulomatous disorder primarily involving the lung associated with the exposition to low doses of Beryllium (Be) in the workplace. Berylliosis risk has been associated with the presence of a glutamate at position 69 of the HLA-DP beta chain (HLA-DPbetaGlu69) that is expressed in about 97% of disease cases and in 27% of the unaffected Be-exposed controls (p<0.0001) (Richeldi et al. Science 1993; 262: 242-244.12). Since this first observation of an immunogenetic association between berylliosis and HLA-DPbetaGlu69 a number of studies have confirmed the role of this marker as the primary gene of susceptibility of berylliosis (Richeldi et al Am J Ind Med. 1997; 32:337-40; Wang et al J. Immunol. 1999; 163: 1647-53; Saltini et al Eur Respir J. 2001 18:677-84; Rossman et al Am J Respir Crit Care Med. 2002 165:788-94). Moreover, a structure/function interaction between HLA-DP molecules carrying Glu69 and beryllium in driving and developing the immune response against beryllium itself has been observed as: (1) Be-specific T-cells clones obtained from berylliosis patients recognize beryllium as antigen only when presented in the context of the HLA-DP{beta}Glu69 molecules but not in the context of HLA-DP allelic variants carrying Lys69 (Lombardi G et al. J Immunol 2001; 166: 3549-3555), and (2) beryllium presents an affinity for the HLA-DP2, carrying the berylliosis marker of susceptibility HLA-DPGlu69, from 40 to 100 times higher that the HLA-DP molecule carrying Lys69 (Amicosante M. et al Hum. Immunol. 2001; 62: 686-93). However, although the immunogenetic studies performed have been addressed a number of different questions about the genetic association between berylliosis and/or beryllium sensitization, exposure levels to beryllium and HLA markers, a number of questions are still open in the field mainly due to the limitation imposed by the low number of subjects carrying berylliosis or beryllium sensitization enrolled

  1. Statistical methods for the analysis of a screening test for chronic beryllium disease

    Energy Technology Data Exchange (ETDEWEB)

    Frome, E.L.; Neubert, R.L. [Oak Ridge National Lab., TN (United States). Mathematical Sciences Section; Smith, M.H.; Littlefield, L.G.; Colyer, S.P. [Oak Ridge Inst. for Science and Education, TN (United States). Medical Sciences Div.

    1994-10-01

    The lymphocyte proliferation test (LPT) is a noninvasive screening procedure used to identify persons who may have chronic beryllium disease. A practical problem in the analysis of LPT well counts is the occurrence of outlying data values (approximately 7% of the time). A log-linear regression model is used to describe the expected well counts for each set of test conditions. The variance of the well counts is proportional to the square of the expected counts, and two resistant regression methods are used to estimate the parameters of interest. The first approach uses least absolute values (LAV) on the log of the well counts to estimate beryllium stimulation indices (SIs) and the coefficient of variation. The second approach uses a resistant regression version of maximum quasi-likelihood estimation. A major advantage of the resistant regression methods is that it is not necessary to identify and delete outliers. These two new methods for the statistical analysis of the LPT data and the outlier rejection method that is currently being used are applied to 173 LPT assays. The authors strongly recommend the LAV method for routine analysis of the LPT.

  2. OVERVIEW OF BERYLLIUM SAMPLING AND ANALYSIS

    Energy Technology Data Exchange (ETDEWEB)

    Brisson, M

    2009-04-01

    Because of its unique properties as a lightweight metal with high tensile strength, beryllium is widely used in applications including cell phones, golf clubs, aerospace, and nuclear weapons. Beryllium is also encountered in industries such as aluminium manufacturing, and in environmental remediation projects. Workplace exposure to beryllium particulates is a growing concern, as exposure to minute quantities of anthropogenic forms of beryllium may lead to sensitization and to chronic beryllium disease, which can be fatal and for which no cure is currently known. Furthermore, there is no known exposure-response relationship with which to establish a 'safe' maximum level of beryllium exposure. As a result, the current trend is toward ever lower occupational exposure limits, which in turn make exposure assessment, both in terms of sampling and analysis, more challenging. The problems are exacerbated by difficulties in sample preparation for refractory forms of beryllium, such as beryllium oxide, and by indications that some beryllium forms may be more toxic than others. This chapter provides an overview of sources and uses of beryllium, health risks, and occupational exposure limits. It also provides a general overview of sampling, analysis, and data evaluation issues that will be explored in greater depth in the remaining chapters. The goal of this book is to provide a comprehensive resource to aid personnel in a wide variety of disciplines in selecting sampling and analysis methods that will facilitate informed decision-making in workplace and environmental settings.

  3. Beryllium-induced lung disease in the dog following two exposures to BeO

    Energy Technology Data Exchange (ETDEWEB)

    Haley, P.J.; Finch, G.L.; Hoover, M.D.; Mewhinney, J.A.; Bice, D.E.; Muggenburg, B.A. (Lovelace Biomedical and Environmental Research Inst., Albuquerque, NM (United States))

    1992-12-01

    The authors have shown previously that dogs exposed once to aerosols of beryllium oxide (BeO) calcined at 500 or 1,000[degrees]C developed granulomatous lung lesions as well as Be-specific immune responses in the blood and lung. In this report, they investigate the immunopathologic consequences of exposing dogs twice to aerosols of BeO. Dogs previously exposed to aerosols of 500 or 1,000[degrees]C calcined BeO to achieve an initial lung burden (ILB) of either 50 or 17 [mu]g/kg body wt were exposed a second time to BeO calcined at 500[degrees]C, 2.5 years after the first exposure, to achieve an ILB of about 50 [mu]g/kg body wt. Immune responses of peripheral blood and lung lymphocytes were measured at 0, 14, 30, 60, 90, 120, 150, 165, 180, and 210 days postexposure (dpe), and dogs were euthanized at 210 dpe. Be-specific immune responses occurred in blood at 30 dpe and again at 150 to 210 dpe. Only sporadic positive responses were seen among lung lymphocytes when cells were cultured in 10% fetal bovine serum. In contrast, samples collected at 165, 180, and 210 dpe and incubated with 10% dog serum showed a large number of positive responses in both blood and lung. Histologic lesions were characterized by perivascular and interstitial infiltrates of lymphocytes and macrophages with progression to patchy granulomatous pneumonia accompanied by focal septal fibrosis. The authors conclude that Be-induced granulomatous and fibrotic lung lesions are accompanied by Be-specific immune responses within the lung but these changes do not appear to be cumulative if enough time has elapsed between exposures. 20 refs., 8 figs., 3 tabs.

  4. Beryllium chemistry and processing

    CERN Document Server

    Walsh, Kenneth A

    2009-01-01

    This book introduces beryllium; its history, its chemical, mechanical, and physical properties including nuclear properties. The 29 chapters include the mineralogy of beryllium and the preferred global sources of ore bodies. The identification and specifics of the industrial metallurgical processes used to form oxide from the ore and then metal from the oxide are thoroughly described. The special features of beryllium chemistry are introduced, including analytical chemical practices. Beryllium compounds of industrial interest are identified and discussed. Alloying, casting, powder processing, forming, metal removal, joining and other manufacturing processes are covered. The effect of composition and process on the mechanical and physical properties of beryllium alloys assists the reader in material selection. The physical metallurgy chapter brings conformity between chemical and physical metallurgical processing of beryllium, metal, alloys, and compounds. The environmental degradation of beryllium and its all...

  5. Acute Infectious Disease,

    Science.gov (United States)

    1984-03-23

    intracelLular proteins such as metallothionine, hemosiderin , and ferritin.3 𔃻 6𔃼 1𔃽 5 A large variety of proteins must be produced during infection for...acute infections.50 On the other hand, iron is sequestered through its incorporation into hemosiderin .6,7,16 and ferritin in various tissue storage... hemosiderin and ferritin during infectious or inflammatory states. Concomitantly, plas1a ir. • - concentrations decline, sometimes to almost nondectable

  6. METHOD OF BRAZING BERYLLIUM

    Science.gov (United States)

    Hanks, G.S.; Keil, R.W.

    1963-05-21

    A process is described for brazing beryllium metal parts by coating the beryllium with silver (65- 75 wt%)-aluminum alloy using a lithium fluoride (50 wt%)-lithium chloride flux, and heating the coated joint to a temperature of about 700 un. Concent 85% C for about 10 minutes. (AEC)

  7. Acute Valvular Heart Disease.

    Science.gov (United States)

    Maheshwari, Varun; Barr, Brian; Srivastava, Mukta

    2018-02-01

    Valvular heart disease (VHD) is a common clinical entity. Recognition of decompensated VHD is crucial to instituting appropriate workup and management. Initial evaluation focuses on hemodynamics, peripheral perfusion, volume overload, and active myocardial ischemia. Initial therapy is targeted at improving hemodynamics, fluid status, and decreasing myocardial ischemia before intervention. Echocardiography can rapidly identify VHD etiology and severity along with physical examination findings. Owing to improved survival with cardiac surgery over the past several decades, prosthetic valve dysfunction should be recognized and initial treatment understood. Mechanical circulatory support is increasingly part of clinical practice in stabilizing patients with decompensated VHD. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Acute graft versus host disease

    Directory of Open Access Journals (Sweden)

    Vogelsang Georgia B

    2007-09-01

    Full Text Available Abstract Acute graft-versus-host disease (GVHD occurs after allogeneic hematopoietic stem cell transplant and is a reaction of donor immune cells against host tissues. Activated donor T cells damage host epithelial cells after an inflammatory cascade that begins with the preparative regimen. About 35%–50% of hematopoietic stem cell transplant (HSCT recipients will develop acute GVHD. The exact risk is dependent on the stem cell source, age of the patient, conditioning, and GVHD prophylaxis used. Given the number of transplants performed, we can expect about 5500 patients/year to develop acute GVHD. Patients can have involvement of three organs: skin (rash/dermatitis, liver (hepatitis/jaundice, and gastrointestinal tract (abdominal pain/diarrhea. One or more organs may be involved. GVHD is a clinical diagnosis that may be supported with appropriate biopsies. The reason to pursue a tissue biopsy is to help differentiate from other diagnoses which may mimic GVHD, such as viral infection (hepatitis, colitis or drug reaction (causing skin rash. Acute GVHD is staged and graded (grade 0-IV by the number and extent of organ involvement. Patients with grade III/IV acute GVHD tend to have a poor outcome. Generally the patient is treated by optimizing their immunosuppression and adding methylprednisolone. About 50% of patients will have a solid response to methylprednisolone. If patients progress after 3 days or are not improved after 7 days, they will get salvage (second-line immunosuppressive therapy for which there is currently no standard-of-care. Well-organized clinical trials are imperative to better define second-line therapies for this disease. Additional management issues are attention to wound infections in skin GVHD and fluid/nutrition management in gastrointestinal GVHD. About 50% of patients with acute GVHD will eventually have manifestations of chronic GVHD.

  9. Beryllium Manufacturing Processes

    Energy Technology Data Exchange (ETDEWEB)

    Goldberg, A

    2006-06-30

    This report is one of a number of reports that will be combined into a handbook on beryllium. Each report covers a specific topic. To-date, the following reports have been published: (1) Consolidation and Grades of Beryllium; (2) Mechanical Properties of Beryllium and the Factors Affecting these Properties; (3) Corrosion and Corrosion Protection of Beryllium; (4) Joining of Beryllium; (5) Atomic, Crystal, Elastic, Thermal, Nuclear, and other Properties of Beryllium; and (6) Beryllium Coating (Deposition) Processes and the Influence of Processing Parameters on Properties and Microstructure. The conventional method of using ingot-cast material is unsuitable for manufacturing a beryllium product. Beryllium is a highly reactive metal with a high melting point, making it susceptible to react with mold-wall materials forming beryllium compounds (BeO, etc.) that become entrapped in the solidified metal. In addition, the grain size is excessively large, being 50 to 100 {micro}m in diameter, while grain sizes of 15 {micro}m or less are required to meet acceptable strength and ductility requirements. Attempts at refining the as-cast-grain size have been unsuccessful. Because of the large grain size and limited slip systems, the casting will invariably crack during a hot-working step, which is an important step in the microstructural-refining process. The high reactivity of beryllium together with its high viscosity (even with substantial superheat) also makes it an unsuitable candidate for precision casting. In order to overcome these problems, alternative methods have been developed for the manufacturing of beryllium. The vast majority of these methods involve the use of beryllium powders. The powders are consolidated under pressure in vacuum at an elevated temperature to produce vacuum hot-pressed (VHP) blocks and vacuum hot-isostatic-pressed (HIP) forms and billets. The blocks (typically cylindrical), which are produced over a wide range of sizes (up to 183 cm dia. by 61

  10. Validation of cleaning method for various parts fabricated at a Beryllium facility

    Energy Technology Data Exchange (ETDEWEB)

    Davis, Cynthia M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-12-15

    This study evaluated and documented a cleaning process that is used to clean parts that are fabricated at a beryllium facility at Los Alamos National Laboratory. The purpose of evaluating this cleaning process was to validate and approve it for future use to assure beryllium surface levels are below the Department of Energy’s release limits without the need to sample all parts leaving the facility. Inhaling or coming in contact with beryllium can cause an immune response that can result in an individual becoming sensitized to beryllium, which can then lead to a disease of the lungs called chronic beryllium disease, and possibly lung cancer. Thirty aluminum and thirty stainless steel parts were fabricated on a lathe in the beryllium facility, as well as thirty-two beryllium parts, for the purpose of testing a parts cleaning method that involved the use of ultrasonic cleaners. A cleaning method was created, documented, validated, and approved, to reduce beryllium contamination.

  11. Aggressive and acute periodontal diseases.

    Science.gov (United States)

    Albandar, Jasim M

    2014-06-01

    Inflammatory periodontal diseases are highly prevalent, although most of these diseases develop and progress slowly, often unnoticed by the affected individual. However, a subgroup of these diseases include aggressive and acute forms that have a relatively low prevalence but show a rapid-course, high rate of progression leading to severe destruction of the periodontal tissues, or cause systemic symptoms that often require urgent attention from healthcare providers. Aggressive periodontitis is an early-onset, destructive disease that shows a high rate of periodontal progression and distinctive clinical features. A contemporary case definition of this disease is presented. Population studies show that the disease is more prevalent in certain geographic regions and ethnic groups. Aggressive periodontitis is an infectious disease, and recent data show that in affected subjects the subgingival microbiota is composed of a mixed microbial infection, with a wide heterogeneity in the types and proportions of microorganisms recovered. Furthermore, there are significant differences in the microbiota of the disease among different geographic regions and ethnicities. There is also evidence that the Aggregatibacter actinomycetemycomitans-JP2 clone may play an important role in the development of the disease in certain populations. The host response plays an important role in the susceptibility to aggressive periodontitis, where the immune response may be complex and involve multiple mechanisms. Also, genetic factors seem to play an important role in the pathogenesis of this disease, but the mechanisms of increased susceptibility are complex and not yet fully understood. The available data suggest that aggressive periodontitis is caused by mutations either in a few major genes or in multiple small-effect genes, and there is also evidence of gene-gene and gene-environment interaction effects. Diagnostic methods for this disease, based on a specific microbiologic, immunologic or

  12. Ultrasound in Acute Kidney Disease.

    Science.gov (United States)

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

    2016-01-01

    Kidneys' imaging provides useful information in acute kidney injury (AKI) diagnosis and management. Today, several imaging techniques give information on kidneys anatomy, urinary obstruction, differential diagnosis between AKI and chronic kidney disease (CKD), renal blood flow and glomerular filtration rate. Ultrasound is a safe, non-invasive and repeatable imaging technique so it is widely used in the first level work-up of AKI. The utility of contrast-enhanced computed tomography and magnetic resonance imaging in AKI or in AKI during CKD is limited because of renal toxicity associated with contrast agents used. © 2016 S. Karger AG, Basel.

  13. Solubility and chemistry of materials encountered by beryllium mine and ore extraction workers: relation to risk.

    Science.gov (United States)

    Deubner, David C; Sabey, Philip; Huang, Wenjie; Fernandez, Diego; Rudd, Abigail; Johnson, William P; Storrs, Jason; Larson, Rod

    2011-10-01

    Beryllium mine and ore extraction mill workers have low rates of beryllium sensitization and chronic beryllium disease relative to the level of beryllium exposure. The objective was to relate these rates to the solubility and composition of the mine and mill materials. Medical surveillance and exposure data were summarized. Dissolution of BeO, ore materials and beryllium hydroxide, Be(OH)(2) was measured in synthetic lung fluid. The ore materials were more soluble than BeO at pH 7.2 and similar at pH 4.5. Be(OH)(2) was more soluble than BeO at both pH. Aluminum dissolved along with beryllium from ore materials. Higher solubility of beryllium ore materials and Be(OH)(2) at pH 7.2 might shorten particle longevity in the lung. The aluminum content of the ore materials might inhibit the cellular immune response to beryllium.

  14. Evaluation of the hazard associated with fabricating beryllium copper alloys

    Energy Technology Data Exchange (ETDEWEB)

    Senn, T.J.

    1977-05-05

    Beryllium-copper alloys should be considered toxic materials and proper controls must be used when they are machined, heated, or otherwise fabricated. Air samples should be taken for each type of fabrication to determine the worker's exposure and the effectiveness of the controls in use. It has been shown that aerosols containing beryllium are generated during the four methods of fabrication tested, and that these aerosols can be reduced through local exhaust to undetectable levels. Considering the acute, chronic and possibly carcinogenic effects of exposure to beryllium, effective controls should be required because they are feasible both technologically and economically. The health hazards and control measures are reviewed.

  15. Focus on acute diarrhoeal disease.

    Science.gov (United States)

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

    2009-07-21

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

  16. Acute exacerbations of fibrotic interstitial lung disease.

    Science.gov (United States)

    Churg, Andrew; Wright, Joanne L; Tazelaar, Henry D

    2011-03-01

    An acute exacerbation is the development of acute lung injury, usually resulting in acute respiratory distress syndrome, in a patient with a pre-existing fibrosing interstitial pneumonia. By definition, acute exacerbations are not caused by infection, heart failure, aspiration or drug reaction. Most patients with acute exacerbations have underlying usual interstitial pneumonia, either idiopathic or in association with a connective tissue disease, but the same process has been reported in patients with fibrotic non-specific interstitial pneumonia, fibrotic hypersensitivity pneumonitis, desquamative interstitial pneumonia and asbestosis. Occasionally an acute exacerbation is the initial manifestation of underlying interstitial lung disease. On biopsy, acute exacerbations appear as diffuse alveolar damage or bronchiolitis obliterans organizing pneumonia (BOOP) superimposed upon the fibrosing interstitial pneumonia. Biopsies may be extremely confusing, because the acute injury pattern can completely obscure the underlying disease; a useful clue is that diffuse alveolar damage and organizing pneumonia should not be associated with old dense fibrosis and peripheral honeycomb change. Consultation with radiology can also be extremely helpful, because the fibrosing disease may be evident on old or concurrent computed tomography scans. The aetiology of acute exacerbations is unknown, and the prognosis is poor; however, some patients survive with high-dose steroid therapy. © 2010 Blackwell Publishing Limited.

  17. Acute Ischemic Stroke and Acute on Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Raja Ahsan Aftab

    2016-06-01

    Full Text Available Ischemic stroke is due to either local thrombus formation or emboli that occlude a cerebral artery, together with chronic kidney disease represent major mortality and morbidity. Here wer present a case of 53 years old Malay man, admitted to a hospital in Malaysia complaining of sudden onset of weakness on right sided upper and lower limb associated with slurred speech. Patient was also suffering from uncontrolled hypertension, hyperlipidemia, chronic kidney disease stage 4, and diabetes mellitus(un controlled. He was diagnosed with acute ischemic stroke with cranial nerve 7 palsy (with right hemiparesis, acute on chronic kidney disease precipitated by dehydration and ACE inhibitor, and hyperkalemia. Patients with ischemic disease and chronic kidney disaese require constant monitering and carefull selected pharmacotherapy. Patient was placed under observation and was prescribed multiple pharamacotherpay to stabalise detoriating condition. Keywords: ischemic disease; chronic kidney disease; uncontrolled hypertension. | PubMed

  18. Characterization of Shocked Beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Cady, Carl M [Los Alamos National Laboratory; Adams, Chris D [Los Alamos National Laboratory; Hull, Lawrence M [Los Alamos National Laboratory; Gray III, George T [Los Alamos National Laboratory; Prime, Michael B [Los Alamos National Laboratory; Addessio, Francis L [Los Alamos National Laboratory; Wynn, Thomas A [Los Alamos National Laboratory; Brown, Eric N [Los Alamos National Laboratory

    2012-08-24

    Beryllium metal has many excellent structural properties in addition to its unique radiation characteristics, including: high elastic modulus, low Poisson's ratio, low density, and high melting point. However, it suffers from several major mechanical drawbacks: 1) high anisotropy - due to its hexagonal lattice structure and its susceptibility to crystallographic texturing; 2) susceptibility to impurity-induced fracture - due to grain boundary segregation; and 3) low intrinsic ductility at ambient temperatures thereby limiting fabricability. While large ductility results from deformation under the conditions of compression, the material can exhibit a brittle behavior under tension. Furthermore, there is a brittle to ductile transition at approximately 200 C under tensile conditions. While numerous studies have investigated the low-strain-rate constitutive response of beryllium, the combined influence of high strain rate and temperature on the mechanical behavior and microstructure of beryllium has received limited attention over the last 40 years. Prior studies have focused on tensile loading behavior, or limited conditions of dynamic strain rate and/or temperature. The beryllium used in this study was Grade S200-F (Brush Wellman, Inc., Elmore, OH) material. The work focused on high strain rate deformation and examine the validity of constitutive models in deformation rate regimes, including shock, the experiments were modeled using a Lagrangian hydrocode. Two constitutive strength (plasticity) models, the Preston-Tonks-Wallace (PTW) and Mechanical Threshold Stress (MTS) models, were calibrated using the same set of quasi-static and Hopkinson bar data taken at temperatures from 77K to 873K and strain rates from 0.001/sec to 4300/sec. In spite of being calibrated on the same data, the two models give noticeably different results when compared with the measured wave profiles. These high strain rate tests were conducted using both explosive drive and a gas gun to

  19. Acute meningococcal disease in children and adolescents

    DEFF Research Database (Denmark)

    Nygaard, Ulrikka; Vissing, Nadja Hawwa; Steensen, Morten

    2017-01-01

    Meningococcal disease is a rapidly progressing infection, which continues to cause deaths among children and adolescents. In this review, clinical signs and initial treatment of acute childhood meningococcal disease is described. Operational flow charts have been developed for assessment of non...

  20. Thermal fatigue of beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Deksnis, E.; Ciric, D.; Falter, H. [JET Joint undertaking, Abingdon (United Kingdom)] [and others

    1995-09-01

    Thermal fatigue life of S65c beryllium castellated to a geometry 6 x 6 x (8-10)mm deep has been tested for steady heat fluxes of 3 MW/m{sup 2} to 5 MW/m{sup 2} and under pulsed heat fluxes (10-20 MW/m{sup 2}) for which the time averaged heat flux is 5 MW/m{sup 2}. These tests were carried out in the JET neutral beam test facility A test sequence with peak surface temperatures {le} 600{degrees}C produced no visible fatigue cracks. In the second series of tests, with T{sub max} {le} 750{degrees}C evidence for fatigue appeared after a minimum of 1350 stress cycles. These fatigue data are discussed in view of the observed lack of thermal fatigue in JET plasma operations with beryllium PFC. JET experience with S65b and S65c is reviewed; recent operations with {Phi} = 25 MW/m{sup 2} and sustained melting/resolidification are also presented. The need for a failure criterion for finite element analyses of Be PFC lifetimes is discussed.

  1. Beryllium uptake and related biological effects studied in THP-1 differentiated macrophages.

    Science.gov (United States)

    Ding, Jian; Lin, Lin; Hang, Wei; Yan, Xiaomei

    2009-11-01

    Investigation of cellular uptake of metal compounds is important in understanding metal-related toxicity and diseases. Inhalation of beryllium aerosols can cause chronic beryllium disease, a progressive, granulomatous fibrosis of the lung. Studies in laboratory animals and cultured animal cells indicate that alveolar macrophages take up beryllium compounds and participate in a hypersensitivity immune response to a beryllium-containing antigen. In the present work, human monocyte cell line THP-1 was induced with phorbol myristate acetate to differentiate into a macrophage. This cell with characteristics of human alveolar macrophages was employed to study cellular beryllium uptake and related biological effects. Morphological changes, phagocytosis of fluorescent latex beads, and cell surface CD14 expression were used to verify the successful differentiation of THP-1 monocytes into macrophages. An improved mass spectrometry method for quantitative analysis of intracellular beryllium as opposed to the traditional radioisotopic approach was developed using ICP-MS. The influence of the solubility of beryllium compounds, exposure duration, and beryllium concentration on the incorporation of beryllium was studied. Our data indicated that the uptake of particulate BeO was much more significant than that of soluble BeSO(4), suggesting the major cellular uptake pathway is phagocytosis. Nevertheless, subsequent DAPI nuclear staining and PARP cleavage study indicated that beryllium uptake had a negligible effect on the apoptosis of THP-1 macrophages compared to the unstimulated macrophage control. Meanwhile, no substantial variation of tumour necrosis factor-alpha production was observed for THP-1 macrophages upon beryllium exposure. These data imply alveolar macrophages could have some level of tolerance to beryllium and this may explain why most Be-exposed individuals remain healthy throughout life.

  2. Management of acute and refractory Kawasaki disease

    NARCIS (Netherlands)

    Tacke, Carline E.; Burgner, David; Kuipers, Irene M.; Kuijpers, Taco W.

    2012-01-01

    Expert Rev. Anti Infect Ther. 10(10), 1203-1215 (2012) Acute Kawasaki disease (KD) is treated with high-dose intravenous immunoglobulin (IVIG), which is proven to decrease the incidence of coronary artery aneurysms from 25% to less than 5%. Aspirin is also given, although the evidence base is less

  3. Proteomic analysis of beryllium-induced genotoxicity in an Escherichia coli mutant model system.

    Science.gov (United States)

    Taylor-McCabe, Kirsten J; Wang, Zaolin; Sauer, Nancy N; Marrone, Babetta L

    2006-03-01

    Beryllium is the second lightest metal, has a high melting point and high strength-to-weight ratio, and is chemically stable. These unique chemical characteristics make beryllium metal an ideal choice as a component material for a wide variety of applications in aerospace, defense, nuclear weapons, and industry. However, inhalation of beryllium dust or fumes induces significant health effects, including chronic beryllium disease and lung cancer. In this study, the mutagenicity of beryllium sulfate (BeSO(4)) and the comutagenicity of beryllium with a known mutagen 1-methyl-3-nitro-1-nitrosoguanidine (MNNG) were evaluated using a forward mutant detection system developed in Escherichia coli. In this system, BeSO(4) was shown to be weakly mutagenic alone and significantly enhanced the mutagenicity of MNNG up to 3.5-fold over MNNG alone. Based on these results a proteomic study was conducted to identify the proteins regulated by BeSO(4). Using the techniques of 2-DE and oMALDI-TOF MS, we successfully identified 32 proteins being differentially regulated by beryllium and/or MNNG in the E. coli test system. This is the first study to describe the proteins regulated by beryllium in vitro, and the results suggest several potential pathways for the focus of further research into the mechanisms underlying beryllium-induced genotoxicity.

  4. Acute onset of adult Alexander disease.

    Science.gov (United States)

    Schmidt, Holger; Kretzschmar, Benedikt; Lingor, Paul; Pauli, Silke; Schramm, Peter; Otto, Markus; Ohlenbusch, Andreas; Brockmann, Knut

    2013-08-15

    Adult-onset Alexander disease (AOAD) is a rare leukoencephalopathy affecting predominantly the brainstem and cervical cord with insidious onset of clinical features. Acute onset is very rare and has yet been described only twice, to our knowledge. We report a 32-year-old hitherto healthy male who, after excessive consumption of alcohol, presented with stroke-like onset of symptoms including rigidospasticity, loss of consciousness, and bulbar dysfunction. MRI features comprised bilateral T2-hyperintensities of frontal white matter and basal ganglia as well as atrophy of medulla oblongata with a peculiar "tadpole" appearance, a pattern characteristic of AOAD. Mutation analysis of the GFAP gene revealed a heterozygous de novo 9-bp microduplication in exon 1. Adult Alexander disease may present with stroke-like features. MRI patterns of chronic neurodegenerative conditions may be recognizable even in acute neurological emergencies. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. Acute brachial diplegia due to Lyme disease.

    Science.gov (United States)

    Gorson, Kenneth C; Kolb, David A; Marks, Donald S; Hayes, Michael T; Baquis, George D

    2011-01-01

    to describe acute brachial diplegia as the initial manifestation of Lyme disease. bilateral, predominantly motor, cervical radiculoplexus neuropathy, the "dangling arm syndrome," has not been reported as a complication of acute Lyme infection. retrospective series of 5 patients from 2 tertiary neuromuscular centers. there were 4 men and 1 woman with an average age of 69 years. One recalled a tick bite, and preceding constitutional symptoms included headache (2) and fever, arthralgias, and fatigue in 1 patient each. Proximal arm weakness and acute pain developed within 3 weeks from onset; pain was bilateral in 3 patients and unilateral in 2 patients, and was described as severe throbbing. Arm weakness was bilateral at onset in 3 patients, and right sided in 2 patients followed by spread to the left arm within days. All the patients had weakness in the deltoid and biceps that was 3/5 or less (Medical Research Council scale), with variable weakness of the triceps and wrist extensors; 1 patient had a flail right arm and moderate (4/5) weakness of the proximal left arm muscles. Light touch was normal in the regions of weakness, and 1 patient had mildly reduced pin sensation over the forearm. Serum IgM Lyme titers were elevated in all the patients and were detected in the cerebrospinal fluid in 4 tested patients. The cerebrospinal fluid protein ranged between 135 and 176 mg/dL with lymphocytic pleocytosis (range, 42 to 270 cells). Electrodiagnostic studies showed normal median and ulnar motor potentials with asymmetrically reduced sensory amplitudes in the median (4), ulnar (3), and radial, and lateral antebrachial cutaneous potentials in 1 patient each. Two patients had acute denervation in the cervical or proximal arm muscles. There was full recovery after antibiotic therapy in 4 patients and considerable improvement in 1 patient after 2 months. acute brachial diplegia is a rare manifestation of acute Lyme infection and responds promptly to antibiotic therapy.

  6. Machining of low percentage beryllium copper alloys

    Science.gov (United States)

    Habermeyer, J. G.

    1969-01-01

    Airborne beryllium sampling during machining of low percentage beryllium-copper alloys shows that normal dry machining creates 45.2 microgram/cu m of airborne beryllium in the casting operators breathing zone and 2.3 microgram/cu m in an adjacent machine working area. A small vacuum system placed over the tool effectively removes airborne beryllium in the breathing zone sample to 0.2 microgram/cu m.

  7. Beryllium--important for national defense

    Science.gov (United States)

    Boland, M.A.

    2012-01-01

    Beryllium is one of the lightest and stiffest metals, but there was little industrial demand for it until the 1930s and 1940s when the aerospace, defense, and nuclear sectors began using beryllium and its compounds. Beryllium is now classified by the U.S. Department of Defense as a strategic and critical material because it is used in products that are vital to national security. The oxide form of beryllium was identified in 1797, and scientists first isolated metallic beryllium in 1828. The United States is the world's leading source of beryllium. A single mine at Spor Mountain, Utah, produced more than 85 percent of the beryllium mined worldwide in 2010. China produced most of the remainder, and less than 2 percent came from Mozambique and other countries. National stockpiles also provide significant amounts of beryllium for processing. To help predict where future beryllium supplies might be located, U.S.Geological Survey (USGS) scientists study how and where beryllium resources are concentrated in Earth's crust and use that knowledge to assess the likelihood that undiscovered beryllium resources may exist. Techniques to assess mineral resources have been developed by the USGS to support the stewardship of Federal lands and to better evaluate mineral resource availability in a global context. The USGS also compiles statistics and information on the worldwide supply of, demand for, and flow of beryllium. These data are used to inform U.S. national policymaking.

  8. Crohn's disease and acute pancreatitis. A review of literature.

    Science.gov (United States)

    Jasdanwala, Sarfaraz; Babyatsky, Mark

    2015-03-20

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

  9. Transvaginal sonography of acute pelvic inflammatory disease

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Soo; Kim, Young Hwa; Shin, Hyung Chul; Han, Gun Soo; Kim, Il Young [Chonan Hospital, Soonchunhyang University College of Medicine, Chonan (Korea, Republic of)

    1999-12-15

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

  10. Reactivity test between beryllium and copper

    Energy Technology Data Exchange (ETDEWEB)

    Kawamura, H. [Japan Atomic Energy Research Institute, Ibaraki-ken (Japan); Kato, M. [NGK Insulators, Ltd., Aichi-ken (Japan)

    1995-09-01

    Beryllium has been expected for using as plasma facing material on ITER. And, copper alloy has been proposed as heat sink material behind plasma facing components. Therefore, both materials must be joined. However, the elementary process of reaction between beryllium and copper alloy does not clear in detail. For example, other authors reported that beryllium reacted with copper at high temperature, but it was not obvious about the generation of reaction products and increasing of the reaction layer. In the present work, from this point, for clarifying the elementary process of reaction between beryllium and copper, the out-of-pile compatibility tests were conducted with diffusion couples of beryllium and copper which were inserted in the capsule filled with high purity helium gas (6N). Annealing temperatures were 300, 400, 500, 600 and 700{degrees}C, and annealing periods were 100, 300 and 1000h. Beryllium specimens were hot pressed beryllium, and copper specimens were OFC (Oxygen Free Copper).

  11. Worker Environment Beryllium Characterization Study

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environment, Safety, Health & Quality

    2009-12-28

    This report summarizes the conclusion of regular monitoring of occupied buildings at the Nevada Test Site and North Las Vegas facility to determine the extent of beryllium (Be) contamination in accordance with Judgment of Needs 6 of the August 14, 2003, “Minnema Report.”

  12. Phytotherapy of Acute Respiratory Viral Diseases

    Directory of Open Access Journals (Sweden)

    I.B. Ershova

    2016-11-01

    Full Text Available Nowadays phytotherapy is increasingly being implemented into medical practice, especially for the prevention and treatment of many diseases. Acute respiratory viral infections are most common in childhood and in adults. Acute rhinitis, pharyngitis, tonsillitis, sinusitis, nasopharyngitis and acute laryngitis refer to diseases of the upper respiratory tract. The main reason for respiratory diseases in recurrent respiratory infection child is disorders of mucociliary and immune protection. The therapeutic value of medicinal plants is determined by their biologically active substances. The method of application of phytotherpy is an integral part of traditional medicine. Herbal medicine can be used at home and does not require special equipment. The main indications for the herbal medicine use in pediatrics are the initial stage of the disease as a primary method of treatment due to mild and low toxicity; as a supporting treatment for enhancing the protective forces of the child’s body during the disease deterioration. During the recovery period herbal medicine again occupies a leading position, especially in case of chronic diseases because it can be used for a long time and is well combined with synthetic drugs. The terms of appointment of herbs for children: prescription of medicinal plants for children must be individual according to indications, taking into account the child’s age; it is recommended to take into account the form and nature of the course of the main disease and comorbidities as well; at the initial stage of the treatment it is better to use some medicinal plants or species consisting of 2–3 plants and in the future a more complex composition; therapy with medicinal plants requires a long period to be used use, especially in chronic diseases; in the treatment of chronic diseases a good effect preventive courses of herbal medicine was revealed, which are appointed during seasonal exacerbations; in case of intolerance

  13. Pathophysiology of acute small bowel disease with CT correlation

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-01-15

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

  14. Beryllium-induced immune response in C3H mice

    Energy Technology Data Exchange (ETDEWEB)

    Benson, J.M.; Bice, D.E.; Nikula, K.J. [and others

    1995-12-01

    Studies conducted at ITRI over the past several years have investigated whether Beagle dogs, monkeys, and mice are suitable models for human chronic beryllium-induced lung disease (CBD). Recent studies have focused on the histopathological and immunopathological changes occurring in A/J and C3H/HeJ mice acutely exposed by inhalation to Be metal. Lung lesions in both strains of mice included focal lymphocyte aggregates comprised primarily of B lymphocytes and lesser amounts of T-helper lymphocytes and microgranulomas consisting chiefly of macrophages and T-helper lymphocytes. The distribution of proliferating cells within the microgranulomas was similar to the distribution of T-helper cells. These results strongly suggested that A/J and C3H/HeJ mice responded to inhaled Be metal in a fashion similar to humans in terms of pulmonary lesions and the apparent in situ proliferation of T-helper cells. Results of these studies confirm lymphocyte involvement in the pulmonary response to inhaled Be metal.

  15. Beryllium - A Unique Material in Nuclear Applications

    Energy Technology Data Exchange (ETDEWEB)

    T., A. Tomberlin

    2004-11-01

    Beryllium, due to its unique combination of structural, chemical, atomic number, and neutron absorption cross section characteristics, has been used successfully as a neutron reflector for three generations of nuclear test reactors at the Idaho National Engineering and Environmental Laboratory (INEEL). The Advanced Test Reactor (ATR), the largest test reactor in the world, has utilized five successive beryllium neutron reflectors and is scheduled for continued operation with a sixth beryllium reflector. A high radiation environment in a test reactor produces radiation damage and other changes in beryllium. These changes necessitate safety analysis of the beryllium, methods to predict performance, and appropriate surveillances. Other nuclear applications also utilize beryllium. Beryllium, given its unique atomic, physical, and chemical characteristics, is widely used as a “window” for x-rays and gamma rays. Beryllium, intimately mixed with high-energy alpha radiation emitters has been successfully used to produce neutron sources. This paper addresses operational experience and methodologies associated with the use of beryllium in nuclear test reactors and in “windows” for x-rays and gamma rays. Other nuclear applications utilizing beryllium are also discussed.

  16. Acute Respiratory Distress: from syndrome to disease.

    Science.gov (United States)

    Cardinal-Fernández, P; Correger, E; Villanueva, J; Rios, F

    2016-04-01

    The acute respiratory distress syndrome (ARDS) is currently one of the most important critical entities given its high incidence, rate of mortality, long-term sequelae and non-specific pharmacological treatment. The histological hallmark of ARDS is diffuse alveolar damage (DAD). Approximately 50% of ARDS patients present DAD, the rest is made up of a heterogeneous group of histological patterns, many of which correspond to a well-recognized disease. For that reason, if these patterns could be diagnosed, patients could benefit from a treatment. Recently, the effect of DAD in clinical and analytical evolution of ARDS has been demonstrated, so the classical approach to ARDS as an entity defined solely by clinical, radiological and gasometrical variables should be reconsidered. This narrative review aims to examine the need to evolve from the concept of ARDS as a syndrome to ARDS as a specific disease. So we have raised 4 critical questions: a) What is a disease?; b) what is DAD?; c) how is DAD considered according to ARDS definition?, and d) what is the relationship between ARDS and DAD? Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  17. Chronic kidney disease in acute coronary syndromes.

    Science.gov (United States)

    Marenzi, Giancarlo; Cabiati, Angelo; Assanelli, Emilio

    2012-10-06

    Chronic kidney disease (CKD) is associated with a high burden of coronary artery disease. In patients with acute coronary syndromes (ACS), CKD is highly prevalent and associated with poor short- and long-term outcomes. Management of patients with CKD presenting with ACS is more complex than in the general population because of the lack of well-designed randomized trials assessing therapeutic strategies in such patients. The almost uniform exclusion of patients with CKD from randomized studies evaluating new targeted therapies for ACS, coupled with concerns about further deterioration of renal function and therapy-related toxic effects, may explain the less frequent use of proven medical therapies in this subgroup of high-risk patients. However, these patients potentially have much to gain from conventional revascularization strategies used in the general population. The objective of this review is to summarize the current evidence regarding the epidemiology and the clinical and prognostic relevance of CKD in ACS patients, in particular with respect to unresolved issues and uncertainties regarding recommended medical therapies and coronary revascularization strategies.

  18. Recommended design correlations for S-65 beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Billone, M.C.

    1995-12-31

    The properties of tritium and helium behavior in irradiated beryllium are reviewed, along with the thermal-mechanical properties needed for ITER design analysis. Correlations are developed to describe the performance of beryllium in a fusion reactor environment. While this paper focuses on the use of beryllium as a plasma-facing component (PFC) material, the correlations presented here can also be used to describe the performance of beryllium as a neutron multiplier for a tritium breeding blanket. The performance properties for beryllium are subdivided into two categories: properties which do not change with irradiation damage to the bulk of the material; and properties which are degraded by neutron irradiation. The approach taken in developing properties correlations is to describe the behavior of dense, pressed S-65 beryllium as a function of temperature. As there are essentially no data on the performance of porous and/or irradiated S-65 beryllium, the degradation of properties with as-fabricated porosity and irradiation are determined form the broad data base on S-200F, as well as other types and grades, and applied to S-65 beryllium by scaling factors. The resulting correlations can be used for Be produced by vacuum hot pressing (VHP) and cold-pressing (CP)/sintering(S)/hot-isostatic-pressing(HIP). The performance of plasma-sprayed beryllium is discussed but not quantified.

  19. Enteropathogens associated with acute diarrhoeal diseases.

    Science.gov (United States)

    Niyogi, S K; Saha, M R; De, S P

    1994-01-01

    Five types of Escherichia coli are responsible for as much as 25% of all diarrheal diseases in developing countries. They tend to be transmitted via contaminated foods, particularly weaning foods, and water. They include enterotoxigenic, enteropathogenic, enteroadherent, enteroinvasive, and enterohemorrhagic E. coli. Shigella species are responsible for 10-15% of acute diarrheas in children less than 5 years old and the most common etiologic agents of childhood dysentery. Shigellosis is common in the warm season. An outbreak of shigella dysentery in West Bengal, India, had a high attack rate in children less than 5 years old and was resistant to many drugs. Nontyphoid Salmonella species cause watery diarrhea with nausea, cramps, and fever. Worldwide, various Salmonella strains exhibit resistance to ampicillin, chloramphenicol, and co-trimoxazole. Campylobacter jejuni produces watery diarrhea which, in 33% of cases and 1-2 days after onset, contains blood and mucus. Many normal healthy children in developing countries are carriers of C. jejuni. Vibrio cholerae O1 is endemic in parts of Africa and Asia (e.g., 5-10% of hospitalized diarrhea patients). The ElTor cholera biotype is responsible for the 7th pandemic. Other bacterial enteropathogens are Aeromonas species, Bacteroides fragilis, and Providencia alcalifaciens. Rotavirus is a major cause of sporadic and epidemic diarrhea among 6-23 month olds. Its incidence peaks in cold or dry seasons. Other viral enteropathogens are Norwalk virus, adenoviruses, astroviruses, and coronaviruses. In India, the prevalence of Entamoeba histolytica varies from 3.6% to 47.4%. It occurs equally in high and low socioeconomic classes. Giardia lamblia usually infects 1-5 year old children. Its transmission routes are food, water, and the fecal-oral route. Cryptosporidia produce acute watery diarrhea, especially in children less than 2 years old. Cryptosporidia diarrhea is common among AIDS patients. Oral rehydration therapy and proper

  20. Unsuspected exposure to beryllium: potential implications for sarcoidosis diagnoses.

    Science.gov (United States)

    Laczniak, Andrew N; Gross, Nathan A; Fuortes, Laurence J; Field, R William

    2014-07-21

    Exposure to Beryllium (Be) can cause sensitization (BeS) and chronic beryllium disease (CBD) in some individuals.  Even relatively low exposures may be sufficient to generate an asymptomatic, or in some cases a symptomatic, immune response. Since the clinical presentation of CBD is similar to that of sarcoidosis, it is helpful to have information on exposure to beryllium in order to reduce misdiagnosis. The purpose of this pilot study is to explore the occurrence of Be surface deposits at worksites with little or no previous reported use of commercially available Be products.  The workplaces chosen for this study represent a convenience sample of businesses in eastern Iowa. One hundred thirty-six surface dust samples were collected from 27 businesses for analysis of Be. The results were then divided into categories by the amount of detected Be according to U.S. Department of Energy guidelines as described in 10 CFR 850.30 and 10 CFR 850.31. Overall, at least one of the samples at 78% of the work sites tested contained deposited Be above the analytical limit of quantitation (0.035 µg beryllium per sample).  Beryllium was detected in 46% of the samples collected. Twelve percent of the samples exceeded 0.2 µg/100 cm² and 4% of the samples exceeded a Be concentration of 3 µg/100 cm². The findings from this study suggest that there may be a wider range and greater number of work environments that have the potential for Be exposure than has been documented previously.  These findings could have implications for the accurate diagnosis of sarcoidosis.

  1. Thermal shock induced oxidation of beryllium

    Science.gov (United States)

    Spilker, B.; Linke, J.; Pintsuk, G.; Wirtz, M.

    2017-12-01

    Beryllium has been chosen as a plasma facing material for the first wall of the experimental fusion reactor ITER, mainly because of its low atomic number and oxygen getter capabilities, which are favorable for a high plasma performance. While the steady state operational temperature of 250 °C has no deteriorating effect on the beryllium surface, transient plasma events can deposit power densities of up to 1 GW m‑2 on the beryllium armor tiles. Previous research has shown that the oxidation of beryllium can occur under these thermal shock events. In the present study, S-65 grade beryllium specimens were exposed to 100 thermal shocks with an absorbed power density of 0.6 GW m‑2 and a pulse duration of 1 ms, leading to a peak surface temperature of ∼800 °C. The induced surface morphology changes were compared to a steady state heated specimen at the same surface temperature with a holding time of 150 s. As a result, a pitting structure with an average pit diameter of ∼0.45 μm was observed on the thermal shock loaded surface, which was caused by beryllium oxide grain nucleation and subsequent erosion of the weakly bound beryllium oxide particles. In contrast, the steady state heated surface exhibited a more homogeneous beryllium oxide layer featuring small pits with diameters of tens of nm and showed the beryllium oxide grain nucleation in a beginning stage. The experiment demonstrated that thermal shock loading conditions can significantly accelerate the beryllium oxide grain nucleation. The resulting surface morphology change can potentially alter the fusion application relevant erosion, absorption, and retention characteristics of beryllium.

  2. Modeling of hydrogen interactions with beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Longhurst, G.R. [Lockheed Martin Idaho Technologies Co., Idaho Falls, ID (United States)

    1998-01-01

    In this paper, improved mathematical models are developed for hydrogen interactions with beryllium. This includes the saturation effect observed for high-flux implantation of ions from plasmas and retention of tritium produced from neutronic transmutations in beryllium. Use of the models developed is justified by showing how they can replicated experimental data using the TMAP4 tritium transport code. (author)

  3. Investigation of beryllium/steam interaction

    Energy Technology Data Exchange (ETDEWEB)

    Chekhonadskikh, A.M.; Vurim, A.D.; Vasilyev, Yu.S.; Pivovarov, O.S. [Inst. of Atomic Energy National Nuclear Center of the Republic of Kazakstan Semipalatinsk (Kazakhstan); Shestakov, V.P.; Tazhibayeva, I.L.

    1998-01-01

    In this report program on investigations of beryllium emissivity and transient processes on overheated beryllium surface attacked by water steam to be carried out in IAE NNC RK within Task S81 TT 2096-07-16 FR. The experimental facility design is elaborated in this Report. (author)

  4. Some characteristics of fine beryllium particle combustion

    Science.gov (United States)

    Davydov, D. A.; Kholopova, O. V.; Kolbasov, B. N.

    2007-08-01

    Beryllium dust will be produced under plasma interaction with beryllium armor of the first wall in ITER. Exothermal reaction of this dust with water steam or air, which can leak into the reactor vacuum chamber in some accidents, gives concern in respect to reactor safety. Results of studies devoted to combustion of fine beryllium particles are reviewed in the paper. A chemically active medium and elevated temperature are prerequisite to the combustion of beryllium particles. Their ignition is hampered by oxide films, which form a diffusion barrier on the particle surface as a result of pre-flame oxidation. The temperature to initiate combustion of particles depends on flame temperature, particle size, composition of combustible mixture, heating rate and other factors. In mixtures enriched with combustible, the flame temperature necessary to ignite individual particles approaches the beryllium boiling temperature.

  5. BERYLLIUM MEASUREMENT IN COMMERCIALLY AVAILABLE WET WIPES

    Energy Technology Data Exchange (ETDEWEB)

    Youmans-Mcdonald, L.

    2011-02-18

    Analysis for beryllium by fluorescence is now an established method which is used in many government-run laboratories and commercial facilities. This study investigates the use of this technique using commercially available wet wipes. The fluorescence method is widely documented and has been approved as a standard test method by ASTM International and the National Institute for Occupational Safety and Health (NIOSH). The procedure involves dissolution of samples in aqueous ammonium bifluoride solution and then adding a small aliquot to a basic hydroxybenzoquinoline sulfonate fluorescent dye (Berylliant{trademark} Inc. Detection Solution Part No. CH-2) , and measuring the fluorescence. This method is specific to beryllium. This work explores the use of three different commercial wipes spiked with beryllium, as beryllium acetate or as beryllium oxide and subsequent analysis by optical fluorescence. The effect of possible interfering metals such as Fe, Ti and Pu in the wipe medium is also examined.

  6. [Acute renal failure in paediatric oncological disease].

    Science.gov (United States)

    Stefanowicz, Joanna; Maciejka-Kapuścińska, Lucyna; Rückemann-Dziurdzińska, Katarzyna; Drozyńska-Duklas, Magdalena; Zurowska, Aleksandra; Balcerska, Anna

    2007-01-01

    Acute renal failure (ARF) in children with malignancies is a rare clinical situation, but nonetheless it is a serious life threatening condition. It may arise from different clinical situations and may be caused by various factors. The aim of the study was to determine the frequency, aetiology and the course of ARF in children treated for malignancies in the Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical University of Gdansk. A group of 586 pediatric oncology patients treated between 1992 and 2004 were enrolled in a retrospective study. ARF was diagnosed in 29 cases including: 12 patients with prerenal course of ARF (11 due to septic shock and 1 due to dehydration), 16 patients with intrinsic renal aetiology of ARF (as a complication after cisplatinum and carboplatinum therapy in 2 children, in 2 cases after methotrexate, as a consequence of bilateral nephrectomy due to nephroblastoma in 1 patient and in 11 children with tumour lysis syndrome, including 5 patients with neoplasmatic infiltration of kidneys) and postrenal ARF in 1 patient as a first symptom of a tumour located in the small pelvis (Rhabdomyosarcoma). Renal replacement therapy (dialysis) was necessary in 11 children. Among 29 analysed children, in 20 cases renal failure was reversible. Due to appropriate treatment, ARF in course of tumour lysis syndrome is nowadays reversible. ARF due to septic shock or cytostatics nephrotoxicity is a significant therapeutic problem. In most of the cases it is irreversible. 1. ARF in these studies occurred in 29 out of 586 children with malignancies (4.9%). 2. Prerenal and renal ARF were the most frequent forms. 3. Implementation of tumour lysis prophylaxis in the treatment of children with blood system proliferative diseases reduces the incidence of ARF. 4. In cases of ARF in children's malignancies close cooperation between paediatric oncologist and nephrologist is necessary.

  7. Drug management in acute kidney disease - Report of the Acute Disease Quality Initiative XVI meeting.

    Science.gov (United States)

    Ostermann, Marlies; Chawla, Lakhmir S; Forni, Lui G; Kane-Gill, Sandra L; Kellum, John A; Koyner, Jay; Murray, Patrick T; Ronco, Claudio; Goldstein, Stuart L

    2018-02-01

    To summarize and extend the main conclusions and recommendations relevant to drug management during acute kidney disease (AKD) as agreed at the 16 th Acute Disease Quality Initiative (ADQI) consensus conference. Using a modified Delphi method to achieve consensus, experts attending the 16 th ADQI consensus conference reviewed and appraised the existing literature on drug management during AKD and identified recommendations for clinical practice and future research. The group focussed on drugs with one of the following characteristics: (i) predominant renal excretion; (ii) nephrotoxicity; (iii) potential to alter glomerular function; and (iv) presence of metabolites that are modified in AKD and may affect other organs. We recommend that medication reconciliation should occur at admission and discharge, at AKD diagnosis and change in AKD phase, and when the patient's condition changes. Strategies to avoid adverse drug reactions in AKD should seek to minimize adverse events from overdosing and nephrotoxicity and therapeutic failure from under-dosing or incorrect drug selection. Medication regimen assessment or introduction of medications during the AKD period should consider the nephrotoxic potential, altered renal and nonrenal elimination, the effects of toxic metabolites and drug interactions and altered pharmacodynamics in AKD. A dynamic monitoring plan including repeated serial assessment of clinical features, utilization of renal diagnostic tests and therapeutic drug monitoring should be used to guide medication regimen assessment. Drug management during different phases of AKD requires an individualized approach and frequent re-assessment. More research is needed to avoid drug associated harm and therapeutic failure. © 2017 The British Pharmacological Society.

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

    Directory of Open Access Journals (Sweden)

    A. Yu. Ischenko

    2015-01-01

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

  9. Acute Demyelinating Disease after Oral Therapy with Herbal Extracts

    Directory of Open Access Journals (Sweden)

    Alex Kostianovsky

    2011-06-01

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

  10. Acute myeloid leukaemia as a cause of acute ischaemic heart disease

    NARCIS (Netherlands)

    van Haelst, P.L.; Schot, Bart; Hoendermis, E.S.; van den Berg, M.P.

    2006-01-01

    Ischaemic heart disease is almost invariably the result of atherosclerotic degeneration of the coronary arteries. However, other causes of ischaemic heart disease should always be considered. Here we describe two patients with a classic presentation of ischaemic heart disease resulting from acute

  11. Determine Neutron Yield From Beryllium Compounds Bombarding With Alpha Particles

    Directory of Open Access Journals (Sweden)

    Osamah Nawfal Oudah

    2015-04-01

    Full Text Available Abstract The chemical combination of Beryllium used in the amp945n reaction as a target materials. wherefore Beryllium has generally been the material of select when manufacturing a neutron source. Beryllium compounds has a significant impact on the scheme and manufacture of the 238Cm-9Be neutron source. In present work the Beryllium chemical combinations were considered as a producer of neutrons with different percentage of mass and the neutron yields were likewise determined using the outcomes of the ASTAR calculations per unit incident charge. The neutron yields of Beryllium Oxide Beryllium Carbide Beryllium Hydride Beryllium Hydroxide and Beryllium Nitride were calculated as 3.1006e-005 3.0365e-005 2.2866e-005 2.0464e-005 and 3.0386e-005respectively. The results show that the Beryllium Oxide is a suitable material to use in the 238Cm-9Be neutron source.

  12. Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Cardiovascular Links

    Science.gov (United States)

    Laratta, Cheryl R.; van Eeden, Stephan

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is a chronic, progressive lung disease resulting from exposure to cigarette smoke, noxious gases, particulate matter, and air pollutants. COPD is exacerbated by acute inflammatory insults such as lung infections (viral and bacterial) and air pollutants which further accelerate the steady decline in lung function. The chronic inflammatory process in the lung contributes to the extrapulmonary manifestations of COPD which are predominantly cardiovascular in nature. Here we review the significant burden of cardiovascular disease in COPD and discuss the clinical and pathological links between acute exacerbations of COPD and cardiovascular disease. PMID:24724085

  13. Kawasaki Disease Presenting as Acute Clinical Hepatitis

    Directory of Open Access Journals (Sweden)

    Seyed Ali Jafari

    2013-12-01

    Full Text Available Kawasaki disease is a systemic vasculitis of children. Among gastrointestinal symptoms of this disease jaundice occurs uncommonly. We present a 23 month boy with icter and clinical hepatitis and final diagnosis of kawasaki disease.

  14. Ultrasonographic Findings of Extratesticular Diseases Causing Acute Scrotal Disorders

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Jae Joon; Lee, Tack; Chang, So Yong; Kim, Myeong Jin; Yoo, Hyung Sik; Lee, Jong Tae [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1996-12-15

    To evaluate the kinds of extratesticular diseases causing acute scrotal disorders by emergent sonography of the scrotum. Scrotal sonography in sixty-five patients, with age ranging from 5months to 82 years (mean : 27.3 years), with acute scrotal pain and swelling, was prospectively carried out by either a 10 or 7.5 MHz transducer. We evaluated the size and echogenicity of the epididymis, the presence of extratesticular solid mass or cyst, testicular involvement by extratesticular diseases, calcification, hydrocele and scrotal wall thickening. The most common cause of acute scrotal disorders was acute epididymitis (n= 50), followed by acute epididymo-orchitis (n = 4), mumps epididymo-orchitis (n = 2), enlarged epididymis secondary to testicular torsion (n = 2), infected hydrocele (n = 2), epididymal cyst (n = 2), rupture of varicocele (n = 1), angioneurotic edema (n = 1), and sperm granuloma (n = 1). Hydrocele was seen in 20 cases, and epididymal calcification was noted in 6 cases. Emergent scrotal sonography was useful for correct diagnosis and proper treatment in patients with acute scrotal disorders, especially in the differentiation of the acute epididymitis from other intrascrotal diseases

  15. Cerebrospinal Fluid Proteome of Patients with Acute Lyme Disease

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-10-05

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

  16. Acute colonic disease: How to image in emergency

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania [Department of Diagnostic Imaging, A. Cardarelli Hospital, Viale Cardarelli 9, 80131 Naples (Italy)]. E-mail: stefromano@libero.it; Lombardo, Patrizia [Department of Diagnostic Imaging, A. Cardarelli Hospital, Viale Cardarelli 9, 80131 Naples (Italy); Cinque, Teresa [Department of Diagnostic Imaging, A. Cardarelli Hospital, Viale Cardarelli 9, 80131 Naples (Italy); Tortora, Giovanni [Department of Diagnostic Imaging, A. Cardarelli Hospital, Viale Cardarelli 9, 80131 Naples (Italy); Romano, Luigia [Department of Diagnostic Imaging, A. Cardarelli Hospital, Viale Cardarelli 9, 80131 Naples (Italy)

    2007-03-15

    The diseases affecting the large intestine represent a diagnostic problem in adult patients with acute abdomen, especially when clinical symptoms are not specific. The role of the diagnostic imaging is to help clinicians and surgeons in differential diagnosis for an efficient early and prompt therapy to perform. This review article summarizes the imaging spectrum of findings of colonic acute disease, from mechanical obstruction to inflammatory diseases and perforation, offering keys to problem solving in doubtful cases as well as discussing regarding the more indicated imaging method to use in emergency, particularly MDCT.

  17. Minimally Invasive Management of Acute Biliary Tract Disease during Pregnancy

    Directory of Open Access Journals (Sweden)

    Luis Tomás Chiappetta Porras

    2009-01-01

    Full Text Available Background. Acute biliary diseases during pregnancy have been classically managed conservatively. Advances in minimally invasive surgery and the high recurrence rate of symptoms observed changed this management. Methods. This is a prospective observational study. Initial management was medical. Unresponsive patients were treated with minimally invasive techniques including gallbladder percutaneous aspiration or cholecystostomy, endoscopic retrograde cholangiography, and laparoscopic cholecystectomy, depending on the pregnancy trimester and underlying diagnosis. Results. 122 patients were admitted. 69 (56.5% were unresponsive to medical treatment. Recurrent gallbladder colic was the most frequent indication for minimally invasive intervention, followed by acute cholecystitis, choledocholithiasis, and acute biliary pancreatitis. 8 patients were treated during the first trimester, 54 during the second, and 7 during the last trimester. There was no fetal morbidity or mortality. Maternal morbidity was minor with no mortality. Conclusion. Acute biliary tract diseases during pregnancy may be safely treated with minimally invasive procedures according to the underlying diagnosis and to the trimester of pregnancy.

  18. Beryllium concentration in pharyngeal tonsils in children

    Directory of Open Access Journals (Sweden)

    Ewa Nogaj

    2014-06-01

    Full Text Available Power plant dust is believed to be the main source of the increased presence of the element beryllium in the environment which has been detected in the atmospheric air, surface waters, groundwater, soil, food, and cigarette smoke. In humans, beryllium absorption occurs mainly via the respiratory system. The pharyngeal tonsils are located on the roof of the nasopharynx and are in direct contact with dust particles in inhaled air. As a result, the concentration levels of beryllium in the pharyngeal tonsils are likely to be a good indicator of concentration levels in the air. The presented study had two primary aims: to investigate the beryllium concentration in pharyngeal tonsils in children living in southern Poland, and the appropriate reference range for this element in children’s pharyngeal tonsils. Pharyngeal tonsils were extracted from a total of 379 children (age 2–17 years, mean 6.2 ± 2.7 years living in southern Poland. Tonsil samples were mineralized in a closed cycle in a pressure mineralizer PDS 6, using 65% spectrally pure nitric acid. Beryllium concentration was determined using the ICP-AES method with a Perkin Elmer Optima 5300DVTM. The software Statistica v. 9 was used for the statistical analysis. It was found that girls had a significantly greater beryllium concentration in their pharyngeal tonsils than boys. Beryllium concentration varies greatly, mostly according to the place of residence. Based on the study results, the reference value for beryllium in pharyngeal tonsils of children is recommended to be determined at 0.02–0.04 µg/g.

  19. Tritium release from neutron irradiated beryllium pebbles

    Energy Technology Data Exchange (ETDEWEB)

    Scaffidi-Argentina, F.; Werle, H. [Forschungszentrum Karlsruhe GmbH Technik und Umwelt (Germany). Inst. fuer Neutronenphysik und Reactortechnik

    1998-01-01

    One of the most important open issues related to beryllium for fusion applications refers to the kinetics of the tritium release as a function of neutron fluence and temperature. The EXOTIC-7 as well as the `Beryllium` experiments carried out in the HFR reactor in Petten are considered as the most detailed and significant tests for investigating the beryllium response under neutron irradiation. This paper reviews the present status of beryllium post-irradiation examinations performed at the Forschungszentrum Karlsruhe with samples from the above mentioned irradiation experiments, trying to elucidate the tritium release controlling processes. In agreement with previous studies it has been found that release starts at about 500-550degC and achieves a maximum at about 700-750degC. The observed release at about 500-550degC is probably due to tritium escaping from chemical traps, while the maximum release at about 700-750degC is due to tritium escaping from physical traps. The consequences of a direct contact between beryllium and ceramics during irradiation, causing tritium implanting in a surface layer of beryllium up to a depth of about 40 mm and leading to an additional inventory which is usually several times larger than the neutron-produced one, are also presented and the effects on the tritium release are discussed. (author)

  20. Sanitary-hygienic and ecological aspects of beryllium production

    Energy Technology Data Exchange (ETDEWEB)

    Dvinskykh, E.M.; Savchuk, V.V.; Sidorov, V.L.; Slobodin, D.B.; Tuzov, Y.V. [Ulba Metallurgical Plant, Ust-Kamenogorsk (Kazakhstan)

    1998-01-01

    The Report describes An organization of sanitary-hygienic and ecological control of beryllium production at Ulba metallurgical plant. It involves: (1) the consideration of main methods for protection of beryllium production personnel from unhealthy effect of beryllium, (2) main kinds of filters, used in gas purification systems at different process areas, (3) data on beryllium monitoring in water, soil, on equipment. This Report also outlines problems connected with designing devices for a rapid analysis of beryllium in air as well as problems of beryllium production on ecological situation in the town. (author)

  1. CLARYTROMYCIN IN TREATMENT OF PEDIATRIC ACUTE RESPIRATORY DISEASES

    Directory of Open Access Journals (Sweden)

    A. Yu. Simonova

    2012-01-01

    Full Text Available Acute respiratory diseases still occupy leading positions among all pediatric diseases. This article contains modern data upon etiology of acute and recurrent bronchitides, as well as that of out-of-hospital pneumonias in children. Special attention is paid to the choice of antibacterial therapy. We observe modern Russian and international data upon bacterial resistance to antibacterial drugs. This article also contains description of biological, pharmacokinetic and antibacterial traits of macrolides, especially these of clarytromycin with description of its use in treatment of pediatric respiratory disorders.

  2. Graves’ disease as an uncommon cause of acute pericarditis

    Science.gov (United States)

    Kortekaas, Kirsten; van der Lienden, Bas; Jong, Simone; Riezebos, Robert

    2014-01-01

    Acute pericarditis is either dry, fibrinous or effusive, independent of its aetiology. A case is presented involving a 44-year-old man with acute pericarditis. The cause was established to be an aggravation of Graves’ disease due to non-compliance with treatment. Pericarditis is an uncommon cardiac complication of Graves’ disease and is associated with more recurrent episodes when not detected. Pharmacological treatment should include anti-inflammatory drugs in combination with treatment for hyperthyroidism. The specific pathophysiological link between the two conditions is still to be elucidated. PMID:24769665

  3. Acute rheumatic fever and rheumatic heart disease in indigenous populations.

    Science.gov (United States)

    Steer, Andrew C; Carapetis, Jonathan R

    2009-12-01

    Acute rheumatic fever and rheumatic heart disease are diseases of socioeconomic disadvantage. These diseases are common in developing countries and in Indigenous populations in industrialized countries. Clinicians who work with Indigenous populations need to maintain a high index of suspicion for the potential diagnosis of acute rheumatic fever, particularly in patients presenting with joint pain. Inexpensive medicines, such as aspirin, are the mainstay of symptomatic treatment of rheumatic fever; however, antiinflammatory treatment has no effect on the long-term rate of progression or severity of chronic valvular disease. The current focus of global efforts at prevention of rheumatic heart disease is on secondary prevention (regular administration of penicillin to prevent recurrent rheumatic fever), although primary prevention (timely treatment of streptococcal pharyngitis to prevent rheumatic fever) is also important in populations in which it is feasible.

  4. NAMPT serum levels are selectively elevated in acute infectious disease and in acute relapse of chronic inflammatory diseases in children.

    Directory of Open Access Journals (Sweden)

    Julia Gesing

    Full Text Available Nicotinamide phosphoribosyl transferase (NAMPT is an inflammatory adipocytokine shown to interact in immune modulation in chronic inflammatory diseases, acute respiratory distress syndrome, sepsis, cancer and obesity in adulthood. It is, however, not clear whether this association reflects a chronic elevation or acute inflammatory response. We analyzed NAMPT concentrations in distinct states of inflammation in 102 children and found consistently significantly increased NAMPT levels in subjects with acute infections. NAMPT concentrations in children with stable chronic inflammatory diseases were not significantly different, whereas in patients with acute relapse of chronic disease NAMPT was significantly higher than in children in remission or healthy controls. In states of low-grade inflammation (children with atopic disease or obesity we did not detect alterations in NAMPT serum levels. NAMPT correlated positively with inflammatory markers such as CRP. The most predictive factor for NAMPT serum concentrations was leucocyte count and therein the neutrophil count. Furthermore, systemic circulating NAMPT levels were closely associated with NAMPT release from corresponding cultured PBMCs. In conclusion, NAMPT is selectively increased in states of acute but not chronic inflammation in children. The close relationship between systemic circulating NAMPT with leucocyte counts and release indicate that leucocytes most probably are the source of inflammation related NAMPT levels.

  5. [Tears' immunology in acute eye diseases].

    Science.gov (United States)

    Ignat, F; Godeanu, L; Davidescu, L; Voiculescu, M

    2001-01-01

    The aim of the study is to research the immunoglobulins' concentration into the tears liquid and into the blood serum at the patients with acute affections of the anterior ocular pole. The study was accomplished on two groups of patients: one group with herpetic Keratitis, the other with anterior uveitis, the second having a different etiology--that the viral one. Another group of patients with senile cataract was used like witness-group. The immunoglobulins concentration were detected into the serum and into the tears by the Mancini method of the radial immunodiffusion. The results indicate a general immunodefficiency signed by the decrease of IgG and IgM into the serum on the one hand, and the increase of local defense mechanisms reflected on the growing of IgA and IgG level into the tears, on the other hand.

  6. Acute tubulointerstitial nephritis complicating Legionnaires' disease: a case report

    Directory of Open Access Journals (Sweden)

    Daumas Aurélie

    2012-04-01

    Full Text Available Abstract Introduction Legionnaires' disease is recognized as a multi-systemic illness. Afflicted patients may have pulmonary, renal, gastrointestinal tract and central nervous system complications. However, renal insufficiency is uncommon. The spectrum of renal involvement may range from a mild and transient elevation of serum creatinine levels to anuric renal failure requiring dialysis and may be linked to several causes. In our present case report, we would like to draw attention to the importance of the pathological documentation of acute renal failure by reporting a case of a patient with acute tubulointerstitial nephritis complicating Legionnaires' disease. Case presentation A 55-year-old Caucasian man was admitted to our hospital for community-acquired pneumonia complicated by acute renal failure. Legionella pneumophila serogroup type 1 was diagnosed. Although the patient's respiratory illness responded to intravenous erythromycin and ofloxacin therapy, his renal failure worsened, he became anuric, and hemodialysis was started. A renal biopsy was performed, which revealed severe tubulointerstitial nephritis. After initiation of steroid therapy, his renal function improved dramatically. Conclusions This case highlights the importance of kidney biopsies in cases where acute renal failure is a complicating factor in Legionnaires' disease. If the presence of acute tubulointerstitial nephritis can be confirmed, it will likely respond favorably to steroidal treatment and thus irreversible renal damage and chronic renal failure will be avoided.

  7. Acute Chagas Disease: New Global Challenges for an Old Neglected Disease

    Science.gov (United States)

    Andrade, Daniela V.; Gollob, Kenneth J.; Dutra, Walderez O.

    2014-01-01

    Chagas disease is caused by infection with the protozoan Trypanosoma cruzi, and although over 100 years have passed since the discovery of Chagas disease, it still presents an increasing problem for global public health. A plethora of information concerning the chronic phase of human Chagas disease, particularly the severe cardiac form, is available in the literature. However, information concerning events during the acute phase of the disease is scarce. In this review, we will discuss (1) the current status of acute Chagas disease cases globally, (2) the immunological findings related to the acute phase and their possible influence in disease outcome, and (3) reactivation of Chagas disease in immunocompromised individuals, a key point for transplantation and HIV infection management. PMID:25077613

  8. Long-term follow-up of beryllium sensitized workers from a single employer

    Directory of Open Access Journals (Sweden)

    Curtis Anne M

    2010-01-01

    Full Text Available Abstract Background Up to 12% of beryllium-exposed American workers would test positive on beryllium lymphocyte proliferation test (BeLPT screening, but the implications of sensitization remain uncertain. Methods Seventy two current and former employees of a beryllium manufacturer, including 22 with pathologic changes of chronic beryllium disease (CBD, and 50 without, with a confirmed positive test were followed-up for 7.4 +/-3.1 years. Results Beyond predicted effects of aging, flow rates and lung volumes changed little from baseline, while DLCO dropped 17.4% of predicted on average. Despite this group decline, only 8 subjects (11.1% demonstrated physiologic or radiologic abnormalities typical of CBD. Other than baseline status, no clinical or laboratory feature distinguished those who clinically manifested CBD at follow-up from those who did not. Conclusions The clinical outlook remains favorable for beryllium-sensitized individuals over the first 5-12 years. However, declines in DLCO may presage further and more serious clinical manifestations in the future. These conclusions are tempered by the possibility of selection bias and other study limitations.

  9. Adenosine Signaling During Acute and Chronic Disease States

    Science.gov (United States)

    Karmouty-Quintana, Harry; Xia, Yang; Blackburn, Michael R.

    2013-01-01

    Adenosine is a signaling nucleoside that is produced following tissue injury, particularly injury involving ischemia and hypoxia. The production of extracellular adenosine and its subsequent signaling through adenosine receptors plays an important role in orchestrating injury responses in multiple organs. There are four adenosine receptors that are widely distributed on immune, epithelial, endothelial, neuronal and stromal cells throughout the body. Interestingly, these receptors are subject to altered regulation following injury. Studies in mouse models and human cells and tissues have identified that the production of adenosine and its subsequent signaling through its receptors plays largely beneficial roles in acute disease states, with the exception of brain injury. In contrast, if elevated adenosine levels are sustained beyond the acute injury phase, adenosine responses can become detrimental by activating pathways that promote tissue injury and fibrosis. Understanding when during the course of disease adenosine signaling is beneficial as opposed to detrimental and defining the mechanisms involved will be critical for the advancement of adenosine based therapies for acute and chronic diseases. The purpose of this review is to discuss key observations that define the beneficial and detrimental aspects of adenosine signaling during acute and chronic disease states with an emphasis on cellular processes such as inflammatory cell regulation, vascular barrier function and tissue fibrosis. PMID:23340998

  10. Acute Phase Reactants in Immune-Related Inner Ear Disease ...

    African Journals Online (AJOL)

    In this study, the clinical profile of patients with immune-related inner ear disease (IRIED) was correlated with the laboratory results of acute phase reactants and quantitative immunoglobulin as ... The predisposing factor was presumed to be autoimmune in 7(48%), allergy in 6(40%) and one patient had trauma in addition.

  11. Clinical Course of Acute Pancreatitis in Chronic Kidney Disease ...

    African Journals Online (AJOL)

    Introduction: The aim of this study was to assess the clinical course, etiology and complications of acute pancreatitis among chronic kidney disease (CKD) patients in a tertiary care renal center in Karachi. Methods: We retrospectively evaluated the clinical course of CKD patients who presented to our emergency room with ...

  12. Acute Pelvic Inflammatory Disease in Cameroon: A Cross Sectional ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Abstract. This cross-sectional descriptive study, aimed at identifying the sociodemographic characteristics of women diagnosed with acute pelvic inflammatory disease (PID), as well as the microorganisms isolated, was carried out between October 1st, 2013 and March ... responsible can be sexually transmitted (Chlamydia.

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

    LENUS (Irish Health Repository)

    Saeed, A

    2012-01-31

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

  14. Mechanical performance of irradiated beryllium pebbles

    Energy Technology Data Exchange (ETDEWEB)

    Scaffidi-Argentina, F.; Dalle-Donne, M.; Werle, H. [Forschungszentrum Karlsruhe GmbH Technik und Umwelt (Germany). Inst. fuer Neutronenphysik und Reaktortechnik

    1998-01-01

    For the Helium Cooled Pebble Bed (HCPB) Blanket, which is one of the two reference concepts studied within the European Fusion Technology Programme, the neutron multiplier consists of a mixed bed of about 2 and 0.1-0.2 mm diameter beryllium pebbles. Beryllium has no structural function in the blanket, however microstructural and mechanical properties are important, as they might influence the material behavior under neutron irradiation. The EXOTIC-7 as well as the `Beryllium` experiments carried out in the HFR reactor in Petten are considered as the most detailed and significant tests for investigating it. This paper reviews the present status of beryllium post-irradiation examinations performed at the Forschungszentrum Karlsruhe with samples from these irradiation experiments, emphasizing the effects of irradiation of essential material properties and trying to elucidate the processes controlling the property changes. The microstructure, the porosity distribution, the impurity content, the behavior under compression loads and the compatibility of the beryllium pebbles with lithium orthosilicate (Li{sub 4}SiO{sub 4}) during the in-pile irradiation are presented and critically discussed. Qualitative information on ductility and creep obtained by hardness-type measurements are also supplied. (author)

  15. Acute viscerotropic disease following vaccination against yellow fever.

    Science.gov (United States)

    Hayes, Edward B

    2007-10-01

    Acute viscerotropic disease following yellow fever vaccination (YEL-AVD) is a rare but serious complication of vaccination with 17D yellow fever vaccine. This paper reviews the existing literature regarding YEL-AVD and discusses possible etiologic mechanisms. A greater understanding of this condition is essential to assuring safe and effective prevention of yellow fever and vaccination against other arboviral diseases for which 17D-based vaccines are being developed.

  16. Metabolic Liver Diseases Presenting as Acute Liver Failure in Children.

    Science.gov (United States)

    Alam, Seema; Lal, Bikrant Bihari

    2016-08-08

    Suspecting metabolic liver disease in an infant or young child with acute liver failure, and a protocol-based workup for diagnosis is the need of the hour. Data over the last 15 years was searched through Pubmed using the keywords Metabolic liver disease and Acute liver failure with emphasis on Indian perspective. Those published in English language where full text was retrievable were included for this review. Metabolic liver diseases account for 13-43% cases of acute liver failure in infants and young children. Etiology remains indeterminate in very few cases of liver failure in studies where metabolic liver diseases were recognized in large proportion. Galactosemia, tyrosinemia and mitochondrial disorders in young children and Wilsons disease in older children are commonly implicated. A high index of suspicion for metabolic liver diseases should be kept when there is strong family history of consanguinity, recurrent abortions or sibling deaths; and history of recurrent diarrhea, vomiting, failure to thrive or developmental delay. Simple dietary modifications and/or specific management can be life-saving if instituted promptly. A high index of suspicion in presence of red flag symptoms and signs, and a protocol-based approach helps in timely diagnosis and prompt administration of lifesaving therapy.

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

    Science.gov (United States)

    Eitel, Ingo; Friedrich, Matthias G

    2011-02-18

    Cardiovascular magnetic resonance (CMR) using T2-weighted sequences can visualize myocardial edema. When compared to previous protocols, newer pulse sequences with substantially improved image quality have increased its clinical utility. The assessment of myocardial edema provides useful incremental diagnostic and prognostic information in a variety of clinical settings associated with acute myocardial injury. In patients with acute chest pain, T2-weighted CMR is able to identify acute or recent myocardial ischemic injury and has been employed to distinguish acute coronary syndrome (ACS) from non-ACS as well as acute from chronic myocardial infarction.T2-weighted CMR can also be used to determine the area at risk in reperfused and non-reperfused infarction. When combined with contrast-enhanced imaging, the salvaged area and thus the success of early coronary revascularization can be quantified. Strong evidence for the prognostic value of myocardial salvage has enabled its use as a primary endpoint in clinical trials. The present article reviews the current evidence and clinical applications for T2-weighted CMR in acute cardiac disease and gives an outlook on future developments."The principle of all things is water"Thales of Miletus (624 BC - 546 BC). © 2011 Eitel and Friedrich; licensee BioMed Central Ltd.

  18. Moyamoya disease in a child with previous acute necrotizing encephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Taik-Kun; Cha, Sang Hoon; Chung, Kyoo Byung; Kim, Jung Hyuck; Kim, Baek Hyun; Chung, Hwan Hoon [Department of Diagnostic Radiology, Korea University College of Medicine, Ansan Hospital, 516 Kojan-Dong, Ansan City, Kyungki-Do 425-020 (Korea); Eun, Baik-Lin [Department of Pediatrics, Korea University College of Medicine, Seoul (Korea)

    2003-09-01

    A previously healthy 24-day-old boy presented with a 2-day history of fever and had a convulsion on the day of admission. MRI showed abnormal signal in the thalami, caudate nuclei and central white matter. Acute necrotising encephalopathy was diagnosed, other causes having been excluded after biochemical and haematological analysis of blood, urine and CSF. He recovered, but with spastic quadriparesis. At the age of 28 months, he suffered sudden deterioration of consciousness and motor weakness of his right limbs. MRI was consistent with an acute cerebrovascular accident. Angiography showed bilateral middle cerebral artery stenosis or frank occlusion with numerous lenticulostriate collateral vessels consistent with moyamoya disease. (orig.)

  19. Recent Developments in Epigenetics of Acute and Chronic Kidney Diseases

    Science.gov (United States)

    Reddy, Marpadga A.; Natarajan, Rama

    2015-01-01

    The growing epidemic of obesity and diabetes, the aging population as well as prevalence of drug abuse has led to significant increases in the rates of the closely associated acute and chronic kidney diseases, including diabetic nephropathy. Furthermore, evidence shows that parental behavior and diet can affect the phenotype of subsequent generations via epigenetic transmission mechanisms. These data suggest a strong influence of the environment on disease susceptibility and that, apart from genetic susceptibility, epigenetic mechanisms need to be evaluated to gain critical new information about kidney diseases. Epigenetics is the study of processes that control gene expression and phenotype without alterations in the underlying DNA sequence. Epigenetic modifications, including cytosine DNA methylation and covalent post translational modifications of histones in chromatin are part of the epigenome, the interface between the stable genome and the variable environment. This dynamic epigenetic layer responds to external environmental cues to influence the expression of genes associated with disease states. The field of epigenetics has seen remarkable growth in the past few years with significant advances in basic biology, contributions to human disease, as well as epigenomics technologies. Further understanding of how the renal cell epigenome is altered by metabolic and other stimuli can yield novel new insights into the pathogenesis of kidney diseases. In this review, we have discussed the current knowledge on the role of epigenetic mechanisms (primarily DNA me and histone modifications) in acute and chronic kidney diseases, and their translational potential to identify much needed new therapies. PMID:25993323

  20. Recent developments in epigenetics of acute and chronic kidney diseases.

    Science.gov (United States)

    Reddy, Marpadga A; Natarajan, Rama

    2015-08-01

    The growing epidemic of obesity and diabetes, the aging population as well as prevalence of drug abuse has led to significant increases in the rates of the closely associated acute and chronic kidney diseases, including diabetic nephropathy. Furthermore, evidence shows that parental behavior and diet can affect the phenotype of subsequent generations via epigenetic transmission mechanisms. These data suggest a strong influence of the environment on disease susceptibility and that, apart from genetic susceptibility, epigenetic mechanisms need to be evaluated to gain critical new information about kidney diseases. Epigenetics is the study of processes that control gene expression and phenotype without alterations in the underlying DNA sequence. Epigenetic modifications, including cytosine DNA methylation and covalent post-translational modifications of histones in chromatin, are part of the epigenome, the interface between the stable genome and the variable environment. This dynamic epigenetic layer responds to external environmental cues to influence the expression of genes associated with disease states. The field of epigenetics has seen remarkable growth in the past few years with significant advances in basic biology, contributions to human disease, as well as epigenomics technologies. Further understanding of how the renal cell epigenome is altered by metabolic and other stimuli can yield novel new insights into the pathogenesis of kidney diseases. In this review, we have discussed the current knowledge on the role of epigenetic mechanisms (primarily DNAme and histone modifications) in acute and chronic kidney diseases, and their translational potential to identify much needed new therapies.

  1. Preliminary results for explosion bonding of beryllium to copper

    Energy Technology Data Exchange (ETDEWEB)

    Butler, D.J. [Northwest Technical Industries, Inc., Sequim, WA (United States); Dombrowski, D.E. [Brush Wellman, Inc., Cleveland, OH (United States)

    1995-09-01

    This program was undertaken to determine if explosive bonding is a viable technique for joining beryllium to copper substrates. The effort was a cursory attempt at trying to solve some of the problems associated with explosive bonding beryllium and should not be considered a comprehensive research effort. There are two issues that this program addressed. Can beryllium be explosive bonded to copper substrates and can the bonding take place without shattering the beryllium? Thirteen different explosive bonding iterations were completed using various thicknesses of beryllium that were manufactured with three different techniques.

  2. Gut microbiota and acute graft-versus-host disease.

    Science.gov (United States)

    Yoshioka, Kosuke; Kakihana, Kazuhiko; Doki, Noriko; Ohashi, Kazuteru

    2017-08-01

    Although allogeneic stem cell transplantation (allo-SCT) is a potentially curative treatment for various hematological diseases, acute graft-versus-host disease (GVHD) is a major cause of morbidity and mortality, and its management is clinically important. Advances in biological techniques have led to great progress in understanding the complex interactions between the host and the gut microbiota. The gut microbiota clearly modulates the immune response and is associated with the pathogenesis of various disorders. Also in allo-SCT, both preclinical and clinical results indicate that the gut microbiota is closely associated with the development of acute GVHD and transplant outcomes. These results led to the idea that improvement in quantitative and/or qualitative abnormalities of microbiota (dysbiosis) may be a new treatment strategy for acute GVHD. Evaluations of therapies targeting the gut microbiota such as probiotics or fecal microbiota transplantation have just begun. Furthermore, intervention in the gut microbiota with a nutritional approach including prebiotics, postbiotics, and antibiotics selection may also be another promising treatment option for acute GVHD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Protective Role for Antioxidants in Acute Kidney Disease

    Directory of Open Access Journals (Sweden)

    Joanne M. Dennis

    2017-07-01

    Full Text Available Acute kidney injury causes significant morbidity and mortality in the community and clinic. Various pathologies, including renal and cardiovascular disease, traumatic injury/rhabdomyolysis, sepsis, and nephrotoxicity, that cause acute kidney injury (AKI, induce general or regional decreases in renal blood flow. The ensuing renal hypoxia and ischemia promotes the formation of reactive oxygen species (ROS such as superoxide radical anions, peroxides, and hydroxyl radicals, that can oxidatively damage biomolecules and membranes, and affect organelle function and induce renal tubule cell injury, inflammation, and vascular dysfunction. Acute kidney injury is associated with increased oxidative damage, and various endogenous and synthetic antioxidants that mitigate source and derived oxidants are beneficial in cell-based and animal studies. However, the benefit of synthetic antioxidant supplementation in human acute kidney injury and renal disease remains to be realized. The endogenous low-molecular weight, non-proteinaceous antioxidant, ascorbate (vitamin C, is a promising therapeutic in human renal injury in critical illness and nephrotoxicity. Ascorbate may exert significant protection by reducing reactive oxygen species and renal oxidative damage via its antioxidant activity, and/or by its non-antioxidant functions in maintaining hydroxylase and monooxygenase enzymes, and endothelium and vascular function. Ascorbate supplementation may be particularly important in renal injury patients with low vitamin C status.

  4. Endotoxicosis as the Contents of Posresuscitative Disease in Acute Poisoning

    Directory of Open Access Journals (Sweden)

    Ye. A. Luzhnikov

    2007-01-01

    Full Text Available Objective: to study the specific features of the diagnosis and treatment of endothoxicosis as a manifestation of postresus-citative disease in acute exogenous poisoning.Subjects and methods. Clinical, laboratory, and statistical methods of the diagnosis of endotoxicosis complicating the course of acute poisoning by narcotics, psychopharmacological agents, and cauterants, as well as complex physicochemical detoxification were applied to 554 patients.Results. The study pathology has been ascertained to have 3 developmental stages — from functional (primary to developed and terminal clinical and laboratory manifestations as multiple organ dysfunctions. The best therapeutic results are achieved by effective therapeutic measures just in early-stage endotoxicosis, by substantially reducing the rates of death and pneumonia and the time of the latter’s resolution. The major contribution to the reduction in the rate of death due acute poisoning is associated with physicochemical detoxification that considerably lessens the influence of the intoxication factors of postresuscitative disease.Conclusion. When diagnosing endotoxicosis in patients with acute endogenous intoxication, it is necessary to keep in mind a whole spectrum of typical changes in endotoxicosis markers and homeostatic parameters: hematologi-cal, blood rheological, lipid peroxidation/antioxidative systems, which should be timely corrected by the basic efferent artificial detoxification techniques (hemosorption, hemodiafiltration, hemofiltration, by compulsorily employing physio-and chemohemotherapy (laser-ultraviolet hemotherapy, sodium hypochlorite infusion. 

  5. Beryllium-stimulated apoptosis in macrophage cell lines.

    Science.gov (United States)

    Sawyer, R T; Fadok, V A; Kittle, L A; Maier, L A; Newman, L S

    2000-08-21

    In vitro stimulation of bronchoalveolar lavage cells from patients with chronic beryllium disease (CBD) induces the production of TNF-alpha. We tested the hypothesis that beryllium (Be)-stimulated TNF-alpha might induce apoptosis in mouse and human macrophage cell lines. These cell lines were selected because they produce a range of Be-stimulated TNF-alpha. The mouse macrophage cell line H36.12j produces high levels of Be-stimulated TNF-alpha. The mouse macrophage cell line P388D.1 produces low, constitutive, levels of TNF-alpha and does not up-regulate Be-stimulated TNF-alpha production. The DEOHS-1 human CBD macrophage cell line does not produce constitutive or Be-stimulated TNF-alpha. Apoptosis was determined by microscopic observation of propidium iodide stained fragmented nuclei in unstimulated and BeSO(4)-stimulated macrophage cell lines. BeSO(4) induced apoptosis in all macrophage cell lines tested. Beryllium-stimulated apoptosis was dose-responsive and maximal after 24 h of exposure to 100 microM BeSO(4). In contrast, unstimulated and Al(2)(SO(4))(3)-stimulated macrophage cell lines did not undergo apoptosis. The general caspase inhibitor BD-fmk inhibited Be-stimulated macrophage cell line apoptosis at concentrations above 50 microM. Our data show that Be-stimulated macrophage cell line apoptosis was caspase-dependent and not solely dependent on Be-stimulated TNF-alpha levels. We speculate that the release of Be-antigen from apoptotic macrophages may serve to re-introduce Be material back into the lung microenvironment, make it available for uptake by new macrophages, and thereby amplify Be-stimulated cytokine production, promoting ongoing inflammation and granuloma maintenance in CBD.

  6. Disseminated Lyme disease presenting with nonsexual acute genital ulcers.

    Science.gov (United States)

    Finch, Justin J; Wald, Jenna; Ferenczi, Katalin; Khalid, Saima; Murphy, Michael

    2014-11-01

    Nonsexual acute genital ulceration (NAGU) is a rare vulvar skin condition typically affecting girls and young women, characterized by acute onset of singular or multiple painful vaginal ulcers. The etiology of this ulcerative dermatosis has not been identified, although it has been associated with systemic infections. To our knowledge, this is the first report of an association with Lyme disease. A case of a woman with early disseminated Lyme disease presenting with NAGU is reported. A thorough workup ruled out other causes of genital ulceration, and the ulcers completely resolved after treatment with topical steroids and oral doxycycline. Although the etiology of NAGU is unknown, the vulvar ulcers may result from an exuberant immune response to infection. Most patients with NAGU exhibit nonspecific symptoms such as myalgias and fever, suggesting an infectious agent, but the majority have no identifiable pathogen. In addition to previously reported associations with systemic infection, which are reviewed herein, Lyme disease should be considered in women presenting with acute-onset genital ulcers.

  7. Metabolomics and its application to acute lung diseases

    Directory of Open Access Journals (Sweden)

    Kathleen A. Stringer

    2016-02-01

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

  8. Metabolomics and Its Application to Acute Lung Diseases

    Science.gov (United States)

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

    2016-01-01

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

  9. PHYTOTHERAPY IN SEASONAL PREVENTION OF ACUTE RESPIRATORY DISEASES AMONG SCHOOL-AGED CHILDREN

    Directory of Open Access Journals (Sweden)

    T.I. Garashchenko

    2006-01-01

    Full Text Available The article provides the research findings of the application efficiency of the complex plant based preparation Sinupret (Bionorica AG, Germany for prevention of the acute respiratory diseases among sickly children. The authors showed that the application of the plant based preparation decreased the sick rate caused by the acute respiratory diseases and influenza, alleviated the run of the acute respiratory diseases, had some really good tolerance and might be recommended for the wide use, for the prevention of the acute respiratory diseases in organized children groups.Key words: acute respiratory diseases, prevention, phytotherapy, children, homeopathic remedies, vaccines.

  10. Assessment of the beryllium lymphocyte proliferation test using statistical process control.

    Science.gov (United States)

    Cher, Daniel J; Deubner, David C; Kelsh, Michael A; Chapman, Pamela S; Ray, Rose M

    2006-10-01

    Despite more than 20 years of surveillance and epidemiologic studies using the beryllium blood lymphocyte proliferation test (BeBLPT) as a measure of beryllium sensitization (BeS) and as an aid for diagnosing subclinical chronic beryllium disease (CBD), improvements in specific understanding of the inhalation toxicology of CBD have been limited. Although epidemiologic data suggest that BeS and CBD risks vary by process/work activity, it has proven difficult to reach specific conclusions regarding the dose-response relationship between workplace beryllium exposure and BeS or subclinical CBD. One possible reason for this uncertainty could be misclassification of BeS resulting from variation in BeBLPT testing performance. The reliability of the BeBLPT, a biological assay that measures beryllium sensitization, is unknown. To assess the performance of four laboratories that conducted this test, we used data from a medical surveillance program that offered testing for beryllium sensitization with the BeBLPT. The study population was workers exposed to beryllium at various facilities over a 10-year period (1992-2001). Workers with abnormal results were offered diagnostic workups for CBD. Our analyses used a standard statistical technique, statistical process control (SPC), to evaluate test reliability. The study design involved a repeated measures analysis of BeBLPT results generated from the company-wide, longitudinal testing. Analytical methods included use of (1) statistical process control charts that examined temporal patterns of variation for the stimulation index, a measure of cell reactivity to beryllium; (2) correlation analysis that compared prior perceptions of BeBLPT instability to the statistical measures of test variation; and (3) assessment of the variation in the proportion of missing test results and how time periods with more missing data influenced SPC findings. During the period of this study, all laboratories displayed variation in test results that

  11. Demodex folliculitis mimicking acute graft-vs-host disease.

    Science.gov (United States)

    Cotliar, Jonathan; Frankfurt, Olga

    2013-12-01

    Acute graft-vs-host disease (GVHD) typically requires high-dose systemic steroids as first-line treatment. Like drug eruptions, viral exanthema, and toxic erythema of chemotherapy, Demodex folliculitis is a clinical mimicker of acute GVHD and requires nonimmunosuppressive therapy. This case of Demodex folliculitis mimicking acute GVHD highlights the need for skin biopsy in patients who have undergone a stem cell transplant with eruptions on the head and neck. A 46-year-old white woman with a history of Fms-like tyrosine kinase 3 acute myeloid leukemia presented to the dermatology clinic with a 5-day history of a nonpruritic eruption on her face and neck 28 days after undergoing a double umbilical cord blood hematopoietic stem cell transplant (HSCT). Findings from the skin biopsy demonstrated a deep dermal lymphocytic infiltrate adjacent to follicular units along with an abundance of Demodex mites noted within the hair follicles consistent with Demodex folliculitis. Oral ivermectin, 12 mg, was given, and the eruption cleared within 24 hours. To our knowledge, this is only the fifth reported case of Demodex folliculitis following HSCT, but the first ever reported to be successfully treated with oral ivermectin. Demodex folliculitis should be added to the differential diagnosis of skin eruptions that arise after HSCT.

  12. Isolated Acute Terminal Ileitis Without Preexisting Inflammatory Bowel Disease Rarely Progresses to Crohn's Disease.

    Science.gov (United States)

    Tse, Chung Sang; Deepak, Parakkal; Smyrk, Thomas C; Raffals, Laura E

    2017-10-24

    Isolated acute terminal ileitis without chronic features of inflammation poses a diagnostic challenge. Few studies have investigated the clinical significance of this entity in patients without history of inflammatory bowel disease. We sought to elucidate the long-term prognosis of patients with isolated acute terminal ileitis, its rate of progression to Crohn's disease, and the factors associated with terminal ileitis development to Crohn's disease. Retrospective review of clinical, endoscopic, and radiographic records was performed on 108 patients with histologic evidence of isolated acute terminal ileitis on terminal ileal biopsies obtained by diagnostic ileocolonoscopy performed between January 1, 2002, and December 31, 2014, at the Mayo Clinic. Statistical analysis was performed with Student's t test and Fisher's exact test to identify the factors associated with the progression of isolated acute terminal ileitis to Crohn's disease. The median follow-up time across 108 patients was 54.7 months (interquartile range 32.0-89.0 months). Five patients (4.6%) developed Crohn's disease after a median of 32.3 months (7.5-43.2 months). The presence of narrowing/stricturing (p = 0.03) on abdominal cross-sectional imaging at the time of terminal ileitis diagnosis was correlated with eventual Crohn's disease development. No significant correlation was found with clinical symptoms, endoscopic features, laboratory testing, NSAID use, smoking history, or family history of inflammatory bowel disease. Isolated acute terminal ileitis discovered on diagnostic ileocolonoscopy rarely develops to Crohn's disease. Presence of stricturing/narrowing on cross-sectional imaging may predict eventual Crohn's disease development.

  13. Characterization of plasma sprayed beryllium ITER first wall mockups

    Energy Technology Data Exchange (ETDEWEB)

    Castro, R.G.; Vaidya, R.U.; Hollis, K.J. [Los Alamos National Lab., NM (United States). Material Science and Technology Div.

    1998-01-01

    ITER first wall beryllium mockups, which were fabricated by vacuum plasma spraying the beryllium armor, have survived 3000 thermal fatigue cycles at 1 MW/m{sup 2} without damage during high heat flux testing at the Plasma Materials Test Facility at Sandia National Laboratory in New Mexico. The thermal and mechanical properties of the plasma sprayed beryllium armor have been characterized. Results are reported on the chemical composition of the beryllium armor in the as-deposited condition, the through thickness and normal to the through thickness thermal conductivity and thermal expansion, the four-point bend flexure strength and edge-notch fracture toughness of the beryllium armor, the bond strength between the beryllium armor and the underlying heat sink material, and ultrasonic C-scans of the Be/heat sink interface. (author)

  14. Mechanisms of hydrogen retention in metallic beryllium and beryllium oxide and properties of ion-induced beryllium nitride; Rueckhaltemechanismen fuer Wasserstoff in metallischem Beryllium und Berylliumoxid sowie Eigenschaften von ioneninduziertem Berylliumnitrid

    Energy Technology Data Exchange (ETDEWEB)

    Oberkofler, Martin

    2011-09-22

    In the framework of this thesis laboratory experiments on atomically clean beryllium surfaces were performed. They aim at a basic understanding of the mechanisms occurring upon interaction of a fusion plasma with a beryllium first wall. The retention and the temperature dependent release of implanted deuterium ions are investigated. An atomistic description is developed through simulations and through the comparison with calculations based on density functional theory. The results of these investigations are compared to the behaviour of hydrogen upon implantation into thermally grown beryllium oxide layers. Furthermore, beryllium nitride is produced by implantation of nitrogen into metallic beryllium and its properties are investigated. The results are interpreted with regard to the use of beryllium in a fusion reactor. (orig.)

  15. Comparison of beryllium and graphite first-walls in JET

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, P.R.

    1990-01-01

    JET has operated with beryllium as a first-wall material in 1989 and 1990. An initial period with beryllium evaporation onto the original graphite surfaces was followed by operation with beryllium belt-limiter tiles. Beryllium Faraday shields for the ICRH antennae and lower X-point target tiles were installed for experiments in 1990. The use of beryllium has increased the density limit, significantly reduced deconditioning following disruptions, allowed heavy gas fueling for impurity control, reduced the impurity influx from the ICRH antennae so that ICRH-only H modes were possible for the first time and permitted hot-ion plasmas on the outer limiters. This paper describes the primary effects of beryllium which led to these improvements in performance. 11 refs., 3 figs.

  16. Characterization of Plasma Sprayed Beryllium ITER First Wall Mockups

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Richard G.; Vaidya, Rajendra U.; Hollis, Kendall J.

    1997-12-31

    ITER first wall beryllium mockups, which were fabricated by vacuum plasma spraying the beryllium armor, have survived 3000 thermal fatigue cycles at 1 MW/sq m without damage during high heat flux testing at the Plasma Materials Test Facility at Sandia National Laboratory in New Mexico. The thermal and mechanical properties of the plasma sprayed beryllium armor have been characterized. Results are reported on the chemical composition of the beryllium armor in the as-deposited condition, the through thickness and normal to the through thickness thermal conductivity and thermal expansion, the four-point bend flexure strength and edge-notch fracture toughness of the beryllium armor, the bond strength between the beryllium armor and the underlying heat sink material, and ultrasonic C-scans of the Be/heat sink interface.

  17. Epidemiology of coronary heart disease and acute coronary syndrome.

    Science.gov (United States)

    Sanchis-Gomar, Fabian; Perez-Quilis, Carme; Leischik, Roman; Lucia, Alejandro

    2016-07-01

    The aim of this review is to summarize the incidence, prevalence, trend in mortality, and general prognosis of coronary heart disease (CHD) and a related condition, acute coronary syndrome (ACS). Although CHD mortality has gradually declined over the last decades in western countries, this condition still causes about one-third of all deaths in people older than 35 years. This evidence, along with the fact that mortality from CHD is expected to continue increasing in developing countries, illustrates the need for implementing effective primary prevention approaches worldwide and identifying risk groups and areas for possible improvement.

  18. Beryllium induces premature senescence in human fibroblasts.

    Science.gov (United States)

    Coates, Shannon S A; Lehnert, Bruce E; Sharma, Sunil; Kindell, Susan M; Gary, Ronald K

    2007-07-01

    After cells have completed a sufficient number of cell divisions, they exit the cell cycle and enter replicative senescence. Here, we report that beryllium causes proliferation arrest with premature expression of the principal markers of senescence. After young presenescent human fibroblasts were treated with 3 microM BeSO(4) for 24 h, p21 cyclin-dependent kinase inhibitor mRNA increased by >200%. Longer periods of exposure caused mRNA and protein levels to increase for both p21 and p16(Ink4a), a senescence regulator that prevents pRb-mediated cell cycle progression. BeSO(4) also caused dose-dependent induction of senescence-associated beta-galactosidase activity (SA-beta-gal). Untreated cells had 48 relative fluorescence units (RFU)/microg/h of SA-beta-gal, whereas 3 microM BeSO(4) caused activity to increase to 84 RFU/microg/h. In chromatin immunoprecipitation experiments, BeSO(4) caused p53 protein to associate with its DNA binding site in the promoter region of the p21 gene, indicating that p53 transcriptional activity is responsible for the large increase in p21 mRNA elicited by beryllium. Forced expression of human telomerase reverse transcriptase (hTERT) rendered HFL-1 cells incapable of normal replicative senescence. However, there was no difference in the responsiveness of normal HFL-1 fibroblasts (IC(50) = 1.9 microM) and hTERT-immortalized cells (IC(50) = 1.7 microM) to BeSO(4) in a 9-day proliferation assay. The effects of beryllium resemble those of histone deacetylase-inhibiting drugs, which also cause large increases in p21. However, beryllium produced no changes in histone acetylation, suggesting that Be(2+) acts as a novel and potent pharmacological inducer of premature senescence.

  19. Current Understanding of Acute Bovine Liver Disease in Australia.

    Science.gov (United States)

    Read, Elizabeth; Edwards, Jacqueline; Deseo, Myrna; Rawlin, Grant; Rochfort, Simone

    2016-12-26

    Acute bovine liver disease (ABLD) is a hepatotoxicity principally of cattle which occurs in southern regions of Australia. Severely affected animals undergo rapid clinical progression with mortalities often occurring prior to the recognition of clinical signs. Less severely affected animals develop photosensitization and a proportion can develop liver failure. The characteristic histopathological lesion in acute fatal cases is severe, with acute necrosis of periportal hepatocytes with hemorrhage into the necrotic areas. Currently there are a small number of toxins that are known to cause periportal necrosis in cattle, although none of these have so far been linked to ABLD. Furthermore, ABLD has frequently been associated with the presence of rough dog's tail grass (Cynosurus echinatus) and Drechslera spp. fungi in the pasture system, but it is currently unknown if these are etiological factors. Much of the knowledge about ABLD is contained within case reports, with very little experimental research investigating the specific cause(s). This review provides an overview of the current and most recently published knowledge of ABLD. It also draws on wider research and unpublished reports to suggest possible fungi and mycotoxins that may give rise to ABLD.

  20. Pathogenic mechanisms of Acute Graft versus Host Disease

    Directory of Open Access Journals (Sweden)

    Ferrara James L.M.

    2002-01-01

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

  1. Quantitative method of determining beryllium or a compound thereof in a sample

    Science.gov (United States)

    McCleskey, T. Mark; Ehler, Deborah S.; John, Kevin D.; Burrell, Anthony K.; Collis, Gavin E.; Minogue, Edel M.; Warner, Benjamin P.

    2010-08-24

    A method of determining beryllium or a beryllium compound thereof in a sample, includes providing a sample suspected of comprising beryllium or a compound thereof, extracting beryllium or a compound thereof from the sample by dissolving in a solution, adding a fluorescent indicator to the solution to thereby bind any beryllium or a compound thereof to the fluorescent indicator, and determining the presence or amount of any beryllium or a compound thereof in the sample by measuring fluorescence.

  2. Extractive metallurgy of the beryllium; Fundamentos da metalurgia extrativa do berilio

    Energy Technology Data Exchange (ETDEWEB)

    Alonso, Neusa; Capocchi, Jose Deodoro Trani [Sao Paulo Univ., SP (Brazil). Escola Politecnica

    1995-07-01

    A bibliographic review is performed on the beryllium extractive metallurgy. The work describes the main type of ores and processes applied to the metallic beryllium production, beryllium oxide production using fluoride, sulfide and direct chlorination. The thermodynamic consideration are made on beryllium reduction processes, discussing the viability of the beryllium oxide and hallide reduction processes. Under the technological viewpoint, the Cu-Be alloys main production processes are discussed, and the main toxicity problems related with beryllium are mentioned 15 refs..

  3. Behavior of beryllium pebbles under irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Dalle-Donne, M.; Scaffidi-Argentina, F. [Forschungszentrum Karlsruhe GmbH Technik und Umwelt (Germany). Inst. fuer Neutronenphysik und Reactortechnik; Baldwin, D.L.; Gelles, D.S.; Greenwood, L.R.; Kawamura, H.; Oliver, B.M.

    1998-01-01

    Beryllium pebbles are being considered in fusion reactor blanket designs as neutron multiplier. An example is the European `Helium Cooled Pebble Bed Blanket.` Several forms of beryllium pebbles are commercially available but little is known about these forms in response to fast neutron irradiation. Commercially available beryllium pebbles have been irradiated to approximately 1.3 x 10{sup 22} n/cm{sup 2} (E>1 MeV) at 390degC. Pebbles 1-mm in diameter manufactured by Brush Wellman, USA and by Nippon Gaishi Company, Japan, and 3-mm pebbles manufactured by Brush Wellman were included. All were irradiated in the below-core area of the Experimental Breeder Reactor-II in Idaho Falls, USA, in molybdenum alloy capsules containing helium. Post-irradiation results are presented on density change measurements, tritium release by assay, stepped-temperature anneal, and thermal ramp desorption tests, and helium release by assay and stepped-temperature anneal measurements, for Be pebbles from two manufacturing methods, and with two specimen diameters. The experimental results on density change and tritium and helium release are compared with the predictions of the code ANFIBE. (author)

  4. Pulmonary Surfactants for Acute and Chronic Lung Diseases (Part II

    Directory of Open Access Journals (Sweden)

    O. A. Rozenberg

    2014-01-01

    Full Text Available Part 2 of the review considers the problem of surfactant therapy for acute respiratory distress syndrome (ARDS in adults and young and old children. It gives information on the results of surfactant therapy and prevention of ARDS in patients with severe concurrent trauma, inhalation injuries, complications due to complex expanded chest surgery, or severe pneumonias, including bilateral pneumonia in the presence of A/H1N1 influenza. There are data on the use of a surfactant in obstetric care and prevention of primary graft dysfunction during lung transplantation. The results of longterm use of surfactant therapy in Russia, suggesting that death rates from ARDS may be substantially reduced (to 20% are discussed. Examples of surfactant therapy for other noncritical lung diseases, such as permanent athelectasis, chronic obstructive pulmonary diseases, and asthma, as well tuberculosis, are also considered.

  5. Functionally Graded Nanophase Beryllium/Carbon Composites

    Science.gov (United States)

    Choi, Michael K.

    2003-01-01

    Beryllium, beryllium alloys, beryllium carbide, and carbon are the ingredients of a class of nanophase Be/Be2C/C composite materials that can be formulated and functionally graded to suit a variety of applications. In a typical case, such a composite consists of a first layer of either pure beryllium or a beryllium alloy, a second layer of B2C, and a third layer of nanophase sintered carbon derived from fullerenes and nanotubes. The three layers are interconnected through interpenetrating spongelike structures. These Be/Be2C/C composite materials are similar to Co/WC/diamond functionally graded composite materials, except that (1) W and Co are replaced by Be and alloys thereof and (2) diamond is replaced by sintered carbon derived from fullerenes and nanotubes. (Optionally, one could form a Be/Be2C/diamond composite.) Because Be is lighter than W and Co, the present Be/Be2C/C composites weigh less than do the corresponding Co/WC/diamond composites. The nanophase carbon is almost as hard as diamond. WC/Co is the toughest material. It is widely used for drilling, digging, and machining. However, the fact that W is a heavy element (that is, has high atomic mass and mass density) makes W unattractive for applications in which weight is a severe disadvantage. Be is the lightest tough element, but its toughness is less than that of WC/Co alloy. Be strengthened by nanophase carbon is much tougher than pure or alloy Be. The nanophase carbon has an unsurpassed strength-to-weight ratio. The Be/Be2C/C composite materials are especially attractive for terrestrial and aerospace applications in which there are requirements for light weight along with the high strength and toughness of the denser Co/WC/diamond materials. These materials could be incorporated into diverse components, including cutting tools, bearings, rocket nozzles, and shields. Moreover, because Be and C are effective as neutron moderators, Be/Be2C/C composites could be attractive for some nuclear applications.

  6. Acute erythroid leukemia: autopsy report of a rare disease

    Directory of Open Access Journals (Sweden)

    Cristiane Rúbia Ferreira

    2011-12-01

    Full Text Available Acute erythroid leukemia (AEL is a rare subtype of acute myeloid leukemia(AML, characterized by predominant erythroid proliferation. The 2008 WorldHealth Organization (WHO classification of AML defined two AEL subtypes:erythroleukaemia (EL, in which erythroid precursors account for 50% or moreof all nucleated bone marrow cells and myeloblasts account for 20% or more ofthe nonerythroid cell population; and pure erythroid leukemia (PEL, in whicherythroid precursors account for 80% or more of all nucleated bone marrowcells. We report the case of an elderly female patient with wasting syndromeand pancytopenia without evidence of blasts in peripheral blood. A diagnosisof PEL was established on the basis of bone marrow biopsy findings. Thepatient died on postadmission day 20, and an autopsy was performed. Wereclassified the disease as EL on the basis of the autopsy findings, whichincluded myeloblasts accounting for more than 20% of the nonerythroid cellsin the bone marrow, as well as leukemic infiltration and myeloid metaplasia insolid organs, such as the liver, spleen, kidneys, adrenal glands, and abdominallymph nodes. A rare disease, AEL accounts for less than 5% of all AMLs and ispractically a diagnosis of exclusion. Autopsy reports of AEL are extremely rarein the literature. We demonstrate that in the case reported here, leukemia cellstended to infiltrate solid organs with myeloid metaplasia. Our findings alsoshow that a larger neoplastic bone marrow sample is crucial to the correctdiagnosis of EL, which is based on morphological and quantitative criteria.

  7. Acute methemoglobinemia associated with ochronotic valvular heart disease: report of a case.

    Science.gov (United States)

    Uchiyama, C; Kondoh, H; Shintani, H

    2010-03-01

    We describe the first reported case of acute methemoglobinemia associated with ochronotic valvular heart disease. A 79-year-old man with ochronotic valvular heart disease experienced decreased urinary output starting 9 days after an operation. Thereafter, the patient's methemoglobin concentration acutely increased, indicating systemic cyanosis, while the arterial partial oxygen pressure (PaO (2)) was maintained at around 200 mmHg. In patients with ochronotic valvular heart disease, acute methemoglobinemia may occur, as in cases of renal failure or oliguresis.

  8. Chronic granulomatous pneumonia and lymphocytic responses induced by inhaled beryllium metal in A/J and C3H/HeJ mice

    Energy Technology Data Exchange (ETDEWEB)

    Nikula, K.J.; Swafford, D.S.; Hoover, M.D.; Tohulka, M.D.; Finch, G.L. [Inhalation Toxicology Research Institute, Albuquerque, NM (United States)

    1997-12-31

    Inhalation of beryllium (Be) has been associated with 2 syndromes: an acute chemical pneumonitis and a granulomatous lung disease known as chronic beryllium disease (CBD). The purpose of this study was to establish a mouse model of CBD using the inhalation route of exposure. A/J (H-2a haplotype) and C3H/HeJ (H-2{sup k}) Mice were exposed once for 90 min in nose-only exposure tubes to aerosols of Be metal. Six mo later, lung histopathologic responses were assessed. Further analyses defined the phenotypic profile of lymphocytes in pulmonary lesions and evaluated proliferation of lymphocytes in situ and in response to Be in vitro. Responses were similar in both strains of mice. Most Be-exposed mice had minimal to mild interstitial fibrosis. The majority of lymphocytes in interstitial infiltrates and in microgranulomas were CD4+ T cells. Interstitial compact aggregates of lymphocytes contained B cells centrally and CD4+ cells peripherally. Lymphocyte labeling indices, used to assess proliferation in situ, were significantly greater within microgranulomas compared to compact lymphocytic aggregates. Lymphocyte stimulation indices in response to BeSO{sub 4} in vitro were not positive in blood, spleen, or tracheobronchial lymph node samples. Be-specific immune responses and nonspecific inflammatory responses to toxic and foreign-body properties of Be may have contributed to the histopathology in both strains of mice. The interstitial mononuclear cell infiltrates, presence of microgranulomas, multinucleated foreign-body and Langhans giant cells, interstitial fibrosis, and CD4+ T-cell predominance with local proliferation are features similar to CBD in humans. The chronic lung disease induced in these mice by inhaled Be can be used to investigate the importance of variables such as dose, exposure pattern, and physicochemical form of Be in producing this disease. 29 refs., 6 figs., 3 tabs.

  9. Risk of acute coronary artery disease associated with functional thrombin activatable fibrinolysis inhibitor plasma level.

    Science.gov (United States)

    Santamaría, Amparo; Martínez-Rubio, Antonio; Borrell, Montserrat; Mateo, José; Ortín, Rosa; Fontcuberta, Jordi

    2004-07-01

    To our knowledge, there is little information about functional thrombin activatable fibrinolysis inhibitor (TAFI) levels and the risk of acute coronary artery disease (CAD). We investigated the risk of acute CAD related to plasma levels of functional TAFI. We found that functional TAFI levels in plasma (above 126%), increased the risk of acute CAD almost 4-fold.

  10. Acute abdominal conditions in people with sickle cell disease: A 10 ...

    African Journals Online (AJOL)

    Background: Abdominal crises (vaso-occlusive) are not infrequent in patients with sickle cell anemia. They usually present as acute abdomen. These patients none the less present with other causes of acute abdomen like others without hemoglobinopathy. Six cases of surgical acute abdomen in sickle cell disease patients ...

  11. Joining of beryllium by braze welding technique: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Banaim, P.; Abramov, E. [Ben-Gurion Univ. of the Negev, Beersheba (Israel); Zalkind, S.; Eden, S.

    1998-01-01

    Within the framework of some applications, there is a need to join beryllium parts to each other. Gas Tungsten Arc Braze Welds were made in beryllium using 0.3 mm commercially Aluminum (1100) shim preplaced at the joint. The welds exhibited a tendency to form microcracks in the Fusion Zone and Heat Affected Zone. All the microcracks were backfilled with Aluminum. (author)

  12. 10 CFR 850.20 - Baseline beryllium inventory.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Baseline beryllium inventory. 850.20 Section 850.20 Energy... Baseline beryllium inventory. (a) The responsible employer must develop a baseline inventory of the... inventory, the responsible employer must: (1) Review current and historical records; (2) Interview workers...

  13. Steroid Exposure, Acute Coronary Syndrome, and Inflammatory Bowel Disease: Insights into the Inflammatory Milieu

    Science.gov (United States)

    Deaño, Roderick C.; Basnet, Sandeep; Onandia, Zurine Galvan; Gandhi, Sachin; Tawakol, Ahmed; Min, James K.; Truong, Quynh A.

    2014-01-01

    Background Steroids are anti-inflammatory agents commonly used to treat inflammatory bowel disease. Inflammation plays a critical role in the pathophysiology of both inflammatory bowel disease and acute coronary syndrome. We examined the relationship between steroid use in patients with inflammatory bowel disease and acute coronary syndrome. Methods In 177 patients with inflammatory bowel disease (mean age 67, 75% male, 44% Crohn's disease, 56% ulcerative colitis), we performed a 1:2 case-control study matched for age, sex and inflammatory bowel disease type and compared 59 patients with inflammatory bowel disease with acute coronary syndrome to 118 patients with inflammatory bowel disease without acute coronary syndrome. Steroid use was defined as current or prior exposure. Acute coronary syndrome was defined as myocardial infarction or unstable angina, confirmed by cardiac biomarkers and coronary angiography. Results In patients with inflammatory bowel disease, 34% with acute coronary syndrome had exposure to steroids versus 58% without acute coronary syndrome (pinflammatory bowel disease, 77% in Crohn's disease (OR 0.36, 95% CI 0.14-0.92; adjusted OR 0.23, 95% CI 0.06-0.98), and 78% in ulcerative colitis (OR 0.41, 95% CI 0.16-1.04; adjusted OR 0.22, 95% CI 0.06-0.90). There was no association between other inflammatory bowel disease medications and acute coronary syndrome. Conclusions In patients with inflammatory bowel disease, steroid use significantly reduces the odds of acute coronary syndrome. These findings provide further mechanistic insight into the inflammatory processes involved in inflammatory bowel disease and acute coronary syndrome. PMID:25446295

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

    Science.gov (United States)

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

    1998-01-01

    Background—In patients with major trauma and burns, total enteral nutrition (TEN) significantly decreases the acute phase response and incidence of septic complications when compared with total parenteral nutrition (TPN). Poor outcome in acute pancreatitis is associated with a high incidence of systemic inflammatory response syndrome (SIRS) and sepsis. 
Aims—To determine whether TEN can attenuate the acute phase response and improve clinical disease severity in patients with acute pancreatitis. 
Methods—Glasgow score, Apache II, computed tomography (CT) scan score, C reactive protein (CRP), serum IgM antiendotoxin antibodies (EndoCAb), and total antioxidant capacity (TAC) were determined on admission in 34 patients with acute pancreatitis. Patients were stratified according to disease severity and randomised to receive either TPN or TEN for seven days and then re-evaluated. 
Results—SIRS, sepsis, organ failure, and ITU stay, were globally improved in the enterally fed patients. The acute phase response and disease severity scores were significantly improved following enteral nutrition (CRP: 156 (117-222) to 84 (50-141), pAPACHE II scores 8 (6-10) to 6 (4-8), p<0.0001) without change in the CT scan scores. In parenterally fed patients these parameters did not change but there was an increase in EndoCAb antibody levels and a fall in TAC. Enterally fed patients showed no change in the level of EndoCAb antibodies and an increase in TAC. 
Conclusion—TEN moderates the acute phase response, and improves disease severity and clinical outcome despite unchanged pancreatic injury on CT scan. Reduced systemic exposure to endotoxin and reduced oxidant stress also occurred in the TEN group. Enteral feeding modulates the inflammatory and sepsis response in acute pancreatitis and is clinically beneficial. 

 Keywords: acute pancreatitis; enteral nutrition; bacterial translocation; oxidative stress PMID:9577354

  15. Hydrodynamic instabilities in beryllium targets for the National Ignition Facility

    Energy Technology Data Exchange (ETDEWEB)

    Yi, S. A., E-mail: austinyi@lanl.gov; Simakov, A. N.; Wilson, D. C.; Olson, R. E.; Kline, J. L.; Batha, S. H. [Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, New Mexico 87545 (United States); Clark, D. S.; Hammel, B. A.; Milovich, J. L.; Salmonson, J. D.; Kozioziemski, B. J. [Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551 (United States)

    2014-09-15

    Beryllium ablators offer higher ablation velocity, rate, and pressure than their carbon-based counterparts, with the potential to increase the probability of achieving ignition at the National Ignition Facility (NIF) [E. I. Moses et al., Phys. Plasmas 16, 041006 (2009)]. We present here a detailed hydrodynamic stability analysis of low (NIF Revision 6.1) and high adiabat NIF beryllium target designs. Our targets are optimized to fully utilize the advantages of beryllium in order to suppress the growth of hydrodynamic instabilities. This results in an implosion that resists breakup of the capsule, and simultaneously minimizes the amount of ablator material mixed into the fuel. We quantify the improvement in stability of beryllium targets relative to plastic ones, and show that a low adiabat beryllium capsule can be at least as stable at the ablation front as a high adiabat plastic target.

  16. Protection of air in premises and environment against beryllium aerosols

    Energy Technology Data Exchange (ETDEWEB)

    Bitkolov, N.Z.; Vishnevsky, E.P.; Krupkin, A.V. [Research Inst. of Industrial and Marine Medicine, St. Petersburg (Russian Federation)

    1998-01-01

    First and foremost, the danger of beryllium aerosols concerns a possibility of their inhalation. The situation is aggravated with high biological activity of the beryllium in a human lung. The small allowable beryllium aerosols` concentration in air poses a rather complex and expensive problem of the pollution prevention and clearing up of air. The delivery and transportation of beryllium aerosols from sites of their formation are defined by the circuit of ventilation, that forms aerodynamics of air flows in premises, and aerodynamic links between premises. The causes of aerosols release in air of premises from hoods, isolated and hermetically sealed vessels can be vibrations, as well as pulses of temperature and pressure. Furthermore, it is possible the redispersion of aerosols from dirty surfaces. The effective protection of air against beryllium aerosols at industrial plants is provided by a complex of hygienic measures: from individual means of breath protection up to collective means of the prevention of air pollution. (J.P.N.)

  17. Coronary Artery Aneurysmal Disease and Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Wesam Ostwani MD

    2016-03-01

    Full Text Available The patient is a 70-year-old male with no other atherogenic risk factors who presented with an acute coronary syndrome (ACS of unstable angina subsequently complicated by a non-ST elevation myocardial infarction (NSTEMI. The patient’s presentation posed 3 unique features: (1 cardiac catheterization demonstrated nonobstructive 3-vessel multi-aneurysmal coronary artery disease with sluggish antegrade coronary flow; (2 a nonobstructive aneurysmal dissection flap based on contrast staining of the mid left anterior descending artery, which may have led to in situ nonocclusive thrombosis and distal microvascular embolization; and (3 successful conservative medical therapy of coronary artery aneurysmal disease (CAAD complicated with ACS. CAAD has an incidence of 1.5% to 4.9% in adults. The most common etiology of CAAD is atherosclerotic coronary artery disease. There are no guidelines for the management of CAAD complicated by ACS, and controversies exist as to whether conservative, catheter-based, or surgical management should be pursued.

  18. Acute alithiasic cholecystitis: a not so rare disease

    Directory of Open Access Journals (Sweden)

    Javier Blasco-Alonso

    2014-08-01

    Full Text Available Introduction: Acute acalculous cholecystitis (AAC occurs more frequently in critically ill patients, in the immediate postoperative period, after trauma or extensive burns. It has a high rate of morbidity and mortality. Ischemia, infection and vesicular stasis are determinants in its pathogenesis. Material and method: Retrospective study including all cases of AAC diagnosed in our pediatric intensive care unit between January 1997 and December 2012. Results: We included 7 patients, all associated with viral or bacterial infection. All of them suffered from abdominal pain, mainly localized in the right upper quadrant, jaundice and dark urine. Abdominal ultrasound showed thickening and hypervascularity of the gallbladder wall in all cases. The outcome was satisfactory without surgery in all patients. Conclusions: The clinical presentation is oligosymptomatic within severe systemic diseases. The AAC should be suspected in the appearance of any abdominal pain with jaundice/dark urine and hypertransaminasemia in patients suffering from critical or serious infections.

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

    Energy Technology Data Exchange (ETDEWEB)

    Gold, R.P. (New York Medical Coll., Valhalla); McClennan, B.L.; Rottenberg, R.R.

    1983-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Ricardo Coentre

    2016-01-01

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

  1. ZIRCONIUM-TITANIUM-BERYLLIUM BRAZING ALLOY

    Science.gov (United States)

    Gilliland, R.G.; Patriarca, P.; Slaughter, G.M.; Williams, L.C.

    1962-06-12

    A new and improved ternary alloy is described which is of particular utility in braze-bonding parts made of a refractory metal selected from Group IV, V, and VI of the periodic table and alloys containing said metal as a predominating alloying ingredient. The brazing alloy contains, by weight, 40 to 50 per cent zirconium, 40 to 50 per cent titanium, and the balance beryllium in amounts ranging from 1 to 20 per cent, said alloy having a melting point in the range 950 to 1400 deg C. (AEC)

  2. International Initiatives Pursuing Interleukin-1 Blockade for Treatment of Acute Kawasaki Disease

    NARCIS (Netherlands)

    Burns, Jane C.; Koné-Paut, Isabelle; Kuijpers, Taco; Shimizu, Chisato; Tremoulet, Adriana; Arditi, Moshe

    2017-01-01

    The decision to move forward with three clinical trials of IL-1 blockade for treatment of acute Kawasaki disease is a case study in translational science. These trials were born on the one hand from transcriptome studies of host response during the acute disease coupled with animal model

  3. Moyamoya disease presenting as acute onset cortical blindness: a case report

    Directory of Open Access Journals (Sweden)

    Maniram Dudi

    2016-03-01

    Full Text Available We report a case where acute onset cortical blindness is the mode of presentation in Moyamoya disease. Cortical blindness is very rare presenting symptom of Moyamoya disease. Progressive visual loss and homonymous anopsia has been described previously, but this case had acute visual loss.

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

    Science.gov (United States)

    Windsor, A C; Kanwar, S; Li, A G; Barnes, E; Guthrie, J A; Spark, J I; Welsh, F; Guillou, P J; Reynolds, J V

    1998-03-01

    In patients with major trauma and burns, total enteral nutrition (TEN) significantly decreases the acute phase response and incidence of septic complications when compared with total parenteral nutrition (TPN). Poor outcome in acute pancreatitis is associated with a high incidence of systemic inflammatory response syndrome (SIRS) and sepsis. To determine whether TEN can attenuate the acute phase response and improve clinical disease severity in patients with acute pancreatitis. Glasgow score, Apache II, computed tomography (CT) scan score, C reactive protein (CRP), serum IgM antiendotoxin antibodies (EndoCAb), and total antioxidant capacity (TAC) were determined on admission in 34 patients with acute pancreatitis. Patients were stratified according to disease severity and randomised to receive either TPN or TEN for seven days and then re-evaluated. SIRS, sepsis, organ failure, and ITU stay, were globally improved in the enterally fed patients. The acute phase response and disease severity scores were significantly improved following enteral nutrition (CRP: 156 (117-222) to 84 (50-141), p APACHE II scores 8 (6-10) to 6 (4-8), p < 0.0001) without change in the CT scan scores. In parenterally fed patients these parameters did not change but there was an increase in EndoCAb antibody levels and a fall in TAC. Enterally fed patients showed no change in the level of EndoCAb antibodies and an increase in TAC. TEN moderates the acute phase response, and improves disease severity and clinical outcome despite unchanged pancreatic injury on CT scan. Reduced systemic exposure to endotoxin and reduced oxidant stress also occurred in the TEN group. Enteral feeding modulates the inflammatory and sepsis response in acute pancreatitis and is clinically beneficial.

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

    DEFF Research Database (Denmark)

    Ringbaek, T.; Lange, P.; Mogensen, T.

    2008-01-01

    Acute exacerbation of COPD is a major cause of hospitalisation in Denmark. Most of the patients require supplemental oxygen in the acute phase and some patients continue oxygen therapy at home after discharge. In this paper we discuss the physiological mechanisms of respiratory failure seen...... in acute exacerbations of COPD. The principles for oxygen therapy in the acute phase are described and recommendations for oxygen therapy are suggested Udgivelsesdato: 2008/5/5...

  6. Diarrhoeal and acute respiratory disease: the current situation.

    Science.gov (United States)

    1991-06-01

    This paper describes the serious effect of diarrheal and acute respiratory (ARI) disease upon children under 5 years old, and international efforts undertaken by the World Health Organization (WHO) to reduce such mortality. Combined, these diseases account for more then 1/2 of all deaths in this age group, and constitute the most serious threat to their health. WHO estimates for 1990 that diarrheal illnesses caused 3.2 million childhood deaths and that ARI caused 4.3 million. While some child deaths are due to measles and pertussis, the majority is caused by pneumonia and the consequences of diarrheal illnesses. These deaths could be readily averted through the timely, effective treatment of trained health workers with essential drugs. Immunization as well as improved nutrition, particularly through the practice of exclusive breast feeding of the child's 1st 4-6 months of life, are addition weapons potentially employed against child mortality. WHO programs for diarrhea and ARI control focus upon simplified treatment guidelines, training, communication messages, drug supplies, and evaluation methodology. Despite obstacles such as the marketing of useless and/or potentially dangerous anti-diarrheal drugs and cough and cold remedies, and inappropriate breastmilk substitutes and unnecessary foods, widespread progress in program development and implementation has been made over the past decade. Increased amounts of oral rehydration therapy and solutions are available and used, while many health workers have benefited from training programs.

  7. Laparoscopic versus clinical diagnosis of acute pelvic inflammatory disease.

    Science.gov (United States)

    Morcos, R; Frost, N; Hnat, M; Petrunak, A; Caldito, G

    1993-01-01

    The purpose of this study was to evaluate the accuracy of clinical diagnosis of acute pelvic inflammatory disease (PID). Data were obtained on 176 consecutive women admitted to St. Elizabeth Hospital Medical Center with a clinical diagnosis of PID. All underwent diagnostic laparoscopy. PID was established laparoscopically in 134 (76.1%) of the patients. Statistical tests for significant associations between PID and each of 21 clinical indicators of the disease were conducted using the chi 2 and Mann-Whitney tests. Stepwise logistic regression was performed on those variables whose univariate tests of significant association with PID resulted in P values < 0.20. An optimal set of PID indicators consisted of adnexal tenderness, lower abdominal pain of < one week's duration and an elevated white blood cell count. Use of these indicators resulted in a test with an estimated sensitivity and specificity of 86.6% and 45.7%, respectively. Estimated predictive values for positive and negative test results were 0.84 and 0.52, respectively. These results confirm the fact that laparoscopy is the definitive diagnostic modality in PID.

  8. Revisiting the beryllium bonding interactions from energetic and wavefunction perspectives

    Science.gov (United States)

    Zhong, Aiguo; Chen, Dan; Li, Rongrong

    2015-07-01

    Not too much is known about the beryllium bonding interactions. Here, the total energy partition schemes as well as DFT-SAPT are used to explore the origin and nature of the beryllium bonds from an energetic point of view. In addition, Shannon entropy and Fisher information, which are based upon the electron probability density, rather than the shape function, are adopted to dissect the impact resulted from a wavefunction perspective. Results reveal that the electrostatic potential largely causes the formation of beryllium bonds. Moreover, there are strong linear relationships between atomic Shannon entropy and Fisher information of Be atoms, which can aid to distinguish the different sources of noncovalent weak interactions.

  9. Hypokalemic Rhabdomyolysis Induced Acute Renal Failure As a Presentation of Coeliac Disease

    Directory of Open Access Journals (Sweden)

    Funda Sarı

    2012-03-01

    Full Text Available Adult coeliac disease commonly presents without classical symptoms as chronic diarrhea and weight loss. We describe the case of a 31-year-old woman with persistent life-threatening hypokalemia, acute renal failure, and acute quadriplegia due to diarrhea that had continued for one month. Although there are cases of coeliac disease diagnosed with hypokalemic rhabdomyolysis in the literature, none of the cases developed acute renal failure. This is the first case in the literature diagnosed with acute renal failure due to hypokalemic rhabdomyolysis as a presentation of coeliac disease. In acute renal failure cases that present with hypokalemic rhabdomyolysis due to severe diarrhea, coeliac disease should be considered as a differential diagnosis despite the negative antigliadin IgA antibody.

  10. Acute-phase reactants in periodontal disease: current concepts and future implications.

    Science.gov (United States)

    Archana, Vilasan; Ambili, Ranjith; Nisha, Krishnavilasam Jayakumary; Seba, Abraham; Preeja, Chandran

    2015-05-01

    Periodontal disease has been linked to adverse cardiovascular events by unknown mechanisms. C-reactive protein is a systemic marker released during the acute phase of an inflammatory response and is a prognostic marker for cardiovascular disease, with elevated serum levels being reported during periodontal disease. Studies also reported elevated levels of various other acute-phase reactants in periodontal disease. It has been reported extensively in the literature that treatment of periodontal infections can significantly lower serum levels of C-reactive protein. Therefore, an understanding of the relationship between acute-phase response and the progression of periodontal disease and other systemic health complications would have a profound effect on the periodontal treatment strategies. In view of this fact, the present review highlights an overview of acute-phase reactants and their role in periodontal disease. © 2014 Wiley Publishing Asia Pty Ltd.

  11. Immunoglobulin G4-related Kidney Disease as a Cause of Acute Renal Insufficiency.

    Science.gov (United States)

    Li, Cai; Du, Xiao-Gang

    2015-09-01

    Immunoglobulin G4 (IgG4)-related kidney disease is a systemic autoimmune disease which characterized by elevated serum IgG4 and dense infiltration of IgG4-positive plasma cells into tubular interstitium. It can be a mimicker of acute renal insufficiency. We herein report a rare case of IgG4-related kidney disease as a cause of acute renal insufficiency.

  12. Hemostasis in acute myeloid leukemia patients during disease manifestation

    Directory of Open Access Journals (Sweden)

    S. G. Vladimirova

    2014-07-01

    Full Text Available The aim of the study was assessment of blood coagulation parameters in acute myeloid leukemia (AML patients during disease manifestation.Coagulation and fibrinolysis parameters, physiological anticoagulants levels and intravascular coagulation markers were detected. 44 patients with newly diagnosed AML (FAB: M0, M1, M2, M4, M5, m/f = 20/24, aged 20–76 years (median – 49.5 years were included in the study. 18 patients without infectious complications were classified as a group 1; 26 patients with infectious complication – as a group 2. Hemorrhages were observed in 15 patients (57.7 % from group 2 and only in 2 patients (11 % from group 1. The patients showed elevated levels of soluble fibrin monomer complexes and D-dimer levels, decreased protein C activity, inhibition of Hageman-dependent fibrinolysis, which indicates the hypercoagulation. Infection in AML patients accompanied by increased intravascular coagulation that confirmed by positive correlation of CRP with D-dimer levels and von Willebrand factor antigen (VWF:Ag and by negative correlation with prothrombin tests results. Thus, infection and high leucocytes count in patients with newly diagnosed AML should be considered as significant risk factors for thrombohemorrhagic complications as well as thrombocytopenia.

  13. Hemostasis in acute myeloid leukemia patients during disease manifestation

    Directory of Open Access Journals (Sweden)

    S. G. Vladimirova

    2012-01-01

    Full Text Available The aim of the study was assessment of blood coagulation parameters in acute myeloid leukemia (AML patients during disease manifestation.Coagulation and fibrinolysis parameters, physiological anticoagulants levels and intravascular coagulation markers were detected. 44 patients with newly diagnosed AML (FAB: M0, M1, M2, M4, M5, m/f = 20/24, aged 20–76 years (median – 49.5 years were included in the study. 18 patients without infectious complications were classified as a group 1; 26 patients with infectious complication – as a group 2. Hemorrhages were observed in 15 patients (57.7 % from group 2 and only in 2 patients (11 % from group 1. The patients showed elevated levels of soluble fibrin monomer complexes and D-dimer levels, decreased protein C activity, inhibition of Hageman-dependent fibrinolysis, which indicates the hypercoagulation. Infection in AML patients accompanied by increased intravascular coagulation that confirmed by positive correlation of CRP with D-dimer levels and von Willebrand factor antigen (VWF:Ag and by negative correlation with prothrombin tests results. Thus, infection and high leucocytes count in patients with newly diagnosed AML should be considered as significant risk factors for thrombohemorrhagic complications as well as thrombocytopenia.

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

    Science.gov (United States)

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

    2016-01-01

    Acute kidney injury (AKI) in the ICU frequently requires costly supportive therapies, has high morbidity, and its long-term prognosis is not as good as it has been presumed so far. Consequently, AKI generates a significant burden for the healthcare system. The problem is that AKI lacks an effective treatment and the best approach relies on early secondary prevention. Therefore, to facilitate early diagnosis, a broader definition of AKI should be established, and a marker with more sensitivity and early-detection capacity than serum creatinine - the most common marker of AKI - should be identified. Fortunately, new classification systems (RIFLE, AKIN or KDIGO) have been developed to solve these problems, and the discovery of new biomarkers for kidney injury will hopefully change the way we approach renal patients. As a first step, the concept of renal failure has changed from being a "static" disease to being a "dynamic process" that requires continuous evaluation of kidney function adapted to the reality of the ICU patient. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  15. Primordial beryllium as a big bang calorimeter.

    Science.gov (United States)

    Pospelov, Maxim; Pradler, Josef

    2011-03-25

    Many models of new physics including variants of supersymmetry predict metastable long-lived particles that can decay during or after primordial nucleosynthesis, releasing significant amounts of nonthermal energy. The hadronic energy injection in these decays leads to the formation of ⁹Be via the chain of nonequilibrium transformations: Energy(h)→T, ³He→⁶He, ⁶Li→⁹Be. We calculate the efficiency of this transformation and show that if the injection happens at cosmic times of a few hours the release of O(10 MeV) per baryon can be sufficient for obtaining a sizable ⁹Be abundance. The absence of a plateau structure in the ⁹Be/H abundance down to a O(10⁻¹⁴) level allows one to use beryllium as a robust constraint on new physics models with decaying or annihilating particles.

  16. Simulations of threshold displacement in beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, Matthew L. [Centre for Nuclear Engineering, Department of Materials, Imperial College London, London SW7 2AZ (United Kingdom); Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxfordshire OX14 3DB (United Kingdom); Fossati, Paul C. M.; Grimes, Robin W. [Centre for Nuclear Engineering, Department of Materials, Imperial College London, London SW7 2AZ (United Kingdom)

    2016-07-28

    Atomic scale molecular dynamics simulations of radiation damage have been performed on beryllium. Direct threshold displacement simulations along a geodesic projection of directions were used to investigate the directional dependence with a high spatial resolution. It was found that the directionally averaged probability of displacement increases from 0 at 35 eV, with the energy at which there is a 50% chance of a displacement occurring is 70 eV and asymptotically approaching 1 for higher energies. This is, however, strongly directionally dependent with a 50% probability of displacement varying from 35 to 120 eV, with low energy directions corresponding to the nearest neighbour directions. A new kinetic energy dependent expression for the average maximum displacement of an atom as a function of energy is derived which closely matches the simulated data.

  17. Scared for the scar: fearsome impact of acute cardiovascular disease on perceived kinesiophobia (fear of movement).

    Science.gov (United States)

    Brunetti, Natale D; Guerra, Antonio; Ieva, Riccardo; Correale, Michele; Santoro, Francesco; Tarantino, Nicola; Di Biase, Matteo

    2017-07-01

    To assess levels of kinesiophobia (fear of movement) in patients hospitalized for acute cardiovascular disease. Increased levels of kinesiophobia can be found in subjects hospitalized for acute cardiovascular disease. Seventy-four consecutive patients admitted for acute coronary syndrome and 58 for acute heart failure were enrolled in the study and assessed by the Tampa Scale for the evaluation of kinesiophobia. Subjects were compared with a reference population with stable coronary artery disease and healthy controls. No significant differences were found between acute coronary syndrome and acute heart failure in terms of kinesiophobia, even considering the rates of high kinesiophobia (Tampa score >37) and the 4 groups of questionnaire items (danger, fear, avoidance, dysfunction). Differences, however, were significant comparing our population with an historical population of subjects with stable coronary artery disease and controls (43 ± 5 vs 35 ± 7 vs 33 ± 6, P kinesiophobia in the Tampa Scale and the age of subjects (r = 0.27, P = 0.001) and inversely with level of education (r = -0.33, P kinesiophobia can be found in subjects hospitalized for acute cardiovascular disease. Kinesiophobia is related to age and education. Kinesiophobia should be carefully considered in subjects hospitalized in acute cardiac care units. © 2017 Wiley Periodicals, Inc.

  18. EXTRAMEDULLARY DISEASE IN ACUTE PROMYELOCYTIC LEUKEMIA: TWO-IN-ONE DISEASE

    Directory of Open Access Journals (Sweden)

    Giorgina Specchia

    2011-01-01

    Full Text Available

    In acute promyelocytic leukemia (APL, extramedullary disease (EMD is particularly rare and shows special clinical and biological features. It is estimated that about 3–5% of APL patients will suffer extramedullary relapse. The most common site of EMD in APL is the CNS.  At present, there are still many issues of EMD in APL needing further clarification, including pathogenesis, risk factors, prognosis and treatment. A better understanding of the biological mechanisms underlying EMD is important to be able to devise more effective CNS prophylaxis and induction-consolidation therapeutic strategies

  19. EXTRAMEDULLARY DISEASE IN ACUTE PROMYELOCYTIC LEUKEMIA: TWO-IN-ONE DISEASE

    Directory of Open Access Journals (Sweden)

    Francesco Albano

    2011-12-01

    Full Text Available In acute promyelocytic leukemia (APL, extramedullary disease (EMD is particularly rare and shows special clinical and biological features. It is estimated that about 3–5% of APL patients will suffer extramedullary relapse. The most common site of EMD in APL is the CNS.  At present, there are still many issues of EMD in APL needing further clarification, including pathogenesis, risk factors, prognosis and treatment. A better understanding of the biological mechanisms underlying EMD is important to be able to devise more effective CNS prophylaxis and induction-consolidation therapeutic strategies

  20. Found in Translation: International initiatives pursuing interleukin-1 blockade for treatment of acute Kawasaki Disease

    Science.gov (United States)

    Burns, Jane C.; Koné-Paut, Isabelle; Kuijpers, Taco; Shimizu, Chisato; Tremoulet, Adriana; Arditi, Moshe

    2016-01-01

    The decision to move forward with three clinical trials of IL-1 blockade for treatment of acute Kawasaki disease is a case study in translational science. These trials were born on the one hand from transcriptome studies of host response during the acute disease coupled with animal model investigations of key immune signaling pathways and, on the other hand, out of clinical desperation to intervene in patients with severe inflammation in the setting of acute Kawasaki disease. The convergence of laboratory science and clinical observations led to the clinical trials described here and serves as a model for how such observations can be translated into new therapies. PMID:27792871

  1. Onset of Crohn’s Disease by Symptoms of Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Ya.I. Lomei

    2015-11-01

    Full Text Available The analysis of current views on Crohn’s disease (CD has been carried out. A case report of the sudden onset of CD by symptoms of acute appendicitis in young patient is described. The events took place as follows: cumulative negative impact of risk factors — acute CD with primary lesion of vermiform appendix — clinical manifestations of acute appendicitis — appendectomy — recovery, possibly deceptive.

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

    DEFF Research Database (Denmark)

    Ringbaek, T.; Lange, P.; Mogensen, T.

    2008-01-01

    Acute exacerbation of COPD is a major cause of hospitalisation in Denmark. Most of the patients require supplemental oxygen in the acute phase and some patients continue oxygen therapy at home after discharge. In this paper we discuss the physiological mechanisms of respiratory failure seen in ac...

  3. The beryllium production at Ulba metallurgical plant (Ust-Kamenogrsk, Kazakhstan)

    Energy Technology Data Exchange (ETDEWEB)

    Dvinskykh, E.M.; Savchuk, V.V.; Tuzov, Y.V. [Ulba Metallurgical Plant (Zavod), Ust-Kamenogorsk, Abay prospect 102 (Kazakhstan)

    1998-01-01

    The Report includes data on beryllium production of Ulba metallurgical plant, located in Ust-Kamenogorsk (Kazakhstan). Beryllium production is showed to have extended technological opportunities in manufacturing semi-products (beryllium ingots, master alloys, metallic beryllium powders, beryllium oxide) and in production of structural beryllium and its parts. Ulba metallurgical plant owns a unique technology of beryllium vacuum distillation, which allows to produce reactor grades of beryllium with a low content of metallic impurities. At present Ulba plant does not depend on raw materials suppliers. The quantity of stored raw materials and semi-products will allow to provide a 25-years work of beryllium production at a full capacity. The plant has a satisfactory experience in solving ecological problems, which could be useful in ITER program. (author)

  4. Waarschuwingssignalen voor acute verergering van chronische ziekten ; Early warning signs for acute episodes in chronic diseases

    NARCIS (Netherlands)

    Olde Rikkert, M.G.M.; Melis, R.J.F.; Claassen, J.A.; Ferrari, M.D.; Lagro, J.; Tolner, E.A.; Scheffer, M.

    2015-01-01

    •Met de sterke toename van het aantal patiënten met chronische ziekten – vooral ouderen – zullen acute verergeringen van deze ziekten in aantal toenemen en een belangrijk deel van de ziektelast gaan vormen. •Het is mogelijk patiëntengroepen te identificeren met een verhoogd risico op acute

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-01-15

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

  6. Impurities effect on the swelling of neutron irradiated beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Donne, M.D.; Scaffidi-Argentina, F. [Institut fuer Neutronenphysik und Reaktortechnik, Karlsruhe (Germany)

    1995-09-01

    An important factor controlling the swelling behaviour of fast neutron irradiated beryllium is the impurity content which can strongly affect both the surface tension and the creep strength of this material. Being the volume swelling of the old beryllium (early sixties) systematically higher than that of the more modem one (end of the seventies), a sensitivity analysis with the aid of the computer code ANFIBE (ANalysis of Fusion Irradiated BEryllium) to investigate the effect of these material properties on the swelling behaviour of neutron irradiated beryllium has been performed. Two sets of experimental data have been selected: the first one named Western refers to quite recently produced Western beryllium, whilst the second one, named Russian refers to relatively old (early sixties) Russian beryllium containing a higher impurity rate than the Western one. The results obtained with the ANFIBE Code were assessed by comparison with experimental data and the used material properties were compared with the data available in the literature. Good agreement between calculated and measured values has been found.

  7. Hemophagocytosis in the Acute Phase of Fatal Kawasaki Disease in a 4 Month-Old Girl.

    Science.gov (United States)

    Doğan, Vehbi; Karaaslan, Erhan; Özer, Samet; Gümüşer, Rüveyda; Yılmaz, Resul

    2016-07-01

    Kawasaki disease is a systemic vasculitis predominately affecting coronary arteries. Hemophagocytic lymphohistiocytosis can complicate the course of Kawasaki disease. Rare cases of secondary hemophagocytic lymphohistiocytosis occurring during the acute phase of Kawasaki disease have been reported. We report here a 4 month-old girl with diffuse coronary ectasia and secondary hemophagocytic lymphohistiocytosis occurring during the acute phase of incomplete Kawasaki disease. Due to the large overlap in clinical symptoms, the presence of atypical findings for Kawasaki disease should suggest the possible diagnosis of hemophagocytic lymphohistiocytosis in these patients.

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Manfroi Waldomiro Carlos

    2002-01-01

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

  10. Biliary tract disease and acute non-A-E hepatitis in Hong Kong: prospective study

    National Research Council Canada - National Science Library

    Chau, T N; Sung, J J; Kwan, C P; Ng, C; Lai, J Y; Lai, T S; Yuen, H

    2001-01-01

    .... Prospective study. Infectious diseases unit, government hospital, Hong Kong. Sixty-one consecutive patients, admitted with the diagnosis of acute hepatitis and negative hepatitis serology for hepatitis A, B, C, D, and E virus...

  11. Disease course and outcome of acute disseminated encephalomyelitis is more severe in adults than in children

    NARCIS (Netherlands)

    Ketelslegers, I. A.; Visser, I. E. R.; Neuteboom, R. F.; Boon, M.; Catsman-Berrevoets, C. E.; Hintzen, R. Q.

    Background: Acute disseminated encephalomyelitis (ADEM) affects children more frequently than adults. Current studies investigating ADEM in different age groups are difficult to compare. Objective: To investigate whether the clinical presentation, outcome and disease course of ADEM differ between

  12. Feasibility and Acute Care Utilization Outcomes of a Post-Acute Transitional Telemonitoring Program for Underserved Chronic Disease Patients.

    Science.gov (United States)

    Davis, Cecile; Bender, Miriam; Smith, Tyler; Broad, Jason

    2015-09-01

    Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are chronic diseases that impart significant health and care costs to the patient and health system. Limited access to health services affects disease severity and functional status. Telemonitoring has shown promise in reducing acute care utilization for chronic disease patients, but the benefit for the underserved has not been determined. We evaluated acute care utilization outcomes following an acute event of a 90-day transitional care program integrating telemonitoring technology and home visits for underserved COPD and HF patients. Patients were enrolled into the program between October 2010 and August 2012. Primary outcomes included rates of emergency department (ED) visits and all-cause re-admission at 30, 90, and 180 days postdischarge. Program and functional status at enrollment and discharge and satisfaction with telemonitoring at discharge were measured. Telemonitoring included daily symptomatology recording and was removed at 90 days. A control cohort was identified through electronic health records and propensity-matched via 15 variables to achieve a sample size with balanced baseline characteristics. Program patients showed 50% reduction in 30-day re-admission and 13-19% reduction in 180-day re-admission compared with control patients. There was no significant difference in ED utilization. Patients were satisfied with telemonitoring services, and functional status improved by program end. This feasibility study suggests telemonitoring in the context of a transitional care model following an acute event may reduce all-cause 30-day re-admissions by up to 50% and has the potential to reduce long-term acute care utilization and thus care costs. More rigorous and long-term investigation is warranted.

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

    Science.gov (United States)

    Brenton, J Nicholas; Banwell, Brenda L

    2016-01-01

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

  14. Endovascular Interventions for Acute and Chronic Lower Extremity Deep Venous Disease: State of the Art.

    Science.gov (United States)

    Sista, Akhilesh K; Vedantham, Suresh; Kaufman, John A; Madoff, David C

    2015-07-01

    The societal and individual burden caused by acute and chronic lower extremity venous disease is considerable. In the past several decades, minimally invasive endovascular interventions have been developed to reduce thrombus burden in the setting of acute deep venous thrombosis to prevent both short- and long-term morbidity and to recanalize chronically occluded or stenosed postthrombotic or nonthrombotic veins in symptomatic patients. This state-of-the-art review provides an overview of the techniques and challenges, rationale, patient selection criteria, complications, postinterventional care, and outcomes data for endovascular intervention in the setting of acute and chronic lower extremity deep venous disease. Online supplemental material is available for this article.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-07-15

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

  16. Difference in Risk Factors for Subtypes of Acute Cardiac Lesions Resulting from Kawasaki Disease.

    Science.gov (United States)

    Yamashita, Maho; Ae, Ryusuke; Yashiro, Mayumi; Aoyama, Yasuko; Sano, Takashi; Makino, Nobuko; Nakamura, Yosikazu

    2017-02-01

    Few studies discuss the risk factors for acute cardiac lesions (within 30 days) resulting from Kawasaki disease (KD). We aimed to clarify the characteristics of patients with cardiac lesions within 30 days and determine the risk factors for acute cardiac lesion subtypes. Using the 23rd nationwide survey of KD in Japan, we analyzed data from patients with or without acute cardiac lesions resulting from KD (n = 31,380). We subdivided patients with acute cardiac lesions into three types: acute valvular lesions, coronary aneurysms, and giant coronary aneurysms (GCA), and calculated the odds ratios of potential risk factors for acute cardiac lesion subtypes. The prevalence of acute cardiac lesions was 8.6%, and these lesions were more prevalent among males than females (1.98:1). Male sex, age valvular lesions differed from the risk factors for CALs, but GCA risk factors were similar to CAL risk factors: age acute GCA. We found differences in cardiac lesion risk factors within 30 days of diagnosing KD between acute CAL and valvular lesions resulting from KD. In particular, pediatricians should consider atypical definite cases and resistance to initial IVIG when assessing the risk of acute-phase GCA.

  17. Addison���s Disease Mimicking as Acute Pancreatitis: A Case Report

    OpenAIRE

    Chaudhuri, Sayani; Rao, Karthik N.; Patil, Navin; Ommurugan, Balaji; Varghese, George

    2017-01-01

    Over past two decades there has been significant improvement in medical field in elucidating the underlying pathophysiology and genetics of Addison���s disease. Adrenal insufficiency (Addison���s disease) is a rare disease with an incidence of 0.8/100,000 cases. The diagnosis may be delayed if the clinical presentation mimics a gastrointestinal disorder or psychiatric illness. We report a case of Addison���s disease presenting as acute pain in abdomen mimicking clinical presentation of acute ...

  18. Proton irradiation effects on beryllium – A macroscopic assessment

    Energy Technology Data Exchange (ETDEWEB)

    Simos, Nikolaos, E-mail: simos@bnl.gov [Nuclear Sciences & Technology Department, Brookhaven National Laboratory, Upton, NY, 11973 (United States); Elbakhshwan, Mohamed [Nuclear Sciences & Technology Department, Brookhaven National Laboratory, Upton, NY, 11973 (United States); Zhong, Zhong [Photon Sciences, NSLS II, Brookhaven National Laboratory, Upton, NY, 11973 (United States); Camino, Fernando [Center for Functional Nanomaterials, Brookhaven National Laboratory, Upton, NY, 11973 (United States)

    2016-10-15

    Beryllium, due to its excellent neutron multiplication and moderation properties, in conjunction with its good thermal properties, is under consideration for use as plasma facing material in fusion reactors and as a very effective neutron reflector in fission reactors. While it is characterized by unique combination of structural, chemical, atomic number, and neutron absorption cross section it suffers, however, from irradiation generated transmutation gases such as helium and tritium which exhibit low solubility leading to supersaturation of the Be matrix and tend to precipitate into bubbles that coalesce and induce swelling and embrittlement thus degrading the metal and limiting its lifetime. Utilization of beryllium as a pion production low-Z target in high power proton accelerators has been sought both for its low Z and good thermal properties in an effort to mitigate thermos-mechanical shock that is expected to be induced under the multi-MW power demand. To assess irradiation-induced changes in the thermal and mechanical properties of Beryllium, a study focusing on proton irradiation damage effects has been undertaken using 200 MeV protons from the Brookhaven National Laboratory Linac and followed by a multi-faceted post-irradiation analysis that included the thermal and volumetric stability of irradiated beryllium, the stress-strain behavior and its ductility loss as a function of proton fluence and the effects of proton irradiation on the microstructure using synchrotron X-ray diffraction. The mimicking of high temperature irradiation of Beryllium via high temperature annealing schemes has been conducted as part of the post-irradiation study. This paper focuses on the thermal stability and mechanical property changes of the proton irradiated beryllium and presents results of the macroscopic property changes of Beryllium deduced from thermal and mechanical tests.

  19. Adaptation prevents the extinction of Chlamydomonas reinhardtii under toxic beryllium

    Directory of Open Access Journals (Sweden)

    Beatriz Baselga-Cervera

    2016-03-01

    Full Text Available The current biodiversity crisis represents a historic challenge for natural communities: the environmental rate of change exceeds the population’s adaptation capability. Integrating both ecological and evolutionary responses is necessary to make reliable predictions regarding the loss of biodiversity. The race against extinction from an eco-evolutionary perspective is gaining importance in ecological risk assessment. Here, we performed a classical study of population dynamics—a fluctuation analysis—and evaluated the results from an adaption perspective. Fluctuation analysis, widely used with microorganisms, is an effective empirical procedure to study adaptation under strong selective pressure because it incorporates the factors that influence demographic, genetic and environmental changes. The adaptation of phytoplankton to beryllium (Be is of interest because human activities are increasing the concentration of Be in freshwater reserves; therefore, predicting the effects of human-induced pollutants is necessary for proper risk assessment. The fluctuation analysis was performed with phytoplankton, specifically, the freshwater microalgae Chlamydomonas reinhardtii, under acute Be exposure. High doses of Be led to massive microalgae death; however, by conducting a fluctuation analysis experiment, we found that C. reinhardtii was able to adapt to 33 mg/l of Be due to pre-existing genetic variability. The rescuing adapting genotype presented a mutation rate of 9.61 × 10−6 and a frequency of 10.42 resistant cells per million wild-type cells. The genetic adaptation pathway that was experimentally obtained agreed with the theoretical models of evolutionary rescue (ER. Furthermore, the rescuing genotype presented phenotypic and physiologic differences from the wild-type genotype, was 25% smaller than the Be-resistant genotype and presented a lower fitness and quantum yield performance. The abrupt distinctions between the wild-type and the Be

  20. Postoperative acute respiratory failure caused by adult-onset Pompe disease.

    Science.gov (United States)

    Tan, Dingyu; Xu, Jun; Yang, Yi; Gu, Ming; Yu, Xuezhong

    2018-01-01

    Pompe disease, which leads to dysfunction of the enzyme acid a-glucosidase, is a genetic disorder seen in 1 in 40000 births. Adult-onset Pompe disease is known as a slowly progressive myasthenia with or without respiratory dysfunction. We herein report two cases of adult-onset Pompe disease, in which postoperative acute respiratory failure was the the initial manifestation. The two patients showed no symptoms of ambulatory and respiratory dysfunction before operation. The diagnosis of Pompe disease was determined by muscle biopsy and acid a-glucosidase assay in the blood. Rapid deterioration of already struggling diaphragmatic function induced by stress of surgery and anesthesia were thought to be the main reason of postoperative acute respiratory failure. Physicians should be aware of the existence of an adult form of Pompe disease which may present with postoperative acute respiratory failure. © 2016 John Wiley & Sons Ltd.

  1. Steam-chemical reactivity for irradiated beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Anderl, R.A.; McCarthy, K.A.; Oates, M.A.; Petti, D.A.; Pawelko, R.J.; Smolik, G.R. [Idaho National Engineering and Environmental Lab., Idaho Falls, ID (United States)

    1998-01-01

    This paper reports the results of an experimental investigation to determine the influence of neutron irradiation effects and annealing on the chemical reactivity of beryllium exposed to steam. The work entailed measurements of the H{sub 2} generation rates for unirradiated and irradiated Be and for irradiated Be that had been previously annealed at different temperatures ranging from 450degC to 1200degC. H{sub 2} generation rates were similar for irradiated and unirradiated Be in steam-chemical reactivity experiments at temperatures between 450degC and 600degC. For irradiated Be exposed to steam at 700degC, the chemical reactivity accelerated rapidly and the specimen experienced a temperature excursion. Enhanced chemical reactivity at temperatures between 400degC and 600degC was observed for irradiated Be annealed at temperatures of 700degC and higher. This reactivity enhancement could be accounted for by the increased specific surface area resulting from development of a surface-connected porosity in the irradiated-annealed Be. (author)

  2. Electronic band structure of beryllium oxide

    CERN Document Server

    Sashin, V A; Kheifets, A S; Ford, M J

    2003-01-01

    The energy-momentum resolved valence band structure of beryllium oxide has been measured by electron momentum spectroscopy (EMS). Band dispersions, bandwidths and intervalence bandgap, electron momentum density (EMD) and density of occupied states have been extracted from the EMS data. The experimental results are compared with band structure calculations performed within the full potential linear muffin-tin orbital approximation. Our experimental bandwidths of 2.1 +- 0.2 and 4.8 +- 0.3 eV for the oxygen s and p bands, respectively, are in accord with theoretical predictions, as is the s-band EMD after background subtraction. Contrary to the calculations, however, the measured p-band EMD shows large intensity at the GAMMA point. The measured full valence bandwidth of 19.4 +- 0.3 eV is at least 1.4 eV larger than the theory. The experiment also finds a significantly higher value for the p-to-s-band EMD ratio in a broad momentum range compared to the theory.

  3. Chronic obstructive pulmonary disease: Emergency care in acute exacerbation

    Directory of Open Access Journals (Sweden)

    Tedd J. Welniak

    2015-06-01

    The purpose of this paper is to outline the current state of research and international guidelines surrounding the management of acute exacerbation of COPD in the emergency centre. Strict adherence to international guidelines for management of acute exacerbation of COPD may be difficult for many African providers given factors affecting diagnosis, treatment, and access to care for many Africans suffering from COPD. Research looking into the role of the African EM practitioner in providing more cost-effective means of diagnosis and treatment of COPD is limited.

  4. Treatment of acute gout in patients with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Chan CW

    2013-10-01

    Full Text Available Case ScenarioMr. L, aged 63 years, was recently diagnosed to have with acute gouty arthritis. He had an acute gout flare last month and was given diclofenac injection by a private general practitioner. He comes to you for advice whether he should take the injection if he has another flare. Mr. L has been on treatment for his chronic essential hypertension and dyslipidaemia for the past 10 years. He also had two previous episodes of myocardial infarction in year 2005 and 2010, and he had angioplasty done twice. He stopped smoking and consuming alcohol three months ago.

  5. Beryllium processing technology review for applications in plasma-facing components

    Energy Technology Data Exchange (ETDEWEB)

    Castro, R.G.; Jacobson, L.A.; Stanek, P.W.

    1993-07-01

    Materials research and development activities for the International Thermonuclear Experimental Reactor (ITER), i.e., the next generation fusion reactor, are investigating beryllium as the first-wall containment material for the reactor. Important in the selection of beryllium is the ability to process, fabricate and repair beryllium first-wall components using existing technologies. Two issues that will need to be addressed during the engineering design activity will be the bonding of beryllium tiles in high-heat-flux areas of the reactor, and the in situ repair of damaged beryllium tiles. The following review summarizes the current technology associated with welding and joining of beryllium to itself and other materials, and the state-of-the-art in plasma-spray technology as an in situ repair technique for damaged beryllium tiles. In addition, a review of the current status of beryllium technology in the former Soviet Union is also included.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-01-15

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

  7. A Report on the Validation of Beryllium Strength Models

    Energy Technology Data Exchange (ETDEWEB)

    Armstrong, Derek Elswick [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-02-05

    This report discusses work on validating beryllium strength models with flyer plate and Taylor rod experimental data. Strength models are calibrated with Hopkinson bar and quasi-static data. The Hopkinson bar data for beryllium provides strain rates up to about 4000 per second. A limitation of the Hopkinson bar data for beryllium is that it only provides information on strain up to about 0.15. The lack of high strain data at high strain rates makes it difficult to distinguish between various strength model settings. The PTW model has been calibrated many different times over the last 12 years. The lack of high strain data for high strain rates has resulted in these calibrated PTW models for beryllium exhibiting significantly different behavior when extrapolated to high strain. For beryllium, the α parameter of PTW has recently been calibrated to high precision shear modulus data. In the past the α value for beryllium was set based on expert judgment. The new α value for beryllium was used in a calibration of the beryllium PTW model by Sky Sjue. The calibration by Sjue used EOS table information to model the temperature dependence of the heat capacity. Also, the calibration by Sjue used EOS table information to model the density changes of the beryllium sample during the Hopkinson bar and quasi-static experiments. In this paper, the calibrated PTW model by Sjue is compared against experimental data and other strength models. The other strength models being considered are a PTW model calibrated by Shuh- Rong Chen and a Steinberg-Guinan type model by John Pedicini. The three strength models are used in a comparison against flyer plate and Taylor rod data. The results show that the Chen PTW model provides better agreement to this data. The Chen PTW model settings have been previously adjusted to provide a better fit to flyer plate data, whereas the Sjue PTW model has not been changed based on flyer plate data. However, the Sjue model provides a reasonable fit to

  8. Screening for acute HIV infection in South Africa: finding acute and chronic disease

    Science.gov (United States)

    Bassett, Ingrid V.; Chetty, Senica; Giddy, Janet; Reddy, Shabashini; Bishop, Karen; Lu, Zhigang; Losina, Elena; Freedberg, Kenneth A.; Walensky, Rochelle P.

    2010-01-01

    Background The yield of screening for acute HIV infection among general medical patients in resource-scarce settings remains unclear. Our objective was to evaluate a strategy of pooled HIV plasma RNA to diagnose acute HIV infection in patients with negative or discordant rapid HIV antibody tests in Durban, South Africa. Methods We prospectively enrolled patients with negative or discordant rapid HIV antibody tests from a routine HIV screening program in an outpatient department in Durban with an HIV prevalence of 48%. Study participants underwent venipuncture for pooled qualitative HIV RNA, and if positive, quantitative RNA, enzyme immunoassay and Western Blot (WB). Patients with negative or indeterminate WB and positive quantitative HIV RNA were considered acutely infected. Those with chronic infection (positive RNA and WB) despite negative or discordant rapid HIV tests were considered false negative rapid antibody tests. Results Nine hundred ninety-four participants were enrolled with either negative (N=976) or discordant (N=18) rapid test results. Eleven (1.1%, 95% CI: 0.6–2.0%) had acute HIV infection. Of the 994 patients, an additional 20 (2.0%, 95% CI: 1.3–.3.1%) had chronic HIV infection (false negative rapid test). Conclusions One percent of outpatients with negative or discordant rapid HIV tests in Durban, South Africa had acute HIV infection readily detectable through pooled serum HIV RNA screening. Pooled RNA testing also identified an additional 2% of patients with chronic HIV infection. HIV RNA screening has the potential to identify both acute and chronic HIV infections that are otherwise missed by standard HIV testing algorithms. PMID:20553336

  9. [Application of Ischemia Modified Albumin for Acute Ischemic Heart Disease in Forensic Science].

    Science.gov (United States)

    Wang, P; Zhu, Z L; Zhu, N; Yu, H; Yue, Q; Wang, X L; Feng, C M; Wang, C L; Zhang, G H

    2017-10-01

    To explore the application value and forensic significance of ischemia modified albumin (IMA) in pericardial fluid to diagnose sudden cardiac death. IMA level in pericardial fluid was detected in acute ischemic heart disease group ( n =36), acute myocardial infarction group ( n =6), cardiomyopathy group ( n =4) and control group ( n =15) by albumin cobalt binding method. The levels of IMA were compared among these groups. The best cut-off IMA value was estimated and the sensitivity and specificity of acute myocardial ischemia group was distinguished from control group by receiver operating characteristics (ROC) curve. The IMA level in acute ischemic heart disease group was significantly higher than that of control group ( P 0.05). The cut-off value for the identification of acute myocardial ischemia which obtained by ROC analysis was 40.65 U/mL. And the sensitivity and specificity for distinguishing acute ischemia cardiac disease was 60.0% and 80.5%, respectively. The IMA value in pericardial fluid can be a reference marker for the diagnosis of acute myocardial ischemia, which also can provide objective basis for the forensic identification of sudden cardiac death.

  10. [Systolic blood pressure and functional outcome in patients with acute stroke: a Mexican registry of acute cerebrovascular disease (RENAMEVASC)].

    Science.gov (United States)

    Baños-González, Manuel; Cantú-Brito, Carlos; Chiquete, Erwin; Arauz, Antonio; Ruiz-Sandoval, José Luís; Villarreal-Careaga, Jorge; Barinagarrementeria, Fernando; Lozano, José Juan

    2011-01-01

    To analyze the association between the admission systolic blood pressure (SBP) and 30-day outcome in patients with acute cerebrovascular disease. The REgistro NAcional Mexicano de Enfermedad VAScular Cerebral (RENAMEVASC) is a hospital-based multicenter registry performed between November 2002 and October 2004. A total of 2000 patients with clinical syndromes of acute cerebrovascular disease confirmed by neuroimaging were registered. The modified Rankin scale was used for outcome stratification. We analyzed 1721 patients who had registered their SBP: 78 (4.5%) had transient ischemic attack, 894 (51.9%) brain infarction, 534 (30.9%) intracerebral hemorrhage, 165 (9.6%) subarachnoid hemorrhage and 50 (2.9%) cerebral venous thrombosis. Among 1036 (60.2%) patients with the antecedent of hypertension, only 32.4% had regular treatment. The 30-day case fatality rate presented a J pattern with respect to SBP, so that the risk of death was highest in 65 years (RR: 2.16, IC 95%: 1.74 - 2.67). Both hypotension and significant arterial hypertension at hospital admission are associated with an adverse outcome after acute cerebrovascular disease. Nevertheless, a good functional outcome can be attained in a wide range of SBP.

  11. Structure and mechanical properties of foils made of nanocrystalline beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Zhigalina, O. M., E-mail: zhigal@ns.crys.ras.ru [Russian Academy of Sciences, Shubnikov Institute of Crystallography (Russian Federation); Semenov, A. A.; Zabrodin, A. V. [Bochvar High-Technology Scientific Research Institute for Inorganic Materials (Russian Federation); Khmelenin, D. N. [Russian Academy of Sciences, Shubnikov Institute of Crystallography (Russian Federation); Brylev, D. A.; Lizunov, A. V.; Nebera, A. L.; Morozov, I. A.; Anikin, A. S. [Bochvar High-Technology Scientific Research Institute for Inorganic Materials (Russian Federation); Orekhov, A. S.; Kuskova, A. N. [Russian Academy of Sciences, Shubnikov Institute of Crystallography (Russian Federation); Mishin, V. V. [Peter the Great St. Petersburg Polytechnic University (Russian Federation); Seryogin, A. V. [Russian Academy of Sciences, Shubnikov Institute of Crystallography (Russian Federation)

    2016-07-15

    The phase composition and structural features of (45–90)-μm-thick foils obtained from nanocrystalline beryllium during multistep thermomechanical treatment have been established using electron microscopy, electron diffraction, electron backscattering diffraction, and energy-dispersive analysis. This treatment is shown to lead to the formation of a structure with micrometer- and submicrometer-sized grains. The minimum average size of beryllium grains is 352 nm. The inclusions of beryllium oxide (BeO) of different modifications with tetragonal (sp. gr. P4{sub 2}/mnm) and hexagonal (sp. gr. P6{sub 3}/mmc) lattices are partly ground during deformation to a size smaller than 100 nm and are located along beryllium grain boundaries in their volume, significantly hindering migration during treatment. The revealed structural features of foils with submicrometer-sized crystallites provide the thermal stability of their structural state. Beryllium with this structure is a promising material for X-ray instrument engineering and for the production of ultrathin (less than 10 μm) vacuum-dense foils with very high physicomechanical characteristics.

  12. Report of a technical evaluation panel on the use of beryllium for ITER plasma facing material and blanket breeder material

    Energy Technology Data Exchange (ETDEWEB)

    Ulrickson, M.A. [ed.] [Sandia National Labs., Albuquerque, NM (United States); Manly, W.D. [Oak Ridge National Lab., TN (United States); Dombrowski, D.E. [Brush Wellman, Inc., Cleveland, OH (United States)] [and others

    1995-08-01

    Beryllium because of its low atomic number and high thermal conductivity, is a candidate for both ITER first wall and divertor surfaces. This study addresses the following: why beryllium; design requirements for the ITER divertor; beryllium supply and unirradiated physical/mechanical property database; effects of irradiation on beryllium properties; tritium issues; beryllium health and safety; beryllium-coolant interactions and safety; thermal and mechanical tests; plasma erosion of beryllium; recommended beryllium grades for ITER plasma facing components; proposed manufacturing methods to produce beryllium parts for ITER; emerging beryllium materials; proposed inspection and maintenance techniques for beryllium components and coatings; time table and costs; and the importance of integrating materials and manufacturing personnel with designers.

  13. Serum hepcidin level and disease course of acute leukemia in ...

    African Journals Online (AJOL)

    Acute leukemia (AL) is a heterogeneous group of hematopoietic neoplasms and it is the most common childhood malignancy. Many patients with AL develop severe anemia that requires multiple blood transfusions. Hepcidin expression may play a role in anemia which is often seen in these patients. The aim of this study is ...

  14. Experimental studies and modeling of processes of hydrogen isotopes interaction with beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Tazhibaeva, I.L.; Chikhray, Y.V.; Romanenko, O.G.; Klepikov, A.Kh.; Shestakov, V.P.; Kulsartov, T.V. [Science Research Inst. of Experimental and Theoretical Physics of Kazakh State Univ., Almaty (Kazakhstan); Kenzhin, E.A.

    1998-01-01

    The objective of this work was to clarify the surface beryllium oxide influence on hydrogen-beryllium interaction characteristics. Analysis of experimental data and modeling of processes of hydrogen isotopes accumulation, diffusion and release from neutron irradiated beryllium was used to achieve this purpose as well as the investigations of the changes of beryllium surface element composition being treated by H{sup +} and Ar{sup +} plasma glowing discharge. (author)

  15. Bilateral foot drop, weight loss and rectal bleeding as an acute presentation of Crohn's disease.

    OpenAIRE

    Gariballa, S. E.; Gunasekera, N. P.

    1994-01-01

    We report a 71 year old lady who presented with weight loss, rectal bleeding and bilateral foot drop having been previously fit and well. Clinical examination, laboratory investigation and postmortem examination confirmed the diagnosis of active Crohn's disease and acute peripheral neuropathy. The clinical course of this patient suggests that the peripheral neuropathy might have resulted from the common pathogenesis for Crohn's disease.

  16. [Acute pancreatitis in childhood. Is it the same disease in adults?].

    Science.gov (United States)

    Baeza-Herrera, Carlos; Velasco-Soria, Luis; Mora-Hernández, Francisco; Godoy-Esquivel, Arturo Hermilo; Osorio-Agüero, Cecilia Dinorah

    2003-01-01

    Acute pancreatitis in children is an uncommon, little known, poorly defined disease and thus is rarely considered in diagnosis of pediatric abdominal pain. It is rare but is being recognized more frequently, and differs from the disease in the adult both in etiology and therapeutic approach. Fifty children with acute pancreatitis were managed. Their history and postoperative course were analyzed in a retrospective study. The clinical presentation was unremarkable; all patients had abdominal pain, specially in epigastrium, and vomiting was the only other clinical sign exhibited by > 80%. More than 40 biliary diseases were the cause of pancreatitis; trauma was the cause in 30%. Diagnosis could be difficult and unnecessary laparotomy was performed in 16 cases (32.0%) instances of suspected acute abdomen. Morbidity included sepsis, diabetic cetoacidosis, and pancreatic pseudocyst. Biliary disease is a frequent cause of both pediatric and adult pancreatitis. They are differences in clinical course and prognosis. In children, pancreatitis is usually confused with appendicitis.

  17. Renal and urological diseases of the newborn neonatal acute kidney injury.

    Science.gov (United States)

    Mistry, Kirtida

    2014-01-01

    Survival of critically ill neonates in the intensive care unit has improved over the past decades reflecting improvements in obstetric, delivery room and neonatal intensive care, however, morbidity remains significant. Acute kidney injury is a common occurrence in these neonates and despite improved understanding of the pathophysiology and management of acute kidney injury in full term and preterm infants, the mortality remains as high as 61%. Furthermore, there is growing evidence that despite recovery from the acute injury, these infants are at risk for developing hypertension and chronic kidney disease later in life. Emphasis on improving our capability to detect renal insult and injury early, before renal failure occurs, and identification of novel therapeutic agents to prevent and treat acute kidney injury may impact mortality and morbidity. This review focuses on our current knowledge of acute kidney injury in the newborn, approaches to investigating and managing this complication and what future trends in this field may bring.

  18. Corrosion of beryllium exposed to celotex and water

    Energy Technology Data Exchange (ETDEWEB)

    Hill, M.A.; Butt, D.P.; Lillard, R.S. [Los Alamos National Lab., NM (United States). Materials Corrosion and Environmental Effects Lab.

    1997-12-01

    Celotex is a commercial rigid cellulose fiberboard product primarily used in the building construction industry. Currently celotex is being used as a packing material in AL-R8 containers. Ion chromatography of celotex packing material at Lawrence Livermore National Laboratory (LLNL) has indicated that this material contains aggressive anions, including chloride, which may accelerate corrosion. It is well known that beryllium is susceptible to pitting corrosion when exposed to chloride containing environments. Levy noted pitting in beryllium at the open circuit potential when exposed to 0.1 M NaCl solution. This investigation attempts to evaluate the potential risk of accelerated beryllium corrosion from celotex and water which may occur naturally when celotex dust comes into contact with moisture from the atmosphere.

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

    Directory of Open Access Journals (Sweden)

    Luiz Henrique Conde SANGENIS

    2015-08-01

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

  20. Acute calcific tendonitis of dorsal interosseous muscles of the hand: uncommon site of a frequent disease

    Directory of Open Access Journals (Sweden)

    D. Schneider

    2017-05-01

    Full Text Available Acute calcific tendinopathy is one of the manifestations of hydroxyapatite crystal deposition disease. While it is more frequent in the shoulder, it has been described in virtually all areas of the body, but rarely in the muscles of the hand. Its etiopathogenesis is not yet fully understood and despite being a fairly frequent condition, it is commonly misdiagnosed. The onset of the disease is usually acute and resolves spontaneously. Acute calcific tendinitis of the interosseous tendons of the hand is an uncommon site of a frequent condition. The clinical presentation is similar to other entities, thus errors in diagnosis frequently occur, resulting in over-treatment or unnecessary tests. We describe a case of acute calcific tendinitis of the interosseous muscles of the hand with a brief review of the current literature with emphasis on diagnostic imaging methods.

  1. Inhibition of normal human lung fibroblast growth by beryllium.

    Science.gov (United States)

    Lehnert, N M; Gary, R K; Marrone, B L; Lehnert, B E

    2001-03-07

    Inhalation of particulate beryllium (Be) and its compounds causes chronic Be disease (CBD) in a relatively small subset ( approximately 1-6%) of exposed individuals. Hallmarks of this pulmonary disease include increases in several cell types, including lung fibroblasts, that contribute to the fibrotic component of the disorder. In this regard, enhancements in cell proliferation appear to play a fundamental role in CBD development and progression. Paradoxically, however, some existing evidence suggests that Be actually has antiproliferative effects. In order to gain further information about the effects of Be on cell growth, we: (1) assessed cell proliferation and cell cycle effects of low concentrations of Be in normal human diploid fibroblasts, and (2) investigated the molecular pathway(s) by which the cell cycle disturbing effects of Be may be mediated. Treatment of human lung and skin fibroblasts with Be added in the soluble form of BeSO(4) (0.1-100 microM) caused inhibitions of their growth in culture in a concentration-dependent manner. Such growth inhibition was found to persist, even after cells were further cultured in Be(2+)-free medium. Flow cytometric analyses of cellular DNA labeled with the DNA-binding fluorochrome DAPI revealed that Be causes a G(0)-G(1)/pre-S phase arrest. Western blot analyses indicated that the Be-induced G(0)-G(1)/pre-S phase arrest involves elevations in TP53 (p53) and the cyclin-dependent kinase inhibitor CDKN1A (p21(Waf-1,Cip1)). That Be at low concentrations inhibits the growth of normal human fibroblasts suggests the possibility of the existence of abnormal cell cycle inhibitory responses to Be in individuals who are sensitive to the metal and ultimately develop CBD.

  2. Neutron irradiation behavior of ITER candidate beryllium grades

    Energy Technology Data Exchange (ETDEWEB)

    Kupriyanov, I.B.; Gorokhov, V.A.; Nikolaev, G.N. [A.A.Bochvar All-Russia Scientific Research Inst. of Inorganic Materials (VNIINM), Moscow (Russian Federation); Melder, R.R.; Ostrovsky, Z.E.

    1998-01-01

    Beryllium is one of the main candidate materials both for the neutron multiplier in a solid breeding blanket and for the plasma facing components. That is why its behaviour under the typical for fusion reactor loading, in particular, under the neutron irradiation is of a great importance. This paper presents mechanical properties, swelling and microstructure of six beryllium grades (DshG-200, TR-30, TshG-56, TRR, TE-30, TIP-30) fabricated by VNIINM, Russia and also one - (S-65) fabricated by Brush Wellman, USA. The average grain size of the beryllium grades varied from 8 to 25 {mu}m, beryllium oxide content was 0.8-3.2 wt. %, initial tensile strength was 250-680 MPa. All the samples were irradiated in active zone of SM-3 reactor up to the fast neutron fluence (5.5-6.2) {center_dot} 10{sup 21} cm{sup -2} (2.7-3.0 dpa, helium content up to 1150 appm), E > 0.1 MeV at two temperature ranges: T{sub 1} = 130-180degC and T{sub 2} = 650-700degC. After irradiation at 130-180degC no changes in samples dimensions were revealed. After irradiation at 650-700degC swelling of the materials was found to be in the range 0.1-2.1 %. Beryllium grades TR-30 and TRR, having the smallest grain size and highest beryllium oxide content, demonstrated minimal swelling, which was no more than 0.1 % at 650-700degC and fluence 5.5 {center_dot} 10{sup 21} cm{sup -2}. Tensile and compression test results and microstructure parameters measured before and after irradiation are also presented. (author)

  3. Method for removal of beryllium contamination from an article

    Science.gov (United States)

    Simandl, Ronald F.; Hollenbeck, Scott M.

    2012-12-25

    A method of removal of beryllium contamination from an article is disclosed. The method typically involves dissolving polyisobutylene in a solvent such as hexane to form a tackifier solution, soaking the substrate in the tackifier to produce a preform, and then drying the preform to produce the cleaning medium. The cleaning media are typically used dry, without any liquid cleaning agent to rub the surface of the article and remove the beryllium contamination below a non-detect level. In some embodiments no detectible residue is transferred from the cleaning wipe to the article as a result of the cleaning process.

  4. CHAPTER 7. BERYLLIUM ANALYSIS BY NON-PLASMA BASED METHODS

    Energy Technology Data Exchange (ETDEWEB)

    Ekechukwu, A

    2009-04-20

    The most common method of analysis for beryllium is inductively coupled plasma atomic emission spectrometry (ICP-AES). This method, along with inductively coupled plasma mass spectrometry (ICP-MS), is discussed in Chapter 6. However, other methods exist and have been used for different applications. These methods include spectroscopic, chromatographic, colorimetric, and electrochemical. This chapter provides an overview of beryllium analysis methods other than plasma spectrometry (inductively coupled plasma atomic emission spectrometry or mass spectrometry). The basic methods, detection limits and interferences are described. Specific applications from the literature are also presented.

  5. Occurrence of acute pathologic ophthalmologic findings in cats with systemic disease

    OpenAIRE

    Cinquoncie, Sara

    2015-01-01

    Due to its strong vascularization, the eye can be a target organ of systemic diseases. The aim of this prospective study was to examine cats suffering from systemic diseases for acute, pathological, ophthalmological findings. Cats that were presented to the Clinic for Small Animals, Freie Universität Berlin over a period of 36 months suffering certain systemic diseases or defined laboratory abnormalities were examined for ophthalmological changes. The inclusion criteria included evidence of a...

  6. Acute leukemia presenting with extramedullary diseases and completely normal hemogram: an extremely unusual manifestation unique to pre-B ALL

    National Research Council Canada - National Science Library

    Chen, Chih-Cheng; Weng, Hsu-Huei; Hwang, Cih-En; Lu, Chang-Hsien; Chen, Ping-Tsung; Gau, Jyh-Pyng

    2010-01-01

    Acute lymphoblastic leukemia (ALL) is a clonal hematological disease characterized by inadequate normal hematopoiesis secondary to excessive proliferation of leukemic blasts and their impaired differentiation...

  7. Extraction of beryllium sulfate by a long chain amine; Extraction du sulfate de beryllium par une amine a longue chaine

    Energy Technology Data Exchange (ETDEWEB)

    Etaix, E.S. [Commissariat a l' Energie Atomique, Fontenay-Aux-Roses (France). Centre d' Etudes Nucleaires

    1968-06-01

    The extraction of sulfuric acid in aqueous solution by a primary amine in benzene solution, 3-9 (diethyl) - 6-amino tri-decane (D.E.T. ) - i.e., with American nomenclature 1-3 (ethyl-pentyl) - 4-ethyl-octyl amine (E.P.O.) - has made it possible to calculate the formation constants of alkyl-ammonium sulfate and acid sulfate. The formula of the beryllium and alkyl-ammonium sulfate complex formed in benzene has next been determined, for various initial acidity of the aqueous solution. Lastly, evidence has been given of negatively charged complexes of beryllium and sulfate in aqueous solution, through the dependence of the aqueous sulfate ions concentration upon beryllium extraction. The formation constant of these anionic complexes has been evaluated. (author) [French] L'etude de l'extraction de l'acide sulfurique en solution aqueuse par une amine primaire en solution dans le benzene, le diethyl-3,9 amino-6 tridecane (D.E.T.) - autre nom americain 1-3 (ethylpentyl) - 4-ethyloctylamine (E.P.O.) a permis de calculer les constantes de formation du sulfate et de l'hydrogenosulfate d'alkyl-ammonium. La formule du complexe de sulfate de beryllium et d'alkyl-ammonium forme en solution benzenique a ete ensuite determinee pour diverses acidites initiales de la solution aqueuse. Enfin, l'influence de la concentration des ions sulfate de la phase aqueuse sur l'extraction du beryllium a mis en evidence la formation en solution aqueuse de complexes anioniques de sulfate et de beryllium dont la constante de formation a ete evaluee. (auteur)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-15

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

  9. Revisiting the role of steroids and aspirin in the management of acute Kawasaki disease.

    Science.gov (United States)

    Dhanrajani, Anita; Yeung, Rae S M

    2017-09-01

    Kawasaki disease is an acute multisystem childhood vasculitis with a predilection for the coronary arteries. The role of corticosteroids and acetyl salicylic acid (ASA) in the treatment of acute Kawasaki disease are matters of ongoing debate and changing attitudes from one extreme to the other. Recent work has provided new evidence to guide our thinking about these two therapeutic agents, which will be the focus of this review. Corticosteroids are effective and well tolerated in Kawasaki disease, both as initial adjunctive treatment in those at high-risk for poor outcome, and as rescue therapy after failed intravenous immunoglobulin (IVIG).Higher doses of ASA (> 30 mg/kg/day) in the acute phase of Kawasaki disease, have no clear benefit over antiplatelet doses in improving coronary outcome. Corticosteroids should be used in patients at high-risk for poor coronary outcome, and in patients who fail IVIG. The absence of widely applicable and validated risk-scoring systems in Kawasaki disease outside of Japan remains a limiting factor to identify high-risk children. Current evidence does not demonstrate any advantage of high-dose over low-dose ASA in the acute phase of Kawasaki disease, in preventing coronary artery aneurysms.

  10. Acute Pelvic Inflammatory Disease in Cameroon: A Cross Sectional ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Herzog SA, Althaus CL, Heijne JC, et al. Timing of progression from Chlamydia trachomatis infection to pelvic inflammatory disease: a mathematical modelling study. BMC Infect Dis 2012; 12: 187. 9. Schindlbeck C, Dziura D, Mylonas I. Diagnosis of pelvic inflammatory disease (PID): intra-operative findings and comparison ...

  11. Beryllium solubility in occupational airborne particles: Sequential extraction procedure and workplace application.

    Science.gov (United States)

    Rousset, Davy; Durand, Thibaut

    2016-01-01

    Modification of an existing sequential extraction procedure for inorganic beryllium species in the particulate matter of emissions and in working areas is described. The speciation protocol was adapted to carry out beryllium extraction in closed-face cassette sampler to take wall deposits into account. This four-step sequential extraction procedure aims to separate beryllium salts, metal, and oxides from airborne particles for individual quantification. Characterization of the beryllium species according to their solubility in air samples may provide information relative to toxicity, which is potentially related to the different beryllium chemical forms. Beryllium salts (BeF(2), BeSO(4)), metallic beryllium (Bemet), and beryllium oxide (BeO) were first individually tested, and then tested in mixtures. Cassettes were spiked with these species and recovery rates were calculated. Quantitative analyses with matched matrix were performed using inductively coupled plasma mass spectrometry (ICP-MS). Method Detection Limits (MDLs) were calculated for the four matrices used in the different extraction steps. In all cases, the MDL was below 4.2 ng/sample. This method is appropriate for assessing occupational exposure to beryllium as the lowest recommended threshold limit values are 0.01 µg.m(-3) in France([) (1) (]) and 0.05 µg.m(-3) in the USA.([ 2 ]) The protocol was then tested on samples from French factories where occupational beryllium exposure was suspected. Beryllium solubility was variable between factories and among the same workplace between different tasks.

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

    Science.gov (United States)

    Souza-Lima, Rita de Cássia de; Barbosa, Maria das Graças Vale; Coura, José Rodrigues; Arcanjo, Ana Ruth Lima; Nascimento, Adelaide da Silva; Ferreira, João Marcos Bemfica Barbosa; Magalhães, Laylah Kelre; Albuquerque, Bernardino Cláudio de; Araújo, Guilherme Alfredo Novelino; Guerra, Jorge Augusto de Oliveira

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    K. Sakamoto

    2009-06-01

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

  14. Quantifying design trade-offs of beryllium targets on NIF

    Science.gov (United States)

    Yi, S. A.; Zylstra, A. B.; Kline, J. L.; Loomis, E. N.; Kyrala, G. A.; Shah, R. C.; Perry, T. S.; Kanzleiter, R. J.; Batha, S. H.; MacLaren, S. A.; Ralph, J. E.; Masse, L. P.; Salmonson, J. D.; Tipton, R. E.; Callahan, D. A.; Hurricane, O. A.

    2017-10-01

    An important determinant of target performance is implosion kinetic energy, which scales with the capsule size. The maximum achievable performance for a given laser is thus related to the largest capsule that can be imploded symmetrically, constrained by drive uniformity. A limiting factor for symmetric radiation drive is the ratio of hohlraum to capsule radii, or case-to-capsule ratio (CCR). For a fixed laser energy, a larger hohlraum allows for driving bigger capsules symmetrically at the cost of reduced peak radiation temperature (Tr). Beryllium ablators may thus allow for unique target design trade-offs due to their higher ablation efficiency at lower Tr. By utilizing larger hohlraum sizes than most modern NIF designs, beryllium capsules thus have the potential to operate in unique regions of the target design parameter space. We present design simulations of beryllium targets with a large CCR = 4.3 3.7 . These are scaled surrogates of large hohlraum low Tr beryllium targets, with the goal of quantifying symmetry tunability as a function of CCR. This work performed under the auspices of the U.S. DOE by LANL under contract DE-AC52- 06NA25396, and by LLNL under Contract DE-AC52-07NA27344.

  15. Thermal cycling tests of actively cooled beryllium copper joints

    Energy Technology Data Exchange (ETDEWEB)

    Roedig, M.; Duwe, R.; Linke, J.; Schuster, A.; Wiechers, B. [Forschungszentrum Juelich GmbH (Germany)

    1998-01-01

    Screening tests (steady state heating) and thermal fatigue tests with several kinds of beryllium-copper joints have been performed in an electron beam facility. Joining techniques under investigation were brazing with silver containing and silver-free braze materials, hot isostatic pressing (HIP) and diffusion bonding (hot pressing). Best thermal fatigue performance was found for the brazed samples. (author)

  16. Codeposition of deuterium ions with beryllium oxide at elevated temperatures

    CERN Document Server

    Markin, A V; Gorodetsky, A E; Negodaev, M A; Rozhanskii, N V; Scaffidi-Argentina, F; Werle, H; Wu, C H; Zalavutdinov, R K; Zakharov, A P

    2000-01-01

    Deuterium-loaded BeO films were produced by sputtering the beryllium target with 10 keV Ne ions in D sub 2 gas at a pressure of approximately 1 Pa. The sputtered beryllium reacts - on the substrate surface - with the residual oxygen, thus forming a beryllium oxide layer. Biasing the substrate negatively with respect to the target provides the simultaneous bombardment of the growing film surface with D ions formed by Ne-D sub 2 collisions. Substrate potential governs the maximum energy of ions striking the growing film surface while its size governs the flux density. According to X-ray photoelectron spectroscopy (XPS), electron probe microanalysis (EPMA) and reflection high energy electron diffraction (RHEED) data, the beryllium is deposited in the form of polycrystalline hcp-BeO layers with negligible (about 1 at.%) carbon and neon retention. Thermal desorption spectroscopy (TDS) data shows a strong deuterium bonding, with a desorption peak at 950 K, in the films deposited at -50 and -400 V substrate potentia...

  17. On-line separation of short-lived beryllium isotopes

    CERN Document Server

    Köster, U; Catherall, R; Fedosseev, V; Georg, U; Huber, G; Jading, Y; Jonsson, O; Koizumi, M; Kratz, K L; Kugler, E; Lettry, Jacques; Mishin, V I; Ravn, H L; Sebastian, V; Tamburella, C; Wöhr, A

    1998-01-01

    With the development of a new laser ionization scheme, it became possible to ionize beryllium efficiently in the hot cavity of the ISOLDE laser ion source. The high target and ion source temperatures enable the release of short-lived beryllium isotopes. Thus all particle-stable beryllium isotopes could be extracted from a standard uranium carbide/graphite target. For the first time the short-lived isotopes /sup 12/Be and /sup 14/Be could be identified at an ISOL facility, /sup 14/Be being among the most short-lived isotopes separated so far at ISOLDE. The release time from the UC/graphite target was studied with several beryllium isotopes. Profiting from the element selectivity of laser ionization, the strong and isotopically pure beam of /sup 12/Be allowed to determine the half- life to T/sub 1/2 /=21.34(23) ms and the probability of beta-delayed neutron emission to P/sub n/=0.48/sub -0.10//sup +0.12/(23 refs).

  18. The uses and adverse effects of beryllium on health

    DEFF Research Database (Denmark)

    Cooper, Ross G.; Harrison, Adrian Paul

    2009-01-01

    published in sources unobtainable through requests at the British Library, and some had no impact factor and were excluded. Conclusion: Beryllium has some useful but undoubtedly harmful effects on health and well-being. Measures needed to be taken to prevent hazardous exposure to this element, making its...

  19. Rapid communication: Production from beryllium target using 120 ...

    Indian Academy of Sciences (India)

    A Singh

    2017-11-30

    Nov 30, 2017 ... Rapid communication: K. 0. S. Production from beryllium target using 120 GeV/c protons beam interactions at the MIPP experiment. A SINGH1 ,∗. , A KUMAR1, R RAJA2, V BHATNAGAR1 and V SINGH3. 1Department of Physics, Panjab University, Chandigarh 160 014, India. 2Fermi National Accelerator ...

  20. Fluorometric determination of beryllium with 2-(o-hydroxylphenyl)benzoxazole

    Energy Technology Data Exchange (ETDEWEB)

    Gladilovich, D.B.; Stolyarov, K.P.

    1985-09-01

    According to the authors, of great interest for the fluorometric determination of small quantities of beryllium is 2-(o-hydroxyphenyl)benzthiazole (HPBT). In this work, 2-(o-hydroxyphenyl)benzoaxzole (HPBO), which is an analog of HPBT and differs from it in that the sulfur atom in the heterocyclic portion of the molecule is replaced by an oxygen atom, is proposed as a reagent for the fluorometric determination of beryllium. The fluorescent reaction of HPBO with beryllium is studied in this paper, in addition to the selection of the optimum conditions for the determination and the development of a procedure for the analysis of complex objects on this basis. The reaction proceeds in aqueous ethanol medium at pH 7.2-7.5. The limit of detection is 0.6 ng/ml. Methods have been developed for the determination of 10/sup -2/% beryllium in alloys based on copper and 10/sup -3/-10/sup -4/% in standard samples of silicate rocks.

  1. TEM study of impurity segregations in beryllium pebbles

    Energy Technology Data Exchange (ETDEWEB)

    Klimenkov, M., E-mail: michael.klimenkov@kit.edu [Institute for Applied Materials – Applied Materials Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany); Chakin, V.; Moeslang, A. [Institute for Applied Materials – Applied Materials Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany); Rolli, R. [Institute for Applied Materials – Materials and Biomechanics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany)

    2014-12-15

    Beryllium is planned to be used as a neutron multiplier in the Helium-cooled Pebble Bed European concept of a breeding blanket of demonstration power reactor DEMO. In order to evaluate the irradiation performance, individual pebbles and constrained pebble beds were neutron-irradiated at temperatures typical of fusion blankets. Beryllium pebbles 1 mm in diameter produced by the rotating electrode method were subjected to a TEM study before and after irradiation at High Flux Reactor, Petten, Netherlands at 861 K. The grain size varied in a wide range from sub-micron size up to several tens of micrometers, which indicated formation bimodal grain size distribution. Based on the application of combined electron energy loss spectroscopy and energy dispersive X-ray spectroscopy methods, we suggest that impurity precipitates play an important role in controlling the mechanical properties of beryllium. The impurity elements were present in beryllium at a sub-percent concentration form beryllide particles of a complex (Fe/Al/Mn/Cr)B composition. These particles are often ordered along dislocations lines, forming several micron-long chains. It can be suggested that fracture surfaces often extended along these chains in irradiated material.

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

    Directory of Open Access Journals (Sweden)

    Galea J

    2013-08-01

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

  3. Outcome of Patients with Interstitial Lung Disease Treated with Extracorporeal Membrane Oxygenation for Acute Respiratory Failure.

    Science.gov (United States)

    Trudzinski, Franziska C; Kaestner, Franziska; Schäfers, Hans-Joachim; Fähndrich, Sebastian; Seiler, Frederik; Böhmer, Philip; Linn, Oliver; Kaiser, Ralf; Haake, Hendrik; Langer, Frank; Bals, Robert; Wilkens, Heinrike; Lepper, Philipp M

    2016-03-01

    Patients with interstitial lung disease and acute respiratory failure have a poor prognosis especially if mechanical ventilation is required. To investigate the outcome of patients with acute respiratory failure in interstitial lung disease undergoing extracorporeal membrane oxygenation (ECMO) as a bridge to recovery or transplantation. This was a retrospective analysis of all patients with interstitial lung disease and acute respiratory failure treated with or without ECMO from March 2012 to August 2015. Forty patients with interstitial lung disease referred to our intensive care unit for acute respiratory failure were included in the analysis. Twenty-one were treated with ECMO. Eight patients were transferred by air from other hospitals within a range of 320 km (linear distance) for extended intensive care including the option of lung transplant. In total, 13 patients were evaluated, and eight were finally found to be suitable for lung transplantation from an ECMO bridge. Four patients from external hospitals were de novo listed during acute respiratory failure. Six patients underwent lung transplant, and two died on the waiting list after 9 and 63 days on ECMO, respectively. A total of 14 of 15 patients who did not undergo lung transplantation (93.3%) died after 40.3 ± 27.8 days on ECMO. Five out of six patients (83.3%) receiving a lung transplant could be discharged from hospital. ECMO is a lifesaving option for patients with interstitial lung disease and acute respiratory failure provided they are candidates for lung transplantation. ECMO is not able to reverse the poor prognosis in patients that do not qualify for lung transplantation.

  4. Dynamic Measurement of Disease Activity in Acute Pancreatitis: The Pancreatitis Activity Scoring System.

    Science.gov (United States)

    Wu, Bechien U; Batech, Michael; Quezada, Michael; Lew, Daniel; Fujikawa, Kelly; Kung, Jonathan; Jamil, Laith H; Chen, Wansu; Afghani, Elham; Reicher, Sonya; Buxbaum, James; Pandol, Stephen J

    2017-07-01

    Acute pancreatitis has a highly variable course. Currently there is no widely accepted method to measure disease activity in patients hospitalized for acute pancreatitis. We aimed to develop a clinical activity index that incorporates routine clinical parameters to assist in the measurement, study, and management of acute pancreatitis. We used the UCLA/RAND appropriateness method to identify items for inclusion in the disease activity instrument. We conducted a systematic literature review followed by two sets of iterative modified Delphi meetings including a panel of international experts between November 2014 and November 2015. The final instrument was then applied to patient data obtained from five separate study cohorts across Southern California to assess profiles of disease activity. From a list of 35 items comprising 6 domains, we identified 5 parameters for inclusion in the final weighted clinical activity scoring system: organ failure, systemic inflammatory response syndrome, abdominal pain, requirement for opiates and ability to tolerate oral intake. We applied the weighted scoring system across the 5 study cohorts comprising 3,123 patients. We identified several distinct patterns of disease activity: (i) overall there was an elevated score at baseline relative to discharge across all study cohorts, (ii) there were distinct patterns of disease activity related to duration of illness as well as (iii) early and persistent elevation of disease activity among patients with severe acute pancreatitis defined as persistent organ failure. We present the development and initial validation of a clinical activity score for real-time assessment of disease activity in patients with acute pancreatitis.

  5. The Role of Echocardiography in Coronary Artery Disease and Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Maryam Esmaeilzadeh

    2015-10-01

    Full Text Available Echocardiography is a non-invasive diagnostic technique which provides information regarding cardiac function and hemodynamics. It is the most frequently used cardiovascular diagnostic test after electrocardiography and chest X-ray. However, in a patient with acute chest pain, Transthoracic Echocardiography is essential both for diagnosing acute coronary syndrome, zeroing on the evaluation of ventricular function and the presence of regional wall motion abnormalities, and for ruling out other etiologies of acute chest pain or dyspnea, including aortic dissection and pericardial effusion.Echocardiography is a versatile imaging modality for the management of patients with chest pain and assessment of left ventricular systolic function, diastolic function, and even myocardial and coronary perfusion and is, therefore, useful in the diagnosis and triage of patients with acute chest pain or dyspnea.This review has focused on the current applications of echocardiography in patients with coronary artery disease and myocardial infarction

  6. A challenging diagnosis for potential fatal diseases: recommendations for diagnosing acute porphyrias.

    Science.gov (United States)

    Ventura, Paolo; Cappellini, Maria Domenica; Biolcati, Gianfranco; Guida, Claudio Carmine; Rocchi, Emilio

    2014-07-01

    Acute porphyrias are a heterogeneous group of metabolic disorders resulting from a variable catalytic defect of four enzymes out of the eight involved in the haem biosynthesis pathway; they are rare and mostly inherited diseases, but in some circumstances, the metabolic disturbance may be acquired. Many different environmental factors or pathological conditions (such as drugs, calorie restriction, hormones, infections, or alcohol abuse) often play a key role in triggering the clinical exacerbation (acute porphyric attack) of these diseases that may often mimic many other more common acute medical and neuropsychiatric conditions and whose delayed diagnosis and treatment may be fatal. In order to obtain an accurate diagnosis of acute porphyria, the knowledge and the use of appropriate diagnostic tools are mandatory, even in order to provide as soon as possible the more effective treatment and to prevent the use of potentially unsafe drugs, which can severely precipitate these diseases, especially in the presence of life-threatening symptoms. In this paper, we provide some recommendations for the diagnostic steps of acute porphyrias by reviewing literature and referring to clinical experience of the board members of the Gruppo Italiano Porfiria (GrIP). Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  7. Acute Exacerbations and Lung Function Loss in Smokers with and without Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Dransfield, Mark T; Kunisaki, Ken M; Strand, Matthew J; Anzueto, Antonio; Bhatt, Surya P; Bowler, Russell P; Criner, Gerard J; Curtis, Jeffrey L; Hanania, Nicola A; Nath, Hrudaya; Putcha, Nirupama; Roark, Sarah E; Wan, Emily S; Washko, George R; Wells, J Michael; Wendt, Christine H; Make, Barry J

    2017-02-01

    Acute exacerbations of chronic obstructive pulmonary disease (COPD) increase the risk of death and drive healthcare costs, but whether they accelerate loss of lung function remains controversial. Whether exacerbations in subjects with mild COPD or similar acute respiratory events in smokers without airflow obstruction affect lung function decline is unknown. To determine the association between acute exacerbations of COPD (and acute respiratory events in smokers without COPD) and the change in lung function over 5 years of follow-up. We examined data on the first 2,000 subjects who returned for a second COPDGene visit 5 years after enrollment. Baseline data included demographics, smoking history, and computed tomography emphysema. We defined exacerbations (and acute respiratory events in those without established COPD) as acute respiratory symptoms requiring either antibiotics or systemic steroids, and severe events by the need for hospitalization. Throughout the 5-year follow-up period, we collected self-reported acute respiratory event data at 6-month intervals. We used linear mixed models to fit FEV 1 decline based on reported exacerbations or acute respiratory events. In subjects with COPD, exacerbations were associated with excess FEV 1 decline, with the greatest effect in Global Initiative for Chronic Obstructive Lung Disease stage 1, where each exacerbation was associated with an additional 23 ml/yr decline (95% confidence interval, 2-44; P = 0.03), and each severe exacerbation with an additional 87 ml/yr decline (95% confidence interval, 23-151; P = 0.008); statistically significant but smaller effects were observed in Global Initiative for Chronic Obstructive Lung Disease stage 2 and 3 subjects. In subjects without airflow obstruction, acute respiratory events were not associated with additional FEV 1 decline. Exacerbations are associated with accelerated lung function loss in subjects with established COPD, particularly those with mild disease

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  9. Characterization of defects in deuterium-implanted beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Anderl, R.A.; Denison, A.B. [EG and G Idaho, Inc., Idaho Falls, ID (United States); Szpala, S.; Asoka-Kumar, P.; Lynn, K.G.; Nielsen, B. [Brookhaven National Lab., Upton, NY (United States)

    1994-12-31

    This work investigated surface material modifications in high-purity beryllium foils resulting from 1-keV deuterium ion implantation into specimens for which the anneal temperatures and implantation temperatures were varied. Defects in unimplanted and in deuterium-implanted beryllium were characterized principally by positron-beam depth-profile analyses. Depth-profiles of the defect distributions in the specimens were made by stepping the energy of the positron beam from 0.055 keV to 40 keV, accompanied by measurements of the Doppler-broadened annihilation radiation line shape at each positron energy. These analyses identified a varying defect structure in beryllium, dependent on the previous anneal history of the material and on the temperature of the material during implantation with energetic deuterium ions. For specimens implanted at room temperature with 1-keV/D ions, the beam-induced defect structure had a profile that was peaked near the mean. range of the implanting deuterium and that extended beyond the implantation zone. Isochronal step-thermal anneal experiments revealed that deuterium was released from these defects at a temperature of about 400K, indicative of shallow traps, and that the defect structure annealed at temperatures above 623K. The beam-induced vacancy-defect complexes were estimated to be 1-nm voids for 1-keV/D implantation into Be at room temperature. For beryllium implanted at temperatures of 723K with 1-keV/D ions, these measurements revealed that the beam-induced defect structure was much broader and extended far beyond the implantation zone. Isochronal stepthermal anneal experiments for these specimens revealed a more stable defect structure, with the onset of defect annealing at 775K. There was no evidence of deuterium release at lower temperatures, indicating that for beryllium implanted at elevated temperatures, deuterium is retained in deep traps.

  10. Disease spectrum and management of children admitted with acute respiratory infection in Viet Nam.

    Science.gov (United States)

    Nguyen, T K P; Nguyen, D V; Truong, T N H; Tran, M D; Graham, S M; Marais, B J

    2017-06-01

    To assess the acute respiratory infection (ARI) disease spectrum, duration of hospitalisation and outcome in children hospitalised with an ARI in Viet Nam. We conducted a retrospective descriptive study of ARI admissions to primary (Hoa Vang District Hospital), secondary (Da Nang Hospital for Women and Children) and tertiary (National Hospital of Paediatrics in Ha Noi) level hospitals in Viet Nam over 12 months (01/09/2015 to 31/08/2016). Acute respiratory infections accounted for 27.9% (37 436/134 061) of all paediatric admissions; nearly half (47.6%) of all children admitted to Hoa Vang District Hospital. Most (64.6%) of children hospitalised with an ARI were Acute respiratory infection is a major cause of paediatric hospitalisation in Viet Nam, characterised by prolonged hospitalisation for relatively mild disease. There is huge potential to reduce unnecessary hospital admission and cost. © 2017 John Wiley & Sons Ltd.

  11. Behçet's disease diagnosed after acute HIV infection: viral replication activating underlying autoimmunity?

    Science.gov (United States)

    Roscoe, Clay; Kinney, Rebecca; Gilles, Ryan; Blue, Sky

    2015-05-01

    Behçet's disease is an autoimmune systemic vasculitis that can occur after exposure to infectious agents. Behçet's disease also has been associated with HIV infection, including de novo development of this condition during chronic HIV infection and resolution of Behçet's disease symptoms following initiation of antiretroviral therapy. We describe a patient who presented with systemic vasculitis with skin and mucous membrane ulcerations in the setting of acute HIV infection, who was eventually diagnosed with Behçet's disease, demonstrating a possible link between acute HIV infection, immune activation and development of autoimmunity. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  12. Managing the acute painful episode in sickle cell disease

    Directory of Open Access Journals (Sweden)

    B. Kaya

    2011-12-01

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

  13. Acute disseminated encephalomyelitis in Hansen′s disease

    Directory of Open Access Journals (Sweden)

    Jacob J

    2006-01-01

    Full Text Available The authors report a 24-year-old man with Hansen′s disease in Type 1 reaction, developing a demyelinating disorder affecting the central and peripheral nervous system. He responded well to plasma exchange and intravenous methyl prednisolone. The neural damage could have been due to cross-reacting epitopes causing molecular mimicry and resultant demyelinating disorder.

  14. [Prognostication of malignization and acute complications of gastric ulcer disease, using multiparametric neuronet clasterization].

    Science.gov (United States)

    Dzyubanovskiy, I Ya; Selskiy, P R; Viytovych, L E

    2015-03-01

    Results of examination of 20 gastric ulcer disease patients were analyzed for delineation of a high risk group for an acute complications occurrence, and in whom the conduction of organ preserving preventive operative interventions is expedient. For prognostication such following indices were applied: quantity of cells-producents of various immunoglobulins, mitotic and apoptotic indices, relative volume of damaged epitheliocytes, the patients' age.

  15. Prehospital prognosis is difficult in patients with acute exacerbation of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Lindvig, Katrine P; Brøchner, Anne C; Lassen, Annmarie T; Mikkelsen, Søren

    2017-11-02

    Patients with acute exacerbation of chronic obstructive pulmonary disease often require prehospital emergency treatment. This enables patients who are less ill to be treated on-site and to avoid hospital admission, while severely ill patients can receive immediate ventilatory support in the form of intubation. The emergency physician faces difficult treatment decisions, however, and prognostic tools that could assist in determining which patients would benefit from intubation and ventilator support would be helpful. The aim of the current study was to identify prehospital clinical variables associated with mortality from acute exacerbation of chronic obstructive pulmonary disease. As part of the study, we estimated the 30-day mortality for patients with this prehospital diagnosis. A retrospective study was performed using data collected by the mobile emergency care unit in Odense, Denmark, combined with data from the patients' medical records. Patients with the tentative diagnosis of acute exacerbation of chronic obstructive pulmonary disease between 1st July 2011 and 31st December 2013 were included in the study. Based on data from 530 patients, we found no statistically significant associations between prehospital clinical variables and mortality, apart from a minor association between older age and higher mortality. The overall 30-day mortality was 10%, while that for patients admitted to the intensive care unit was 30%. No specific prehospital prognostic factors for mortality were identified. Prognostic assessment and the decision to withhold treatment for acute exacerbation of chronic obstructive pulmonary disease seem inadvisable in the prehospital setting.

  16. Acute chest syndrome in sickle cell disease – a review | Ocheni ...

    African Journals Online (AJOL)

    Early recognition, immediate administration of oxygen therapy, antibiotics, anticoagulation, intravenous fluids, adequate pain control and treatment of the underlying cause are required in ensuring that the patient responds well to therapy. Keywords: acute chest syndrome, sickle cell disease. Journal of College of Medicine ...

  17. Minimal residual disease diagnostics in acute lymphoblastic leukemia: Need for sensitive, fast, and standardized technologies

    NARCIS (Netherlands)

    J.J.M. van Dongen (Jacques); V.H.J. van der Velden (Vincent); M. Brüggemann (Monika); A. Orfao (Alberto)

    2015-01-01

    textabstractMonitoring of minimal residual disease (MRD) has become routine clinical practice in frontline treatment of virtually all childhood acute lymphoblastic leukemia (ALL) and in many adult ALL patients. MRD diagnostics has proven to be the strongest prognostic factor, allowing for risk group

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

    DEFF Research Database (Denmark)

    Larsen, Mette V; Janner, Julie H; Nielsen, Susanne D

    2009-01-01

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

  19. Pregnancy risks in women with pre-existing coronary artery disease, or following acute coronary syndrome

    NARCIS (Netherlands)

    Burchill, Luke J.; Lameijer, Heleen; Roos-Hesselink, Jolien W.; Grewal, Jasmine; Ruys, Titia P. E.; Kulikowski, Julia D.; Burchill, Laura A.; Oudijk, M. A.; Wald, Rachel M.; Colman, Jack M.; Siu, Samuel C.; Pieper, Petronella G.; Silversides, Candice K.

    2015-01-01

    Objective The objective of this study was to determine outcomes in pregnant women with pre-existing coronary artery disease (CAD) or following an acute coronary syndrome (ACS) including myocardial infarction (MI). Background The physiological changes of pregnancy can contribute to myocardial

  20. Acute and long-term cardiovascular effects of coffee: implications for coronary heart disease.

    NARCIS (Netherlands)

    Riksen, N.P.; Rongen, G.A.P.J.M.; Smits, P.

    2009-01-01

    Despite decades of research, the question as to whether coffee intake increases the risk of coronary heart disease (CHD) remains controversial. In the current paper, we discuss the acute and long-term cardiovascular effects of coffee, and its major constituents, which could underlie such an

  1. Hypercalcaemia and acute kidney injury following administration of vitamin D in granulomatous disease

    OpenAIRE

    Tollitt, James; Solomon, Laurie

    2014-01-01

    Vitamin D deficiency is common. It causes osteomalacia, may contribute to osteoporosis and is an independent risk factor for cancer, diabetes, multiple sclerosis, cardiovascular disease and all-cause mortality. We describe patients with a history of sarcoidosis who developed acute kidney injury due to hypercalcaemia following treatment with colecalciferol.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  3. Prevalence of Psychiatric Morbidities in Acute Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    Saeed Shoja shafti

    2014-01-01

    Full Text Available Introduction. Psychiatric problems and stresses may deteriorate the prognosis of patients with IHD. So evaluating their frequency possibly will promote our perspective regarding their vital importance in the field of consultation-liaison psychiatry. Method and Materials. One hundred and one (101 patients with IHD were interviewed in CCU of a general hospital by a psychiatrist to find whether there was any relationship between cardiac events and psychiatric problems or stresses. Results. Cardiac events were significantly more prevalent among patients with both psychiatric problems and biological risk factors (P<0.05. Also, the number of patients suffering from psychiatric problems was significantly more than cases without that (P<0.05. There was a significant difference between male and female patients regarding the type of stress (P<0.01. 79% of total stresses were experienced by patients who had as well psychiatric problems (P<0.0001. In addition, there was significantly more dysthymic disorder in the acute group of patients in comparison with major or minor depressive disorder in the chronic group (P<0.001. Conclusion. The high prevalence of psychiatric problems and psychosocial stresses among patients with IHD deserves sufficient attention by clinicians for detection, monitoring, and management of them.

  4. the prevalence of chronic kidney disease in patients with acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Radovan Hojs

    2007-03-01

    Full Text Available Background: Chronic kidney disease (CKD is a worldwide public health problem. Glomerular filtration rate (GFR is often estimated from serum creatinine. Recently several formulas for estimation of GFR have been developed. The most widely used are the Modification of Diet in Renal Disease (MDRD Study equation and Cockcroft-Gault equation (C & G. The prevalence of CKD is rising. The patients with CKD are at increased risk of cardiovascular disease.Patients and methods: In our study 449 patients (308 men and 141 women with acute coronary syndrome and percutaneous coronary intervention were included. The average age was 63 years (SD ± 11.9. We collected blood samples for measuring serum concentrations of creatinine. The GFR was estimated using the MDRD Study equation and C & G equation.Results In our study women were statistically significantly older than men. 369 patients (82 % had an acute myocardial infarction. The prevalence of CKD was 26.3 % when GFR was estimated by MDRD Study equation and 25.8 % when GFR was estimated by C & G equation. A greater prevalence of CKD was found in women and in patients older than 65 years old. Stages of CKD correlated with age and gender of the patients, with previously known ishemic heart disease and with diffuse coronary artery disease.Conclusions: In our study the prevalence of CKD in patients with acute coronary syndrome was high. CKD was an independent predictor for development of diffuse coronary artery disease.

  5. Significance of Cerebral Blood Flow Analysis in the Acute Stage after Revascularization Surgery for Moyamoya Disease

    Science.gov (United States)

    FUJIMURA, Miki; TOMINAGA, Teiji

    2015-01-01

    Moyamoya disease is a chronic, occlusive cerebrovascular disease with unknown etiology characterized by steno-occlusive changes at the terminal portion of the internal carotid artery, either bilaterally or unilaterally, and an abnormal vascular network at the base of the brain. Surgical revascularization such as extracranial-intracranial (EC-IC) bypass is the preferred procedure for moyamoya disease. Despite the favorable long-term outcome, cerebral infarction and hyperperfusion syndrome are potential complications of this procedure, which can lead to neurological deterioration in the acute stage. In light of the similar clinical presentations between perioperative ischemia and hyperperfusion, it is essential to attempt a prompt cerebral blood flow (CBF) measurement in the acute stage after EC-IC bypass for moyamoya disease to differentiate these distinct pathologies, because the management of cerebral ischemia and hyperperfusion is contradictory to each other. Routine CBF analysis by single-photon emission computed tomography and/or magnetic resonance imaging not only facilitated a safer perioperative management but also provided important information about dynamic pathology of the hemodynamic conversion in the acute stage after revascularization surgery for moyamoya disease. We represent the current status of CBF analysis during the perioperative period of revascularization surgery for moyamoya disease, and sought to discuss its significance and efficacy to avoid surgical complications. PMID:26369873

  6. Massachusetts Beryllium Screening Program for Former Workers of Wyman-Gordon, Norton Abrasives, and MIT/Nuclear Metals

    Energy Technology Data Exchange (ETDEWEB)

    Pepper, L. D.

    2008-05-21

    The overall objective of this project was to provide medical screening to former workers of Wyman-Gordon Company, Norton Abrasives, and MIT/Nuclear Metals (NMI) in order to prevent and minimize the health impact of diseases caused by site related workplace exposures to beryllium. The program was developed in response to a request by the U.S. Department of Energy (DOE) that had been authorized by Congress in Section 3162 of the 1993 Defense Authorization Act, urging the DOE to carry out a program for the identification and ongoing evaluation of current and former DOE employees who are subjected to significant health risks during such employment." This program, funded by the DOE, was an amendment to the medical surveillance program for former DOE workers at the Nevada Test Site (NTS). This program's scope included workers who had worked for organizations that provided beryllium products or materials to the DOE as part of their nuclear weapons program. These organizations have been identified as Beryllium Vendors.

  7. Investigations of the ternary system beryllium-carbon-tungsten and analyses of beryllium on carbon surfaces; Untersuchung des ternaeren Systems Beryllium-Kohlenstoff-Wolfram und Betrachtungen von Beryllium auf Kohlenstoffoberflaechen

    Energy Technology Data Exchange (ETDEWEB)

    Kost, Florian

    2009-05-25

    Beryllium, carbon and tungsten are planned to be used as first wall materials in the future fusion reactor ITER. The aim of this work is a characterization of mixed material formation induced by thermal load. To this end, model systems (layers) were prepared and investigated, which give insight into the basic physical and chemical concepts. Before investigating ternary systems, the first step was to analyze the binary systems Be/C and Be/W (bottom-up approach), where the differences between the substrates PG (pyrolytic graphite) and HOPG (highly oriented pyrolytic graphite) were of special interest. Particularly X-ray photoelectron spectroscopy (XPS), low energy ion scattering (ISS) and Rutherford backscattering spectroscopy (RBS) were used as analysis methods. Beryllium evaporated on carbon shows an island growth mode, whereas a closed layer can be assumed for layer thicknesses above 0.7 nm. Annealing of the Be/C system induces Be{sub 2}C island formation for T{>=}770 K. At high temperatures (T{>=}1170 K), beryllium carbide dissociates, resulting in (metallic) beryllium desorption. For HOPG, carbide formation starts at higher temperatures compared to PG. Activation energies for the diffusion processes were determined by analyzing the decreasing beryllium amount versus annealing time. Surface morphologies were characterized using angle-resolved XPS (ARXPS) and atomic force microscopy (AFM). Experiments were performed to study processes in the Be/W system in the temperature range from 570 to 1270 K. Be{sub 2}W formation starts at 670 K, a complete loss of Be{sub 2}W is observed at 1170 K due to dissociation (and subsequent beryllium desorption). Regarding ternary systems, particularly Be/C/W and C/Be/W were investigated, attaching importance to layer thickness (reservoir) variations. At room temperature, Be{sub 2}C, W{sub 2}C, WC and Be{sub 2}W formation at the respective interfaces was observed. Further Be{sub 2}C is forming with increasing annealing temperatures

  8. Splenectomy versus conservative management for acute sequestration crises in people with sickle cell disease.

    Science.gov (United States)

    Owusu-Ofori, Shirley; Remmington, Tracey

    2015-09-07

    Acute splenic sequestration crises are a complication of sickle cell disease, with high mortality rates and frequent recurrence in survivors of first attacks. Splenectomy and blood transfusion, with their consequences, are the mainstay of long-term management used in different parts of the world. This is a 2015 update of a Cochrane review first published in 2002, and previously updated in 2013. To assess whether splenectomy (total or partial), to prevent acute splenic sequestration crises in people with sickle cell disease, improved survival and decreased morbidity in people with sickle cell disease, as compared with regular blood transfusions. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register, which comprises of references identified from comprehensive electronic database searches and handsearching relevant journals and abstract books of conference proceedings.Additional trials were sought from the reference lists of the trials and reviews identified by the search strategy.Date of the most recent search: 10 June 2015. All randomized or quasi-randomized controlled trials comparing splenectomy (total or partial) to prevent recurrence of acute splenic sequestration crises with no treatment or blood transfusions in people with sickle cell disease. No trials of splenectomy for acute splenic sequestration were found. No trials of splenectomy for acute splenic sequestration were found. Splenectomy, if full, will prevent further sequestration and if partial, may reduce the recurrence of acute splenic sequestration crises. However, there is a lack of evidence from trials showing that splenectomy improves survival and decreases morbidity in people with sickle cell disease. There is a need for a well-designed, adequately-powered, randomized controlled trial to assess the benefits and risks of splenectomy compared to transfusion programmes, as a means of improving survival and decreasing mortality from acute splenic

  9. Splenectomy versus conservative management for acute sequestration crises in people with sickle cell disease.

    Science.gov (United States)

    Owusu-Ofori, Shirley; Remmington, Tracey

    2017-11-07

    Acute splenic sequestration crises are a complication of sickle cell disease, with high mortality rates and frequent recurrence in survivors of first attacks. Splenectomy and blood transfusion, with their consequences, are the mainstay of long-term management used in different parts of the world. This is a 2017 update of a Cochrane Review first published in 2002, and previously updated, most recently in 2015. To assess whether splenectomy (total or partial), to prevent acute splenic sequestration crises in people with sickle cell disease, improved survival and decreased morbidity in people with sickle cell disease, as compared with regular blood transfusions. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register, which comprises of references identified from comprehensive electronic database searches and handsearching relevant journals and abstract books of conference proceedings. We also searched clinical trial registries. Additional trials were sought from the reference lists of the trials and reviews identified by the search strategy.Date of the most recent search: 14 August 2017. All randomized or quasi-randomized controlled trials comparing splenectomy (total or partial) to prevent recurrence of acute splenic sequestration crises with no treatment or blood transfusions in people with sickle cell disease. No trials of splenectomy for acute splenic sequestration were found. No trials of splenectomy for acute splenic sequestration were found. Splenectomy, if full, will prevent further sequestration and if partial, may reduce the recurrence of acute splenic sequestration crises. However, there is a lack of evidence from trials showing that splenectomy improves survival and decreases morbidity in people with sickle cell disease. There is a need for a well-designed, adequately-powered, randomized controlled trial to assess the benefits and risks of splenectomy compared to transfusion programmes, as a means of

  10. Acute chondrolysis complicating Legg-Calve-Perthes disease

    Energy Technology Data Exchange (ETDEWEB)

    Dominguez, R.; Kook Sang Oh; Young, L.W.; Goodman, M.

    1987-07-01

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

  11. [Treatment of acute inner ear diseases (sudden deafness and vestibular disorder) with meclofenoxate and acetylsalicylic acid].

    Science.gov (United States)

    Weinaug, P

    1988-06-01

    Sixty patients suffering from an acute inner ear disease were treated by a combination of acetylsalicylic acid (Micristin), an inhibitor of platelet aggregation, and meclofenoxate (Cerutil), a nootropic drug. The success rate in 26 patients with acute isolated unilateral vestibular disorder was 73% (69% with complete recovery), and 83% (57% complete remission) in 34 patients with sudden deafness, with an average hearing improvement of 22.4 dB. The success rate of this therapy was similar to that achieved by the usual therapy or no treatment in subjects with sudden deafness and vestibular disorder which we reported in 1984.

  12. Uneventful benznidazole treatment of acute Chagas disease during pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Valeria Rita Corrêa

    2014-06-01

    Full Text Available This report describes the case of a patient with acute Chagas disease in Tocantins, Brazil, who was unaware of her pregnancy during benznidazole treatment. She presented with impaired cardiac function during the acute phase (pericarditis and incomplete right bundle-branch block that resolved favorably after benznidazole therapy. Serological results also became negative, as determined by hemagglutination assays, enzyme-linked immunosorbent assays, and immunofluorescence assays. The child was born without sequelae and showed no evidence of congenital Trypanosoma cruzi infection at birth or 24 days later.

  13. Outcomes of patients calling emergency medical services for suspected acute cardiovascular disease

    DEFF Research Database (Denmark)

    Schoos, Mikkel Malby; Sejersten, Maria Sejersten; Baber, Usman

    2015-01-01

    Adequate health care is increasingly dependent on prehospital systems and cardiovascular (CV) disease remains the most common cause for hospital admission. However the prevalence of CV dispatches of emergency medical services (EMS) is not well reported and survival data described in clinical trials.......4%, respectively. Stroke, acute heart failure, and ST-segment elevation myocardial infarction (STEMI) carried a 25- to 50-fold adjusted mortality hazard during the first 4 days. In patients with suspected STEMI, 90.5% had an acute angiography performed. Nontransferred, nonreperfused patients with STEMI (9...

  14. Tricuspid and mitral regurgitation detected by color flow Doppler in the acute phase of Kawasaki disease

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, A.; Kamiya, T.; Tsuchiya, K.; Sato, I.; Arakaki, Y.; Kohata, T.; Ono, Y.

    1988-02-01

    Valvular lesions in the acute phase of Kawasaki disease were studied in 19 children. The patients were intensively observed by color flow Doppler every day from the day of hospitalization up to 12 days after the onset of the disease and 2 or more times a week thereafter, for up to 28 days. Mitral regurgitation (MR) was found in 9 patients (47%) and tricuspid regurgitation (TR) in 10 (53%). MRs were of transient type and confirmed from 7.5 +/- 1.6 (mean +/- standard deviation) to 13.1 +/- 6.5 days after the onset of the disease. Both types of valvular regurgitation were mild. The direction of regurgitation was from the center of valvular coaptation toward the posterior wall of the atrium. Neither valvular prolapse nor valvular deformity was noted. In patients with MR, left ventricular ejection fraction on M-mode echocardiography was significantly lower in the acute phase than in the convalescent phase of the disease (p less than 0.05). Using gallium-67 scintigram, the positive uptake of the isotope was noted in 7 (88%) of 8 patients with MR, but not found at all in 8 patients free of MR. These results suggest that MR and TR are often transient in the acute phase of Kawasaki disease and could be attributed to myocarditis.

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

    DEFF Research Database (Denmark)

    Alexandersen, Søren; Larsen, S; Aasted, B

    1994-01-01

    The present study addressed the causal role of Aleutian mink disease parvovirus (ADV) in acute interstitial pneumonia in mink kits. All the examined isolates of ADV caused interstitial pneumonia in newborn kits, although the severity of disease and the mortality varied. These findings indicate...... that ADV is the direct causal agent of this disease in mink kits and that cofactors, which could have been present in the original ADV-K isolate, do not play a role. Acute interstitial pneumonia characterized by hypertrophy and hyperplasia of alveolar type II cells, intranuclear viral inclusions...... plasma cells in lung, liver, spleen, kidney, mesenteric lymph node, and intestine. Surviving kits also had hypertrophy of the bronchus-associated lymphoid tissue and focal subpleural, intraalveolar accumulations of large cells with foamy cytoplasm, so-called lipid pneumonia....

  16. Acute psychological stress as a precipitant of acute coronary syndromes in patients with undiagnosed ischemic heart disease: a case report and literature review.

    Science.gov (United States)

    Zupancic, Melanie L

    2009-01-01

    Acute psychological stress causes a number of physiologic responses that can trigger acute coronary syndromes in individuals with silent coronary artery disease. The mechanisms behind this phenomena have been the subject of much speculation. The following is a case report and brief review of the literature. A PubMed search was undertaken using the key words stress and myocardial infarction, stress and ischemia, mental stress and coronary artery disease, psychological stress and acute coronary syndrome, and mental stress and plaque destabilization. Articles were restricted to the English language and those dating through December 2007. Acute coronary syndrome is thought to be the end result of a complex mechanism involving platelet activation and endothelial dysfunction. Several studies have shown that acute mental stress leads to enhanced platelet activation and endothelial dysfunction. The mechanism behind this involves both the autonomic nervous system and the neuroendocrine response. Acute psychological stress may lead to acute coronary syndromes in patients with previously silent disease. Physicians should inquire about cardiac symptoms in patients with cardiac risk factors who are experiencing psychological distress. Further research will hopefully lead to an improved understanding of the mechanism behind this process to improve therapeutic interventions.

  17. What Can We Apply to Manage Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Acute Respiratory Failure?

    Science.gov (United States)

    Kim, Deog Kyeom; Lee, Jungsil; Park, Ju Hee; Yoo, Kwang Ha

    2018-01-24

    Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics. As a non-pharmacologic strategy to combat the effects of AECOPD, noninvasive ventilation (NIV) is recommended as the treatment of choice as this therapy is thought to be most effective in reducing intubation risk in patients diagnosed with AECOPD with acute respiratory failure. Recently, a few adjunctive modalities, including NIV with helmet and helium-oxygen mixture, have been tried in cases of AECOPD with respiratory failure. As yet, insufficient documentation exists to permit recommendation of this therapy without qualification. Although there are too few findings, as yet, to allow for regular andr routine application of those modalities in AECOPD, there is anecdotal evidence to indicate both mechanical and physiological benefits connected with this therapy. High-flow nasal cannula oxygen therapy is another supportive strategy which serves to improve the symptoms of hypoxic respiratory failure. The therapy also produced improvement in ventilatory variables, and it may be successfully applied in cases of hypercapnic respiratory failure. Extracorporeal carbon dioxide removal has been successfully attempted in cases of adult respiratory distress syndrome, with protective hypercapnic ventilatory strategy. Nowadays, it is

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

    Directory of Open Access Journals (Sweden)

    Aws Alherbish

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

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

    Directory of Open Access Journals (Sweden)

    Vijay C Kannan

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

  20. Campylobacter infection in 682 bulgarian patients with acute enterocolitis, inflammatory bowel disease, and other chronic intestinal diseases.

    Science.gov (United States)

    Boyanova, Lyudmila; Gergova, Galina; Spassova, Zoya; Koumanova, Radka; Yaneva, Penka; Mitov, Ivan; Derejian, Sirigan; Krastev, Zacharii

    2004-05-01

    The aim of the study was to assess Campylobacter infections in 309 patients with acute enterocolitis, 272 patients with relapses of chronic enterocolitis, 70 patients with inflammatory bowel disease (involving Crohn's disease and ulcerative colitis) and 31 patients with other chronic intestinal illnesses. Isolation and identification were performed conventionally. Limited agar dilution method was used for susceptibility testing of the strains. Campylobacter species were isolated in patients with acute enterocolitis (7.8%), chronic enterocolitis (6.2%), Crohn's disease (6.2%), ulcerative colitis (3.7%), and irritable bowel syndrome (8.3%). Hippurate-positive Campylobacter jejuni isolates accounted for 62.2% of Campylobacter strains. One tetracycline resistant Campylobacter upsaliensis isolate was detected from a girl with acute enterocolitis. Resistance rates to erythromycin (31.1%) and clarithromycin (22.2%) were high, whereas those to amoxicillin/clavulanate (4.4%), ampicillin/sulbactam (13.3%), tetracycline (24.4%) and ciprofloxacin (22.2%) were relatively low. Resistance to erythromycin and either tetracycline or ciprofloxacin was detected in 8.9% and 6.7%. The involvement of Campylobacter infection in relapses of chronic intestinal disorders and the susceptibility patterns of the strains strongly emphasize the role of Campylobacter as a cause of infection in this group of patients.

  1. The use of moxifloxacin for acute exacerbations of chronic obstructive pulmonary disease and chronic bronchitis.

    Science.gov (United States)

    Wilson, Robert; Macklin-Doherty, Aislinn

    2012-11-01

    Chronic obstructive pulmonary disease is a common condition which causes considerable morbidity and mortality. It is a heterogenous disorder in which the majority of patients have chronic bronchitis. Bacterial infections are a major cause of acute exacerbations of both conditions which have a major impact on healthcare resources, quality of life and disease progression. Antibiotics are used to treat exacerbations involving purulent sputum production, together with increased breathlessness and/or sputum volume. Moxifloxacin is a quinolone antibiotic and is one of the treatment options. This article discusses pathophysiology of these diseases, moxifloxacin clinical studies and appropriate use of moxifloxacin.

  2. [Legionnaires' disease complicated by rhabdomyolysis and acute renal failure: about a case].

    Science.gov (United States)

    Bac, Arnaud; Ramadan, Ahmed Sabry; Youatou, Pierre; Mols, Pierre; Cerf, Dominique; Ngatchou, William

    2016-01-01

    Legionnaires' disease is a bacterial disease of the respiratory system caused by a gram-negative germ whose clinical manifestation can be benign limiting to flu-like syndrome or can be more severe being characterized by pneumonia which may be complicated by multisystem disease that can lead to death. We report the case of a 48 year-old patient with rhabdomyolysis complicated by acute renal failure following Legionella pneumophila pneumonia. We here highlight the pathophysiological aspects and treatment of this rare complication during Legionella infection.

  3. Beryllium coating produced by evaporation-condensation method and some their properties

    Energy Technology Data Exchange (ETDEWEB)

    Pepekin, G.I.; Anisimov, A.B.; Chernikov, A.S.; Mozherinn, S.I.; Pirogov, A.A. [SRI SIA Lutch., Podolsk (Russian Federation)

    1998-01-01

    The method of vacuum evaporation-condensation for deposition of beryllium coatings on metal substrates, considered in the paper, side by side with a plasma-spray method is attractive fon ITER application. In particular this technique may be useful for repair the surface of eroded tiles which is operated in a strong magnetic field. The possibility of deposition of beryllium coatings with the rate of layer growth 0.1-0.2 mm/h is shown. The compatibility of beryllium coating with copper or stainless steel substrate is provided due to intermediate barrier. The results of examination of microstructure, microhardness, porosity, thermal and physical properties and stability under thermal cycling of beryllium materials are presented. The value of thermal expansion coefficient and thermal conductivity of condensed beryllium are approximately the same as for industrial grade material produced by powder mettalurgy technique. However, the condensed beryllium has higher purity (up to 99.9-99.99 % wt.). (author)

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

    Directory of Open Access Journals (Sweden)

    Florent Malard

    2014-01-01

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

  5. N-terminal pro B-type natriuretic peptide levels in infants and children with acute non-cardiac diseases.

    Science.gov (United States)

    Nevo, Inbar; Erlichman, Mati; Algur, Nurit; Nir, Amiram

    2011-07-01

    Cardiac patients express elevated levels of B-type natriuretic peptide and the amino terminal segment of its prohormone (NT-proBNP). However, there are non-cardiac causes of NT-proBNP level elevation. To determine the upper limit of NT-proBNP for pediatric patients with acute non-cardiac disease. We compared NT-proBNP concentrations in children with acute non-cardiac, mostly febrile disease with concentrations in children with acute cardiac disease and in healthy children. We used the Student t-test and Mann-Whitney test for group comparisons, and Pearson's and Spearman's correlation coefficients to test relationships between variables. In 138 patients with acute non-cardiac diseases (mean age 3.7 years, 53% male), median NT-proBNP concentration was 162 pg/ml, upper limit (95% percentile) 1049 pg/ml. The level did not vary significantly by disease category; was negatively correlated with weight, weight percentile, age and hemoglobin level; and positively correlated with creatinine level. Multivariant analysis showed weight to be the only factor influencing NT-proBNP level. Levels were higher in children with acute non-cardiac diseases versus healthy children (median 88 pg/ml, P < 0.001, n = 59), and lower than levels in patients with acute cardiac disease (median 29,986 pg/ml, P < 0.001, n=30). Receiver operating characteristic analysis showed good NT-proBNP performance for differentiation between children with acute cardiac versus non-cardiac disease (area under the curve 0.958), at a cutoff of 415 pg/ml. NT-proBNP levels are higher in children with acute non-cardiac diseases than in healthy children, but lower than in children with acute cardiac disease. NT-proBNP negatively correlated with weight and weight percentile.

  6. Multiscale modelling of hydrogen behaviour on beryllium (0001 surface

    Directory of Open Access Journals (Sweden)

    Ch. Stihl

    2016-12-01

    Full Text Available Beryllium is proposed to be a neutron multiplier and plasma facing material in future fusion devices. Therefore, it is crucial to acquire an understanding of the microscopic mechanisms of tritium accumulation and release as a result of transmutation processes that Be undergoes under neutron irradiation. A multiscale simulation of ad- and desorption of hydrogen isotopes on the beryllium (0001 surface is developed. It consists of ab initio calculations of certain H adsorption configurations, a suitable cluster expansion approximating the energies of arbitrary configurations, and a kinetic Monte Carlo method for dynamic simulations of adsorption and desorption. The processes implemented in the kinetic Monte Carlo simulation are deduced from further ab initio calculations comprising both, static relaxation as well as molecular dynamics runs. The simulation is used to reproduce experimental data and the results are compared and discussed. Based on the observed results, proposals for a refined model are made.

  7. Ultrasonic evaluation of beryllium-copper diffusion bonds

    Energy Technology Data Exchange (ETDEWEB)

    Jamieson, E.E.

    2000-06-08

    A study was performed to compare the effectiveness of several advanced ultrasonic techniques when used to determine the strength of diffusion bonded beryllium-copper, which heretofore have each been applied to only a few material systems. The use of integrated backscatter calculations, frequency domain reflection coefficients, and time-of-flight variance was compared in their ability to characterize the bond strength in a series of beryllium-copper diffusion bond samples having a wide variation in bond quality. Correlation of integrated backscatter calculations and time-of-flight variance with bond strength was good. Some correlation of the slope of the frequency based reflection coefficient was shown for medium and high strength bonds, while its Y-intercept showed moderate correlation for all bond strengths.

  8. Analysis of YKL-40 acute-phase protein and interleukin-6 levels in periodontal disease.

    Science.gov (United States)

    Keles, Zeynep Pinar; Keles, Gonca Cayir; Avci, Bahattin; Cetinkaya, Burcu Ozkan; Emingil, Gulnur

    2014-09-01

    YKL-40, a new acute-phase protein, is shown to be elevated in inflammatory diseases, such as rheumatoid arthritis, type 2 diabetes mellitus, and coronary artery diseases. However, there is no data indicating a relationship between YKL-40 and periodontal disease. Interleukin-6 (IL-6) is the major regulator of acute-phase protein synthesis and one of the most studied inflammatory markers in periodontal disease. The purpose of the present study is to evaluate YKL-40 and IL-6 levels in gingival crevicular fluid (GCF) and serum of patients with periodontal disease and healthy individuals. Periodontally healthy individuals (n = 15), patients with gingivitis (n = 15), and patients with severe chronic periodontitis (CP) (n = 15) without any systemic disease were included in the study. Clinical measurements were recorded; GCF and blood samples were obtained from each participant. GCF and serum YKL-40 and IL-6 levels were analyzed by enzyme-linked immunosorbent assay. Statistical analysis was performed by parametric and non-parametric tests. Total amounts of YKL-40 and IL-6 in GCF as well as serum YKL-40 and IL-6 levels were significantly higher in patients with gingivitis and CP compared with healthy controls (P gingivitis (P gingivitis to periodontitis. Within the limits of the present study, the YKL-40 molecule might be a potential novel inflammatory marker of periodontal disease.

  9. Spectrum of Retinal Vascular Diseases Associated With Paracentral Acute Middle Maculopathy.

    Science.gov (United States)

    Chen, Xuejing; Rahimy, Ehsan; Sergott, Robert C; Nunes, Renata P; Souza, Eduardo C; Choudhry, Netan; Cutler, Nathan E; Houston, Samuel K S; Munk, Marion R; Fawzi, Amani A; Mehta, Sonia; Hubschman, Jean-Pierre; Ho, Allen C; Sarraf, David

    2015-07-01

    To evaluate the spectrum of retinal diseases that can demonstrate paracentral acute middle maculopathy and isolated ischemia of the intermediate and deep capillary plexus. Retrospective, multicenter, observational case series. This is a retrospective case series review of 9 patients (10 eyes) from 5 centers with paracentral acute middle maculopathy lesions and previously unreported retinal vascular etiologies. Case presentations and multimodal imaging, including color photographs, near-infrared reflectance, fluorescein angiography, spectral-domain optical coherence tomography (SD OCT), and orbital color Doppler imaging, are described. Baseline and follow-up findings are correlated with clinical presentation, demographics, and systemic associations. Five men and 4 women, aged 27-66 years, were included. Isolated band-like hyperreflective lesions in the middle retinal layers, otherwise known as paracentral acute middle maculopathy, were observed in all patients at baseline presentation. Follow-up SD OCT analysis of these paracentral acute middle maculopathy lesions demonstrated subsequent thinning of the inner nuclear layer. Novel retinal vascular associations leading to retinal vasculopathy and paracentral acute middle maculopathy include eye compression injury causing global ocular ischemia, sickle cell crisis, Purtscher's retinopathy, inflammatory occlusive retinal vasculitis, post-H1N1 vaccine, hypertensive retinopathy, migraine disorder, and post-upper respiratory infection. Paracentral acute middle maculopathy lesions may develop in a wide spectrum of retinal vascular diseases. They are best identified with SD OCT analysis and may represent ischemia of the intermediate and deep capillary plexus. These lesions typically result in permanent thinning of the inner nuclear layer and are critical to identify in order to determine the cause of unexplained vision loss. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Kawasaki disease and acute haemolytic anaemia after two IVIG infusions

    Directory of Open Access Journals (Sweden)

    Albena Telcharova-Mihaylovska

    2016-05-01

    Full Text Available Kawasaki disease (KD is one of the most common vasculitis disorders of childhood, affecting predominantly medium-sized arteries, particularly the coronary arteries. For treatment, high-dose intravenous immunoglobulin (IVIG is indicated. IVIG infusions are usually safe and well tolerated even though serious complications can be observed. We present a brief overview of KD and report a two-year-old girl with KD and two IVIG infusions (Gammagard® because of persistent fever after the completion of the first IVIG. Haemolytic anaemia developed after IVIG retreatment. The direct antiglobulin test after haemolysis was positive. The etiology of the haemolysis was related to the presence of transient, passively acquired antibodies that cause a direct antibody-mediated attack. There are few reports of haemolytic anaemia after IVIG infusions. The haemolysis in KD is dose-dependent and occurs more frequently after the second IVIG dose. Non-0 blood group patients are at greater risk. Another factor increasing the risk of haemolysis is also the presence of anaemia due to inflammation in KD.

  11. Quality management of dispersion-strengthened beryllium-based composite alloy

    Directory of Open Access Journals (Sweden)

    Дмитро Миколайович Макаренко

    2016-05-01

    Full Text Available The article is devoted to investigation of the composition and properties of dispersion-strengthened beryllium-based composite alloy, used in various industries, including the aircraft manufacture aircraft. Analyzed the properties of these materials are analyzed to ensure their quality management. The mathematical relationship of dispersion strengthened beryllium-based composite alloy parameters from content of beryllium oxide and temperature are built

  12. Impact of HFIR LEU Conversion on Beryllium Reflector Degradation Factors

    Energy Technology Data Exchange (ETDEWEB)

    Ilas, Dan [ORNL

    2013-10-01

    An assessment of the impact of low enriched uranium (LEU) conversion on the factors that may cause the degradation of the beryllium reflector is performed for the High Flux Isotope Reactor (HFIR). The computational methods, models, and tools, comparisons with previous work, along with the results obtained are documented and discussed in this report. The report documents the results for the gas and neutronic poison production, and the heating in the beryllium reflector for both the highly enriched uranium (HEU) and LEU HFIR configurations, and discusses the impact that the conversion to LEU may have on these quantities. A time-averaging procedure was developed to calculate the isotopic (gas and poisons) production in reflector. The sensitivity of this approach to different approximations is gauged and documented. The results show that the gas is produced in the beryllium reflector at a total rate of 0.304 g/cycle for the HEU configuration; this rate increases by ~12% for the LEU case. The total tritium production rate in reflector is 0.098 g/cycle for the HEU core and approximately 11% higher for the LEU core. A significant increase (up to ~25%) in the neutronic poisons production in the reflector during the operation cycles is observed for the LEU core, compared to the HEU case, for regions close to the core s horizontal midplane. The poisoning level of the reflector may increase by more than two orders of magnitude during long periods of downtime. The heating rate in the reflector is estimated to be approximately 20% lower for the LEU core than for the HEU core. The decrease is due to a significantly lower contribution of the heating produced by the gamma radiation for the LEU core. Both the isotopic (gas and neutronic poisons) production and the heating rates are spatially non-uniform throughout the beryllium reflector volume. The maximum values typically occur in the removable reflector and close to the midplane.

  13. Creating σ-holes through the formation of beryllium bonds.

    Science.gov (United States)

    Brea, Oriana; Mó, Otilia; Yáñez, Manuel; Alkorta, Ibon; Elguero, José

    2015-09-01

    Through the use of ab initio theoretical models based on MP2/aug-cc-pVDZ-optimized geometries and CCSD(T)/aug-cc-pVTZ and CCSD(T)/aug-c-pVDZ total energies, it has been shown that the significant electron density rearrangements that follow the formation of a beryllium bond may lead to the appearance of a σ-hole in systems that previously do not exhibit this feature, such as CH3 OF, NO2 F, NO3 F, and other fluorine-containing systems. The creation of the σ-hole is another manifestation of the bond activation-reinforcement (BAR) rule. The appearance of a σ-hole on the F atoms of CH3 OF is due to the enhancement of the electronegativity of the O atom that participates in the beryllium bond. This atom recovers part of the charge transferred to Be by polarizing the valence density of the F into the bonding region. An analysis of the electron density shows that indeed this bond becomes reinforced, but the F atom becomes more electron deficient with the appearance of the σ-hole. Importantly, similar effects are also observed even when the atom participating in the beryllium bond is not directly attached to the F atom, as in NO2 F, NO3 F, or NCF. Hence, whereas the isolated CH3 OF, NO2 F, and NO3 F are unable to yield F⋅⋅⋅Base halogen bonds, their complexes with BeX2 derivatives are able to yield such bonds. Significant cooperative effects between the new halogen bond and the beryllium bond reinforce the strength of both noncovalent interactions. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Acute lung injury and persistent small airway disease in a rabbit model of chlorine inhalation.

    Science.gov (United States)

    Musah, Sadiatu; Schlueter, Connie F; Humphrey, David M; Powell, Karen S; Roberts, Andrew M; Hoyle, Gary W

    2017-01-15

    Chlorine is a pulmonary toxicant to which humans can be exposed through accidents or intentional releases. Acute effects of chlorine inhalation in humans and animal models have been well characterized, but less is known about persistent effects of acute, high-level chlorine exposures. In particular, animal models that reproduce the long-term effects suggested to occur in humans are lacking. Here, we report the development of a rabbit model in which both acute and persistent effects of chlorine inhalation can be assessed. Male New Zealand White rabbits were exposed to chlorine while the lungs were mechanically ventilated. After chlorine exposure, the rabbits were extubated and were allowed to survive for up to 24h after exposure to 800ppm chlorine for 4min to study acute effects or up to 7days after exposure to 400ppm for 8min to study longer term effects. Acute effects observed 6 or 24h after inhalation of 800ppm chlorine for 4min included hypoxemia, pulmonary edema, airway epithelial injury, inflammation, altered baseline lung mechanics, and airway hyperreactivity to inhaled methacholine. Seven days after recovery from inhalation of 400ppm chlorine for 8min, rabbits exhibited mild hypoxemia, increased area of pressure-volume loops, and airway hyperreactivity. Lung histology 7days after chlorine exposure revealed abnormalities in the small airways, including inflammation and sporadic bronchiolitis obliterans lesions. Immunostaining showed a paucity of club and ciliated cells in the epithelium at these sites. These results suggest that small airway disease may be an important component of persistent respiratory abnormalities that occur following acute chlorine exposure. This non-rodent chlorine exposure model should prove useful for studying persistent effects of acute chlorine exposure and for assessing efficacy of countermeasures for chlorine-induced lung injury. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Ultrasensitive detection of acute myeloid leukemia minimal residual disease using single molecule molecular inversion probes.

    Science.gov (United States)

    Waalkes, Adam; Penewit, Kelsi; Wood, Brent L; Wu, David; Salipante, Stephen J

    2017-09-01

    The identification of minimal residual disease is the primary diagnostic finding which predicts relapse in patients treated for acute myeloid leukemia. Ultrasensitive detection of minimal residual disease would enable better patient risk stratification and could open opportunities for early therapeutic intervention. Herein we apply single molecule molecular inversion probe capture, a technology combining multiplexed targeted sequencing with error correction schemes based on molecular barcoding, in order to detect mutations identifying minimal residual disease with ultrasensitive and quantitative precision. We designed a single molecule molecular inversion probe capture panel spanning >50 kb and targeting 32 factors relevant to acute myeloid leukemia pathogenesis. We demonstrate linearity and quantitative precision over 100-fold relative abundance of mutant cells (1 in 100 to 1 in 1,500), with estimated error rates approaching 1 in 1,200 base pairs sequenced and maximum theoretical limits of detection exceeding 1 in 60,000 mutant alleles. In 3 of 4 longitudinally collected specimens from patients with acute myeloid leukemia, we find that single molecule molecular inversion probe capture detects somatic mutations identifying minimal residual disease at substantially earlier time points and with greater sensitivity than clinical diagnostic approaches used as current standard of care (flow cytometry and conventional molecular diagnosis), and identifies persisting neoplastic cells during clinical remission. In 2 patients, single molecule molecular inversion probe capture detected heterogeneous, subclonal acute myeloid leukemia populations carrying distinct mutational signatures. Single molecule molecular inversion probe technology uniquely couples scalable target enrichment with sequence read error correction, providing an integrated, ultrasensitive approach for detecting minimal residual disease identifying mutations. Copyright© 2017 Ferrata Storti Foundation.

  16. The mathematical pathogenetic factors analysis of acute inflammatory diseases development of bronchopulmonary system among infants

    Directory of Open Access Journals (Sweden)

    G. O. Lezhenko

    2017-10-01

    Full Text Available The purpose. To study the factor structure and to establish the associative interaction of pathogenetic links of acute diseases development of the bronchopulmonary system in infants.Materials and methods. The examination group consisted of 59 infants (average age 13.8 ± 1.4 months sick with acute inflammatory bronchopulmonary diseases. Also we tested the level of 25-hydroxyvitamin D (25(ОНD, vitamin D-binding protein, hBPI, cathelicidin LL-37, ß1-defensins, lactoferrin in blood serum with the help of immunoenzymometric analysis. Selection of prognostically important pathogenetic factors of acute bronchopulmonary disease among infants was conducted using ROC-analysis. The procedure for classifying objects was carried out using Hierarchical Cluster Analysis by the method of Centroid-based clustering. Results. Based on the results of the ROC-analysis were selected 15 potential predictors of the development of acute inflammatory diseases of the bronchopulmonary system among infants. The factor analysis made it possible to determine the 6 main components . The biggest influence in the development of the disease was made by "the anemia factor", "the factor of inflammation", "the maternal factor", "the vitamin D supply factor", "the immune factor" and "the phosphorus-calcium exchange factor” with a factor load of more than 0.6. The performed procedure of hierarchical cluster analysis confirmed the initial role of immuno-inflammatory components. The conclusions. The highlighted factors allowed to define a group of parameters, that must be influenced to achieve a maximum effect in carrying out preventive and therapeutic measures. First of all, it is necessary to influence the "the anemia factor" and "the calcium exchange factor", as well as the "the vitamin D supply factor". In other words, to correct vitamin D deficiency and carry out measures aimed at preventing the development of anemia. The prevention and treatment of the pathological course of

  17. Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD)

    Science.gov (United States)

    McCurdy, BR

    2012-01-01

    Executive Summary In July 2010, the Medical Advisory Secretariat (MAS) began work on a Chronic Obstructive Pulmonary Disease (COPD) evidentiary framework, an evidence-based review of the literature surrounding treatment strategies for patients with COPD. This project emerged from a request by the Health System Strategy Division of the Ministry of Health and Long-Term Care that MAS provide them with an evidentiary platform on the effectiveness and cost-effectiveness of COPD interventions. After an initial review of health technology assessments and systematic reviews of COPD literature, and consultation with experts, MAS identified the following topics for analysis: vaccinations (influenza and pneumococcal), smoking cessation, multidisciplinary care, pulmonary rehabilitation, long-term oxygen therapy, noninvasive positive pressure ventilation for acute and chronic respiratory failure, hospital-at-home for acute exacerbations of COPD, and telehealth (including telemonitoring and telephone support). Evidence-based analyses were prepared for each of these topics. For each technology, an economic analysis was also completed where appropriate. In addition, a review of the qualitative literature on patient, caregiver, and provider perspectives on living and dying with COPD was conducted, as were reviews of the qualitative literature on each of the technologies included in these analyses. The Chronic Obstructive Pulmonary Disease Mega-Analysis series is made up of the following reports, which can be publicly accessed at the MAS website at: http://www.hqontario.ca/en/mas/mas_ohtas_mn.html. Chronic Obstructive Pulmonary Disease (COPD) Evidentiary Framework Influenza and Pneumococcal Vaccinations for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Smoking Cessation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Community-Based Multidisciplinary Care for Patients With Stable Chronic Obstructive

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

    Directory of Open Access Journals (Sweden)

    Jan S Suchodolski

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

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

    Science.gov (United States)

    Suchodolski, Jan S; Markel, Melissa E; Garcia-Mazcorro, Jose F; Unterer, Stefan; Heilmann, Romy M; Dowd, Scot E; Kachroo, Priyanka; Ivanov, Ivan; Minamoto, Yasushi; Dillman, Enricka M; Steiner, Jörg M; Cook, Audrey K; Toresson, Linda

    2012-01-01

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

  20. The Fecal Microbiome in Dogs with Acute Diarrhea and Idiopathic Inflammatory Bowel Disease

    Science.gov (United States)

    Suchodolski, Jan S.; Markel, Melissa E.; Garcia-Mazcorro, Jose F.; Unterer, Stefan; Heilmann, Romy M.; Dowd, Scot E.; Kachroo, Priyanka; Ivanov, Ivan; Minamoto, Yasushi; Dillman, Enricka M.; Steiner, Jörg M.; Cook, Audrey K.; Toresson, Linda

    2012-01-01

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

  1. Elastic, micro- and macroplastic properties of polycrystalline beryllium

    Science.gov (United States)

    Kardashev, B. K.; Kupriyanov, I. B.

    2011-12-01

    The Young's modulus and the internal friction of beryllium polycrystals (size grain from 6 to 60 μm) prepared by the powder metallurgy method have been studied as functions of the amplitude and temperature in the range from 100 to 873 K. The measurements have been performed using the composite piezoelectric vibrator method for longitudinal vibrations at frequencies about 100 kHz. Based on the acoustic measurements, the data have been obtained on the elastic and inelastic (microplastic) properties as functions of vibration stress amplitudes within the limits from 0.2 to 30-60 MPa. The microplastic deformation diagram is shown to become nonlinear at the amplitudes higher than 5 MPa. The beryllium mechanical characteristics (the yield strength σ 0.2, the ultimate strength σ u , and the conventional microscopic yield strength σ y ) obtained with various grain sizes are compared. At room temperature, all the parameters satisfactorily obey the Hall-Petch relationship, although there is no complete similarity. The temperature dependences are quite different, namely: σ 0.2( T) and σ u ( T) decrease monotonically during heating from room temperature to higher temperatures; however, σ y ( T) behaves unusually, and it has a minimum near 400 K. The different levels of stresses and the absence of similarity indicate that the scattering of the ultrasound energy and the formation of a level of the macroscopic flow stresses in beryllium occur on dislocation motion obstacles of different origins.

  2. Development of beryllium bonds for plasma-facing components

    Energy Technology Data Exchange (ETDEWEB)

    Franconi, E.; Ceccotti, G.C.; Magnoli, L.

    1991-10-01

    The use of graphite as a plasma facing surface is limited due to strong erosion produced by a combination of physical and chemical sputtering, self-sputtering and radiation enhanced sublimation. The most promising alternative material appears to be beryllium which offers a number of potential advantages over graphite: oxygen impurities abatement, reduced tritium retention and reduced sputtering erosion. The greatest advantage seems to be the rapid and economical repair of the surfaces by means of spray deposition. However, a number of questions remain to be answered concerning the use of beryllium in high power tokamaks. Foremost amongst these are melting of the facing during disruptions, controversial data on self-sputtering yields, neutron irradiation effects, high operational thermal stresses and potential safety problems. This paper focuses on the techniques used to bond beryllium to structural and heat sink materials, and the characterization of the bonding material obtained. In tests of Be bonding to stainless steel and copper by the use of brazing alloys, best results were obtained with a silver-copper eutectic alloy. It was noted that the high temperature capability of the materials prepared by this method is limited by the performance of the brazing alloys at the operating temperature. To avoid this problem, a joining process known as solid state reaction bonding is being developed.

  3. Acute Diverticulitis in the Young: The Same Disease in a Different Patient

    Directory of Open Access Journals (Sweden)

    Adolfo Pisanu

    2013-01-01

    Full Text Available Background. Natural history and risk factors for diverticulitis in young patients are still debatable. This study aimed to assess whether difference exists in patients aged 50 and younger when compared to older patients and to identify risk factors for acute diverticulitis in the young. Patients and Methods. From January 2006 to December 2011, 80 patients were admitted to our department for acute diverticulitis. We carried out a cross-sectional study in 23 patients (28.7% aged 50 and younger and 57 older patients (71.3%. Results. Acute diverticulitis in the young was not more aggressive than in the older patient. Diverticulitis at patient’s admission was similar with respect to Hinchey’s stage and prior history of diverticulitis. No significant difference was found for both medical and surgical treatment. The rate of recurrent diverticulitis in nonoperated patients was similar. Male gender, body mass index ≥25, and assumption of alcohol were independent risk factors for the occurrence of an acute diverticulitis in the young. Conclusions. The same disease seems to be affecting young patients such as overweight or obese male individual. Current policies to prevent diverticular disease and its related complications must include obesity control together with high-fiber diet and regular exercise.

  4. The beryllium quandary: will the lower exposure limits spur new developments in sampling and analysis?

    Energy Technology Data Exchange (ETDEWEB)

    Brisson, Michael

    2013-06-03

    At the time this article was written, new rulemakings were under consideration at OSHA and the U.S. Department of Energy (DOE) that would propose changes to occupational exposure limits for beryllium. Given these developments, it’s a good time to review the tools and methods available to IHs for assessing beryllium air and surface contamination in the workplace—what’s new and different, and what’s tried and true. The article discusses limit values and action levels for beryllium, problematic aspects of beryllium air sampling, sample preparation, sample analysis, and data evaluation.

  5. Beryllium Science: US-UK agreement on the use of Atomic Energy for mutual defense

    Energy Technology Data Exchange (ETDEWEB)

    Hanafee, J.E. (ed.)

    1988-02-19

    Twenty-seven papers are presented on beryllium supply, production, fabrication, safe handling, analysis, powder technology, and coatings. Separate abstracts have been prepared for the individual papers. (DLC)

  6. Beryllium in soils of the Nevada Test Site: A preliminary assessment

    Energy Technology Data Exchange (ETDEWEB)

    Patton, S.E.

    1992-07-01

    A preliminary assessment of the occurrence and distribution of beryllium in soils of the Nevada Test Site (NTS) was conducted by identifying sites on the NTS where beryllium might have been used in past operations and measuring current soil beryllium concentrations at those sites. Eighty-one soil samples were collected from six sites on the NTS. The six sites were chosen after interviews with persons who are or were involved with NTS operations and stated that beryllium might have been used in operations at those sites. The soil samples were prepared for analysis using EPA procedures and analyzed by flame-atomic-absorption spectrophometry. Beryllium concentrations in the soil samples ranged from the analytical detection limit of 0.46 parts-per-million (ppM) to 4.65 ppM. The beryllium concentrations in NTS soils may be higher than estimated local background soil beryllium concentrations, but in concentrations that fall within the range found in surface soils of the United States. Air beryllium concentrations were conservatively estimated to be considerably lower than regulatory exposure limits. Further work is recommended in assessing the spatial distribution of beryllium in soils around several of the sites, with a sampling design that incorporates statistical procedures to ensure statistically valid results.

  7. Early Upregulation of Acute Respiratory Distress Syndrome-Associated Cytokines Promotes Lethal Disease in an Aged-Mouse Model of Severe Acute Respiratory Syndrome Coronavirus Infection

    OpenAIRE

    Rockx, Barry; Baas, Tracey; Zornetzer, Gregory; Haagmans, Bart; Sheahan, Timothy; Frieman, Matthew; Dyer, Matthew; Teal, Thomas; Proll, Sean; Brand, Judith; Baric, Ralph; Katze, Michael

    2009-01-01

    textabstractSeveral respiratory viruses, including influenza virus and severe acute respiratory syndrome coronavirus (SARS-CoV), produce more severe disease in the elderly, yet the molecular mechanisms governing age-related susceptibility remain poorly studied. Advanced age was significantly associated with increased SARS-related deaths, primarily due to the onset of early- and late-stage acute respiratory distress syndrome (ARDS) and pulmonary fibrosis. Infection of aged, but not young, mice...

  8. Prognostic and diagnostic significance of copeptin in acute exacerbation of chronic obstructive pulmonary disease and acute heart failure: data from the ACE 2 study.

    Science.gov (United States)

    Winther, Jacob A; Brynildsen, Jon; Høiseth, Arne Didrik; Strand, Heidi; Følling, Ivar; Christensen, Geir; Nygård, Ståle; Røsjø, Helge; Omland, Torbjørn

    2017-11-03

    Copeptin is a novel biomarker that predicts mortality in lower respiratory tract infections and heart failure (HF), but the diagnostic value of copeptin in acute dyspnea and the prognostic significance of copeptin in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is not clear. We determined copeptin and NT-proBNP concentrations at hospital admission in 314 patients with acute dyspnea who were categorized by diagnosis. Survival was registered after a median follow-up of 816 days, and the prognostic and diagnostic properties of copeptin and NT-proBNP were analyzed in acute HF (n = 143) and AECOPD (n = 84) separately. The median concentration of copeptin at admission was lower in AECOPD compared to acute HF (8.8 [5.2-19.7] vs. 22.2 [10.2-47.9]) pmol/L, p copeptin (ROC-AUC 0.85 [0.81-0.89] vs. 0.71 [0.66-0.77], p copeptin concentrations predicted mortality in AECOPD (HR per log (ln) unit 1.72 [95% CI 1.21-2.45], p = 0.003) and acute HF (1.61 [1.25-2.09], p copeptin reclassified a significant proportion of patients into a more accurate risk strata in AECOPD (NRI 0.60 [0.19-1.02], p = 0.004) and acute HF (0.39 [0.06-0.71], p = 0.020). Copeptin is a strong prognostic marker in both AECOPD and acute HF, while NT-proBNP concentrations predict mortality only in patients with acute HF. NT-proBNP levels are superior to copeptin levels to diagnose acute HF in patients with acute dyspnea.

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

    Directory of Open Access Journals (Sweden)

    Rita de Cássia de Souza-Lima

    2013-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Rita de Cassia de Souza-Lima

    2013-07-01

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

  11. Undiagnosed chronic obstructive pulmonary diseases in patients admittet to an acute assessment unit

    DEFF Research Database (Denmark)

    Eikhof, Karin Dam; Olsen, Kristine R; Wrengler, NCH

    2017-01-01

    Introduction: Chronic obstructive pulmonary disease (COPD) is very prevalent worldwide, yet underdiagnosed. Aim: This study investigates feasibility of performing spirometry in patients in need of acute hospital admission as well as the prevalence of undiagnosed COPD in the same cohort. Methods......% were offered follow-up visit after 6 weeks. Results: Of the 1145 admitted patients, 46% were eligible: 28% of those had an abnormal spirometry. The offered follow-up visit was attended by 51% and in this group 17% were diagnosed with lung disease. COPD was the most prevalent diagnosis (73%), and 2....../3 was in GOLD group A. In total, 75% of the patients with airflow obstruction at the initial examination remained obstructive. Conclusion: Performing spirometry in patients in need of acute hospital admission is feasible, abnormal findings are common, and COPD is the most prevalent diagnosis....

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    gondii) and one viral (porcine respiratory and reproductive syndrome virus) infection and one aseptic inflammation. Immunochemical analyses of seven APPs, four positive (C-reactive protein (CRP), haptoglobin (Hp), pig major acute phase protein (pigMAP) and serum amyloid A (SAA)) and three negative......The acute phase protein (APP) response is an early systemic sign of disease, detected as substantial changes in APP serum concentrations and most disease states involving inflammatory reactions give rise to APP responses. To obtain a detailed picture of the general utility of porcine APPs to detect......, pigMAP, respectively. For the practical use of such combinations, methodology is described for establishing individual APP threshold values, above which, for any APP in the combination, ongoing infection/inflammation is indicated....

  13. p38 Mitogen-Activated Protein Kinase in beryllium-induced dendritic cell activation.

    Science.gov (United States)

    Li, L; Huang, Z; Gillespie, M; Mroz, P M; Maier, L A

    2014-12-01

    Dendritic cells (DC) play a role in the regulation of immune responses to haptens, which in turn impact DC maturation. Whether beryllium (Be) is able to induce DC maturation and if this occurs via the MAPK pathway is not known. Primary monocyte-derived DCs (moDCs) models were generated from Be non-exposed healthy volunteers as a non-sensitized cell model, while PBMCs from BeS (Be sensitized) and CBD (chronic beryllium disease) were used as disease models. The response of these cells to Be was evaluated. The expression of CD40 was increased significantly (pBeSO₄-stimulation. BeSO₄ induced p38MAPK phosphorylation, while IκB-α was degraded in Be-stimulated moDCs. The p38 MAPK inhibitor SB203580 blocked Be-induced NF-κB activation in moDCs, suggesting that p38MAPK and NF-κB are dependently activated by BeSO₄. Furthermore, in BeS and CBD subjects, SB203580 downregulated Be-stimulated proliferation in a dose-dependent manner, and decreased Be-stimulated TNF-α and IFNγ cytokine production. Taken together, this study suggests that Be-induces non-sensitized Glu69+ DCs maturation, and that p38MAPK signaling is important in the Be-stimulated DCs activation as well as subsequent T cell proliferation and cytokine production in BeS and CBD. In total, the MAPK pathway may serve as a potential therapeutic target for human granulomatous lung diseases. Copyright © 2014 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Bekke-Hansen, Sidsel; Weinman, John; Thastum, Mikael; Thygesen, Kristian; Zachariae, Robert

    2014-08-01

    Little is presently known about determinants of cardiac illness perceptions, especially regarding psycho-social factors. Questionnaire study among 97 consecutively recruited inpatients (72.2% male; mean age 60.6 years) with acute coronary syndrome. We examined the role of socio-demographic, illness-related and psycho-social factors (Multidimensional Scale of Perceived Social Support, General Self-Efficacy Scale and Life Orientation Test-Revised) for perceived consequences, controllability and causes (Revised Illness Perception Questionnaire) with standard multiple regression. In final models, dispositional pessimism was associated with perceptions of more severe consequences, less personal control and more attribution of illness to immune system factors. Dispositional optimism was associated with less severe perceived consequences. Higher general self-efficacy was associated with less attribution of illness to psychological factors, smoking and poor medical care. Greater perceived social support was associated with higher perceived treatment control and less attribution of illness to immune system factors, poor medical care, chance and accident. Also, gender, educational status, previous heart disease and family history of cardiovascular disease were significantly related to illness perceptions, whereas present disease severity (Global Registry of Acute Coronary Events) was not. Psycho-social resources and illness history were more important determinants of cardiac illness perceptions than present disease severity. This study was supported by unrestricted grants from The FOOD Study Group and The Danish Ministry of Food, Agriculture and Fisheries; The Beckett-Foundation; and The Augustinus Foundation. Not relevant.

  15. [Puncture scrotostomy--a treatment method in acute inflammatory diseases of the scrotal organs].

    Science.gov (United States)

    Shapoval, V I; Asimov, D A; Lesovoĭ, V N

    1989-01-01

    A method for the treatment of acute inflammatory diseases of the scrotal organs by means of puncture scrotostomy, which consists in passing the indwelling micro-irrigator into a cavity of the serous sheath of the testis and epididymis and administration via this route of antibacterial and resolving preparations for 4-5 days, is suggested. A method approved in treatment of 45 patients permits to avoid surgical intervention, and is highly effective.

  16. Impacts of hot and cold spells differ for acute and chronic ischaemic heart diseases.

    Science.gov (United States)

    Davídkovová, Hana; Plavcová, Eva; Kynčl, Jan; Kyselý, Jan

    2014-05-21

    Many studies have reported associations between temperature extremes and cardiovascular mortality but little has been understood about differences in the effects on acute and chronic diseases. The present study examines hot and cold spell effects on ischaemic heart disease (IHD) mortality in the Czech Republic during 1994-2009, with emphasis upon differences in the effects on acute myocardial infarction (AMI) and chronic IHD. We use analogous definitions for hot and cold spells based on quantiles of daily average temperature anomalies, thus allowing for comparison of results for summer hot spells and winter cold spells. Daily mortality data were standardised to account for the long-term trend and the seasonal and weekly cycles. Periods when the data were affected by epidemics of influenza and other acute respiratory infections were removed from the analysis. Both hot and cold spells were associated with excess IHD mortality. For hot spells, chronic IHD was responsible for most IHD excess deaths in both male and female populations, and the impacts were much more pronounced in the 65+ years age group. The excess mortality from AMI was much lower compared to chronic IHD mortality during hot spells. For cold spells, by contrast, the relative excess IHD mortality was most pronounced in the younger age group (0-64 years), and we found different pattern for chronic IHD and AMI, with larger effects on AMI. The findings show that while excess deaths due to IHD during hot spells are mainly of persons with chronic diseases whose health had already been compromised, cardiovascular changes induced by cold stress may result in deaths from acute coronary events rather than chronic IHD, and this effect is important also in the younger population. This suggests that the most vulnerable population groups as well as the most affected cardiovascular diseases differ between hot and cold spells, which needs to be taken into account when designing and implementing preventive actions.

  17. Haemodialysis is an effective treatment in acute metabolic decompensation of maple syrup urine disease

    Directory of Open Access Journals (Sweden)

    P.S. Atwal

    2015-09-01

    Full Text Available Acute metabolic decompensation in maple syrup urine disease can occur during intercurrent illness and is a medical emergency. A handful of reports in the medical literature describe the use of peritoneal dialysis and haemodialysis as therapeutic inventions. We report the only patient from our centre to have haemodialysis performed in this setting. Combined with dietary BCAA restriction and calorific support, haemodialysis allows rapid reduction in plasma leucine concentrations considerably faster than conservative methods.

  18. Consensus guidelines on pediatric acute rheumatic fever and rheumatic heart disease.

    Science.gov (United States)

    Saxena, Anita; Kumar, R Krishna; Gera, Rani Prem Kumar; Radhakrishnan, S; Mishra, Smita; Ahmed, Z

    2008-07-01

    Acute rheumatic fever and rheumatic chronic valvular heart disease is an important preventable cause of morbidity and mortality in suburban and rural India. Its diagnosis is based on clinical criteria. These criteria need verification and revision in the Indian context. Furthermore, there are glaring differences in management protocols available in literature. These facts prompted Indian Academy of Pediatrics to review the management of rheumatic fever. Management of Rheumatic fever was reviewed and recommendation was formulated at national consultative meeting on 20th May 2007 at New Delhi. To formulate uniform guidelines on management of acute rheumatic fever and rheumatic heart disease in the Indian context. Guidelines were formulated for the management of streptococcal pharyngitis, acute rheumatic fever and its cardiac complication as well as secondary prophylaxis for recurrent episodes. (1) Streptococcal eradication with appropriate antibiotics (Benzathine penicillin single dose or penicillin V oral or azithromycin). (2) Diagnosis of rheumatic fever based on Jones criteria. (3) Control inflammatory process with aspirin with or without steroids (total duration of treatment of 12 weeks). (4) Treatment of chorea according to severity (therapy to continue for 2-3 weeks after clinical improvement). (5) Protocol for managing cardiac complication like valvular heart disease, congestive heart failure and atrial fibrillation. (6) Secondary prophylaxis with benzathine penicillin and management of anaphylaxis.

  19. Etanercept on steroid-refractary acute graft-versus-host disease

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    Silvia González Munguía

    2015-02-01

    Full Text Available Objetive: To describe etanercept use and effectiveness on steroid- refractary acute graft-versus-host disease after hematopoietic cell transplantation. Method: Patients treated with etanercept as off label use for steroid-refractary acute graft-versus-host disease were selected and each patient’s medical history was reviewed to assess the clinical response. Results: The study included five patients: four presented with digestive manifestations and one presented pulmonary and liver manifestations. 80% of patients showed a clinical response: 60% a partial response and 20% a total response. In four cases etanercept 25mg was administered twice a week with variable duration of treatment, achieving no response in 1 case (3 weeks, partial response in two 2 cases (4 weeks and 8 weeks and a complete response in 1 case (8 week period. Only one case was treated with etanercept 50mg administered twice a week for 5 weeks with a partial treatment response. Conclusions: The clinical response rate is consistent with the previously published data. This updates the scarce bibliographic information about etanecept use in steroid-refractary acute graft-versus-host disease. Due to clinical design limitations and the small patient population, future clinical studies should be conducted to assess the efficacy and security of etanercept in these patients.

  20. Impact of graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantation for acute myeloid leukemia

    DEFF Research Database (Denmark)

    Baron, F; Labopin, M; Niederwieser, D

    2012-01-01

    This report investigated the impact of graft-versus-host disease (GVHD) on transplantation outcomes in 1859 acute myeloid leukemia patients given allogeneic peripheral blood stem cells after reduced-intensity conditioning (RIC allo-SCT). Grade I acute GVHD was associated with a lower risk...

  1. Percutaneous coronary intervention for acute myocardial infarction in a pediatric patient with coronary aneurysm and stenosis due to Kawasaki disease.

    Science.gov (United States)

    Drossner, David M; Chappell, Clay; Rab, Tanveer; Kim, Dennis

    2012-06-01

    We report the case of an acutely ill 3-year-old female, with a previous medical history of Kawasaki disease, who presented to care with an acute myocardial infarction. We describe the coordinated therapies employed by pediatric and adult cardiologists aimed to establish coronary revascularization.

  2. Screening for Wilson disease in acute liver failure: a comparison of currently available diagnostic tests

    DEFF Research Database (Denmark)

    Korman, J.D.; Volenberg, I.; Balko, J.

    2008-01-01

    Acute liver failure (ALF) due to Wilson disease (WD) is invariably fatal without emergency liver transplantation. Therefore, rapid diagnosis of WD should aid prompt transplant listing. To identify the best method for diagnosis of ALF due to WD (ALF-WD), data and serum were collected from 140 ALF...... patients (16 with WD), 29 with other chronic liver diseases and 17 with treated chronic WD. Ceruloplasmin (Cp) was measured by both oxidase activity and nephelometry and serum copper levels by atomic absorption spectroscopy. In patients with ALF, a serum Cp

  3. Replication Capacity of Viruses from Acute Infection Drives HIV-1 Disease Progression.

    Science.gov (United States)

    Selhorst, Philippe; Combrinck, Carina; Ndabambi, Nonkululeko; Ismail, Sherazaan D; Abrahams, Melissa-Rose; Lacerda, Miguel; Samsunder, Natasha; Garrett, Nigel; Abdool Karim, Quarraisha; Abdool Karim, Salim S; Williamson, Carolyn

    2017-04-15

    The viral genotype has been shown to play an important role in HIV pathogenesis following transmission. However, the viral phenotypic properties that contribute to disease progression remain unclear. Most studies have been limited to the evaluation of Gag function in the context of a recombinant virus backbone. Using this approach, important biological information may be lost, making the evaluation of viruses obtained during acute infection, representing the transmitted virus, a more biologically relevant model. Here, we evaluate the roles of viral infectivity and the replication capacity of viruses from acute infection in disease progression in women who seroconverted in the CAPRISA 004 tenofovir microbicide trial. We show that viral replication capacity, but not viral infectivity, correlates with the set point viral load (Spearman r = 0.346; P = 0.045) and that replication capacity (hazard ratio [HR] = 4.52; P = 0.01) can predict CD4 decline independently of the viral load (HR = 2.9; P = 0.004) or protective HLA alleles (HR = 0.61; P = 0.36). We further demonstrate that Gag-Pro is not the main driver of this association, suggesting that additional properties of the transmitted virus play a role in disease progression. Finally, we find that although viruses from the tenofovir arm were 2-fold less infectious, they replicated at rates similar to those of viruses from the placebo arm. This indicates that the use of tenofovir gel did not select for viral variants with higher replication capacity. Overall, this study supports a strong influence of the replication capacity in acute infection on disease progression, potentially driven by interaction of multiple genes rather than a dominant role of the major structural gene gagIMPORTANCE HIV disease progression is known to differ between individuals, and defining which fraction of this variation can be attributed to the virus is important both clinically and epidemiologically. In this study, we show that the replication

  4. Competitive PCR for quantification of minimal residual disease in acute lymphoblastic leukaemia

    DEFF Research Database (Denmark)

    Nyvold, C; Madsen, H O; Ryder, L P

    2000-01-01

    A very precise and reproducible polymerase chain reaction (PCR) method was developed in order to quantify minimal residual disease (MRD) in children with acute lymphoblastic leukaemia (ALL). A clone-specific competitor was constructed by introducing a restriction site in a PCR product identical...... under identical conditions. After restriction enzyme cleavage, the PCR products originating from the competitor and the malignant clone can be distinguished by size in a gel electrophoresis step and the amount of residual disease can be determined. The method is very sensitive with a detection limit...

  5. TREATMENT OF ACUTE INFLAMMATORY DISEASES ACCOMPANIED BY THROAT IRRITATION AND PAIN

    Directory of Open Access Journals (Sweden)

    M. I. Petrovskaya

    2013-01-01

    Full Text Available Pathogenetically, prescription of local action drugs containing a wide spectrum antiseptic is reasonable for the upper respiratory tract diseases accompanied by throat irritation and pain. It should be noted that such drugs are very popular among parents; however, most of these drugs may have a range of side effects, which considerably complicate their use in children. That is why the right choice of local action drugs for the acute inflammatory diseases accompanied by throat irritation and pain is a guarantee of treatment efficacy and high compliance. This article examines pharmacological qualities of an antiseptic-containing local action drug permitted to use in children over 4 years of age.

  6. Celiac Disease in Children with Severe Acute Malnutrition (SAM): A Hospital Based Study.

    Science.gov (United States)

    Beniwal, Neetu; Ameta, Gaurav; Chahar, Chandra Kumar

    2017-05-01

    To evaluate the prevalence and clinical features of Celiac disease among children with severe acute malnutrition (SAM). This prospective observational study was conducted in PBM Children Hospital, Bikaner from July 2012 through December 2013. All consecutively admitted children with SAM were recruited. All subjects were screened for Celiac disease by serological test for IgA-anti tissue Transglutaminase (IgA tTG) antibodies. All seropositive children underwent upper gastrointestinal endoscopy for small bowel biopsy for the confirmation. Clinical features of patients with and without celiac disease were compared. The sero-prevalence (IgA tTg positivity) of Celiac disease was found to be 15.38% while prevalence of biopsy confirmed Celiac disease was 14.42% among SAM children. Abdominal distension, diarrhea, anorexia, constipation, pain in abdomen, vitamin deficiencies, edema, clubbing and mouth ulcers were more common in patients of Celiac disease compared to patients without Celiac disease but the difference was statistically significant only for abdominal distension and pain abdomen. There is a high prevalence of Celiac disease in SAM. Screening for Celiac disease (especially in presence of pain abdomen and abdominal distension) should be an essential part of work-up in all children with SAM.

  7. Kikuchi-Fujimoto disease: an unusual association with acute renal failure

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    Amanda Feliciano da Silva

    Full Text Available Kikuchi-Fujimoto disease, also known as histiocytic necrotizing lymphadenitis of unknown etiopathogenesis, is a self-limited disease which frequently appears as feverish lymphadenomegaly, thus creating the need for differential diagnosis with lymphoma, systemic lupus erythematosus (SLE, infectious mononucleosis, cat-scratch disease, and toxoplasmosis with lymphonodal impairment. However, there are cases in which it may evolve with complications such as aseptic meningitis, cerebellar ataxia, and aseptic myocarditis. We are presenting a case of a 24-year-old man who had an initial picture of arthralgia, evening fever and adenomegaly. Kikuchi disease was diagnosed through lymph node biopsy with immunohistochemistry and evolves with severe systemic manifestations, such as pericarditis with cardiac tamponade, pneumonitis, hepatitis, and acute kidney failure - the latter has not been reported in literature yet. There was significant improvement of the clinical picture with prednisone

  8. Intestinal microbiota-kidney cross talk in acute kidney injury and chronic kidney disease.

    Science.gov (United States)

    Noel, Sanjeev; Martina-Lingua, Maria N; Bandapalle, Samatha; Pluznick, Jennifer; Hamad, Abdel Rahim A; Peterson, Daniel A; Rabb, Hamid

    2014-01-01

    The pathophysiology of acute kidney injury (AKI) involves multiple and overlapping immunological, biochemical, and hemodynamic mechanisms that modulate the effects of both the initial insult and the subsequent repair. Limited but recent experimental data have revealed that the intestinal microbiota significantly affects outcomes in AKI. Additional evidence shows significant changes in the intestinal microbiota in chronic kidney disease patients and in experimental AKI. In this minireview, we discuss the current status of the effect of intestinal microbiota on kidney diseases, the immunomodulatory effects of intestinal microbiota, and the potential mechanisms by which microbiota can modify kidney diseases and vice versa. We also propose future studies to clarify the role of intestinal microbiota in kidney diseases and to explore how the modification of gut microbiota may be a potential therapeutic tool. 2014 S. Karger AG, Basel.

  9. Strategies for potential manipulation of anorexia during acute and chronic disease.

    Science.gov (United States)

    Plata-Salamán, C R

    1995-01-01

    Acute and chronic pathologic processes and immunotherapy in humans are frequently accompanied by anorexia and other neurologic manifestations of disease. Various signals (including cytokines such as immunomodulators) are responsible for anorexia during disease or immunotherapy. Anorexia during disease can be beneficial or deleterious to an organism depending on the timing and duration. For example, a restriction in the intake of micronutrients and macronutrients may be part of the biological roles of the temporal anorexia that accompanies infection. However, diseases with long-term anorexia may be associated with cachexia. Present research on anorexia focuses on elucidating the immunochemical and neuronal mechanisms that contribute to anorexia and on developing potential interventions including the following: 1) nutritional substrates; 2) monoclonal antibodies, receptor antagonists, soluble receptors, and other cytokine (including endogenous) inhibitors; 3) glucocorticoids and other steroids; 4) nonsteroidal antiinflammatory agents; 5) neuropeptide inhibitors of cytokine action; and 6) antisense strategies.

  10. Adalimumab-induced acute interstitial lung disease in a patient with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Olivia Meira Dias

    2014-01-01

    Full Text Available The use of immunobiological agents for the treatment of autoimmune diseases is increasing in medical practice. Anti-TNF therapies have been increasingly used in refractory autoimmune diseases, especially rheumatoid arthritis, with promising results. However, the use of such therapies has been associated with an increased risk of developing other autoimmune diseases. In addition, the use of anti-TNF agents can cause pulmonary complications, such as reactivation of mycobacterial and fungal infections, as well as sarcoidosis and other interstitial lung diseases (ILDs. There is evidence of an association between ILD and the use of anti-TNF agents, etanercept and infliximab in particular. Adalimumab is the newest drug in this class, and some authors have suggested that its use might induce or exacerbate preexisting ILDs. In this study, we report the first case of acute ILD secondary to the use of adalimumab in Brazil, in a patient with rheumatoid arthritis and without a history of ILD.

  11. Fluid replacement therapy for acute episodes of pain in people with sickle cell disease.

    Science.gov (United States)

    Okomo, Uduak; Meremikwu, Martin M

    2017-07-31

    Treating vaso-occlusive painful crises in people with sickle cell disease is complex and requires multiple interventions. Extra fluids are routinely given as adjunct treatment, regardless of the individual's state of hydration with the aim of slowing or stopping the sickling process and thereby alleviating pain. This is an update of a previously published Cochrane Review. To determine the optimal route, quantity and type of fluid replacement for people with sickle cell disease with acute painful crises. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.We also conducted searches of Embase (November 2007), LILACS, www.ClinicalTrials.gov (05 January 2010), and the WHO ICTRP (30 June 2017).Date of most recent search of the Group's Haemoglobinopathies Trials Register: 16 February 2017. Randomised and quasi-randomised controlled trials that compared the administration of supplemental fluids adjunctive to analgesics by any route in people with any type of sickle cell disease during an acute painful episode, under medical supervision (inpatient, day care or community). No relevant trials have yet been identified. Sixteen trials were identified by the searches, all of which were not eligible for inclusion in the review. Treating vaso-occlusive crises is complex and requires multiple interventions. Extra fluids, generally oral or intravenous, are routinely administered during acute painful episodes to people with sickle cell disease regardless of the individual's state of hydration. Reports of their use during these acute painful episodes do not state the efficacy of any single route, type or quantity of fluid compared to another. However, there are no randomised controlled trials that have assessed the safety and efficacy of different routes, types or quantities of

  12. Chemokine regulation in response to beryllium exposure in human peripheral blood mononuclear and dendritic cells.

    Science.gov (United States)

    Hong-Geller, Elizabeth; Pardington, Paige E; Cary, Robert B; Sauer, Nancy N; Gupta, Goutam

    2006-02-01

    Exposure to beryllium (Be) induces a delayed-type hypersensitivity immune reaction in the lungs of susceptible individuals, which leads to the onset of Be sensitivity and Chronic Beryllium Disease (CBD). Although some mechanistic aspects of CBD have begun to be characterized, very little is known about the molecular mechanisms by which Be activates the host immune response. To gain insight into the cellular response to Be exposure, we have performed global microarray analysis using a mixture of peripheral blood mononuclear and dendritic cells (PBMC/DCs) from a non-CBD source to identify genes that are specifically upregulated in response to BeSO(4) stimulation, compared to a control metal salt, Al(2)(SO(4))(3). We identified a number of upregulated immunomodulatory genes, including several chemokines in the MIP-1 and GRO families. Using PBMC/DCs from three different donors, we demonstrate that BeSO(4) stimulation generally exhibits an increased rate of both chemokine mRNA transcription and release compared to Al(2)(SO(4))(3) exposure, although variations among the individual donors do exist. We show that MIP-1 alpha and MIP-1 beta neutralizing antibodies can partially inhibit the ability of BeSO(4) to stimulate cell migration of PBMC/DCs in vitro. Finally, incubation of PBMC/DCs with BeSO(4) altered the binding of the transcription factor RUNX to the MIP-1 alpha promoter consensus sequence, indicating that Be can regulate chemokine gene activation. Taken together, these results suggest a model in which Be stimulation of PBMC/DCs can modulate the expression and release of different chemokines, leading to the migration of lymphocytes to the lung and the formation of a localized environment for development of Be disease in susceptible individuals.

  13. Cyclosporine and methotrexate-related pharmacogenomic predictors of acute graft-versus-host disease.

    Science.gov (United States)

    Laverdière, Isabelle; Guillemette, Chantal; Tamouza, Ryad; Loiseau, Pascale; Peffault de Latour, Regis; Robin, Marie; Couture, Félix; Filion, Alain; Lalancette, Marc; Tourancheau, Alan; Charron, Dominique; Socié, Gérard; Lévesque, Éric

    2015-02-01

    Effective immunosuppression is mandatory to prevent graft-versus-host disease and to achieve a successful clinical outcome of hematopoietic stem cell transplantation. Here we tested whether germline single nucleotide polymorphisms in 20 candidate genes related to methotrexate and cyclosporine metabolism and activity influence the incidence of graft-versus-host disease in patients who undergo stem cell transplantation for hematologic disorders. Recipient genetic status of the adenosine triphosphate-binding cassette sub-family C1 and adenosine triphosphate-binding cassette sub-family C2 transporters, 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/ inosine monophosphate cyclohydrolase within the methotrexate pathway, and nuclear factor of activated T cells (cytoplasmic 1) loci exhibit a remarkable influence on severe acute graft-versus-host disease prevalence. Indeed, an increased risk of acute graft-versus-host disease was observed in association with single nucleotide polymorphisms located in 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/inosine monophosphate cyclohydrolase (hazard ratio=3.04; P=0.002), nuclear factor of activated T cells (cytoplasmic 1) (hazard ratio=2.69; P=0.004), adenosine triphosphate-binding cassette sub-family C2 (hazard ratio=3.53; P=0.0018) and adenosine triphosphate-binding cassette sub-family C1 (hazard ratio=3.67; P=0.0005). While donor single nucleotide polymorphisms of dihydrofolate reductase and solute carrier family 19 (member 1) genes are associated with a reduced risk of acute graft-versus-host disease (hazard ratio=0.32-0.41; P=0.0009-0.008), those of nuclear factor of activated T cells (cytoplasmic 2) are found to increase such risk (hazard ratio=3.85; P=0.0004). None of the tested single nucleotide polymorphisms was associated with the occurrence of chronic graft-versus-host disease. In conclusion, by targeting drug-related biologically relevant genes, this work emphasizes the potential role of

  14. INTEGRAL ESTIMATION OF OXIDATIVE STATUS IN PATIENTS WITH ACUTE TOXIC HEPATITIS AND CHRONIC ALCOHOLIC LIVER DISEASE

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    A. Y. Shchupak

    2016-01-01

    Full Text Available BACKGROUND Acute toxic hepatitis associated with acute poisoning with alcohol-containing disinfectants remains a medical and social problem.MATERIAL AND METHODS With an aid of chemiluminescence, we performed the integrated assessment of the oxidative status in the blood serum and homogenized liver biopsy tissue of 62 patients with the diagnosis «severe acute toxic hepatitis associated with the use of alcohol-containing disinfectants».RESULTS The research showed that at the onset of a disease, patients with acute toxic hepatitis had an expressed activation of free radical oxidation of the blood serum and biopsy tissue. This was indicated by almost double increase in the intensity of free radicals generation (Ssp. This signifi cantly increased production of peroxide (Sind-1 and hydroxyl radicals (Slum — 2.5 and 1.86 times, respectively; also, it increased concentration of lipid hydroperoxides (h almost three times, evidencing activation of the initial stage of lipid peroxidation There was no statistically signifi cant fall of figures indicating the liver parenchymal oxidative status 30 days after the admission. The same situation was observed 6 months after the beginning of the study.CONCLUSION Analyzing chemiluminescence scans of blood serums up to 30 days from admission, it is possible to conclude indirectly on a condition of the oxidative status in a liver parenchyma of patients.

  15. [Complementary treatment of acute heart failure in patients with diabetes, chronic obstructive pulmonary disease or anemia].

    Science.gov (United States)

    Carrasco Sánchez, Francisco Javier; Recio Iglesias, Jesús; Grau Amorós, Jordi

    2014-03-01

    Diabetes, chronic obstructive pulmonary disease (COPD) and anemia are comorbidities with a high prevalence and impact in heart failure (HF). The presence of these comorbidities considerably worsens the prognosis of HF. Diabetic patients have a higher likelihood of developing symptoms of HF and both the treatment of diabetes and that of acute HF are altered by the coexistence of both entities. The glycemic targets in patients with acute HF are not well-defined, but could show a U-shaped relationship. Stress hyperglycemia in non-diabetic patients with HF could also have a deleterious effect on the medium-term prognosis. The inter-relationship between COPD and HF hampers diagnosis due to the overlap between the symptoms and signs of both entities and complementary investigations. The treatment of acute HF is also altered by the presence of COPD. Anemia is highly prevalent and is often the direct cause of decompensated HF, the most common cause being iron deficiency anemia. Iron replacement therapy, specifically intravenous forms, has helped to improve the prognosis of acute HF. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  16. Mannose-binding lectin deficiency and acute exacerbations of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Woodruff PG

    2012-11-01

    Full Text Available Richard K Albert,1 John Connett,2 Jeffrey L Curtis,3,4 Fernando J Martinez,3 MeiLan K Han,3 Stephen C Lazarus,5 Prescott G Woodruff51Medicine Service, Denver Health and Department of Medicine, University of Colorado Denver, Denver, CO, 2Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, 3Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, 4Pulmonary and Critical Care Medicine, VA Medical Center, Ann Arbor, MI, 5Pulmonary and Critical Care Medicine, Department of Medicine, and Cardiovascular Research Institute, University of California, San Francisco, CA, USABackground: Mannose-binding lectin is a collectin involved in host defense against infection. Whether mannose-binding lectin deficiency is associated with acute exacerbations of chronic obstructive pulmonary disease is debated.Methods: Participants in a study designed to determine if azithromycin taken daily for one year decreased acute exacerbations had serum mannose-binding lectin concentrations measured at the time of enrollment.Results: Samples were obtained from 1037 subjects (91% in the trial. The prevalence of mannose-binding lectin deficiency ranged from 0.5% to 52.2%, depending on how deficiency was defined. No differences in the prevalence of deficiency were observed with respect to any demographic variable assessed, and no differences were observed in time to first exacerbation, rate of exacerbations, or percentage of subjects requiring hospitalization for exacerbations in those with deficiency versus those without, regardless of how deficiency was defined.Conclusion: In a large sample of subjects with chronic obstructive pulmonary disease selected for having an increased risk of experiencing an acute exacerbation of chronic obstructive pulmonary disease, only 1.9% had mannose-binding lectin concentrations below the normal range and we found no association between mannose-binding lectin

  17. Characteristics and outcomes of chronic liver disease patients with acute deteriorated liver function by severity of underlying liver disease.

    Science.gov (United States)

    Hong, Yun Soo; Sinn, Dong Hyun; Gwak, Geum-Youn; Cho, Juhee; Kang, Danbee; Paik, Yong-Han; Choi, Moon Seok; Lee, Joon Hyeok; Koh, Kwang Cheol; Paik, Seung Woon

    2016-04-14

    To analyze characteristics and outcome of patients with acute-on-chronic liver failure (ACLF) according to the severity of underlying liver disease. One hundred and sixty-seven adult patients with chronic liver disease and acute deteriorated liver function, defined by jaundice and coagulopathy, were analyzed. Predisposition, type of injury, response, organ failure, and survival were analyzed and compared between patients with non-cirrhosis (type A), cirrhosis (type B) and cirrhosis with previous decompensation (type C). The predisposition was mostly hepatitis B in type A, while it was alcoholic liver disease in types B and C. Injury was mostly hepatic in type A, but was non-hepatic in type C. Liver failure, defined by CLIF-SOFA, was more frequent in types A and B, and circulatory failure was more frequent in type C. The 30-d overall survival rate (85.3%, 81.1% and 83.7% for types A, B and C, respectively, P = 0.31) and the 30-d transplant-free survival rate (55.9%, 65.5% and 62.5% for types A, B and C, respectively P = 0.33) were not different by ACLF subtype, but 1-year overall survival rate were different (85.3%, 71.7% and 58.7% for types A, B and C, respectively, P = 0.02). There were clear differences in predisposition, type of injury, accompanying organ failure and long-term mortality according to spectrum of chronic liver disease, implying classifying subtype according to the severity of underlying liver disease is useful for defining, clarifying and comparing ACLF.

  18. [Correlation between Dynamic Change of IL-32 Level and Disease Development in Acute Leukemia Patients].

    Science.gov (United States)

    Chen, Li-Gang; Guo, Jia-Quan; Li, Dong-Dong

    2017-06-01

    To investigate the correlation between dynamic change of IL-32 level and disease development in the patients with acute leukemia(AL) and to explore its clinical significance. The serum IL-32 levels and IL-32 mRNA expression in 82 cases of AL and 30 healthy persons were measured by ELISA and real-time PCR. Compared with healthy persons, the serum IL-32 protein level and IL-32 mRNA expression in AL, acute lymphoblastic leukemia(ALL) and acute non-lymphocytic leukemia(ANLL) groups all were significantly higher(P32 protein and mRNA expression in newly diagnosed, PR and relapsed ALL and ANLL groups were all higher than those in the control group(P32 in relapsed ALL and ANLL groups were higher than that in other stage group(P32 protein and mRNA were not significantly different between CR and control group(P>0.05). The IL-32 in the peripheral blood of patients with AL has been found to be closely related with the occurrence and development of disease, therefore, monitoring the dynamic changes of serum IL-32 level would contribute to the clinical judgment of the severity, the IL-32 levels can be used as indicators for the therapeutic efficacy for AL.

  19. Management of acute diarrhoeal disease at Edendale Hospital: Are standard treatment guidelines followed?

    Directory of Open Access Journals (Sweden)

    Kershinee Reddy

    2016-12-01

    Full Text Available Background. Diarrhoeal disease (DD is a major cause of childhood mortality in developing countries. In South Africa (SA, it ranks as one of the top five causes of under-5 mortality. Local and global guidelines on the management of acute DD are readily available. The Standard Treatment Guidelines (STGs and Essential Drugs List for Hospital Level Paediatrics are a recognised standard of care for children in SA hospitals. However, children still die from this preventable disease. Objective. To determine whether doctors adhered to standard treatment guidelines when treating children under 5 years of age presenting to Edendale Hospital in Pietermaritzburg, KwaZulu-Natal Province, with acute DD. Methods. The study was a retrospective clinical audit of individual patient records. Results. One hundred and thirty-five patient records were reviewed. Forty-seven percent had a correct nutritional assessment, 41% were correctly assessed for shock and 27% for dehydration. Appropriate investigations were undertaken in 12%. Ninety-seven percent of patients had appropriate fluid plans prescribed. Zinc was prescribed in only 39% of patients, whereas 84% were appropriately not prescribed antibiotics and no patients received anti-diarrhoeal medication. In 90% of patients, the correct post-care patient referral was made, and 47% of caregivers were adequately advised about ongoing care of their children. Conclusion. This study identifies substantial non-adherence to the SA STGs for the management of young children with acute DD.

  20. Management of Chronic Kidney Disease Patients in the Intensive Care Unit: Mixing Acute and Chronic Illness.

    Science.gov (United States)

    De Rosa, Silvia; Samoni, Sara; Villa, Gianluca; Ronco, Claudio

    2017-01-01

    Patients with chronic kidney disease (CKD) are at high risk for developing critical illness and for admission to intensive care units (ICU). 'Critically ill CKD patients' frequently develop an acute worsening of renal function (i.e. acute-on-chronic, AoC) that contributes to long-term kidney dysfunction, potentially leading to end-stage kidney disease (ESKD). An integrated multidisciplinary effort is thus necessary to adequately manage the multi-organ damage of those kidney patients and contemporaneously reduce the progression of kidney dysfunction when they are critically ill. The aim of this review is to describe (1) the pathophysiological mechanisms underlying the development of AoC kidney dysfunction and its role in the progression toward ESKD; (2) the most common clinical presentations of critical illness among CKD/ESKD patients; and (3) the continuum of care for CKD/ESKD patients from maintenance hemodialysis/peritoneal dialysis to acute renal replacement therapy performed in ICU and, vice-versa, for AoC patients who develop ESKD. © 2017 S. Karger AG, Basel.

  1. Unexplained acute chest pain in young adults: disease patterns and medication use 25 years later.

    Science.gov (United States)

    Roll, Martin; Rosenqvist, Mårten; Sjöborg, Bengt; Wettermark, Björn

    2015-06-01

    Patients with unexplained chest pain are commonly revisiting an emergency department with various symptoms, but comprehensive long-term studies are lacking. A total of 150 young adults (aged 18-40 years) with unexplained chest pain who presented at an emergency unit for 16 weeks in mid-1980s were included in a prospective cohort study. An age- and sex-matched control group was randomly selected from the same area. Data were retrieved from registers that recorded death, income, education, country of birth, diagnoses, hospitalizations, outpatient visits, and medications dispensed. Patients with unexplained acute chest pain had lower levels of education and income and were more often immigrants. Long-term mortality rates did not differ between cases (4%) and controls (5%) during 25 years of follow-up, nor were there differences in diagnosis of ischemic heart disease. Patients with unexplained acute chest pain had more outpatient visits (median, 5 versus 2; p chest pain, palpitations, abdominal discomfort, musculoskeletal symptoms, sleeping disturbance, and stress reactions (p values acute chest pain showed no increased risk of mortality or ischemic heart disease during 25 years of follow-up, but they had higher incidence of a wide range of disorders and used more medications. Early identification and preventive interventions may improve health outcomes in these patients.

  2. Proceedings of the third IEA international workshop on beryllium technology for fusion

    Energy Technology Data Exchange (ETDEWEB)

    Kawamura, Hiroshi; Okamoto, Makoto [eds.

    1998-01-01

    This report is the Proceedings of the Third International Energy Agency International Workshop on Beryllium Technology for Fusion. The workshop was held on October 22-24, 1997, at the Sangyou Kaikan in Mito City with 68 participants who attended from the Europe, the Russian Federation, the Kazakstan, the United States and Japan. The topics for papers were arranged into 9 sessions; beryllium applications for ITER, production and characterization, chemical compatibility and corrosion, forming and joining, plasma/tritium interactions, beryllium coating, first wall applications, neutron irradiation effects, health and safety. To utilize beryllium in the pebble type blanket, a series of discussions were intensified in multiple view points such as the swelling, He/T release from beryllium pebble irradiated up to high He content, effective thermal conductivity, tritium permeation and coating, and fabrication cost, and so on. As the plasma facing material, life time of beryllium and coated beryllium, dust and particle production, joining, waste treatment, mechanical properties and deformation by swelling were discussed as important issues. Especially, it was recognized throughout the discussions that the comparative study by the different researchers should be carried out to establish the reliability of the data reported in the workshop and in others. To enhance the comparative study, the world wide collaboration for the relative evaluation of the beryllium was proposed by the International Organization Committee and the proposal was approved by all of the participants. The 45 of the presented papers are indexed individually. (J.P.N.)

  3. DETERMINING BERYLLIUM IN DRINKING WATER BY GRAPHITE FURNACE ATOMIC ABSORPTION SPECTROSCOPY

    Science.gov (United States)

    A direct graphite furnace atomic absorption spectroscopy method for the analysis of beryllium in drinking water has been derived from a method for determining beryllium in urine. Ammonium phosphomolybdate and ascorbic acid were employed as matrix modifiers. The matrix modifiers s...

  4. Antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver disease.

    Science.gov (United States)

    Martí-Carvajal, Arturo J; Solà, Ivan

    2015-06-09

    Upper gastrointestinal bleeding is one of the most frequent causes of morbidity and mortality in the course of liver cirrhosis. People with liver disease frequently have haemostatic abnormalities such as hyperfibrinolysis. Therefore, antifibrinolytic amino acids have been proposed to be used as supplementary interventions alongside any of the primary treatments for upper gastrointestinal bleeding in people with liver diseases. This is an update of this Cochrane review. To assess the beneficial and harmful effects of antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or chronic liver disease. We searched The Cochrane Hepato-Biliary Controlled Trials Register (February 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2 of 12, 2015), MEDLINE (Ovid SP) (1946 to February 2015), EMBASE (Ovid SP) (1974 to February 2015), Science Citation Index EXPANDED (1900 to February 2015), LILACS (1982 to February 2015), World Health Organization Clinical Trials Search Portal (accessed 26 February 2015), and the metaRegister of Controlled Trials (accessed 26 February 2015). We scrutinised the reference lists of the retrieved publications. Randomised clinical trials irrespective of blinding, language, or publication status for assessment of benefits and harms. Observational studies for assessment of harms. We planned to summarise data from randomised clinical trials using standard Cochrane methodologies and assessed according to the GRADE approach. We found no randomised clinical trials assessing antifibrinolytic amino acids for treating upper gastrointestinal bleeding in people with acute or chronic liver disease. We did not identify quasi-randomised, historically controlled, or observational studies in which we could assess harms. This updated Cochrane review identified no randomised clinical trials assessing the benefits and harms of antifibrinolytic amino acids for upper gastrointestinal bleeding in people with acute or

  5. Biomarkers in the assessment of acute and chronic kidney diseases in the dog and cat.

    Science.gov (United States)

    Cobrin, A R; Blois, S L; Kruth, S A; Abrams-Ogg, A C G; Dewey, C

    2013-12-01

    In both human and veterinary medicine, diagnosing and staging renal disease can be difficult. Measurement of glomerular filtration rate is considered the gold standard for assessing renal function but methods for its assessment can be technically challenging and impractical. The main parameters used to diagnose acute and chronic kidney disease include circulating creatinine and urea concentrations, and urine-specific gravity. However, these parameters can be insensitive. Therefore, there is a need for better methods to diagnose and monitor patients with renal disease. The use of renal biomarkers is increasing in human and veterinary medicine for the diagnosis and monitoring of acute and chronic kidney diseases. An ideal biomarker would identify site and severity of injury, and correlate with renal function, among other qualities. This article will review the advantages and limitations of renal biomarkers that have been used in dogs and cats, as well as some markers used in humans that may be adapted for veterinary use. In the future, measuring a combination of biomarkers will likely be a useful approach in the diagnosis of kidney disorders. © 2013 British Small Animal Veterinary Association.

  6. Prospective evaluation for respiratory pathogens in children with sickle cell disease and acute respiratory illness.

    Science.gov (United States)

    Srinivasan, Ashok; Wang, Winfred C; Gaur, Aditya; Smith, Teresa; Gu, Zhengming; Kang, Guolian; Leung, Wing; Hayden, Randall T

    2014-03-01

    Human rhinovirus (HRV), human coronavirus (hCoV), human bocavirus (hBoV), and human metapneumovirus (hMPV) infections in children with sickle cell disease have not been well studied. Nasopharyngeal wash specimens were prospectively collected from 60 children with sickle cell disease and acute respiratory illness, over a 1-year period. Samples were tested with multiplexed-PCR, using an automated system for nine respiratory viruses, Chlamydophila pneumoniae, Mycoplasma pneumoniae, and Bordetella pertussis. Clinical characteristics and distribution of respiratory viruses in patients with and without acute chest syndrome (ACS) were evaluated. A respiratory virus was detected in 47 (78%) patients. Nine (15%) patients had ACS; a respiratory virus was detected in all of them. The demographic characteristics of patients with and without ACS were similar. HRV was the most common virus, detected in 29 of 47 (62%) patients. Logistic regression showed no association between ACS and detection of HRV, hCoV, hBoV, hMPV, and other respiratory pathogens. Co-infection with at least one additional respiratory virus was seen in 14 (30%) infected patients, and was not significantly higher in patients with ACS (P = 0.10). Co-infections with more than two respiratory viruses were seen in seven patients, all in patients without ACS. Bacterial pathogens were not detected. HRV was the most common virus detected in children with sickle cell disease and acute respiratory illness, and was not associated with increased morbidity. Larger prospective studies with asymptomatic controls are needed to study the association of these emerging respiratory viruses with ACS in children with sickle cell disease. © 2013 Wiley Periodicals, Inc.

  7. Recurrent acute pancreatitis and cholangitis in a patient with autosomal dominant polycystic kidney disease

    Directory of Open Access Journals (Sweden)

    Kambiz Yazdanpanah

    2013-01-01

    Full Text Available Autosomal dominant polycystic kidney disease (ADPKD is an inherited disorder associated with multiple cyst formation in the different organs. Development of pancreatic cyst in ADPKD is often asymptomatic and is associated with no complication. A 38-year-old man with ADPKD was presented with six episodes of acute pancreatitis and two episodes of cholangitis in a period of 12 months. Various imaging studies revealed multiple renal, hepatic and pancreatic cysts, mild ectasia of pancreatic duct, dilation of biliary system and absence of biliary stone. He was managed with conservative treatment for each attack. ADPKD should be considered as a potential risk factor for recurrent acute and/or chronic pancreatitis and cholangitis.

  8. Noninvasive mechanical ventilation in chronic obstructive pulmonary disease and in acute cardiogenic pulmonary edema.

    Science.gov (United States)

    Rialp Cervera, G; del Castillo Blanco, A; Pérez Aizcorreta, O; Parra Morais, L

    2014-03-01

    Noninvasive ventilation (NIV) with conventional therapy improves the outcome of patients with acute respiratory failure due to hypercapnic decompensation of chronic obstructive pulmonary disease (COPD) or acute cardiogenic pulmonary edema (ACPE). This review summarizes the main effects of NIV in these pathologies. In COPD, NIV improves gas exchange and symptoms, reducing the need for endotracheal intubation, hospital mortality and hospital stay compared with conventional oxygen therapy. NIV may also avoid reintubation and may decrease the length of invasive mechanical ventilation. In ACPE, NIV accelerates the remission of symptoms and the normalization of blood gas parameters, reduces the need for endotracheal intubation, and is associated with a trend towards lesser mortality, without increasing the incidence of myocardial infarction. The ventilation modality used in ACPE does not affect the patient prognosis. Copyright © 2012 Elsevier España, S.L. y SEMICYUC. All rights reserved.

  9. Dopamine-independent locomotor actions of amphetamines in a novel acute mouse model of Parkinson disease.

    Directory of Open Access Journals (Sweden)

    2005-08-01

    Full Text Available Brain dopamine is critically involved in movement control, and its deficiency is the primary cause of motor symptoms in Parkinson disease. Here we report development of an animal model of acute severe dopamine deficiency by using mice lacking the dopamine transporter. In the absence of transporter-mediated recycling mechanisms, dopamine levels become entirely dependent on de novo synthesis. Acute pharmacological inhibition of dopamine synthesis in these mice induces transient elimination of striatal dopamine accompanied by the development of a striking behavioral phenotype manifested as severe akinesia, rigidity, tremor, and ptosis. This phenotype can be reversed by administration of the dopamine precursor, L-DOPA, or by nonselective dopamine agonists. Surprisingly, several amphetamine derivatives were also effective in reversing these behavioral abnormalities in a dopamine-independent manner. Identification of dopamine transporter- and dopamine-independent locomotor actions of amphetamines suggests a novel paradigm in the search for prospective anti-Parkinsonian drugs.

  10. Beryllium, an adjuvant that promotes gamma interferon production.

    Science.gov (United States)

    Lee, J Y; Atochina, O; King, B; Taylor, L; Elloso, M; Scott, P; Rossman, M D

    2000-07-01

    Beryllium is associated with a human pulmonary granulomatosis characterized by an accumulation of CD4(+) T cells in the lungs and a heightened specific lymphocyte proliferative response to beryllium (Be) with gamma interferon (IFN-gamma) release (i.e., a T helper 1 [Th1] response). While an animal model of Be sensitization is not currently available, Be has exhibited adjuvant effects in animals. The effects of Be on BALB/c mice immunized with soluble leishmanial antigens (SLA) were investigated to determine if Be had adjuvant activity for IFN-gamma production, an indicator of the Th1 response. In this strain of Leishmania-susceptible BALB/c mice, a Th2 response is normally observed after in vivo SLA sensitization and in vitro restimulation with SLA. If interleukin-12 (IL-12) is given during in vivo sensitization with SLA, markedly increased IFN-gamma production and decreased IL-4 production are detected. We show here that when beryllium sulfate (BeSO(4)) was added during in vivo sensitization of BALB/c mice with SLA and IL-12, significantly increased IFN-gamma production and decreased IL-4 production from lymph node and spleen cells were detected upon in vitro SLA restimulation. No specific responses were observed to Be alone. Lymph node and spleen cells from all mice proliferated strongly and comparably upon in vitro restimulation with SLA and with SLA plus Be; no differences were noted among groups of mice that received different immunization regimens. In vivo, when Be was added to SLA and IL-12 for sensitization of BALB/c mice, more effective control of Leishmania infection was achieved. This finding has implications for understanding not only the development of granulomatous reactions but also the potential for developing Be as a vaccine adjuvant.

  11. Beryllium resources of the tin-spodumene belt, North Carolina

    Science.gov (United States)

    Griffitts, Wallace R.

    1954-01-01

    Pegmatite dikes in the tin-spodumene belt of North and South Carolina uniformly contain about 0.05 percent BeO. The most abundant minerals in the pegmatite contain from 0. 0001 to 0.01 percent BeO. Beryl, having 12.0 to 12.3 percent BeO, is the only beryllium-rich mineral and contains more than 80 percent of the total beryllium in the rock. Beryl-bearing pegmatite crops out on hillsides near streams that flow through the pegmatite belt. Much of the pegmatite contains spodumene, feldspar, mica, cassiterite, and columbite, as well as beryl, but separating these minerals will require milling. The minable spodumene ore in the Kings Mountain area, above a depth of 300 feet contains about 40,000 tons of beryl, equivalent to 6, 000 tons of BeO, if 80 percent of the BeO is assumed to be in beryl. Other pegmatite in that area contains an additional 238,000 tons of beryl, or 35, 900 tons of BeO. On the basis of the same assumptions the spodumene ore above a depth of 300 feet 1 in the Beaverdam Creek area contains 6, 000 tons of beryl, or 800 tons of BeO, and all other pegmatite in that area contains an additional 13, 000 tons of beryl, or 1, 700 tons of BeO. The entire tin-spodumene belt contains 823, 000 tons of beryl, equivalent to 122,800 tons of BeO. Little beryllium was found in the Piedmont province outside of the tin-spodumene belt.

  12. Early upregulation of acute respiratory distress syndrome-associated cytokines promotes lethal disease in an aged-mouse model of severe acute respiratory syndrome coronavirus infection

    NARCIS (Netherlands)

    B. Rockx (Barry); T. Baas (Tracey); G.A. Zornetzer (Gregory); B.L. Haagmans (Bart); T. Sheahan (Timothy); M. Frieman (Matthew); M.D. Dyer (Matthew); T.H. Teal (Thomas); S. Proll (Sean); J.M.A. van den Brand (Judith); R. Baric (Ralph); M.G. Katze (Michael)

    2009-01-01

    textabstractSeveral respiratory viruses, including influenza virus and severe acute respiratory syndrome coronavirus (SARS-CoV), produce more severe disease in the elderly, yet the molecular mechanisms governing age-related susceptibility remain poorly studied. Advanced age was significantly

  13. Microstructure and mechanical properties of neutron irradiated beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Ishitsuka, E.; Kawamura, H. [Japan Atomic Energy Research Inst., Oarai, Ibaraki (Japan). Oarai Research Establishment; Terai, T.; Tanaka, S.

    1998-01-01

    Microstructure and mechanical properties of the neutron irradiated beryllium with total fast neutron fluences of 1.3 - 4.3 x 10{sup 21} n/cm{sup 2} (E>1 MeV) at 327 - 616degC were studied. Swelling increased by high irradiation temperature, high fluence, and by the small grain size and high impurity. Obvious decreasing of the fracture stress was observed in the bending test and in small grain specimens which had many helium bubbles on the grain boundary. Decreasing of the fracture stress for small grain specimens was presumably caused by crack propagation on the grain boundaries which weekend by helium bubbles. (author)

  14. Excited S-symmetry states of positronic lithium and beryllium.

    Science.gov (United States)

    Strasburger, Krzysztof

    2016-04-14

    The possibility of the existence of excited S-symmetry states of positronic lithium and beryllium, resulting from the positron attachment to high-spin P parent atomic states, is examined and confirmed with variational calculations in the basis of explicitly correlated Gaussian functions. The unexpectedly different order of the energies of the S and P states is explained by the formation of the positronium cluster structure and associated disappearance of the destabilizing centrifugal force. The annihilation properties of newly discovered states are discussed in the context of prospective experimental detection.

  15. Acute phase proteins in naturally occurring respiratory disease of feedlot cattle.

    Science.gov (United States)

    Idoate, Ignacio; Vander Ley, Brian; Schultz, Loren; Heller, Meera

    2015-02-15

    The aim of this study was to evaluate three acute phase proteins (APP) [haptoglobin (HPT), lipopolysaccharide binding protein (LBP) and transferrin (Tf)] in feedlot cattle with naturally occurring respiratory disease diagnosed by a calf health scoring chart (CHSC). Seventy-seven beef calves were observed for signs of Bovine Respiratory Disease (BRD) during the first 28 days after arrival at the feedlot. Fourteen cases and pen matched controls were selected based on the CHSC. BRD cases were defined as a score of ≥ 5, while controls were defined as a score ≤ 4. The mean CHSC score in cases was 6.9 which was significantly greater than the controls 2.8 (P respiratory disease in feedlot conditions. Transferrin concentrations between the two groups were not statistically different. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. The Impact of Obesity on Gallstone Disease, Acute Pancreatitis, and Pancreatic Cancer.

    Science.gov (United States)

    Cruz-Monserrate, Zobeida; Conwell, Darwin L; Krishna, Somashekar G

    2016-12-01

    Obesity is a well-recognized risk factor for gallstone formation and increases the risk for gallstone-related complications. Pancreatic diseases are impacted adversely by obesity. Although weight loss surgery increases the risk of gallstone disease, evidence suggests that bariatric surgery mitigates the obesity-associated adverse prognostication in acute pancreatitis. Obesity is also a significant risk factor for pancreatic cancer. Obesity is a global epidemic and is increasing worldwide and among all age groups. There is an urgent need for focused health policies aimed at reducing the incidence and prevalence of obesity. This article summarizes the current literature highlighting the association between obesity and the pathophysiology and outcome of gallstone disease, pancreatitis, and pancreatic cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Functional Roles of Protein Nitration in Acute and Chronic Liver Diseases

    Directory of Open Access Journals (Sweden)

    Mohamed A. Abdelmegeed

    2014-01-01

    Full Text Available Nitric oxide, when combined with superoxide, produces peroxynitrite, which is known to be an important mediator for a number of diseases including various liver diseases. Peroxynitrite can modify tyrosine residue(s of many proteins resulting in protein nitration, which may alter structure and function of each target protein. Various proteomics and immunological methods including mass spectrometry combined with both high pressure liquid chromatography and 2D PAGE have been employed to identify and characterize nitrated proteins from pathological tissue samples to determine their roles. However, these methods contain a few technical problems such as low efficiencies with the detection of a limited number of nitrated proteins and labor intensiveness. Therefore, a systematic approach to efficiently identify nitrated proteins and characterize their functional roles is likely to shed new insights into understanding of the mechanisms of hepatic disease pathophysiology and subsequent development of new therapeutics. The aims of this review are to briefly describe the mechanisms of hepatic diseases. In addition, we specifically describe a systematic approach to efficiently identify nitrated proteins to study their causal roles or functional consequences in promoting acute and chronic liver diseases including alcoholic and nonalcoholic fatty liver diseases. We finally discuss translational research applications by analyzing nitrated proteins in evaluating the efficacies of potentially beneficial agents to prevent or treat various diseases in the liver and other tissues.

  18. Particle-induced pulmonary acute phase response may be the causal link between particle inhalation and cardiovascular disease

    DEFF Research Database (Denmark)

    Saber, Anne T.; Jacobsen, Nicklas R.; Jackson, Petra

    2014-01-01

    Inhalation of ambient and workplace particulate air pollution is associated with increased risk of cardiovascular disease. One proposed mechanism for this association is that pulmonary inflammation induces a hepatic acute phase response, which increases risk of cardiovascular disease. Induction...... epidemiological studies. In this review, we present and review emerging evidence that inhalation of particles (e.g., air diesel exhaust particles and nanoparticles) induces a pulmonary acute phase response, and propose that this induction constitutes the causal link between particle inhalation and risk...... of cardiovascular disease. Increased levels of acute phase mRNA and proteins in lung tissues, bronchoalveolar lavage fluid and plasma clearly indicate pulmonary acute phase response following pulmonary deposition of different kinds of particles including diesel exhaust particles, nanoparticles, and carbon nanotubes...

  19. [[Features of Pharmacological Correction of Alcoholic Fatty Liver Disease in Patients with Acute Ethanol Intoxication].

    Science.gov (United States)

    Livanov, G A; Shikalova, I A; Lodyagin, A N; Glushkov, S; Batotsyrenov, B V; Loladze, A T; Kovalenko, A L

    2016-01-01

    The aim of the study was to increase the efficiency of the treatment of acute ethanol intoxication in patients with alcoholic fatty liver disease. The article presents the results which received during the investigation and treatment of 166 patients with acute ethanol in- toxication on the background of alcoholic fatty liver disease Patients were assessed by the severity scale APACHE-Il. Were studied the dynamics of clinical, laboratory, biochemical parameters, the state of the antioxidant system activity and lipid peroxidation. The study found the effect of the combination hepatoprotective drug remaxol on the many links of metabolism, which was confirmed by the dynamics of biochemical parameters. There was a quick correction of hyperlactatemia, an effective reduction of ALT activity, the absence of reduction of albumin and urea concentration in the somatic period of ethanol poisoning. Period of using remaxol there was improvement in the clinical course of the disease, which manifested by the reduce the incidence of delirium tremens and shorten the duration of treatment of patients.

  20. Acute kidney injury and chronic kidney disease: an integrated clinical syndrome.

    Science.gov (United States)

    Chawla, Lakhmir S; Kimmel, Paul L

    2012-09-01

    The previous conventional wisdom that survivors of acute kidney injury (AKI) tend to do well and fully recover renal function appears to be flawed. AKI can cause end-stage renal disease (ESRD) directly, and increase the risk of developing incident chronic kidney disease (CKD) and worsening of underlying CKD. In addition, severity, duration, and frequency of AKI appear to be important predictors of poor patient outcomes. CKD is an important risk factor for the development and ascertainment of AKI. Experimental data support the clinical observations and the bidirectional nature of the relationships between AKI and CKD. Reductions in renal mass and nephron number, vascular insufficiency, cell cycle disruption, and maladaptive repair mechanisms appear to be important modulators of progression in patients with and without coexistent CKD. Distinction between AKI and CKD may be artificial. Consideration should be given to the integrated clinical syndrome of diminished GFR, with acute and chronic stages, where spectrum of disease state and outcome is determined by host factors, including the balance of adaptive and maladaptive repair mechanisms over time. Physicians must provide long-term follow-up to patients with first episodes of AKI, even if they presented with normal renal function.

  1. Association between the concentration of fine particles in the atmosphere and acute respiratory diseases in children

    Directory of Open Access Journals (Sweden)

    Antônio Paula Nascimento

    Full Text Available ABSTRACT OBJECTIVE To analyze the association between fine particulate matter concentration in the atmosphere and hospital care by acute respiratory diseases in children. METHODS Ecological study, carried out in the region of Grande Vitória, Espírito Santo, in the winter (June 21 to September 21, 2013 and summer (December 21, 2013 to March 19, 2014. We assessed data of daily count for outpatient care and hospitalization by respiratory diseases (ICD-10 in children from zero to 12 years in three hospitals in the Region of Grande Vitória. For collecting fine particulate matter, we used portable samplers of particles installed in six locations in the studied region. The Generalized Additive Model with Poisson distribution, fitted for the effects of predictor covariates, was used to evaluate the relationship between respiratory outcomes and concentration of fine particulate matter. RESULTS The increase of 4.2 µg/m3 (interquartile range in the concentration of fine particulate matter increased in 3.8% and 5.6% the risk of medical care or hospitalization, respectively, on the same day and with six-day lag from the exposure. CONCLUSIONS We identified positive association between outpatient care and hospitalizations of children under 12 years due to acute respiratory diseases and the concentration of fine particulate matter in the atmosphere.

  2. Recurrent acute liver failure due to NBAS deficiency: phenotypic spectrum, disease mechanisms, and therapeutic concepts.

    Science.gov (United States)

    Staufner, Christian; Haack, Tobias B; Köpke, Marlies G; Straub, Beate K; Kölker, Stefan; Thiel, Christian; Freisinger, Peter; Baric, Ivo; McKiernan, Patrick J; Dikow, Nicola; Harting, Inga; Beisse, Flemming; Burgard, Peter; Kotzaeridou, Urania; Lenz, Dominic; Kühr, Joachim; Himbert, Urban; Taylor, Robert W; Distelmaier, Felix; Vockley, Jerry; Ghaloul-Gonzalez, Lina; Ozolek, John A; Zschocke, Johannes; Kuster, Alice; Dick, Anke; Das, Anib M; Wieland, Thomas; Terrile, Caterina; Strom, Tim M; Meitinger, Thomas; Prokisch, Holger; Hoffmann, Georg F

    2016-01-01

    Acute liver failure (ALF) in infancy and childhood is a life-threatening emergency and in about 50% the etiology remains unknown. Recently biallelic mutations in NBAS were identified as a new molecular cause of ALF with onset in infancy, leading to recurrent acute liver failure (RALF). The phenotype and medical history of 14 individuals with NBAS deficiency was studied in detail and functional studies were performed on patients' fibroblasts. The phenotypic spectrum of NBAS deficiency ranges from isolated RALF to a multisystemic disease with short stature, skeletal dysplasia, immunological abnormalities, optic atrophy, and normal motor and cognitive development resembling SOPH syndrome. Liver crises are triggered by febrile infections; they become less frequent with age but are not restricted to childhood. Complete recovery is typical, but ALF crises can be fatal. Antipyretic therapy and induction of anabolism including glucose and parenteral lipids effectively ameliorates the course of liver crises. Patients' fibroblasts showed an increased sensitivity to high temperature at protein and functional level and a disturbed tethering of vesicles, pointing at a defect of intracellular transport between the endoplasmic reticulum and Golgi. Mutations in NBAS cause a complex disease with a wide clinical spectrum ranging from isolated RALF to a multisystemic phenotype. Thermal susceptibility of the syntaxin 18 complex is the basis of fever dependency of ALF episodes. NBAS deficiency is the first disease related to a primary defect of retrograde transport. Identification of NBAS deficiency allows optimized therapy of liver crises and even prevention of further episodes.

  3. The Impact of Kidney Disease on Acute Tubular Necrosis and Surgical Site Infection After Lumbar Fusion.

    Science.gov (United States)

    Nakhla, Jonathan; de la Garza Ramos, Rafael; Bhashyam, Niketh; Kobets, Andrew; Nasser, Rani; Echt, Murray; Lang, Gernot; Navarro-Ramirez, Rodrigo; Jada, Ajit; Kinon, Merritt; Yassari, Reza

    2017-09-01

    Kidney disease in spine surgery can be associated with serious complications. To investigate the rate of acute tubular necrosis (ATN) and surgical site infection (SSI) after lumbar fusion in patients with kidney disease. A review of the U.S. Nationwide Inpatient Sample from 2002 to 2011 was performed to identify patients who underwent lumbar fusion for degenerative spine disease or disk herniation. Four groups were established: no kidney disease, chronic kidney disease (CKD), end-stage renal disease (ESRD), and posttransplant. A multivariate analysis was performed to control for age, sex, and comorbidities. A total of 268,158 patients met the criteria; 263,757 with no kidney disease (98.4%), 3576 with CKD (1.3%), 586 with ESRD (0.2%), and 239 posttransplant (0.1%). Rates of ATN were 0.1%, 2.9%, 3.6%, and 0.0% for the 4 groups, respectively (P < 0.001). Rates of SSI were 0.3%, 0.4%, 1.0%, and 0.0%, respectively (P = 0.002). After controlling for patient age, sex, and medical comorbidities, patients with CKD (odds ratio [OR], 5.42; 95% confidence interval [CI], 4.14-7.09; P < 0.001) and ESRD (OR, 6.32; 95% CI, 3.89-10.33; P < 0.001) were significantly more likely to develop ATN compared with patients without kidney disease. However, CKD (OR, 0.80; 95% CI, 0.20-3.12; P = 0.754) or ESRD (OR, 1.96; 95% CI, 0.38-10.00; P = 0.415) did not increase the risk for SSI on multivariate analysis. The rate of ATN significantly increases based on severity of kidney disease. However, patients with transplants have ATN and SSI rates comparable with patients without kidney disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Patients With Fibrotic Interstitial Lung Disease Hospitalized for Acute Respiratory Worsening: A Large Cohort Analysis.

    Science.gov (United States)

    Moua, Teng; Westerly, Blair D; Dulohery, Megan M; Daniels, Craig E; Ryu, Jay H; Lim, Kaiser G

    2016-05-01

    Acute respiratory worsening (ARW) requiring hospitalization in patients with fibrotic interstitial lung disease (f-ILD) is common. Little is known about the frequency and implications of ARW in IPF and non-IPF ILD patients hospitalized for acute exacerbation (AE) vs known causes of ARW. All consecutive patients with f-ILD hospitalized with ARW at our institution from 2000 to 2014 were reviewed. ARW was defined as any worsening of respiratory symptoms with new or worsened hypoxemia or hypercapnia within 30 days of admission. Suspected AE was defined using modified 2007 American Thoracic Society/European Respiratory Society criteria. Known causes of ARW were reviewed and collated along with in-hospital and all-cause mortality postdischarge. A total of 220 patients (100 with IPF and 120 non-IPF) composed 311 admissions for ARW. Suspected AE (SAE) comprised 52% of ARW admissions, followed by infection (20%), and subacute progression of disease (15%). In-hospital mortality was similar in patients with IPF vs patients without (55 vs 45%, P = .18), but worse in suspected AE admission types (OR, 3.1 [1.9-5.14]). One-year survival after last ARW admission for the whole cohort was 22%, despite only 27% of patients presenting with baseline oxygen requirement at admission and a mean admission Charlson Comorbidity Index score of 5.4 (expected 1-year survival, 89%). Survival after discharge was similar between SAE and secondary ARW admission types in both IPF and non-IPF patients. Among patients with f-ILD, hospitalization for ARW appears associated with significant in-hospital and postdischarge mortality regardless of underlying fibrotic lung disease or non-AE cause of acute respiratory decline. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  5. Asthma is a risk factor for acute chest syndrome and cerebral vascular accidents in children with sickle cell disease

    Directory of Open Access Journals (Sweden)

    Scott Paul J

    2005-01-01

    Full Text Available Abstract Background Asthma and sickle cell disease are common conditions that both may result in pulmonary complications. We hypothesized that children with sickle cell disease with concomitant asthma have an increased incidence of vaso-occlusive crises that are complicated by episodes of acute chest syndrome. Methods A 5-year retrospective chart analysis was performed investigating 48 children ages 3–18 years with asthma and sickle cell disease and 48 children with sickle cell disease alone. Children were matched for age, gender, and type of sickle cell defect. Hospital admissions were recorded for acute chest syndrome, cerebral vascular accident, vaso-occlusive pain crises, and blood transfusions (total, exchange and chronic. Mann-Whitney test and Chi square analysis were used to assess differences between the groups. Results Children with sickle cell disease and asthma had significantly more episodes of acute chest syndrome (p = 0.03 and cerebral vascular accidents (p = 0.05 compared to children with sickle cell disease without asthma. As expected, these children received more total blood transfusions (p = 0.01 and chronic transfusions (p = 0.04. Admissions for vasoocclusive pain crises and exchange transfusions were not statistically different between cases and controls. SS disease is more severe than SC disease. Conclusions Children with concomitant asthma and sickle cell disease have increased episodes of acute chest syndrome, cerebral vascular accidents and the need for blood transfusions. Whether aggressive asthma therapy can reduce these complications in this subset of children is unknown and requires further studies.

  6. SOURCE AND PATHWAY DETERMINATION FOR BERYLLIUM FOUND IN BECHTEL NEVADA NORTH LAS VEGAS FACILITIES

    Energy Technology Data Exchange (ETDEWEB)

    BECHTEL NEVADA

    2004-07-01

    In response to the report ''Investigation of Beryllium Exposure Cases Discovered at the North Las Vegas Facility of the National Nuclear Security Administration'', published by the U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA) in August 2003, Bechtel Nevada (BN) President and General Manager Dr. F. A. Tarantino appointed the Beryllium Investigation & Assessment Team (BIAT) to identify both the source and pathway for the beryllium found in the North Las Vegas (NLV) B-Complex. From September 8 to December 18, 2003, the BIAT investigated the pathway for beryllium and determined that a number of locations existed at the Nevada Test Site (NTS) which could have contained sufficient quantities of beryllium to result in contamination if transported. Operations performed in the B-1 Building as a result of characterization activities at the Engine Maintenance, Assembly, and Disassembly (EMAD); Reactor Maintenance, Assembly, and Disassembly (RMAD); Test Cells A and C; and the Central Support Facility in Area 25 had the greatest opportunity for transport of beryllium. Investigative monitoring and sampling was performed at these sites with subsequent transport of sample materials, equipment, and personnel from the NTS to the B-1 Building. The timeline established by the BIAT for potential transport of the beryllium contamination into the B-1 Building was from September 1997 through November 2002. Based on results of recently completed swipe sampling, no evidence of transport of beryllium from test areas has been confirmed. Results less than the DOE beryllium action level of 0.2 ???g/100 cm2 were noted for work support facilities located in Area 25. All of the identified sites in Area 25 worked within the B-1 tenant's residency timeline have been remediated. Legacy contaminants have either been disposed of or capped with clean borrow material. As such, no current opportunity exists for release or spread of beryllium

  7. Invasive versus non-invasive ventilation for acute respiratory failure in neuromuscular disease and chest wall disorders.

    Science.gov (United States)

    Luo, Fang; Annane, Djillali; Orlikowski, David; He, Li; Yang, Mi; Zhou, Muke; Liu, Guan J

    2017-12-04

    Acute respiratory failure is a common life-threatening complication of acute onset neuromuscular diseases, and may exacerbate chronic hypoventilation in patients with neuromuscular disease or chest wall disorders. Standard management includes oxygen supplementation, physiotherapy, cough assistance, and, whenever needed, antibiotics and intermittent positive pressure ventilation. Non-invasive mechanical ventilation (NIV) via nasal, buccal or full-face devices has become routine practice in many centres. The primary objective of this review was to compare the efficacy of non-invasive ventilation with invasive ventilation in improving short-term survival in acute respiratory failure in people with neuromuscular disease and chest wall disorders. The secondary objectives were to compare the effects of NIV with those of invasive mechanical ventilation on improvement in arterial blood gas after 24 hours and lung function measurements after one month, incidence of barotrauma and ventilator-associated pneumonia, duration of mechanical ventilation, length of stay in the intensive care unit and length of hospital stay. We searched the following databases on 11 September 2017: the Cochrane Neuromuscular Specialised Register, CENTRAL, MEDLINE and Embase. We also searched conference proceedings and clinical trials registries. We planned to include randomised or quasi-randomised trials with or without blinding. We planned to include trials performed in children or adults with acute onset neuromuscular diseases or chronic neuromuscular disease or chest wall disorders presenting with acute respiratory failure that compared the benefits and risks of invasive ventilation versus NIV. Two review authors reviewed searches and independently selected studies for assessment. We planned to follow standard Cochrane methodology for data collection and analysis. We did not identify any trials eligible for inclusion in the review. Acute respiratory failure is a life-threatening complication of

  8. Acute Fulminant Colitis Caused by Idiopathic Mesenteric Inflammatory Veno-Occlusive Disease

    Directory of Open Access Journals (Sweden)

    James B. Canavan

    2007-12-01

    Full Text Available Mesenteric inflammatory veno-occlusive disease (MIVOD is an uncommon but important cause of bowel inflammation. MIVOD is characterised by lymphocytic inflammation and non-thrombotic occlusion of the mesenteric venules and veins. We present the case of a young man who presented with acute fulminant colitis, requiring colectomy. The differential diagnosis, pathogenesis and treatment are discussed. This case illustrates the rapid progression from ‘well’ to ‘colectomy’ that can occur with MIVOD. MIVOD should be considered in the differential diagnosis of colitis that does not respond to conventional medical treatment.

  9. Detection of minimal residual disease in Acute Myeloid Leukemia with t(8;21) translocation

    OpenAIRE

    Papadaki, Christina

    2017-01-01

    Acute myeloid leukemia (AML) with t(8;21) rearrangement, constitutes about 5% of all AML cases and is characterized by the presence of RUNX1-RUNX1T1 fusion gene. Although this subtype, referred as CBF leukemia, belongs to the favorable cytogenetic risk group, 25% to 30% of the patients relapse. Detection of minimal residual disease (MRD) is of major importance since it evaluates the “depth” of the remission and therefore, risk adapted therapy based on early detection of relapse becomes feasib...

  10. Mesenchymal Stromal Cells: What Is the Mechanism in Acute Graft-Versus-Host Disease?

    Directory of Open Access Journals (Sweden)

    Neil Dunavin

    2017-07-01

    Full Text Available After more than a decade of preclinical and clinical development, therapeutic infusion of mesenchymal stromal cells is now a leading investigational strategy for the treatment of acute graft-versus-host disease (GVHD. While their clinical use continues to expand, it is still unknown which of their immunomodulatory properties contributes most to their therapeutic activity. Herein we describe the proposed mechanisms, focusing on the inhibitory activity of mesenchymal stromal cells (MSCs at immunologic checkpoints. A deeper understanding of the mechanism of action will allow us to design more effective treatment strategies.

  11. The cell biology of disease: Acute promyelocytic leukemia, arsenic, and PML bodies.

    Science.gov (United States)

    de Thé, Hugues; Le Bras, Morgane; Lallemand-Breitenbach, Valérie

    2012-07-09

    Acute promyelocytic leukemia (APL) is driven by a chromosomal translocation whose product, the PML/retinoic acid (RA) receptor α (RARA) fusion protein, affects both nuclear receptor signaling and PML body assembly. Dissection of APL pathogenesis has led to the rediscovery of PML bodies and revealed their role in cell senescence, disease pathogenesis, and responsiveness to treatment. APL is remarkable because of the fortuitous identification of two clinically effective therapies, RA and arsenic, both of which degrade PML/RARA oncoprotein and, together, cure APL. Analysis of arsenic-induced PML or PML/RARA degradation has implicated oxidative stress in the biogenesis of nuclear bodies and SUMO in their degradation.

  12. Incidence and Clinical Outcome of Acute Liver Failure Caused by Dengue in a Hospital for Tropical Diseases, Thailand.

    Science.gov (United States)

    Kye Mon, Khin; Nontprasert, Apichart; Kittitrakul, Chatporn; Tangkijvanich, Pisit; Leowattana, Wattana; Poovorawan, Kittiyod

    2016-12-07

    Acute liver failure is an atypical manifestation of dengue with a high mortality. We performed a retrospective cohort study at the Hospital for Tropical Diseases, Bangkok, Thailand. In total, 1,926 patients with serologically confirmed dengue were enrolled in the study from 2011 to 2015. Of these, six patients presented with acute liver failure, four died, and two survived. The incidence of dengue-associated acute liver failure was 0.31%. Dengue-associated acute liver failure was most common among young adults (median age, 29 years). The median duration from onset of fever to development of acute liver failure was 7.5 days. Patients with the severe stage of dengue had a higher risk of developing acute liver failure (P acute liver failure were an age of ≤ 40 years (odds ratio [OR] = 1.5, 95% confidence interval [CI] = 1.1-2.0, P 10% ratio of atypical lymphocytes (OR = 2.3, 95% CI = 1.8-3.0, P acute liver failure in patients with dengue was quite low, but its impact on morbidity, mortality, and poor clinical outcomes was significant. In summary, this study indicates that various baseline risk factors are associated with acute liver failure in patients with dengue. © The American Society of Tropical Medicine and Hygiene.

  13. Development of a positive psychology intervention for patients with acute cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Julia K. Boehm

    2011-09-01

    Full Text Available The management of depression and other negative psychological states in cardiac patients has been a focus of multiple treatment trials, though such trials have not led to substantial improvements in cardiac outcomes. In contrast, there has been minimal focus on interventions to increase positive psychological states in cardiac patients, despite the fact that optimism and other positive states have been associated with superior cardiovascular outcomes. Our objective was to develop an 8-week, phone-based positive psychology intervention for patients hospitalized with acute cardiac disease (acute coronary syndrome or decompensated heart failure. Such an intervention would consist of positive psychology exercises adapted for this specific population, and it would need to be feasible for practitioners and patients in real-world settings. By adapting exercises that were previously validated in healthy individuals, we were able to generate a positive psychology telemedicine intervention for cardiac patients that focused on optimism, kindness, and gratitude. In addition, we successfully created a companion treatment manual for subjects to enhance the educational aspects of the intervention and facilitate completion of exercises. Finally, we successfully performed a small pilot trial of this intervention, and found that the positive psychology intervention appeared to be feasible and well-accepted in a cohort of patients with acute cardiac illness. Future studies should further develop this promising intervention and examine its impact on psychological and medical outcomes in this vulnerable population of cardiac patients.

  14. The role of purine metabolites as DAMPs in acute graft-versus-host disease.

    Directory of Open Access Journals (Sweden)

    Petya Apostolova

    2016-10-01

    Full Text Available Acute graft-versus-host disease (GVHD causes high mortality in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT. An early event in the classical pathogenesis of acute GVHD is tissue damage caused by the conditioning treatment or infection that consecutively leads to translocation of bacterial products (pathogen-associated molecular patterns, PAMPs into blood or lymphoid tissue, as well as danger-associated molecular patterns (DAMPs, mostly intracellular components which act as pro-inflammatory agents, once they are released into the extracellular space. A subtype of DAMPs are nucleotides such as adenosine triphosphate (ATP released from dying cells that can activate the innate and adaptive immune system by binding to purinergic receptors. Binding to certain purinergic receptors leads to a pro-inflammatory microenvironment and promotes allogeneic T cell priming. After priming, T cells migrate to the acute GVHD target organs, mainly skin, liver and the gastrointestinal tract and induce cell damage which further amplifies the release of intracellular components. This review summarizes the role of different purinergic receptors in particular P2X7 and P2Y2 as well as nucleotides in the pathogenesis of GVHD.

  15. Development of a positive psychology intervention for patients with acute cardiovascular disease.

    Science.gov (United States)

    Huffman, Jeff C; Mastromauro, Carol A; Boehm, Julia K; Seabrook, Rita; Fricchione, Gregory L; Denninger, John W; Lyubomirsky, Sonja

    2011-09-29

    The management of depression and other negative psychological states in cardiac patients has been a focus of multiple treatment trials, though such trials have not led to substantial improvements in cardiac outcomes. In contrast, there has been minimal focus on interventions to increase positive psychological states in cardiac patients, despite the fact that optimism and other positive states have been associated with superior cardiovascular outcomes. Our objective was to develop an 8-week, phone-based positive psychology intervention for patients hospitalized with acute cardiac disease (acute coronary syndrome or decompensated heart failure). Such an intervention would consist of positive psychology exercises adapted for this specific population, and it would need to be feasible for practitioners and patients in real-world settings. By adapting exercises that were previously validated in healthy individuals, we were able to generate a positive psychology telemedicine intervention for cardiac patients that focused on optimism, kindness, and gratitude. In addition, we successfully created a companion treatment manual for subjects to enhance the educational aspects of the intervention and facilitate completion of exercises. Finally, we successfully performed a small pilot trial of this intervention, and found that the positive psychology intervention appeared to be feasible and well-accepted in a cohort of patients with acute cardiac illness. Future studies should further develop this promising intervention and examine its impact on psychological and medical outcomes in this vulnerable population of cardiac patients.

  16. Laser-Ablated Beryllium Ions for Cold Antihydrogen in ALPHA

    CERN Document Server

    Sameed, Muhammed; Charlton, Michael

    One of the best ways to study antimatter is to investigate antihydrogen, the bound state of an antiproton and a positron. Antihydrogen atoms do not exist naturally and must be synthesized in the lab by merging carefully-prepared plasmas of positrons and antiprotons. If the atoms are created in a magnetic trap like the one used by the ALPHA experiment at CERN, then a fraction of the coldest atoms remain trapped, while the rest escape and annihilate on the trap walls. The trapped atoms may then be probed using microwaves or lasers to make high-precision comparisons with hydrogen. Increasing the trapping rate would allow us to perform precision measurements on antihydrogen in a shorter period of time and with better systematics. Particle simulations indicate that by sympathetically cooling positrons using laser-cooled beryllium ions, we have the ability to improve the antihydrogen trapping rate by up to two orders of magnitude. This thesis describes the effort to design and qualify a beryllium ion source that is...

  17. Calculations for electron-impact excitation and ionization of beryllium

    CERN Document Server

    Zatsarinny, Oleg; Fursa, Dmitry V; Bray, Igor

    2016-01-01

    The B-spline R-matrix and the convergent close-coupling methods are used to study electron collisions with neutral beryllium over an energy range from threshold to 100 eV. Coupling to the target continuum significantly affects the results for transitions from the ground state, but to a lesser extent the strong transitions between excited states. Cross sections are presented for selected transitions between low-lying physical bound states of beryllium, as well as for elastic scattering, momentum transfer, and ionization. The present cross sections for transitions from the ground state from the two methods are in excellent agreement with each other, and also with other available results based on nonperturbative convergent pseudo-state and time-dependent close-coupling models. The elastic cross section at low energies is dominated by a prominent shape resonance. The ionization from the $(2s2p)^3P$ and $(2s2p)^1P$ states strongly depends on the respective term. The current predictions represent an extensive set o...

  18. Steam chemical reactivity of plasma-sprayed beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Anderl, R.A.; Pawelko, R.J.; Smolik, G.R. [Lockheed Martin Idaho Technologies Co., Idaho Falls, ID (United States). Idaho National Engineering and Environmental Lab.; Castro, R.G. [Los Alamos National Lab., NM (United States)

    1998-07-01

    Plasma-spraying with the potential for in-situ repair makes beryllium a primary candidate for plasma facing and structural components in experimental magnetic fusion machines. Deposits with good thermal conductivity and resistance to thermal cycling have been produced with low pressure plasma-spraying (LPPS). A concern during a potential accident with steam ingress is the amount of hydrogen produced by the reactions of steam with hot components. In this study the authors measure the reaction rates of various deposits produced by LPPS with steam from 350 C to above 1,000 C. They correlate these reaction rates with measurements of density, open porosity and BET surface areas. They find the reactivity to be largely dependent upon effective surface area. Promising results were obtained below 600 C from a 94% theoretical dense (TD) deposit with a BET specific surface area of 0.085 m{sup 2}/g. Although reaction rates were higher than those for dense consolidated beryllium they were substantially lower, i.e., about two orders of magnitude, than those obtained from previously tested lower density plasma-sprayed deposits.

  19. Influence of neutron irradiation on the tritium retention in beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Rolli, R.; Ruebel, S.; Werle, H. [Forschungszentrum Karlsruhe, Inst. fuer Neutronenphysik und Reaktortechnik, Karlsruhe (Germany); Wu, C.H.

    1998-01-01

    Carbon-based materials and beryllium are the candidates for protective layers on the components of fusion reactors facing plasma. In contact with D-T plasma, these materials absorb tritium, and it is anticipated that tritium retention increases with the neutron damage due to neutron-induced traps. Because of the poor data base for beryllium, the work was concentrated on it. Tritium was loaded into the samples from stagnant T{sub 2}/H{sub 2} atmosphere, and afterwards, the quantity of the loaded tritium was determined by purged thermal annealing. The specification of the samples is shown. The samples were analyzed by SEM before and after irradiation. The loading and the annealing equipments are contained in two different glove boxes with N{sub 2} inert atmosphere. The methods of loading and annealing are explained. The separation of neutron-produced and loaded tritium and the determination of loaded tritium in irradiated samples are reported. Also the determination of loaded tritium in unirradiated samples is reported. It is evident that irradiated samples contained much more loaded tritium than unirradiated samples. The main results of this investigation are summarized in the table. (K.I.)

  20. Seroprevalence and disease burden of acute hepatitis A in adult population in South Korea.

    Science.gov (United States)

    Yoon, Jin Gu; Choi, Min Joo; Yoon, Jae Won; Noh, Ji Yun; Song, Joon Young; Cheong, Hee Jin; Kim, Woo Joo

    2017-01-01

    Adult seroprevalence of HAV is decreasing in developed countries including South Korea, due to general sanitation improvement. Although hepatitis A vaccination was introduced in South Korea more than 20 years ago, recent infection rates have not decreased. In this study, we investigate the seroprevalence of anti-HAV IgG, and estimate the national disease burden of acute hepatitis A in adult population. Seroprevalence data were collected from health promotion center of Korea University Guro Hospital, in Seoul, Korea from 2010 to 2014. Data from adults (≥20-years) being tested for anti-HAV IgG were included. In addition, epidemiological and clinical data of patients diagnosed with acute hepatitis A from 2009 to 2013, were collected from Korean Statistical Information Service (KOSIS) and the National Health Insurance Service (NHIS) database. Data were stratified and compared by age groups. A total of 11,177 subjects were tested for anti-HAV IgG from 2010 to 2014. Age-related seroprevalence showed relatively low seropositivity in young adults. Incidence of acute hepatitis A was highest in 2009 and lowest in 2013. When categorized by age group, adults in their 20s and 30s had more HAV infections and related-admissions than older adults. However, ICU admission rate and average insurance-covered cost was high in older adults. The anti-HAV IgG seropositivity in Korean younger adult population was low while the incidence of acute hepatitis A was high, especially in the 20-39 aged. However, a substantial number of older adults were infected, and required more intensive procedures and incurred higher insurance-covered medical costs.

  1. Seroprevalence and disease burden of acute hepatitis A in adult population in South Korea.

    Directory of Open Access Journals (Sweden)

    Jin Gu Yoon

    Full Text Available Adult seroprevalence of HAV is decreasing in developed countries including South Korea, due to general sanitation improvement. Although hepatitis A vaccination was introduced in South Korea more than 20 years ago, recent infection rates have not decreased. In this study, we investigate the seroprevalence of anti-HAV IgG, and estimate the national disease burden of acute hepatitis A in adult population.Seroprevalence data were collected from health promotion center of Korea University Guro Hospital, in Seoul, Korea from 2010 to 2014. Data from adults (≥20-years being tested for anti-HAV IgG were included. In addition, epidemiological and clinical data of patients diagnosed with acute hepatitis A from 2009 to 2013, were collected from Korean Statistical Information Service (KOSIS and the National Health Insurance Service (NHIS database. Data were stratified and compared by age groups.A total of 11,177 subjects were tested for anti-HAV IgG from 2010 to 2014. Age-related seroprevalence showed relatively low seropositivity in young adults. Incidence of acute hepatitis A was highest in 2009 and lowest in 2013. When categorized by age group, adults in their 20s and 30s had more HAV infections and related-admissions than older adults. However, ICU admission rate and average insurance-covered cost was high in older adults.The anti-HAV IgG seropositivity in Korean younger adult population was low while the incidence of acute hepatitis A was high, especially in the 20-39 aged. However, a substantial number of older adults were infected, and required more intensive procedures and incurred higher insurance-covered medical costs.

  2. Sampling and analysis plan for assessment of beryllium in soils surrounding TA-40 building 15

    Energy Technology Data Exchange (ETDEWEB)

    Ruedig, Elizabeth [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-12-19

    Technical Area (TA) 40 Building 15 (40-15) is an active firing site at Los Alamos National Laboratory. The weapons facility operations (WFO) group plans to build an enclosure over the site in 2017, so that test shots may be conducted year-round. The enclosure project is described in PRID 16P-0209. 40-15 is listed on LANL OSH-ISH’s beryllium inventory, which reflects the potential for beryllium in/on soils and building surfaces at 40-15. Some areas in and around 40-15 have previously been sampled for beryllium, but past sampling efforts did not achieve complete spatial coverage of the area. This Sampling and Analysis Plan (SAP) investigates the area surrounding 40-15 via 9 deep (≥1-ft.) soil samples and 11 shallow (6-in.) soil samples. These samples will fill the spatial data gaps for beryllium at 40-15, and will be used to support OSH-ISH’s final determination of 40-15’s beryllium registry status. This SAP has been prepared by the Environmental Health Physics program in consultation with the Industrial Hygiene program. Industrial Hygiene is the owner of LANL’s beryllium program, and will make a final determination with regard to the regulatory status of beryllium at 40-15.

  3. On use of beryllium in fusion reactors: Resources, impurities and necessity of detritiation after irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kolbasov, B.N., E-mail: b.kolbasov@yandex.ru; Khripunov, V.I., E-mail: Khripunov_VI@nrcki.ru; Biryukov, A.Yu.

    2016-11-01

    Highlights: • Potential needs in Be for fusion power engineering may exceed Be resources. • Be recycling after its operation in a fusion power plant (FPP) seems inevitable. • U impurity in Be seriously impairs environmental properties of fusion power plants. • Upon burial of irradiated Be the main problems are caused by U and {sup 3}H impurities. • Clearance of Be extracted from a FPP is impossible due to U impurity. - Abstract: Worldwide identified resources of beryllium somewhat exceed 80 000 t. Beryllium production in all the countries of the world in 2012 was about 230 t. At the same time, some conceptual designs of fusion power reactors envisage utilization of several hundred tons of this metal. Therefore return of beryllium into the production cycle (recycling) will be necessary. The beryllium ore from some main deposits has uranium content inadmissible for fusion reactors. This fact raises a question on the need to develop and apply an economically acceptable technology for beryllium purification from the uranium. Practically any technological procedure with beryllium used in fusion reactors requires its detritiation. A study of tritium and helium release from irradiated beryllium at different temperatures and rates of temperature increase was performed at Kurchatov Institute.

  4. Immobilisation of beryllium in solid waste (red-mud) by fixation and vitrification.

    Science.gov (United States)

    Bhat, P N; Ghosh, D K; Desai, M V M

    2002-01-01

    The objective of this study was to obtain information on the immobilization of beryllium (Be) in solid waste generated in the extraction process of beryllium from its ore, Beryl. This solid waste, termed red-mud, contains oxides of iron, aluminium, calcium, magnesium and beryllium. The red-mud waste contains beryllium at levels above the permissible limit, which prevents its disposal as solid waste. The total beryllium content in the red-mud analysed showed value ranging from 0.39 to 0.59% Be The studies showed that 50% of the total beryllium in red-mud can be extracted by water by repeated leaching over a period of 45 days. The cement mix, casting into cement blocks, was subjected to leachability studies over a period of 105 days and immobilization factor (IF factor) was determined. These IF values, of the order of 102, were compared with those obtained by performing leachability study on vitrified red-mud masses produced at different temperature conditions. Direct heating of the red-mud gave the gray coloured, non-transparent vitreous mass (as 'bad glass') showed effective immobilisation factor for beryllium in red-mud of the order of 10(4).

  5. Use of 41Ar production to measure ablator areal density in NIF beryllium implosions

    Science.gov (United States)

    Wilson, D. C.; Cassata, W. S.; Sepke, S. M.; Velsko, C. A.; Huang, H.; Yeamans, C. B.; Kline, J. L.; Yi, A.; Simakov, A. N.; Haan, S. W.; Batha, S. H.; Dewald, E. L.; Rygg, J. R.; Tommasini, R.; Xu, H.; Kong, C.; Bae, J.; Rice, N.

    2017-02-01

    For the first time, 41Ar produced by the (n,ϒ) reaction from 40Ar in the beryllium shell of a DT filled Inertial Confinement Fusion capsule has been measured. Ar is co-deposited with beryllium in the sputter deposition of the capsule shell. Combined with a measurement of the neutron yield, the radioactive 41Ar then quantifies the areal density of beryllium during the DT neutron production. The measured 1.15 ± 0.17 × 10+8 atoms of 41Ar are 2.5 times that from the best post-shot calculation, suggesting that the Ar and Be areal densities are correspondingly higher than those calculated. Possible explanations are that (1) the beryllium shell is compressed more than calculated, (2) beryllium has mixed into the cold DT ice, or more likely (3) less beryllium is ablated than calculated. Since only one DT filled beryllium capsule has been fielded at NIF, these results can be confirmed and expanded in the future.

  6. New and Emerging Technologies for Real-Time Air and Surface Beryllium Monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Phifer, B.E. Jr.; Churnetski, E.L.; Cooke, L.E.; Reed, J.J.; Howell, M.L.; Smith, V.D.

    2001-09-01

    In this study, five emerging technologies were identified for real-time monitoring of airborne beryllium: Microwave-Induced Plasma Spectroscopy (MIPS), Aerosol Beam-Focused Laser-Induced Plasma Spectroscopy (ABFLIPS), Laser-Induced Breakdown Spectroscopy (LIBS), Surfaced-Enhanced Raman Scattering (SERS) Spectroscopy, and Micro-Calorimetric Spectroscopy (CalSpec). Desired features of real-time air beryllium monitoring instrumentation were developed from the Y-12 CBDPP. These features were used as guidelines for the identification of potential technologies as well as their unique demonstrated capability to provide real-time monitoring of similar materials. However, best available technologies were considered, regardless of their ability to comply with the desired features. None of the five technologies have the capability to measure the particle size of airborne beryllium. Although reducing the total concentration of airborne beryllium is important, current literature suggests that reducing or eliminating the concentration of respirable beryllium is critical for worker health protection. Eight emerging technologies were identified for surface monitoring of beryllium. CalSpec, MIPS, SERS, LIBS, Laser Ablation, Absorptive Stripping Voltametry (ASV), Modified Inductively Coupled Plasma (ICP) Spectroscopy, and Gamma BeAST. Desired features of real-time surface beryllium monitoring were developed from the Y-12 CBDPP. These features were used as guidelines for the identification of potential technologies. However, the best available technologies were considered regardless of their ability to comply with the desired features.

  7. Development of radiation resistant grades of beryllium for nuclear and fusion facilities

    Energy Technology Data Exchange (ETDEWEB)

    Kupriyanov, I.B.; Gorokhov, V.A.; Nikolaev, G.N. [Russia Research Institute of Inorganic Materials, Moscow (Russian Federation)

    1995-09-01

    R&D results on beryllium with high radiation resistance obtained recently are described in this report. The data are presented on nine different grades of isotropic beryllium manufactured by VNIINM and distinguished by both initial powder characteristics and properties of billets, made of these powders. The average grain size of the investigated beryllium grades varied from 8 to 26 {mu}m, the content of beryllium oxide was 0.9 - 3.9 wt.%, the dispersity of beryllium oxide - 0.04 - 0.5 {mu}m, tensile strength -- 250 - 650 MPa. All materials were irradiated in SM - 2 reactor over the temperature range 550 - 780{degrees}C. The results of the investigation showed, that HIP beryllium grades are less susceptible to swelling at higher temperatures in comparison with hot pressed and extruded grades. Beryllium samples, having the smallest grain size, demonstrated minimal swelling, which was less than 0.8 % at 750{degrees}C and Fs = 3.7 {center_dot}10{sup 21} cm{sup -2} (E>0.1 MeV). The mechanical properties, creep and microstructure parameters, measured before and after irradiation, are presented.

  8. Acute Chest Syndrome in Sickle Cell Disease Patients Post Caesarean Delivery

    Directory of Open Access Journals (Sweden)

    YM Zhang

    2016-02-01

    Full Text Available Sickle cell disease (SCD is the most common inherited disease worldwide and is associated with anaemia and intermittent painful crisis. Pregnant women who are affected are known to have increased maternal and fetal mortality and morbidity. Acute chest syndrome (ACS is an uncommon but serious complication in pregnant women with SCD that can lead to death. We present two cases of patients with SCD, both of whom had severe ACS within 24 hours post Caesarean section. By accurate diagnosis and appropriate management by a multidisciplinary team, both mothers and fetuses had excellent outcomes. It is suggested that prompt recognition of ACS in a pregnant woman with SCD and collaborative medical and obstetric management are essential to optimize maternal and fetal outcomes.

  9. Pharmacological management of acute kidney injury and chronic kidney disease in neonates.

    Science.gov (United States)

    Jetton, Jennifer G; Sorenson, Mark

    2017-04-01

    Both acute kidney injury (AKI) and chronic kidney disease (CKD) are seen more frequently in the neonatal intensive care unit (NICU) as advances in supportive care improve the survival of critically ill infants as well as those with severe, congenital kidney and urinary tract anomalies. Many aspects of the infant's care, including fluid balance, electrolyte and mineral homeostasis, acid-base balance, and growth and nutrition require close monitoring by and collaboration among neonatologists, nephrologists, dieticians, and pharmacologists. This educational review summarizes the therapies widely used for neonates with AKI and CKD. Use of these therapies is extrapolated from data in older children and adults or based on clinical experience and case series. There is a critical need for more research on the use of therapies in infants with kidney disease as well as for the development of drug delivery systems and preparations scaled more appropriately for these small patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Factors That Affect Disease Progression After First Attack of Acute Pancreatitis

    DEFF Research Database (Denmark)

    Bertilsson, Sara; Swärd, Per; Kalaitzakis, Evangelos

    2015-01-01

    BACKGROUND & AIMS: Little is known about recurrence of pancreatitis after an initial episode, and little is known about how the disease progresses or what factors affect progression. We performed a population-based study of patients with acute pancreatitis (AP) to determine their outcomes...... pancreatitis, and mortality. Patients were followed up for a median time of 4.6 years, until death or the end of 2013. RESULTS: We identified 1457 patients with first-time AP (48% biliary disease, 17% alcohol-associated, 9.9% severe); 23% of patients had 1 or more recurrences. Risk for recurrence.......27-2.79; P pancreatitis, although alcohol-associated AP progressed most frequently (2.8/100 patient-years). Patients with recurrent AP were at the highest risk for chronic pancreatitis (HR, 6...

  11. Renal oxygenation and hemodynamics in acute kidney injury and chronic kidney disease

    Science.gov (United States)

    Singh, Prabhleen; Ricksten, Sven-Erik; Bragadottir, Gudrun; Redfors, Bengt; Nordquist, Lina

    2013-01-01

    Summary 1. Acute kidney injury (AKI) puts a major burden on health systems that may arise from multiple initiating insults, including ischemia-reperfusion injury, cardiovascular surgery, radio-contrast administration as well as sepsis. Similarly, the incidence and prevalence of chronic kidney disease (CKD) continues to increase with significant morbidity and mortality. Moreover, an increasing number of AKI patients survive to develop CKD and end-stage kidney disease (ESRD). 2. Although the mechanisms for development of AKI and progression of CKD remain poorly understood, initial impairment of oxygen balance is likely to constitute a common pathway, causing renal tissue hypoxia and ATP starvation that will in turn induce extracellular matrix production, collagen deposition and fibrosis. Thus, possible future strategies for one or both conditions may involve dopamine, loop-diuretics, inducible nitric oxide synthase inhibitors and atrial natriuretic peptide, substances that target kidney oxygen consumption and regulators of renal oxygenation such as nitric oxide and heme oxygenase-1. PMID:23360244

  12. Mitochondrion-Permeable Antioxidants to Treat ROS-Burst-Mediated Acute Diseases

    Directory of Open Access Journals (Sweden)

    Zhong-Wei Zhang

    2016-01-01

    Full Text Available Reactive oxygen species (ROS play a crucial role in the inflammatory response and cytokine outbreak, such as during virus infections, diabetes, cancer, cardiovascular diseases, and neurodegenerative diseases. Therefore, antioxidant is an important medicine to ROS-related diseases. For example, ascorbic acid (vitamin C, VC was suggested as the candidate antioxidant to treat multiple diseases. However, long-term use of high-dose VC causes many side effects. In this review, we compare and analyze all kinds of mitochondrion-permeable antioxidants, including edaravone, idebenone, α-Lipoic acid, carotenoids, vitamin E, and coenzyme Q10, and mitochondria-targeted antioxidants MitoQ and SkQ and propose astaxanthin (a special carotenoid to be the best antioxidant for ROS-burst-mediated acute diseases, like avian influenza infection and ischemia-reperfusion. Nevertheless, astaxanthins are so unstable that most of them are inactivated after oral administration. Therefore, astaxanthin injection is suggested hypothetically. The drawbacks of the antioxidants are also reviewed, which limit the use of antioxidants as coadjuvants in the treatment of ROS-associated disorders.

  13. Acute Sickle Hepatic Crisis after Liver Transplantation in a Patient with Hb SC Disease

    Directory of Open Access Journals (Sweden)

    J. H. Gillis

    2015-01-01

    Full Text Available Acute sickle hepatic crisis (ASHC has been observed in approximately 10% of patients with sickle cell disease. It occurs predominantly in patients with homozygous (Hb SS sickle cell anemia and to a lesser degree in patients with Hb SC disease, sickle cell trait, and Hb S beta thalassemia. Patients commonly present with jaundice, right upper quadrant pain, nausea, low-grade fever, tender hepatomegaly, and mild to moderate elevations in serum AST, ALT, and bilirubin. We describe the case of a patient with a history of hemoglobin SC disease and cirrhosis caused by hepatitis C presenting approximately 1 year after liver transplantation with an ASHC. The diagnosis was confirmed by liver biopsy. Our patient was treated with RBC exchange transfusions, IV hydration, and analgesia and made a complete recovery. Only a limited number of patients with sickle cell disease have received liver transplants, and, to our knowledge, this is the first case of ASHC after transplantation in a patient with Hb SC disease.

  14. Mitochondrion-Permeable Antioxidants to Treat ROS-Burst-Mediated Acute Diseases.

    Science.gov (United States)

    Zhang, Zhong-Wei; Xu, Xiao-Chao; Liu, Ting; Yuan, Shu

    2016-01-01

    Reactive oxygen species (ROS) play a crucial role in the inflammatory response and cytokine outbreak, such as during virus infections, diabetes, cancer, cardiovascular diseases, and neurodegenerative diseases. Therefore, antioxidant is an important medicine to ROS-related diseases. For example, ascorbic acid (vitamin C, VC) was suggested as the candidate antioxidant to treat multiple diseases. However, long-term use of high-dose VC causes many side effects. In this review, we compare and analyze all kinds of mitochondrion-permeable antioxidants, including edaravone, idebenone, α-Lipoic acid, carotenoids, vitamin E, and coenzyme Q10, and mitochondria-targeted antioxidants MitoQ and SkQ and propose astaxanthin (a special carotenoid) to be the best antioxidant for ROS-burst-mediated acute diseases, like avian influenza infection and ischemia-reperfusion. Nevertheless, astaxanthins are so unstable that most of them are inactivated after oral administration. Therefore, astaxanthin injection is suggested hypothetically. The drawbacks of the antioxidants are also reviewed, which limit the use of antioxidants as coadjuvants in the treatment of ROS-associated disorders.

  15. Acute inflammatory bowel disease of the small intestine in adult: MDCT findings and criteria for differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania [Department of Diagnostic Imaging, A.Cardarelli Hospital, Naples (Italy)], E-mail: stefromano@libero.it; Russo, Anna [Institute of Radiology, Second University of Naples, Naples (Italy); Daniele, Stefania; Tortora, Giovanni [Department of Diagnostic Imaging, A.Cardarelli Hospital, Naples (Italy); Maisto, Francesco [Institute of Radiology, Second University of Naples, Naples (Italy); Romano, Luigia

    2009-03-15

    Inflammatory changes of the intestine leading to acute abdomen could represent a frequent diagnostic challenge for radiologists actively involved in the emergency area. MDCT imaging findings needs to be evaluated considering the clinical history and symptoms and other abdominal findings that could be of help in differential diagnosis. Several protocols have been suggested and indicated in the imaging of patient with acute intestine. However, a CT protocol in which the precontrast scanning of the abdomen is followed by i.v. administration of contrast medium using the 45-55 s delay could be effective for an optimal visualization of the bowel wall. It is important to learn to recognize how the intestine reacts to the injury and how it 'talks', in order to become aware of the different patterns of disease manifestation related to an acute intestinal condition, for an effective diagnosis of active and acute inflammatory bowel disease.

  16. Anakinra-Induced Acute Liver Failure in an Adolescent Patient with Still's Disease.

    Science.gov (United States)

    Taylor, Sarah A; Vittorio, Jennifer M; Martinez, Mercedes; Fester, Keith A; Lagana, Stephen M; Lobritto, Steven J; Ovchinsky, Nadia

    2016-01-01

    The interleukin-1 (IL-1) family consists of 11 cytokines that play key regulatory roles in many immune and inflammatory processes. Anakinra (Kineret, Amgen, Inc.) is an IL-1 receptor antagonist (IL-1ra). Increased levels of IL-1 are found in several disease states suggesting that anakinra may be beneficial in disorders associated with elevated IL-1 levels. Anakinra has been effectively used in the treatment of systemic juvenile idiopathic arthritis and adult-onset Still's disease (AOSD). Despite its therapeutic benefits, anakinra also has potential side effects, including hepatotoxicity. We present a case of AOSD in an adolescent male that was treated with anakinra. During treatment, the patient developed acute liver failure that resolved upon withdrawal of anakinra. Although anakinra-induced liver injury has been reported in adults, including one case of subacute liver failure, we believe our case is the first to show severe acute liver failure in an adolescent treated with anakinra. This case provides significant insight into a potentially serious complication associated with anakinra. It is important to further delineate these complications as the treatment indications for this drug expand. © 2016 Pharmacotherapy Publications, Inc.

  17. Hydatid disease in acute leukemia: effect of anticancer treatment on echinococcosis.

    Science.gov (United States)

    Ali, Ridvan; Ozkalemkas, Fahir; Ozkocaman, Vildan; Ozcelik, Tulay; Akalin, Halis; Ozkan, Atilla; Altundal, Yildiz; Tunali, Ahmet

    2005-07-01

    Echinococcosis, also known as hydatid disease or hydatidosis, is a zoonotic illness caused by the larval form of Echinococcus spp. It is highly prevalent in areas where the parasite is endemic such as the Mediterranean region. However, occurrence of echinococcosis and cancer together is rare. We treated and followed approximately 1200 patients with different hematologic neoplastic diseases between 1985 and 2003, and only one of these individuals had concomitant acute leukemia and liver hydatidosis. This report describes the case of a 19-year-old man who had both primary refractoriness of acute leukemia (AML-M4) and liver hydatidosis. Management is discussed. The patient had cystic echinococcosis (CE) of the liver that was classified as CE1 according to the system established by the World Health Organization's Informal Working Group on Echinococcosis. The patient underwent 3 months of treatment with agents that targeted the leukemia (daunorubicin, idarubicin, cytarabine, fludarabine) and its complications (amphotericin B, amphotericin B lipid complex, liposomal amphotericin B). Throughout this period, the size and the contents of the cyst did not change, Echinococcus titers remained unchanged, and the cyst classification remained CE1.

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

    Directory of Open Access Journals (Sweden)

    Marta Martinez-Lopez

    2015-01-01

    Full Text Available The aim of this paper is to present for the first time the functional evaluation of each of the vestibular receptors in the six semicircular canals in a patient diagnosed with Meniere’s disease during an acute attack. A 54-year-old lady was diagnosed with left Meniere’s disease who during her regular clinic review suffers an acute attack of vertigo, with fullness and an increase of tinnitus in her left ear. Spontaneous nystagmus and the results in the video head-impulse test (vHIT are shown before, during, and after the attack. Nystagmus was initially left beating and a few minutes later an upbeat component was added. No skew deviation was observed. A decrease in the gain of the vestibuloocular reflex (VOR and the presence of overt saccades were observed when the stimuli were in the plane of the left superior semicircular canal. At the end of the crisis nystagmus decreased and vestibuloocular reflex returned to almost normal. A review of the different possibilities to explain these findings points to a hypothetical utricular damage.

  19. Corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Woods, J Andrew; Wheeler, James S; Finch, Christopher K; Pinner, Nathan A

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is a chronic and progressive disease that affects an estimated 10% of the world's population over the age of 40 years. Worldwide, COPD ranks in the top ten for causes of disability and death. Given the significant impact of this disease, it is important to note that acute exacerbations of COPD (AECOPD) are by far the most costly and devastating aspect of disease management. Systemic steroids have long been a standard for the treatment of AECOPD; however, the optimal strategy for dosing and administration of these medications continues to be debated. To review the use of corticosteroids in the treatment of acute exacerbations of COPD. Literature was identified through PubMed Medline (1950-February 2014) and Embase (1950-February 2014) utilizing the search terms corticosteroids, COPD, chronic bronchitis, emphysema, and exacerbation. All reference citations from identified publications were reviewed for possible inclusion. All identified randomized, placebo-controlled trials, meta-analyses, and systematic reviews evaluating the efficacy of systemic corticosteroids in the treatment of AECOPD were reviewed and summarized. The administration of corticosteroids in the treatment of AECOPD was assessed. In comparison to placebo, systemic corticosteroids improve airflow, decrease the rate of treatment failure and risk of relapse, and may improve symptoms and decrease the length of hospital stay. Therefore, corticosteroids are recommended by all major guidelines in the treatment of AECOPD. Existing literature suggests that low-dose oral corticosteroids are as efficacious as high-dose, intravenous corticosteroid regimens, while minimizing adverse effects. Recent data suggest that shorter durations of corticosteroid therapy are as efficacious as the traditional treatment durations currently recommended by guidelines. Systemic corticosteroids are efficacious in the treatment of AECOPD and considered a standard of care for patients

  20. Interlaboratory evaluation of an extraction and fluorescence method for the determination of trace beryllium in soils.

    Science.gov (United States)

    Cronin, John P; Agrawal, Anoop; Adams, Lori; Tonazzi, Juan C L; Brisson, Michael J; White, Kenneth T; Marlow, David; Ashley, Kevin

    2008-08-01

    Analytical methods for the determination of trace beryllium in soils are needed so that anthropogenic sources of this element can be distinguished from native (background) levels of beryllium. In this work, a collaborative interlaboratory evaluation of a new extraction and fluorescence-based procedure for determining beryllium in soil samples was carried out to fulfil method validation requirements for ASTM International voluntary consensus standard test methods. A Canadian reference material, CCRMP Till-1 soil, with a background beryllium concentration of 2.4 microg g(-1), was selected for study. This certified reference material (CRM) was spiked and homogenized with varying levels of beryllium oxide in order to give batches of material with beryllium concentrations of 4.36 +/- 0.69, 11.5 +/- 0.7, 124 +/- 7 and 246 +/- 16 microg g(-1) (+/- values are standard deviations). In the interlaboratory study (ILS), which was carried out in accordance with an applicable ASTM International standard practice (ASTM E691), samples of these spiked soils were subjected to extraction in dilute ammonium bifluoride at approximately 90 degrees C for 40 h. Fluorescence measurement of the extracted beryllium was carried out via detection using the high quantum yield fluorophore, hydroxybenzoquinoline sulfonate (HBQS). Interlaboratory precision estimates from six participating laboratories ranged from 0.048 to 0.103 (relative standard deviations) for the five different beryllium concentrations. Pooled bias estimates resulting from this ILS were between -0.049 and 0.177 for the various beryllium levels. These figures of merit support promulgation of the analytical procedure as an ASTM International standard test method.

  1. Primary percutaneous coronary intervention for acute myocardial infarction in a pediatric patient with giant coronary aneurysm due to Kawasaki disease.

    Science.gov (United States)

    Mongiovì, Maurizio; Alaimo, Annalisa; Vernuccio, Federica; Pieri, Daniele

    2014-01-01

    We report a case of acute myocardial infarction in an 8-year-old boy with a history of Kawasaki disease and giant coronary aneurysms in the right and left coronary arteries. We performed coronary angiography and percutaneous coronary intervention 4 hours after the onset of symptoms. This case suggests that primary percutaneous coronary intervention might be safe and effective in the long-term treatment of acute myocardial infarction due to coronary sequelae of Kawasaki. © 2013 Wiley Periodicals, Inc.

  2. Electron microscope study of thin beryllium lamellae (1963); Observation de lames minces de beryllium au microscope electronique (1063)

    Energy Technology Data Exchange (ETDEWEB)

    Beaudier-Antolin, J.; Dupouy, J.; Adda, Y. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1963-07-01

    Thin SR beryllium lamellae are examined by electron microscopy after various treatments, together with other samples made up of Be - Fe at 1 per cent and 0.2 per cent iron. The SR beryllium is examined after annealing at 750 deg C and 900 deg C, strongly cold-worked and quenched at 900 deg C. At 950 deg C the metal is perfectly annealed; at 750 deg C the polygonisation is almost complete, the dislocations are arranged either is dislocation walls in the prismatic planes, or in hexagonal lattices with non-dissociated nodes suggesting a high stacking defect energy. The cold-worked structure has a high dislocation density and already existing crystal walls. In the quenched state, the few dislocations are very straight and are aligned in the crystallographic directions. Iron-precipitation is studied in two alloys during tempering at 660 deg after quenching in salt water. The precipitate appears at the grain boundaries and then spreads through the matrix leaving a depleted zone in the neighbourhood of the joints. These precipitates, in the form of platelets parallel to the base planes of the beryllium lattice have been identified as the inter metallic phase Be{sub 11} Fe oriented in relation to the matrix (0 0 0 1)//(0 0 0 1) (1 0 1-bar 0)//(1 1 2-bar 0). (authors) [French] Des observations au microscope electronique sont faites sur des lames minces de beryllium SR apres divers traitements et sur des lames de Be - Fe a 1 pour cent et 0,2 pour cent en poids de fer. Le Be SR est etudie a l'etat recuit, a 750 deg C et 950 deg C, fortement ecroui et trempe a 900 deg C. A 950 deg C le metal est parfaitement recuit; a 750 deg C la polygonisation est presque complete, les dislocations sont arrangees soit en parois de dislocations dans des plans prismatiques, soit en reseaux hexagonaux aux noeuds non dissocies suggerant une forte energie de faute d'empilement. La structure d'ecrouissage presente une grande densite de dislocations et des parois deja existantes. A l

  3. Mathematical simulation of pressing X-ray lenses from nanocrystalline beryllium

    Science.gov (United States)

    Mishin, V. V.; Shishov, I. A.; Glukhov, P. A.; Zabrodin, A. V.; Semenov, A. A.; Brylev, D. A.; Anikin, A. S.

    2016-10-01

    A computer model is developed to describe the pressing of a beryllium lens using the Deform software package. This model takes into account the rheological properties of beryllium and the deforming tool. The state of stress of a workpiece is determined at various stages of pressing, and the probability of fracture of nanocrystalline beryllium is estimated using the normalized Cockcroft-Latham criterion. The temperature dependence of the limiting values of the fracture criterion is found and used to choose the pressing conditions that exclude fracture of lenses.

  4. Study of beryllium redeposition under bombardment by high intensity -low energy- hydrogen ion beams

    Energy Technology Data Exchange (ETDEWEB)

    Gureev, V.M.; Guseva, M.I.; Danelyan, L.S. [Russian Research Centre Kurchatov Inst., Moscow (Russian Federation)] [and others

    1998-01-01

    The results of studying the erosion of beryllium under an effect of intense ion fluxes with the energy of 250 eV, at the fluences {approx}10{sup 2}1 cm{sup -2}, at the MAGRAS-stand are given. The operating conditions under which a practically-complete redeposition of the sputtered beryllium upon the target surface were experimentally-realized. A change in the microstructure of a beryllium target under sputtering and redeposition is analyzed. Some technological applications are considered. (author)

  5. Measurements of the fallout flux of beryllium-7 and its variability in the soil

    OpenAIRE

    Andrello, Avacir Casanova; Appoloni, Carlos Roberto

    2010-01-01

    The aim of this study was to examine the beryllium-7 behavior in the soil. Natural variability of beryllium-7 concentration was calculated to be about 23% (relative standard deviation), and the depth distribution could be approximated by an exponential decay in bare soil, with an average penetration depth in the soil about 1 cm. The nuclide was not found below 2 cm depth, which confirmed its utilization to infer the erosion processes as a tracer of soil surface. The maximum beryllium-7 concen...

  6. Conditions for preparation of ultrapure beryllium by electrolytic refining in molten alkali-metal chlorides

    Energy Technology Data Exchange (ETDEWEB)

    Wohlfarth, Hagen [Stuttgart Univ. (Germany)

    1982-02-01

    Electrolytic refining is regarded as the most suitable process for the production of beryllium with impurity contents below 1 at.-ppM. Several parameters are important for electrolytic refining of beryllium in a BeCl2-containing LiCl-KCl melt: current density, BeCl2 content, electrolyte temperature, composition of the unpurified beryllium and impurity-ion concentrations in the melt, as well as apparatus characteristics such as rotation speed of the cathode and condition of the crucible material. These factors were studied and optimized such that extensive removal of the maximum number of accompanying and alloying elements was achieved.

  7. Modelisation and distribution of neutron flux in radium-beryllium source (226Ra-Be)

    Science.gov (United States)

    Didi, Abdessamad; Dadouch, Ahmed; Jai, Otman

    2017-09-01

    Using the Monte Carlo N-Particle code (MCNP-6), to analyze the thermal, epithermal and fast neutron fluxes, of 3 millicuries of radium-beryllium, for determine the qualitative and quantitative of many materials, using method of neutron activation analysis. Radium-beryllium source of neutron is established to practical work and research in nuclear field. The main objective of this work was to enable us harness the profile flux of radium-beryllium irradiation, this theoretical study permits to discuss the design of the optimal irradiation and performance for increased the facility research and education of nuclear physics.

  8. Photoluminescence enhancement from GaN by beryllium doping

    Science.gov (United States)

    García-Gutiérrez, R.; Ramos-Carrazco, A.; Berman-Mendoza, D.; Hirata, G. A.; Contreras, O. E.; Barboza-Flores, M.

    2016-10-01

    High quality Be-doped (Be = 0.19 at.%) GaN powder has been grown by reacting high purity Ga diluted alloys (Be-Ga) with ultra high purity ammonia in a horizontal quartz tube reactor at 1200 °C. An initial low-temperature treatment to dissolve ammonia into the Ga melt produced GaN powders with 100% reaction efficiency. Doping was achieved by dissolving beryllium into the gallium metal. The powders synthesized by this method regularly consist of two particle size distributions: large hollow columns with lengths between 5 and 10 μm and small platelets in a range of diameters among 1 and 3 μm. The GaN:Be powders present a high quality polycrystalline profile with preferential growth on the [10 1 bar 1] plane, observed by means of X-ray diffraction. The three characteristics growth planes of the GaN crystalline phase were found by using high resolution TEM microscopy. The optical enhancing of the emission in the GaN powder is attributed to defects created with the beryllium doping. The room temperature photoluminescence emission spectra of GaN:Be powders, revealed the presence of beryllium on a shoulder peak at 3.39 eV and an unusual Y6 emission at 3.32eV related to surface donor-acceptor pairs. Also, a donor-acceptor-pair transition at 3.17 eV and a phonon replica transition at 3.1 eV were observed at low temperature (10 K). The well-known yellow luminescence band coming from defects was observed in both spectra at room and low temperature. Cathodoluminescence emission from GaN:Be powders presents two main peaks associated with an ultraviolet band emission and the yellow emission known from defects. To study the trapping levels related with the defects formed in the GaN:Be, thermoluminescence glow curves were obtained using UV and β radiation in the range of 50 and 150 °C.

  9. Determining the community prevalence of acute gastrointestinal illness and gaps in surveillance of acute gastroenteritis and foodborne diseases in Guyana.

    Science.gov (United States)

    Persuad, Shamdeo; Mohamed-Rambaran, Pheona; Wilson, Alexis; James, Colin; Indar, Lisa

    2013-12-01

    Guyana is an English-speaking country in South America and, culturally, it is part of the Caribbean. Objective of this study was to determine the community prevalence and true burden and economic impact of acute gastroenteritis (AGE) and foodborne diseases (FBDs) in Guyana. A cross-sectional population-based survey was conducted in 7 of the 10 regions in Guyana during August and November 2009 to capture the high- and low-AGE season respectively. Overall, 1,254 individual surveys were administered at a response rate of 96.5%. The overall monthly prevalence of self-reported cases of AGE was 7.7% (97 cases) (95% CI 6.3-9.3), and the yearly incidence was 1.0 episodes per person-year. The highest monthly prevalence of AGE was observed in region 4 (8.9%) and in children aged 1-4 year(s) (12.7%). Of the 97 AGE cases, 23% sought medical care; 65% reported spending time at home due to their illness [range 1-20 day(s), mean 2.7 days], of whom 51% required other individuals to look after them while ill. The maximum number of stools per 24 hours ranged from 3 to 9 (mean 4.5), and number of days an individual suffered from AGE ranged from 1 to 21 day(s) (mean 2.7 days). The burden of syndromic AGE cases in the population for 2009 was estimated to be 131,012 cases compared to the reported 30,468 cases (76.7% underreporting), which implies that, for every syndromic case of AGE reported, there were additional 4.3 cases occurring in the community. For every laboratory-confirmed case of FBD/AGE pathogen reported, it was estimated that approximately 2,881 more cases were occurring in the population. Giardia was the most common foodborne pathogen isolated. The minimum estimated annual cost associated with the treatment for AGE was US$ 2,358,233.2, showing that AGE and FBD pose a huge economic burden on Guyana. Underreporting of AGE and foodbome pathogens, stool collection, and laboratory capacity were major gaps, affecting the surveillance of AGE in Guyana.

  10. Diagnosing and Treating Acute Bronchitis

    Science.gov (United States)

    ... Lung Disease Lookup > Acute Bronchitis Diagnosing and Treating Acute Bronchitis Questions to Ask Your Doctor about Acute Bronchitis ... Symptoms that last a few weeks How Is Acute Bronchitis Diagnosed? Healthcare providers diagnose acute bronchitis by asking ...

  11. Glycosphingolipid analysis in a naturally occurring ovine model of acute neuronopathic Gaucher disease.

    Science.gov (United States)

    Karageorgos, Litsa; Hein, Leanne; Rozaklis, Tina; Adams, Melissa; Duplock, Stephen; Snel, Marten; Hemsley, Kim; Kuchel, Tim; Smith, Nicholas; Hopwood, John J

    2016-07-01

    Gaucher disease arises from mutations in the β-glucocerebrosidase gene which encodes an enzyme required for the lysosomal catabolism of glucosylceramide. We have identified a naturally occurring mutation in the β-glucocerebrosidase gene in sheep that leads to Gaucher disease with acute neurological symptoms. Here we have examined the clinical phenotype at birth and subsequently quantified lipids in Gaucher lamb brain, in order to characterise the disorder. Enzyme activity assessments showed that a reduction in β-glucocerebrosidase activity to 1-5% of wild-type occurs consistently across newborn Gaucher lamb brain regions. We analyzed glucosylceramide, glucosylsphingosine, bis(monoacylglycero)phosphate and ganglioside profiles in brain, liver, and spleen, and observed 30- to 130-fold higher glucosylceramide, and 500- to 2000-fold higher glucosylsphingosine concentrations in Gaucher diseased lambs compared to wild-type. Significant increases of bis(monoacylglycero)phosphate and gangliosides [GM1, GM2, GM3] concentrations were also detected in the brain. As these glycosphingolipids are involved in many cellular events, an imbalance or disruption of the cell membrane lipid homeostasis would be expected to impair normal neuronal function. To our knowledge, this is the first detailed analysis of glycosphingolipids in various brain regions in a large animal model of neuronal disease, which permits the mechanistic investigation of lipid deregulation and their contribution to neurodegenerative process. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Molecular characterization of human calicivirus associated with acute diarrheal disease in mexican children

    Directory of Open Access Journals (Sweden)

    Gómez-Santiago Fabián

    2012-02-01

    Full Text Available Abstract Background Human caliciviruses (HuCV are emerging enteric pathogens that are a common cause of diarrhea in humans worldwide. Due to the paucity of information on the molecular characterization of HuCV circulating in Mexico, the aim of this work was to investigate the diversity and molecular epidemiology of the HuCV infection associated with acute diarrheal disease in Mexican children aged up to 5 years. Results Of the 131/414 (32% HuCV positive-specimens analyzed, 128 were identified as Norovirus (NoV and three as Sapovirus (SaV. Of the NoV positive specimens, 118/128 (92% were NoV GII and 10/128(8% were untypeable by RT-PCR in both polymerase and capsid genes, whereas one SaV isolate was further confirmed by sequencing as GI.2. Phylogenetic analysis based on polymerase partial gene sequences from 89/131 (68% HuCV isolates showed that 86/89 (97% belong to NoV GII.4 with three main variant clusters of this genotype, 2/89 (2% to NoV GII.2, and 1/89 (1% to SaV GI.2. Furthermore, partial sequencing of the capsid gene VP1 of 63/131 (48% strains indicated that 61/63 (97% correlated with NoV GII.4, whereas only 2/63 (3% clustered to NoV GII.2. HuCV infections were detected throughout the year, and the highest number of cases positive for NoV was found in children between 7 and 18 months of age (60%. Conclusions This study highlights the usefulness of analyzing both polymerase and capsid genes for molecular characterization of HuCV and demonstrates the relatedness and predominance of NoV GII.4 with acute diarrheal disease in young Mexican children, thus contributing to better understanding of the molecular epidemiology of this disease.

  13. Small intestinal bacterial overgrowth mimicking acute flare as a pitfall in patients with Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Reinshagen Max

    2009-07-01

    Full Text Available Abstract Background Small intestinal bacterial overgrowth (SIBO is characterized by excessive proliferation of colonic bacterial species in the small bowel. Potential causes of SIBO include fistulae, strictures or motility disturbances. Hence, patients with Crohn's Disease (CD are especially predisposed to develop SIBO. As result, CD patients may experience malabsorption and report symptoms such as weight loss, watery diarrhea, meteorism, flatulence and abdominal pain, mimicking acute flare in these patients. Methods One-hundred-fifty patients with CD reporting increased stool frequency, meteorism and/or abdominal pain were prospectively evaluated for SIBO with the Hydrogen Glucose Breath Test (HGBT. Results Thirty-eight patients (25.3% were diagnosed with SIBO based on positive findings at HGBT. SIBO patients reported a higher rate of abdominal complaints and exhibited increased stool frequency (5.9 vs. 3.7 bowel movements/day, p = 0.003 and lower body weight (63.6 vs 70.4 kg, p = 0.014. There was no correlation with the Crohn's Disease Activity Index. SIBO was significantly more frequent in patients with partial resection of the colon or multiple intestinal surgeries; there was also a clear trend in patients with ileocecal resection that did not reach statistical significance. SIBO rate was also higher in patients with affection of both the colon and small bowel, while inflammation of the (neoterminal ileum again showed only tendential association with the development of SIBO. Conclusion SIBO represents a frequently ignored yet clinically relevant complication in CD, often mimicking acute flare. Because symptoms of SIBO are often difficult to differentiate from those caused by the underlying disease, targeted work-up is recommended in patients with corresponding clinical signs and predisposing factors.

  14. Discrimination of acute lymphoblastic leukemia from systemic-onset juvenile idiopathic arthritis at disease onset

    Science.gov (United States)

    Tamashiro, Mirian S; Aikawa, Nádia Emi; Campos, Lucia Maria A; Cristofani, Lílian Maria; Odone-Filho, Vicente; Silva, Clovis A

    2011-01-01

    OBJECTIVE: To assess clinical and laboratory features that differentiate acute lymphoblastic leukemia from systemic juvenile idiopathic arthritis at disease onset. METHODS: Fifty-seven leukemia patients with musculoskeletal involvement, without blasts on peripheral blood and without glucocorticoid therapy at disease onset and 102 systemic juvenile idiopathic arthritis patients (International League of Associations for Rheumatology criteria) were retrospectively evaluated. The following features were examined: fever, rheumatoid rash, arthritis, limb pain, hepatomegaly, splenomegaly, pericarditis, myocarditis, pleuritis, weight loss, bleeding, anemia, leukopenia, neutropenia, thrombocytopenia, erythrocyte sedimentation rate, and lactic dehydrogenase levels. RESULTS: The median age at disease onset was significantly higher in leukemia patients than in those with systemic-onset juvenile idiopathic arthritis (5.8 vs. 3.8 years). In addition, the frequencies of limb pain, hepatomegaly, weight loss and hemorrhagic manifestations were significantly higher in leukemia patients than in systemic-onset juvenile idiopathic arthritis patients (70% vs. 1%, 54% vs. 32%, 30% vs. 8%, and 9% vs. 0%, respectively). Likewise, the frequencies of anemia, leukopenia, neutropenia, thrombocytopenia and high lactic dehydrogenase levels were statistically higher in leukemia patients than in patients with systemic-onset juvenile idiopathic arthritis (88% vs. 57%, 39% vs. 1%, 60% vs. 1%, 77% vs. 1%, and 56% vs. 14%, respectively). Remarkably, multivariate analysis revealed that limb pain (OR = 553; 95% CI = 46.48-6580.42) and thrombocytopenia (OR = 754.13; 95% CI = 64.57-8806.72) were significant independent variables that differentiated leukemia from systemic-onset juvenile idiopathic arthritis. The R2 of the Nagelkerke test was 0.91, and the Kaplan-Meier survival curves were similar for acute lymphoblastic leukemia patients with and without limb pain. CONCLUSION: Our study

  15. Discrimination of acute lymphoblastic leukemia from systemic-onset juvenile idiopathic arthritis at disease onset

    Directory of Open Access Journals (Sweden)

    Mirian S. Tamashiro

    2011-01-01

    Full Text Available OBJECTIVE: To assess clinical and laboratory features that differentiate acute lymphoblastic leukemia from systemic juvenile idiopathic arthritis at disease onset. METHODS: Fifty-seven leukemia patients with musculoskeletal involvement, without blasts on peripheral blood and without glucocorticoid therapy at disease onset and 102 systemic juvenile idiopathic arthritis patients (International League of Associations for Rheumatology criteria were retrospectively evaluated. The following features were examined: fever, rheumatoid rash, arthritis, limb pain, hepatomegaly, splenomegaly, pericarditis, myocarditis, pleuritis, weight loss, bleeding, anemia, leukopenia, neutropenia, thrombocytopenia, erythrocyte sedimentation rate, and lactic dehydrogenase levels. RESULTS: The median age at disease onset was significantly higher in leukemia patients than in those with systemic-onset juvenile idiopathic arthritis (5.8 vs. 3.8 years. In addition, the frequencies of limb pain, hepatomegaly, weight loss and hemorrhagic manifestations were significantly higher in leukemia patients than in systemic-onset juvenile idiopathic arthritis patients (70% vs. 1%, 54% vs. 32%, 30% vs. 8%, and 9% vs. 0%, respectively. Likewise, the frequencies of anemia, leukopenia, neutropenia, thrombocytopenia and high lactic dehydrogenase levels were statistically higher in leukemia patients than in patients with systemic-onset juvenile idiopathic arthritis (88% vs. 57%, 39% vs. 1%, 60% vs. 1%, 77% vs. 1%, and 56% vs. 14%, respectively. Remarkably, multivariate analysis revealed that limb pain (OR = 553; 95% CI =46.48-6580.42 and thrombocytopenia (OR = 754.13; 95% CI =64.57-8806.72 were significant independent variables that differentiated leukemia from systemic-onset juvenile idiopathic arthritis. The R2 of the Nagelkerke test was 0.91, and the Kaplan-Meier survival curves were similar for acute lymphoblastic leukemia patients with and without limb pain. CONCLUSION: Our study

  16. Inhalational Lung Disease

    Directory of Open Access Journals (Sweden)

    MR Farzaneh

    2010-01-01

    Full Text Available Inhalational lung diseases are among the most important occupational diseases. Pneumoconiosis refers to a group of lung diseases result from inhalation of usually inorganic dusts such as silicon dioxide, asbestos, coal, etc., and their deposition in the lungs. The resultant pulmonary disorders depend on the susceptibility of lungs; size, concentration, solubility and fibrogenic properties of the inhaled particles; and duration of exposure. Radiographic manifestations of pneumoconiosis become apparent several years after exposure to the particles. However, for certain types of dusts, e.g., silicone dioxide crystal and beryllium, heavy exposure within a short period can cause an acute disease. Pulmonary involvement in asbestosis is usually in the lower lobes. On the contrary, in silicosis and coal worker pneumoconiosis, the upper lobes are involved predominantly. For imaging evaluation of pneumoconiosis, high-resolution computed tomography (CT is superior to conventional chest x-ray. Magnetic resonance imaging (MRI and positron emission tomography (PET scan are helpful in those with suspected tumoral lesions. In this essay, we reviewed the imaging aspects of inhalational lung disease.

  17. Risk factors for acute Toxoplasma gondii diseases in Taiwan: a population-based case-control study.

    Directory of Open Access Journals (Sweden)

    Ting-Yi Chiang

    Full Text Available Although human toxoplasmosis is a notifiable disease in Taiwan since 2007, little is known about its risk factors. This study aimed to investigate the risk factors for acute Toxoplasma gondii diseases in Taiwan. We conducted a nationwide population-based case-control study. Cases of acute human toxoplasmosis notified to the Taiwan Centers for Diseases Control (Taipei, Taiwan during 2008-2013 were compared with controls that were randomly selected from healthy T. gondii-seronegative blood donors who participated in a nationwide T. gondii seroepidemiologic study during 2009-2010. Cases and controls were matched according to age, gender and residency at an 1:8 ratio. Structured questionnaires were used to gather information regarding risk factors. A total of 30 laboratory-confirmed acute T. gondii disease cases and 224 controls were enrolled. The most common clinical manifestation of the cases was flu-like symptoms (n = 20, followed by central nervous system disease (n = 4, ocular diseases (n = 3, abortion (n = 2, and congenital infection (n = 1. Multivariate conditional logistic regression showed that raw clam consumption (adjusted odds ratio [OR] = 3.7; 95% confidence interval [CI] = 1.4-9.9 and having a cat in the household (adjusted OR = 2.9; 95% CI = 1.1-7.9 were two independent risk factors for acute T. gondii disease. We conclude that raw shellfish consumption and domestic cat exposure were risk factors for acquiring acute T. gondii diseases in Taiwan. This finding may guide future research and control policies.

  18. RF magnetron sputtering of thick film amorphous beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Burt, R.J.; Meyer, S.F.; Hsieh, E.J.

    1979-09-19

    Thick film coatings of beryllium, needed for the low-Z ablator layer in proposed laser fusion targets, have been prepared using high rate magnetron rf sputtering. The requirements for these Be coatings include thicknesses from 5 to 50 ..mu..m, complete freedom from surface defects, and an average surface roughness of 100 nm or less. We have sputtered very smooth, dense, thick Be films with surface roughness less than 100 nm. X-ray diffraction analysis of impurity doped films indicates an amorphous-like structure. Impurity stabilized amorphous Be with smooth surfaces is reported on both cooled copper and higher temperature glass substrates. The sputtering parameters (substrate temperature, deposition rate, argon pressure, and impurity gas levels) affecting surface roughness and film structure are discussed in terms of SEM, AES, and x-ray diffraction results.

  19. Tensile and fracture toughness test results of neutron irradiated beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Chaouadi, R.; Moons, F.; Puzzolante, J.L. [Centre d`Etude de l`Energie Nucleaire, Mol (Belgium)

    1998-01-01

    Tensile and fracture toughness test results of four Beryllium grades are reported here. The flow and fracture properties are investigated by using small size tensile and round compact tension specimens. Irradiation was performed at the BR2 material testing reactor which allows various temperature and irradiation conditions. The fast neutron fluence (>1 MeV) ranges between 0.65 and 2.45 10{sup 21} n/cm{sup 2}. In the meantime, un-irradiated specimens were aged at the irradiation temperatures to separate if any the effect of temperature from irradiation damage. Test results are analyzed and discussed, in particular in terms of the effects of material grade, test temperature, thermal ageing and neutron irradiation. (author)

  20. Nuclear charge radius measurements of radioactive beryllium isotopes

    CERN Multimedia

    2002-01-01

    We propose to measure the nuclear charge radii of the beryllium isotopes $^{7,9,10}$Be and the one-neutron halo isotope $^{11}$Be using laser spectroscopy of trapped ions. Ions produced at ISOLDE and ionized with the laser ion source will be cooled and bunched in the radio-frequency buncher of the ISOLTRAP experiment and then transferred into a specially designed Paul trap. Here, they will be cooled to temperatures in the mK range employing sympathetic and direct laser cooling. Precision laser spectroscopy of the isotope shift on the cooled ensemble in combination with accurate atomic structure calculations will provide nuclear charge radii with a precision of better than 3%. This will be the first model-independent determination of a one-neutron halo nuclear charge radius.

  1. Electromagnetic properties of the Beryllium-11 nucleus in Halo EFT

    Directory of Open Access Journals (Sweden)

    Hammer H.-W.

    2010-04-01

    Full Text Available We compute electromagnetic properties of the Beryllium-11 nucleus using an effective field theory that exploits the separation of scales in this halo system. We fix the parameters of the EFT from measured data on levels and scattering lengths in the 10Be plus neutron system. We then obtain predictions for the B(E1 strength of the 1/2+ to 1/2− transition in the 11Be nucleus. We also compute the charge radius of the ground state of 11Be. Agreement with experiment within the expected accuracy of a leading-order computation in this EFT is obtained. We also indicate how higher-order corrections that affect both s-wave and p-wave 10 Be-neutron interactions will affect our results.

  2. Development of beryllium bonds for plasma-facing components

    Energy Technology Data Exchange (ETDEWEB)

    Franconi, E. (Associazione EURATOM-ENEA sulla Fusione, C.R.E. Frascati (Italy)); Ceccotti, G.C.; Magnoli, L. (ENEA, Dipt. Processi Chimici e Materiali Ceramici, C.R.E. Saluggia (Italy))

    1992-09-01

    This study concerns the techniques of bonding beryllium to both structural material (AISI 316 SS) and heat sink material (copper and DS-copper) plates, and the characterization of the bonding material obtained. Conventional bonding techniques for joining Be to SS and copper using brazing alloys were first investigated. The best result was obtained using a silver-copper eutetic alloy as a brazing alloy. However, the high-temperature capability of the materials prepared by this method is limited by the performance of brazing alloys at the operating temperature. To avoid this problem, we are developing a joining process known as solid-state reaction bonding that improves the capability at the operating temperature. (orig.).

  3. Modelling of radiation impact on ITER Beryllium wall

    Science.gov (United States)

    Landman, I. S.; Janeschitz, G.

    2009-04-01

    In the ITER H-Mode confinement regime, edge localized instabilities (ELMs) will perturb the discharge. Plasma lost after each ELM moves along magnetic field lines and impacts on divertor armour, causing plasma contamination by back propagating eroded carbon or tungsten. These impurities produce enhanced radiation flux distributed mainly over the beryllium main chamber wall. The simulation of the complicated processes involved are subject of the integrated tokamak code TOKES that is currently under development. This work describes the new TOKES model for radiation transport through confined plasma. Equations for level populations of the multi-fluid plasma species and the propagation of different kinds of radiation (resonance, recombination and bremsstrahlung photons) are implemented. First simulation results without account of resonance lines are presented.

  4. Validation of NCSSHP for highly enriched uranium systems containing beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Krass, A.W.; Elliott, E.P.; Tollefson, D.A.

    1994-09-29

    This document describes the validation of KENO V.a using the 27-group ENDF/B-IV cross section library for highly enriched uranium and beryllium neutronic systems, and is in accordance with ANSI/ANS-8.1-1983(R1988) requirements for calculational methods. The validation has been performed on a Hewlett Packard 9000/Series 700 Workstation at the Oak Ridge Y-12 Plant Nuclear Criticality Safety Department using the Oak Ridge Y-12 Plant Nuclear Criticality Safety Software code package. Critical experiments from LA-2203, UCRL-4975, ORNL-2201, and ORNL/ENG-2 have been identified as having the constituents desired for this validation as well as sufficient experimental detail to allow accurate construction of KENO V.a calculational models. The results of these calculations establish the safety criteria to be employed in future calculational studies of these types of systems.

  5. A Salivary Urea Nitrogen Dipstick to Detect Obstetric-Related Acute Kidney Disease in Malawi.

    Science.gov (United States)

    Evans, Rhys D R; Cooke, William; Hemmila, Ulla; Calice-Silva, Viviane; Raimann, Jochen; Craik, Alison; Mandula, Chimwemwe; Mvula, Priscilla; Msusa, Ausbert; Dreyer, Gavin; Levin, Nathan W; Pecoits-Filho, Roberto

    2018-01-01

    Obstetric-related acute kidney injury (AKI) is associated with adverse outcomes for mother and fetus, particularly in low-income countries. However, laboratory-independent tools to facilitate diagnosis are lacking. We assessed the diagnostic performance of a salivary urea nitrogen (SUN) dipstick to detect obstetric-related acute kidney disease in Malawi. Women at high risk for AKI admitted to an obstetric unit in Blantyre, Malawi, were recruited between 21 September and 11 December 2015. Patients underwent serum creatinine (SCr) testing alongside measurement of SUN using a dipstick on admission, and every 48 hours thereafter if evidence of kidney disease was found. A total of 301 patients were included (mean age 25.9 years, 11% HIV positive). Of the patients, 23 (7.6%) had AKI, stage 1 in 47.8%, most commonly due to preeclampsia/eclampsia. Mean presenting SCr values were 108.8 ± 21.8 μmol/l (1.23 ± 0.25 mg/dl), 118 ± 34.45 μmol/l (1.33 ± 0.39 mg/dl), and 136.1 ± 30.4 μmol/l (1.54 ± 0.34 mg/dl) in AKI stages 1 to 3 respectively. SUN > 14 mg/dl had a sensitivity of 12.82% and a specificity of 97.33% to detect acute kidney disease; the area under the receiver operating characteristic curve was 0.551. In patients with normal SUN on admission, perinatal mortality was 11.8%, and was 25.0% if SUN was > 14 mg/dl (P = 0.18). The SUN dipstick was specific but insensitive when used to diagnose obstetric-related AKI. Limited biochemical derangement and low salivary urea concentrations due to physiological changes in pregnancy, as opposed to a technical limitation of the dipstick itself, are the likely reason for the lack of sensitivity in this study.

  6. Similar virus spectra and seasonality in paediatric patients with acute respiratory disease, Ghana and Germany.

    Science.gov (United States)

    Annan, A; Ebach, F; Corman, V M; Krumkamp, R; Adu-Sarkodie, Y; Eis-Hübinger, A M; Kruppa, T; Simon, A; May, J; Evans, J; Panning, M; Drosten, C; Drexler, J F

    2016-04-01

    Epidemiological differences between tropical and temperate regions regarding viruses causing acute respiratory infection are poorly understood. This is in part because methodological differences limit the comparability of data from these two regions. Using identical molecular detection methods, we tested 1174 Ghanaian and 539 German children with acute respiratory infections sampled over 12 months for the 15 most common respiratory viruses by PCR. A total 43.2% of the Ghanaian and 56.6% of the German children tested positive for at least one respiratory virus. The pneumoviruses respiratory syncytial virus and human metapneumovirus were most frequently detected, in 13.1% and 25.1% within the Ghanaian and German children, respectively. At both study sites, pneumoviruses were more often observed at younger ages (p prevalence rate ratio (PR) 2.0, 95% CI 1.7-2.4). In contrast, non-enveloped viruses were more frequent during the Ghanaian dry season (PR 0.6, 95% CI 0.4-0.8). In Germany, enveloped viruses were also more frequently detected during the relatively colder winter season (PR 1.6, 95% CI 1.2-2.1) and non-enveloped viruses during summer (PR 0.7, 95% CI 0.5-0.9). Despite a distance of about 5000 km and a difference of 44° latitude separating Germany and Ghana, virus spectra, age associations and seasonal fluctuation showed similarities between sites. Neither respiratory viruses overall, nor environmentally stable (non-enveloped) viruses in particular were more frequent in tropical Ghana. The standardization of our sampling and laboratory testing revealed similarities in acute respiratory infection virus patterns in tropical and temperate climates. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  7. Third-party regulatory T cells prevent murine acute graft-versus-host disease.

    Science.gov (United States)

    Lim, Jung-Yeon; Im, Keon-Il; Song, Yunejin; Kim, Nayoun; Nam, Young-Sun; Jeon, Young-Woo; Cho, Seok-Goo

    2017-10-19

    Adoptive therapy with regulatory T (Treg) cells to prevent graft-versus-host disease (GVHD) would benefit from a strategy to improve homing to the sites of inflammation following hematopoietic stem cell transplantation (HSCT). Although donor-derived Treg cells have mainly been used in these models, third-party-derived Treg cells are a promising alternative for cell-based immunotherapy, as they can be screened for pathogens and cell activity, and banked for GVHD prevention. In this study, we explored major histocompatibility complex (MHC) disparities between Treg cells and conventional T cells in HSCT to evaluate the impact of these different cell populations on the prevention of acute GVHD, as well as survival after allogeneic transplantation. To induce acute GVHD, lethally irradiated BALB/c (H-2d) mice were transplanted with 5 × 105 T cell-depleted bone marrow cells and 5 × 105 CD4+CD25- splenic T cells from C57BL/6 (H-2b) mice. Recipients were injected with 5 × 105 cultured donor-, host-, or third-party-derived CD4+CD25+CD62L+ Treg cells (bone marrow transplantation + day 1). Systemic infusion of three groups of Treg cell improved clinicopathological manifestations and survival in an acute GVHD model. Although donor-derived Treg cells were immunologically the most effective, the third-party-derived Treg cell therapy group displayed equal regulation of expansion of CD4+CD25+- Foxp3+ Treg cells and suppressive CD4+IL-17+ T-helper (Th17) cells in ex vivo assays compared with the donor- and host-derived groups. Our findings demonstrate that the use of third-party Treg cells is a viable alternative to donor-derived Treg cellular therapy in clinical settings, in which human leukocyte antigen-matched donors are not always readily available.

  8. Acute aerobic exercise increases brain-derived neurotrophic factor levels in elderly with Alzheimer's disease.

    Science.gov (United States)

    Coelho, Flávia Gomes de Melo; Vital, Thays Martins; Stein, Angelica Miki; Arantes, Franciel José; Rueda, André Veloso; Camarini, Rosana; Teodorov, Elizabeth; Santos-Galduróz, Ruth Ferreira

    2014-01-01

    Studies indicate the involvement of brain-derived neurotrophic factor (BDNF) in the pathogenesis of Alzheimer's disease (AD). Decreased BDNF levels may constitute a lack of trophic support and contribute to cognitive impairment in AD. The benefits of acute and chronic physical exercise on BDNF levels are well-documented in humans, however, exercise effects on BDNF levels have not been analyzed in older adults with AD. The aim of this study was to investigate the effects of acute aerobic exercise on BDNF levels in older adults with AD and to verify associations among BDNF levels, aerobic fitness, and level of physical activity. Using a controlled design, twenty-one patients with AD (76.3 ± 6.2 years) and eighteen healthy older adults (74.6 ± 4.7 years) completed an acute aerobic exercise. The outcomes included measures of BDNF plasma levels, aerobic fitness (treadmill grade, time to exhaustion, VO2, and maximal lactate) and level of physical activity (Baecke Questionnaire Modified for the Elderly). The independent t-test shows differences between groups with respect to the BDNF plasma levels at baseline (p = 0.04; t = 4.53; df = 37). In two-way ANOVA, a significant effect of time was found (p = 0.001; F = 13.63; df = 37), the aerobic exercise significantly increased BDNF plasma levels in AD patients and healthy controls. A significant correlation (p = 0.04; r = 0.33) was found between BDNF levels and the level of physical activity. The results of our study suggest that aerobic exercise increases BDNF plasma levels in patients with AD and healthy controls. In addition to that, BDNF levels had association with level of physical activity.

  9. Clinical use of enteral immune nutrition in patients with acute exacerbation of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Zhi-cheng ZHANG

    2015-06-01

    Full Text Available Objective To investigate the use of enteral immune nutrition preparation in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD, regard its efficacy in improving nutritional status, and its influence on immunity and the status of acute inflammatory reaction of the patients. Methods Sixty-two AECOPD patients requiring mechanical ventilation in ICU of our hospital were randomly divided into two groups: immune nutrition group [study group, n=32, receiving Ruineng (a product of Huarui Pharmaceutical Ltd., which contained essential fatty acids, Omega-3 fatty acids, and energy 1.3 kcal/ml] and conventional nutrition group (control group, n=30, receiving the hospital self-made homogenized diet with 1.2 kal/ml. Patients in the two groups took enteral nutrition of equal calorie, and it was given by nasointestinal tube. On the day of admission and the 14th and 18th after admission, venous blood was obtained for the determination of serum albumin, prealbumin, transferrin, C reactive protein (CRP, tumor necrosis factor-α (TNF-α, and interleukin-6 (IL-6. At the same time upper arm muscle circumference (MAMC was measured at the bed side. The 14-day off-respirator rate and mechanical ventilation time within 28 days were compared between the two groups. Results The 14-day off-respirator rate was higher in study group than in control group (P0.05. Conclusions Compared with homogenized diet, immune enteral nutrition could better improve the nutritional status and immune function, lower the acute inflammatory response level, increase the success rate of early off-respirator in AECOPD patients, therefore, enteral immune nutrition preparation is a better nutrition support solution for AECOPD. DOI: 10.11855/j.issn.0577-7402.2015.05.17

  10. First beryllium capsule implosions on the National Ignition Facility

    Energy Technology Data Exchange (ETDEWEB)

    Kline, J. L.; Yi, S. A.; Simakov, A. N.; Olson, R. E.; Wilson, D. C.; Kyrala, G. A.; Perry, T. S.; Batha, S. H.; Zylstra, A. B.; Dewald, E. L.; Tommasini, R.; Ralph, J. E.; Strozzi, D. J.; MacPhee, A. G.; Callahan, D. A.; Hinkel, D. E.; Hurricane, O. A.; Milovich, J. L.; Rygg, J. R.; Khan, S. F.; Haan, S. W.; Celliers, P. M.; Clark, D. S.; Hammel, B. A.; Kozioziemski, B.; Schneider, M. B.; Marinak, M. M.; Rinderknecht, H. G.; Robey, H. F.; Salmonson, J. D.; Patel, P. K.; Ma, T.; Edwards, M. J.; Stadermann, M.; Baxamusa, S.; Alford, C.; Wang, M.; Nikroo, A.; Rice, N.; Hoover, D.; Youngblood, K. P.; Xu, H.; Huang, H.; Sio, H.

    2016-05-01

    The first indirect drive implosion experiments using Beryllium (Be) capsules at the National Ignition Facility confirm the superior ablation properties and elucidate possible Be-ablator issues such as hohlraum filling by ablator material. Since the 1990s, Be has been the preferred Inertial Confinement Fusion (ICF) ablator because of its higher mass ablation rate compared to that of carbon-based ablators. This enables ICF target designs with higher implosion velocities at lower radiation temperatures and improved hydrodynamic stability through greater ablative stabilization. Recent experiments to demonstrate the viability of Be ablator target designs measured the backscattered laser energy, capsule implosion velocity, core implosion shape from self-emission, and in-flight capsule shape from backlit imaging. The laser backscatter is similar to that from comparable plastic (CH) targets under the same hohlraum conditions. Implosion velocity measurements from backlit streaked radiography show that laser energy coupling to the hohlraum wall is comparable to plastic ablators. The measured implosion shape indicates no significant reduction of laser energy from the inner laser cone beams reaching the hohlraum wall as compared with plastic and high-density carbon ablators. These results indicate that the high mass ablation rate for beryllium capsules does not significantly alter hohlraum energetics. In addition, these data, together with data for low fill-density hohlraum performance, indicate that laser power multipliers, required to reconcile simulations with experimental observations, are likely due to our limited understanding of the hohlraum rather than the capsule physics since similar multipliers are needed for both Be and CH capsules as seen in experiments.

  11. First beryllium capsule implosions on the National Ignition Facility

    Energy Technology Data Exchange (ETDEWEB)

    Kline, J. L.; Yi, S. A.; Simakov, A. N.; Olson, R. E.; Wilson, D. C.; Kyrala, G. A.; Perry, T. S.; Batha, S. H.; Zylstra, A. B. [Los Alamos National Laboratory, Los Alamos, New Mexico 87544 (United States); Dewald, E. L.; Tommasini, R.; Ralph, J. E.; Strozzi, D. J.; MacPhee, A. G.; Callahan, D. A.; Hinkel, D. E.; Hurricane, O. A.; Milovich, J. L.; Rygg, J. R.; Khan, S. F. [Lawrence Livermore National Laboratory, Livermore, California 94550 (United States); and others

    2016-05-15

    The first indirect drive implosion experiments using Beryllium (Be) capsules at the National Ignition Facility confirm the superior ablation properties and elucidate possible Be-ablator issues such as hohlraum filling by ablator material. Since the 1990s, Be has been the preferred Inertial Confinement Fusion (ICF) ablator because of its higher mass ablation rate compared to that of carbon-based ablators. This enables ICF target designs with higher implosion velocities at lower radiation temperatures and improved hydrodynamic stability through greater ablative stabilization. Recent experiments to demonstrate the viability of Be ablator target designs measured the backscattered laser energy, capsule implosion velocity, core implosion shape from self-emission, and in-flight capsule shape from backlit imaging. The laser backscatter is similar to that from comparable plastic (CH) targets under the same hohlraum conditions. Implosion velocity measurements from backlit streaked radiography show that laser energy coupling to the hohlraum wall is comparable to plastic ablators. The measured implosion shape indicates no significant reduction of laser energy from the inner laser cone beams reaching the hohlraum wall as compared with plastic and high-density carbon ablators. These results indicate that the high mass ablation rate for beryllium capsules does not significantly alter hohlraum energetics. In addition, these data, together with data for low fill-density hohlraum performance, indicate that laser power multipliers, required to reconcile simulations with experimental observations, are likely due to our limited understanding of the hohlraum rather than the capsule physics since similar multipliers are needed for both Be and CH capsules as seen in experiments.

  12. Monitoring of minimal residual disease in acute leukemia by multiparametric flow cytometry.

    Science.gov (United States)

    Kusenda, J; Fajtova, M; Kovarikova, A

    2014-01-01

    In this review, we discuss methodological principles and clinical applications of minimal residual disease (MRD) assays based on multiparameter flow cytometry (MFC). The introduction of methods for MRD detection has revolutionized monitoring of treatment response in acute leukemia. Great progress has been made in the development of wide array of flow cytometric techniques for rare event detection. This advance was accompanied by increasingly greater understanding of the immunophenotypic features of leukemic and normal lymphoid cells, and of the antigenic differences that make MRD studies possible. Immunologic testing of MRD relies on "leukemia-associated" immunophenotypes which can be identified by MFC in the most of acute leukemia cases. The recent technical innovations in routine MFC (3 lasers and≥8 colors) and the new developments in software for data analysis make this technology the most attractive for MRD diagnostics. The importance of MFC methodology will be further strengthened by the ongoing international standardization efforts. Results of MRD testing provide unique and clinically important information. The systematic application of immunologic techniques to study MRD in clinical samples has demonstrated the prognostic significance of MRD in patients, leading to the use of MRD to regulate treatment intensity in many contemporary protocols. The identification of new markers of MRD should increase the sensitivity of MRD testing by MFC and is required to widen the applicability of MRD studies.

  13. [Chronic obstructive pulmonary disease in patients with acute symptomatic pulmonary embolism].

    Science.gov (United States)

    Fernández, Carolina; Jiménez, David; De Miguel, Javier; Martí, David; Díaz, Gema; Sueiro, Antonio

    2009-06-01

    The diagnosis of pulmonary embolism (PE) is often complicated by the presence of chronic obstructive pulmonary disease (COPD). Some studies have suggested that patients with PE and concomitant COPD have a worse prognosis than patients without COPD. Outpatients diagnosed with acute symptomatic PE at a university tertiary care hospital were prospectively included in the study. Clinical characteristics, time between onset of symptoms and diagnosis, and outcome were analyzed according to presence or absence of COPD. The primary endpoint was all-cause deaths at 3 months. Of 882 patients with a confirmed diagnosis of acute symptomatic PE, 8% (95% confidence interval [CI], 6%-9%) had COPD. Patients with COPD were significantly more likely to have a delay in diagnosis of more than 3 days and to have a low pretest probability of pulmonary embolism according to a standardized clinical score. The total number of deaths during 3 months of follow-up was 128 (14%; 95% CI, 12%-17%). Factors significantly associated with mortality from all causes were a history of cancer or immobilization, systolic blood pressure less than 100mm Hg, and arterial oxyhemoglobin saturation less than 90%. COPD was significantly associated with PE-related death in the logistic regression analysis (relative risk, 2.2; 95% CI, 1.0-5.1). Patients with COPD and PE more often have a lower pretest probability and a longer delay in diagnosis of PE. COPD is significantly associated with PE-related death in the 3 months following diagnosis.

  14. Polyvascular Disease in Patients Presenting with Acute Coronary Syndrome: Its Predictors and Outcomes

    Directory of Open Access Journals (Sweden)

    Hassan Al Thani

    2012-01-01

    Full Text Available We evaluated prevalence and clinical outcome of polyvascular disease (PolyVD in patients presenting with acute coronary syndrome (ACS. Data for 7689 consecutive ACS patients were collected from the 2nd Gulf Registry of Acute Coronary Events between October 2008 and June 2009. Patients were divided into 2 groups (ACS with versus without PolyVD. All-cause mortality was assessed at 1 and 12 months. Patients with PolyVD were older and more likely to have cardiovascular risk factors. On presentation, those patients were more likely to have atypical angina, high resting heart rate, high Killip class, and GRACE risk scoring. They were less likely to receive evidence-based therapies. Diabetes mellitus, renal failure, and hypertension were independent predictors for presence of PolyVD. PolyVD was associated with worse in-hospital outcomes (except for major bleedings and all-cause mortality even after adjusting for baseline covariates. Great efforts should be directed toward primary and secondary preventive measures.

  15. Efficacy of calcium dobesilate in treating acute attacks of hemorrhoidal disease.

    Science.gov (United States)

    Menteş, B B; Görgül, A; Tatlicioğlu, E; Ayoğlu, F; Unal, S

    2001-10-01

    A randomized, double-blind, controlled study was conducted to investigate the efficacy of oral calcium dobesilate therapy in treating acute attacks of internal hemorrhoids. Twenty-nine well-documented adult patients with first- or second-degree internal hemorrhoids were treated with calcium dobesilate for two weeks, while16 patients received only a high-fiber diet to serve as control. Both symptoms and anoscopic inflammation were scored on a scale from 0 to 2 before (T0) and two weeks after treatment (T2). A success rate of 86.21 percent with cessation of bleeding plus lack of severe anitis anoscopically at two weeks were achieved with calcium dobesilate. The pretreatment symptom score of 2 fell significantly to 0.45 +/- 0.13, and the pretreatment anitis score of 1.69 +/- 0.09 fell to 0.55 +/- 0.12 at T2 (P = 0.0001 for both comparisons). The symptom and anoscopic inflammation scores obtained with calcium dobesilate treatment were also significantly better than those with diet only (P = 0.0017 and P = 0.0013, respectively). Together with recommendations about diet and bowel discipline, oral calcium dobesilate treatment provides an efficient, fast, and safe symptomatic relief from acute symptoms of hemorrhoidal disease. This symptomatic healing is associated with a significant improvement in the anoscopically observed inflammation.

  16. Loss of Ifnar1 in Pancreatic Acinar Cells Ameliorates the Disease Course of Acute Pancreatitis.

    Science.gov (United States)

    Miller, Katharina J; Raulefs, Susanne; Kong, Bo; Steiger, Katja; Regel, Ivonne; Gewies, Andreas; Kleeff, Jörg; Michalski, Christoph W

    2015-01-01

    Type I interferon constitutes an essential component of the combinational therapy against viral disease. Acute pancreatitis is one side effect of type I interferon-based therapy, implying that activation of type I interferon signaling affects the homeostasis and integrity of pancreatic acinar cells. Here, we investigated the role of type I interferon signaling in pancreatic acinar cells using a caerulein-induced murine model of acute pancreatitis. Pancreas-specific ablation of interferon (alpha and beta) receptor 1 (Ifnar1) partially protected animals from caerulein-induced pancreatitis, as demonstrated by reduced tissue damage. Profiling of infiltrating immune cells revealed that this dampened tissue damage response correlated with the number of macrophages in the pancreas. Pharmacologic depletion of macrophages reversed the protective effect of Ifnar1 deficiency. Furthermore, expression of chemokine (C-C motif) ligand 2 (Ccl2), a potent factor for macrophage recruitment, was significantly increased in the Ifnar1-deficient pancreas. Thus, type I interferon signaling in pancreatic acinar cells controls pancreatic homeostasis by affecting the macrophage-mediated inflammatory response in the pancreas.

  17. Loss of Ifnar1 in Pancreatic Acinar Cells Ameliorates the Disease Course of Acute Pancreatitis.

    Directory of Open Access Journals (Sweden)

    Katharina J Miller

    Full Text Available Type I interferon constitutes an essential component of the combinational therapy against viral disease. Acute pancreatitis is one side effect of type I interferon-based therapy, implying that activation of type I interferon signaling affects the homeostasis and integrity of pancreatic acinar cells. Here, we investigated the role of type I interferon signaling in pancreatic acinar cells using a caerulein-induced murine model of acute pancreatitis. Pancreas-specific ablation of interferon (alpha and beta receptor 1 (Ifnar1 partially protected animals from caerulein-induced pancreatitis, as demonstrated by reduced tissue damage. Profiling of infiltrating immune cells revealed that this dampened tissue damage response correlated with the number of macrophages in the pancreas. Pharmacologic depletion of macrophages reversed the protective effect of Ifnar1 deficiency. Furthermore, expression of chemokine (C-C motif ligand 2 (Ccl2, a potent factor for macrophage recruitment, was significantly increased in the Ifnar1-deficient pancreas. Thus, type I interferon signaling in pancreatic acinar cells controls pancreatic homeostasis by affecting the macrophage-mediated inflammatory response in the pancreas.

  18. MR diffusion imaging and MR spectroscopy of maple syrup urine disease during acute metabolic decompensation

    Energy Technology Data Exchange (ETDEWEB)

    Jan, Wajanat; Wang, Zhiyue J. [Department of Radiology, University of Pennsylvania School of Medicine, Children' s Hospital of Philadelphia, Pennsylvania (United States); Zimmerman, Robert A. [Department of Radiology, University of Pennsylvania School of Medicine, Children' s Hospital of Philadelphia, Pennsylvania (United States); Department of Radiology, Children' s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, PA 19104, Philadelphia (United States); Berry, Gerard T.; Kaplan, Paige B.; Kaye, Edward M. [Department of Pediatrics, University of Pennsylvania School of Medicine, The Children' s Hospital of Philadelphia, Philadelphia, Pennsylvania (United States)

    2003-06-01

    Maple syrup urine disease (MSUD) is an inborn error of amino acid metabolism, which affects the brain tissue resulting in impairment or death if untreated. Imaging studies have shown reversible brain edema during acute metabolic decompensation. The purpose of this paper is to describe the diffusion-weighted imaging (DWI) and spectroscopy findings during metabolic decompensation and to assess the value of these findings in the prediction of patient outcome. Six patients with the diagnosis of MSUD underwent conventional MR imaging with DWI during acute presentation with metabolic decompensation. Spectroscopy with long TE was performed in four of the six patients. Follow-up examinations were performed after clinical and metabolic recovery. DWI demonstrated marked restriction of proton diffusion compatible with cytotoxic or intramyelinic sheath edema in the brainstem, basal ganglia, thalami, cerebellar and periventricular white matter and the cerebral cortex. This was accompanied by the presence of an abnormal branched-chain amino acids (BCAA) and branched-chain alpha-keto acids (BCKA) peak at 0.9 ppm as well as elevated lactate on proton spectroscopy in all four patients. The changes in all six patients were reversed with treatment without evidence of volume loss or persistent tissue damage. The presence of cytotoxic or intramyelinic edema as evidenced by restricted water diffusion on DWI, with the presence of lactate on spectroscopy, could imply imminent cell death. However, in the context of metabolic decompensation in MSUD, it appears that changes in cell osmolarity and metabolism can reverse completely after metabolic correction. (orig.)

  19. Corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Woods JA

    2014-05-01

    Full Text Available J Andrew Woods,1 James S Wheeler,1 Christopher K Finch,2 Nathan A Pinner3 1School of Pharmacy, Wingate University, Wingate, NC, USA; 2Department of Pharmacy, Methodist University Hospital, Memphis, TN, USA; 3Harrison School of Pharmacy, Auburn University, Auburn, AL, USA Background: Chronic obstructive pulmonary disease (COPD is a chronic and progressive disease that affects an estimated 10% of the world's population over the age of 40 years. Worldwide, COPD ranks in the top ten for causes of disability and death. Given the significant impact of this disease, it is important to note that acute exacerbations of COPD (AECOPD are by far the most costly and devastating aspect of disease management. Systemic steroids have long been a standard for the treatment of AECOPD; however, the optimal strategy for dosing and administration of these medications continues to be debated. Objective: To review the use of corticosteroids in the treatment of acute exacerbations of COPD. Materials and methods: Literature was identified through PubMed Medline (1950–February 2014 and Embase (1950–February 2014 utilizing the search terms corticosteroids, COPD, chronic bronchitis, emphysema, and exacerbation. All reference citations from identified publications were reviewed for possible inclusion. All identified randomized, placebo-controlled trials, meta-analyses, and systematic reviews evaluating the efficacy of systemic corticosteroids in the treatment of AECOPD were reviewed and summarized. Results: The administration of corticosteroids in the treatment of AECOPD was assessed. In comparison to placebo, systemic corticosteroids improve airflow, decrease the rate of treatment failure and risk of relapse, and may improve symptoms and decrease the length of hospital stay. Therefore, corticosteroids are recommended by all major guidelines in the treatment of AECOPD. Existing literature suggests that low-dose oral corticosteroids are as efficacious as high

  20. Perihepatic nodes detected by point-of-care ultrasound in acute hepatitis and acute-on-chronic liver disease.

    Science.gov (United States)

    Feng, I Che; Wang, Szu Jen; Sheu, Ming Jen; Koay, Lok-Beng; Lin, Ching Yih; Ho, Chung Han; Sun, Chi Shu; Kuo, Hsing Tao

    2015-11-28

    To study the manifestations of perihepatic lymph nodes during the episode of acute hepatitis flare by point-of-care ultrasonography. One hundred and seventy-six patients with an episode of acute hepatitis flare (ALT value > 5 × upper normal limit) were enrolled retrospectively. Diagnosis of etiology of the acute hepatitis flare was based on chart records and serological and virological assays. The patients were categorized into two groups (viral origin and non-viral origin) and further defined into ten subgroups according to the etiologies. An ultrasonograpy was performed within 2 h to 72 h (median, 8 h). The maximum size of each noticeable lymph node was measured. Correlation between clinical parameters and nodal manifestations was analyzed Enlarged lymph nodes (width ≥ 5mm) were noticeable in 110 (62.5%) patients, mostly in acute on chronic hepatitis B (54.5%). The viral group had a higher prevalence rate (89/110 = 80.9%) and larger nodal size (median, 7 mm) than those of the non-viral group (21/66 = 31.8%; median, 0 mm) (P hepatitis A and non-hepatitis A viral groups (P hepatitis flare.

  1. Benefits and complications of noninvasive mechanical ventilation for acute exacerbation of chronic obstructive pulmonary disease.

    Science.gov (United States)

    Rocha, Eduardo; Carneiro, Elida Mara

    2008-06-01

    Chronic obstructive pulmonary disease (COPD) is defined as a syndrome characterized by usually progressive chronic airflow limitation which is associated to a bronchial hyperresponsiveness and is partially reversible. Noninvasive mechanical ventilation is an alternative treatment for patients with COPD exacerbations. The objective of the literature reviews was to verify noninvasive mechanical ventilation benefits and complications in acute exacerbations of chronic obstructive pulmonary disease in patients. This national and international's scientific literature review was developed according to criteria established for documentary research in the MedLine, LILACS, SciElo, PubMed and Cochrane, databases using the key words: chronic obstructive pulmonary disease and noninvasive mechanical ventilation. Inclusion criteria were articles published from 1995 to 2007; in English, Spanish and Portuguese; studies in the human model and with no gender restriction. Noninvasive mechanical ventilation can reduce partial pressure of carbon dioxide, improve gas exchange, alleviate symptoms as dyspnea caused by fatigue of the respiratory muscles, reduce duration of hospitalization, decrease need for invasive mechanical ventilation, reduce number of complications and also lessen hospital mortality. The main complications found were: facial skin erythema, claustrophobia, nasal congestion, face pain, eye irritation, aspiration pneumonia, hypotension, pneumothorax, aerophagia, hypercapnia, gastric insufflation, vomit, bronchoaspiration, morning headaches, face injuries, air embolism and, last but not least, discomfort of the patient. Noninvasive mechanical ventilation can be more effective in patients with moderate-severe exacerbations of COPD and these complications can be minimized by an adequate interface also by the contribution of the physiotherapist experience.

  2. PROGNOSTIC IMPORTANCE OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROME

    Directory of Open Access Journals (Sweden)

    K. G. Alidzhanova

    2017-01-01

    Full Text Available The study of acute coronary syndrome (ACS in patients with chronic kidney disease (CKD is one of the areas of modern cardiology. The prevalence, course, prognosis and tactics of treatment of myocardial infarction in CKD are not well understood. The analysis of literature sources allows us to state that CKD in ACS doubles the risk of immediate and long-term death and adverse cardiovascular events. It is necessary to determine the CKD stage to predict the hospital and long-term mortality of the infarct patient. It is difficult to diagnose ACS at advanced stages of CKD. CKD should be considered an independent risk of death after percutaneous coronary intervention and coronary bypass surgery.

  3. Pediatric acute liver failure: variations in referral timing are associated with disease subtypes.

    Science.gov (United States)

    Sturm, Ekkehard; Lexmond, Willem S; Verkade, Henkjan J

    2015-02-01

    In pediatric acute liver failure (PALF), rapid referral to a transplant center (TC) is advocated. Clinical variability of PALF may influence referral timing. We aimed to analyze early or late timing of referral in relation to clinical characteristics and outcome in PALF. We conducted a retrospective, single-center, comparative analysis of clinical and liver function parameters in two PALF cohorts (n = 23 per cohort): cohort 1 (early referral, duration of in-patient care before referral (DCR) liver failure (SLF >7 days between disease onset and development of encephalopathy) was independently associated with late referral (relative risk 9.48; 95 % CI 1.37-64.85, p liver function patterns. Early recognition of prognostic indicators and of SLF may help to improve referral timing and thus PALF management.

  4. Message about the « severe acute respiratory disease syndrome »

    CERN Multimedia

    2003-01-01

    If you are back from a journey in one of the zones pointed out by WHO concerned by the severe acute respiratory disease syndrome (SARS), it is necessary to monitor your health for at least ten days. This syndrome shows a high fever accompanied by cough or difficulty in breathing. If you become ill, you have to contact as quickly as possible the CERN medical service by dialling 73802 - 73186 during work hours or the Fire Brigade 74444 outside work hours. Tell this service about your recent travel to one of the regions where WHO has reported cases*. * For instant, the areas identified are the cities of Hanoi, Hong Kong, Singapore and the Province of Guangdong (South of China) and Toronto. The medical service recommends to avoid any trip in these world areas until further instruction. CERN Medical Service

  5. Experimental results of beryllium exposed to intense high energy proton beam pulses

    OpenAIRE

    Ammigan, K.; Hartsell, B.; Hurh, P.; Zwaska, R.; Butcher, M.; Guinchard, M; Calviani, M; Losito, R; Roberts, S; Kuksenko, V.; Atherton, A.; Caretta, O.; Davenne, T.; Densham, C.; Fitton, M

    2017-01-01

    Beryllium is extensively used in various accelerator beam lines and target facilities as a material for beam windows, and to a lesser extent, as secondary particle production targets. With increasing beam intensities of future accelerator facilities, it is critical to understand the response of beryllium under extreme conditions to reliably operate these components as well as avoid compromising particle production efficiency by limiting beam parameters. As a result, an exploratory experiment ...

  6. Functional Outcomes of Acute Inpatient Rehabilitation In Patients With Chronic Graft-Versus Host Disease.

    Science.gov (United States)

    Leung, Jason; Smith, Sean; Kalpakjian, Claire

    2017-11-12

    Growing numbers of allogeneic stem cell transplants (HSCT) and improved post-transplant care have led to an increase of individuals with chronic graft versus host disease (cGVHD). Although cGVHD leads to functional impairment for many, there is limited literature regarding the benefits of acute inpatient rehabilitation for cGVHD patients. To assess Functional Independence Measure (FIM) outcomes of cGVHD patients during acute inpatient rehabilitation, and to compare inpatient rehabilitation outcomes to burn patients, a rehabilitation patient population with similar co-morbidities. Retrospective chart review. Acute rehabilitation center at a large academic medical center. 37 adult patients with cGVHD and 30 with burn injuries admitted to inpatient rehabilitation from 2010-2015. Linear regression analysis to evaluate group (cGVHD vs. burn) differences in functional gains. Effect size and minimal detectable change (MDC90) were used to evaluate change in FIM outcomes. Total FIM gain, motor FIM gain, and FIM efficiency. cGVHD patients had statistically significant lower functional gains than burn patients, with an average of 11.66 fewer total FIM points (p < .001), 10.54 fewer motor FIM points (p = .01), and 2.45 units less of FIM efficiency (p = .01). At the time of discharge, 7 (18%) patients with cGVHD exceeded the MDC90 values for total FIM gain vs. 9 (30%) patients with burn injuries (p = .26). Eight (21%) patients with cGVHD exceeded the MDC90 for motor FIM gain vs. 13 (43%) patients with burn injuries (p = .048). Effect sizes for cGVHD and burn patients were moderate to large, respectively, with burn patients having nearly twice the magnitude of gains as cGVHD patients. Despite achieving more modest functional gains than patients with burn injuries, patients with cGVHD improved in function after acute inpatient rehabilitation. If replicated in larger studies, patients with functional impairment from cGVHD can be considered for inpatient rehabilitation. Future work

  7. MODERN INSIGHTS INTO THE ROLE OF HEMORHEOLOGICAL DEVIATIONS AND FUNCTIONAL STATUS OF THE ENDOTHELIAL TISSUE IN THE PATHOGENESIS OF ACUTE INFLAMMATORY LUNG AND BRONCHIAL DISEASES AMONG CHILDREN

    Directory of Open Access Journals (Sweden)

    A.V. Mozhaev

    2007-01-01

    Full Text Available Disorders of the endothelial tissue and hemorheology function build up one of the pathogenic bases to form the acute inflammatory abnormality of the respiratory tract among children. The overview highlights the information on the role and disorders of the erythrocyte clumping and plasticity, blood viscosity and function of the endothelial tissue as a response to the acute respiratory infections among children.Key words: endothelial dysfunction, hemorheology, hemorheological deviations, acute respiratory infections, acute bronchopulmonary diseases, children.

  8. Acute care costs of patients admitted for management of chronic obstructive pulmonary disease exacerbations: contribution of disease severity, infection and chronic heart failure.

    Science.gov (United States)

    Hutchinson, A; Brand, C; Irving, L; Roberts, C; Thompson, P; Campbell, D

    2010-05-01

    In 2003, chronic obstructive pulmonary disease (COPD) accounted for 46% of the burden of chronic respiratory disease in the Australian community. In the 65-74-year-old age group, COPD was the sixth leading cause of disability for men and the seventh for women. To measure the influence of disease severity, COPD phenotype and comorbidities on acute health service utilization and direct acute care costs in patients admitted with COPD. Prospective cohort study of 80 patients admitted to the Royal Melbourne Hospital in 2001-2002 for an exacerbation of COPD. Patients were followed for 12 months and data were collected on acute care utilization. Direct hospital costs were derived using Transition II, an activity-based costing system. Individual patient costs were then modelled to ascertain which patient factors influenced total direct hospital costs. Direct costs were calculated for 225 episodes of care, the median cost per admission was AU$3124 (interquartile range $1393 to $5045). The median direct cost of acute care management per patient per year was AU$7273 (interquartile range $3957 to $14 448). In a multivariate analysis using linear regression modelling, factors predictive of higher annual costs were increasing age (P= 0.041), use of domiciliary oxygen (P= 0.008) and the presence of chronic heart failure (P= 0.006). This model has identified a number of patient factors that predict higher acute care costs and awareness of these can be used for service planning to meet the needs of patients admitted with COPD.

  9. Blue light and near-infrared fundus autofluorescence in acute Vogt-Koyanagi-Harada disease.

    Science.gov (United States)

    Koizumi, Hideki; Maruyama, Kazuichi; Kinoshita, Shigeru

    2010-11-01

    To investigate the characteristics of fundus autofluorescence (FAF) in acute Vogt-Koyanagi-Harada (VKH) disease. FAF photography with blue light (BL-FAF) and near-infrared light (NIR-FAF) was performed on 10 eyes of five patients using a confocal scanning laser ophthalmoscope before and after treatment. The FAF images were followed for 6 months and retrospectively reviewed with comparisons of the other imaging modalities. At presentation, four eyes of two patients who presented soon after the initial ocular symptoms showed mild and uniform hyperautofluorescence in the macula mixed with hypoautofluorescence in the areas of serous retinal detachment. After immediate treatment with an intravenous high-dose steroid, the abnormal FAF returned to normal at 6 months. The other six eyes of three patients, who presented weeks after the symptoms, initially demonstrated diffuse and mottled hyperautofluorescence over the posterior pole, mixed with hypoautofluorescence induced by serous retinal detachment in four eyes. After treatment with an intravenous high-dose steroid, all six eyes showed scattered and widespread hyperautofluorescence, which gradually became evident and concentrated in the macula, partially resulting in some hypoautofluorescent dots at 6 months. The BL-FAF and the NIR-FAF demonstrated similar FAF patterns, but more evidently in NIR-FAF. FAF photography non-invasively visualised sequential metabolic and functional changes in the retinal pigment epithelium (RPE) in acute VKH disease. The results suggest that early and sufficient treatment with a high-dose steroid might prevent persistent RPE damage. In addition, NIR-FAF can be an alternative method for the early detection of RPE abnormality.

  10. Acute response of non-motor symptoms to subthalamic deep brain stimulation in Parkinson's disease.

    Science.gov (United States)

    Fabbri, Margherita; Coelho, Miguel; Guedes, Leonor Correia; Rosa, Mario M; Abreu, Daisy; Gonçalves, Nilza; Antonini, Angelo; Ferreira, Joaquim J

    2017-08-01

    Subthalamic deep brain stimulation (STN-DBS) is an established treatment for the motor complications of Parkinson's disease (PD) and may have beneficial effects on non-motor symptoms (NMS). However, the acute effect of STN stimulation on NMS has only been explored in small PD cohorts with short post-surgical follow-up. To study NMS response to an acute stimulation challenge in an STN-DBS PD population with a medium/long-term post-surgical follow-up. 32 STN-DBS PD patients were tested twice (MED OFF/STIM OFF and MED OFF/STIM ON). MDS-UPDRS-III, blood pressure (BP) assessment, a visual analogue scale for pain and fatigue and State Trait Anxiety Scale score were evaluated during both stimulation conditions. NMS were assessed with MDS-UPDRS-I, Non-Motor Symptoms Scale, Geriatric Depression Scale and the Neuropsychiatric Inventory scale. Mean (SD) age was 62.5 (±13.3) years, mean disease duration 18.7 (±5.1) years, mean post-surgical follow-up 4.6 (±1.3) years, and the mean reduction of levodopa equivalent daily dose after surgery was 58.9% (±25.4%). Mean (SD) motor response to stimulation was 40% (15%). STN stimulation significantly improved anxiety (mean 18% ± 19%, P stimulation ON, BP significantly decreased during orthostatism (P stimulation improves anxiety and fatigue but decreases orthostatic BP in PD, several years after surgery. These effects should be considered when assessing long-term effect of DBS. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Erosion behaviour of ultrathin carbon layers and hydrogen retention in beryllium; Untersuchungen zur Erosion ultraduenner Kohlenstoffschichten und Wasserstoffrueckhaltung in Beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Reinelt, Matthias

    2008-04-16

    Plasma-wall-interaction plays an important role on the way to technical feasibility of thermonuclear fusion. In this context, the erosion behavior of few nanometer thin amorphous carbon layers on different metallic substrates by energetic deuterium and helium ions is investigated. Several aspects of the interaction are distinguishable by XPS. Ion induced carbide formation is governed by kinematic intermixing of carbon and metal substrate. Several methods of quantification of XPS measurements are developed and discussed. Comparison of results from these methods with NRA measurements show that surface roughness and implantation of particles into the carbon layer and intermixing zone influence the XPS measurements, which are sensitive to parameters such as material density. The retention of 1 keV deuterium ions implanted into single crystalline and cleaned beryllium at room temperature is investigated by temperature programmed desorption (TPD). The residual BeO coverage was 0.2 ML. The retention is 78% at low fluences and saturates above a bombardment with a fluence of 2.10{sup 17} cm{sup -2}. The retained maximum areal density is 2.10{sup 17} cm{sup -2}. Above 900 K, no deuterium is retained in the sample. An onset of self diffusion is observed at this temperature and metallic beryllium from the bulk segregates though thin BeO layers on the surface. From deuterium desorption traces, retention mechanisms are obtained. The measured TPDspectra are modeled by TMAP7 and rate equations to obtain activation energies for the release processes. From these, binding energies for the system Be-D are derived. Up to a implantation fluence of 1.10{sup 17} cm{sup -2}, deuterium is trapped in ion induced defects in the beryllium lattice with binding energies of 1.69 eV and 1.86 eV and release temperatures of 770 K and 840 K, respectively. The occupation of these states shows a different isotope behavior for {sup 1}H and {sup 2}H. The states are filled by diffusion of deuterium at the

  12. Preparation of nuclear purity beryllium oxalate tri-hydrate; Preparation d'oxalate de beryllium trihydrate de purete nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Delcorte, M.; Lecocq, A.; Rigaud, A. [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

    1964-07-01

    In this report we have gathered the whole of the knowledge acquired by our group during the campaign for preparation of beryllium oxalate we carried out through the first half year of 1962. The reader shall find in the first place information and bibliographic data gathered by Miss OLLIVIER, documentalist of the Section d'Etudes, Recherches et Applications Chimiques. We then describe the original process perfected in the laboratories, and the production techniques we employed for the semi-large operative units. Finally, we publish the results we obtained on one hand on the chemical aspect, in the industrial meaning of the term, which is to-day concerning the ponderal output, on the other hand on the analytical aspect as you can evidently not dissociate the quantity of substance produced from its purity. (authors) [French] Nous avons reuni dans ce document l'ensemble des connaissances acquises par notre groupe pendant la campagne de preparation d'oxalate de beryllium que nous avons effectuee au cours du 1er semestre 1962. Le lecteur y trouvera en premier lieu les renseignements et donnees bibliographiques rassembles par Mlle OLLIVIER, documentaliste a la Section d'Etudes, Recherches et Applications Chimiques. Nous decrivons ensuite le procede original mis au point dans les laboratoires et les techniques de fabrication que nous avons utilisees pour des unites operatoires demi-grand. Pour terminer nous publions les resultats obtenus, d'une part sur le plan chimique, au sens industriel du terme, c'est-a-dire du point de vue rendement ponderal, d'autre part sur le plan analytique puisqu'on ne peut evidemment pas dissocier la quantite de produit fabrique, de sa purete. (auteurs)

  13. Characterization of beryllium deformation using in-situ x-ray diffraction

    Energy Technology Data Exchange (ETDEWEB)

    Magnuson, Eric Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Brown, Donald William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Clausen, Bjorn [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Sisneros, Thomas A. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Park, Jun-Sang [Argonne National Lab. (ANL), Argonne, IL (United States)

    2015-08-24

    Beryllium’s unique mechanical properties are extremely important in a number of high performance applications. Consequently, accurate models for the mechanical behavior of beryllium are required. However, current models are not sufficiently microstructure aware to accurately predict the performance of beryllium under a range of processing and loading conditions. Previous experiments conducted using the SMARTS and HIPPO instruments at the Lujan Center(LANL), have studied the relationship between strain rate and texture development, but due to the limitations of neutron diffraction studies, it was not possible to measure the response of the material in real-time. In-situ diffraction experiments conducted at the Advanced Photon Source have allowed the real time measurement of the mechanical response of compressed beryllium. Samples of pre-strained beryllium were reloaded orthogonal to their original load path to show the reorientation of already twinned grains. Additionally, the in-situ experiments allowed the real time tracking of twin evolution in beryllium strained at high rates. The data gathered during these experiments will be used in the development and validation of a new, microstructure aware model of the constitutive behavior of beryllium.

  14. The Status of Beryllium Research for Fusion in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Glen R. Longhurst

    2003-12-01

    Use of beryllium in fusion reactors has been considered for neutron multiplication in breeding blankets and as an oxygen getter for plasma-facing surfaces. Previous beryllium research for fusion in the United States included issues of interest to fission (swelling and changes in mechanical and thermal properties) as well as interactions with plasmas and hydrogen isotopes and methods of fabrication. When the United States formally withdrew its participation in the International Thermonuclear Experimental Reactor (ITER) program, much of this effort was terminated. The focus in the U.S. has been mainly on toxic effects of beryllium and on industrial hygiene and health-related issues. Work continued at the INEEL and elsewhere on beryllium-containing molten salts. This activity is part of the JUPITER II Agreement. Plasma spray of ITER first wall samples at Los Alamos National Laboratory has been performed under the European Fusion Development Agreement. Effects of irradiation on beryllium structure are being studied at Oak Ridge National Laboratory. Numerical and phenomenological models are being developed and applied to better understand important processes and to assist with design. Presently, studies are underway at the University of California Los Angeles to investigate thermo-mechanical characteristics of beryllium pebble beds, similar to research being carried out at Forschungszentrum Karlsruhe and elsewhere. Additional work, not funded by the fusion program, has dealt with issues of disposal, and recycling.

  15. Pharmacological intervention of tiferron and propolis to alleviate beryllium-induced hepatorenal toxicity.

    Science.gov (United States)

    Nirala, Satendra Kumar; Bhadauria, Monika; Shukla, Sangeeta; Agrawal, Om Prakash; Mathur, Asha; Li, Pei Qiang; Mathur, Ramesh

    2008-08-01

    Intervention of chelating agent tiferron (sodium-4,5-dihydroxy-1,3-benzene disulfonate; 300 mg/kg, intraperitoneal) with propolis (honey beehive product; 200 mg/kg, p.o.) was evaluated to encounter the characteristic biochemical and ultra-morphological alterations following subchronic exposure to beryllium. Female albino rats were challenged with beryllium nitrate (1 mg/kg, i.p.) daily for 28 days followed by treatment of the above-mentioned therapeutic agents either individually or in combination for five consecutive days. Exposure to beryllium increased its concentration in the serum, liver and kidney, and caused significant alterations in cytochrome P450 activity, microsomal lipid peroxidation and proteins. Activities of alkaline phosphatase, lactate dehydrogenase, gamma-glutamyl transpeptidase, bilirubin, creatinine and urea in the serum and activity of acid phosphatase, alkaline phosphatase, adenosine triphosphatase, glucose-6-phophatase and succinic dehydrogenase in the liver and kidney were significantly altered after beryllium administration. Beryllium exposure also induced severe hepatorenal alterations at histopathological and ultra-morphological level. Tiferron along with propolis dramatically reversed the alterations in all the variables more towards control rather than their individual treatment. The study concludes that pharmacological intervention of tiferron and propolis is beneficial in attenuating beryllium-induced systemic toxicity.

  16. Corticotherapy vs. Corticotherapy Plus Immunosuppressive Therapy in Acute Vogt-Koyanagi-Harada Disease.

    Science.gov (United States)

    Concha-Del Río, L E; Gómez, L; Arellanes-García, L

    2017-12-16

    Vogt-Koyanagi-Harada disease is a multisystem disorder characterized by a bilateral granulomatous panuveitis. Multiple therapeutic regimens have been used to control inflammation in acute uveitic stage to prevent irreversible visual loss. The purpose of this paper is to compare the effect, on functional and anatomic outcomes, of early treatment with standard corticotherapy vs. corticotherapy plus immunosuppressive (IMT) therapy in acute Vogt-Koyanagi-Harada disease (Group A vs Group B). A retrospective chart review of patients with Vogt-Koyanagi-Harada disease, with an evolution time of 2 weeks or less, who attended the Inflammatory Eye Disease Clinic, from 2001 to 2015. Data collected included demographic information, presenting features, treatment and improvement in visual acuity (VA). Sixteen charts were reviewed; 15 females (93.75%). Mean age: 30.81±10.53 years, follow-up time (months): 54.94±43.43. Ten patients (66.6%) had IMT, azathioprine, methotrexate and cyclophosphamide. In group A, initial VA<20/200 in 66.7%; final VA was ≥20/40 in 9 eyes (75%). In group B, initial VA<20/200 in 65%; final VA≥20/40 in 15 eyes (75%). In group A, VA improved faster at one and 3 months (ANOVA P<.057). Clinical characteristics in convalescent stage and complications were similar. Anterior chamber recurrences occurred in both groups and posterior pole recurrences were observed in group A. Time to first recurrence was similar (P<.279). Frequency of recurrence was 2.33±1.80 vs 1.5±0.79 (P<.01). At recurrence 15 patients were still having oral steroids, nine in group A, 6 in Group B. In group A, prednisone was given during more time: mean 15.17±12.08 months, and time to reach to 10mg dose was longer: 8.60±11.7 (P<.008 and P<.046). Adding IMT as first line therapy to corticosteroids, do not matter significantly in terms of final VA or development of visually significant complications. In the IMT plus corticosteroids group number of recurrences was significantly lower

  17. Longitudinal Transcriptome Analysis Reveals a Sustained Differential Gene Expression Signature in Patients Treated for Acute Lyme Disease.

    Science.gov (United States)

    Bouquet, Jerome; Soloski, Mark J; Swei, Andrea; Cheadle, Chris; Federman, Scot; Billaud, Jean-Noel; Rebman, Alison W; Kabre, Beniwende; Halpert, Richard; Boorgula, Meher; Aucott, John N; Chiu, Charles Y

    2016-02-12

    Lyme disease is a tick-borne illness caused by the bacterium Borrelia burgdorferi, and approximately 10 to 20% of patients report persistent symptoms lasting months to years despite appropriate treatment with antibiotics. To gain insights into the molecular basis of acute Lyme disease and the ensuing development of post-treatment symptoms, we conducted a longitudinal transcriptome study of 29 Lyme disease patients (and 13 matched controls) enrolled at the time of diagnosis and followed for up to 6 months. The differential gene expression signature of Lyme disease following the acute phase of infection persisted for at least 3 weeks and had fewer than 44% differentially expressed genes (DEGs) in common with other infectious or noninfectious syndromes. Early Lyme disease prior to antibiotic therapy was characterized by marked upregulation of Toll-like receptor signaling but lack of activation of the inflammatory T-cell apoptotic and B-cell developmental pathways seen in other acute infectious syndromes. Six months after completion of therapy, Lyme disease patients were found to have 31 to 60% of their pathways in common with three different immune-mediated chronic diseases. No differential gene expression signature was observed between Lyme disease patients with resolved illness to those with persistent symptoms at 6 months post-treatment. The identification of a sustained differential gene expression signature in Lyme disease suggests that a panel of selected human host-based biomarkers may address the need for sensitive clinical diagnostics during the "window period" of infection prior to the appearance of a detectable antibody response and may also inform the development of new therapeutic targets. Lyme disease is the most common tick-borne infection in the United States, and some patients report lingering symptoms lasting months to years despite antibiotic treatment. To better understand the role of the human host response in acute Lyme disease and the

  18. Emergency endovascular treatment of acute aortic diseases; Endovaskulaere Behandlung akuter Erkrankungen der thorakalen Aorta

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, M.B.; Herber, S.; Thelen, M. [Mainz Univ. (Germany). Klinik fuer Radiologie; Schmiedt, W.; Neufang, A. [Klinik fuer Herz-, Thorax- und Gefaesschirurgie, Johannes Gutenberg-Univ. Mainz (Germany); Dueber, C. [Inst. fuer Klinische Radiologie, Klinikum Mannheim GmbH (Germany)

    2002-05-01

    Purpose: To investigate the safety and efficacy of emergency treatment of acute aortic diseases with endovascular stent grafts. Methods: In 11 patients (median age 55 years, range 18 - 85) with acute complications of descending aortic diseases endovascular emergency treatment was performed: traumatic aortic rupture (n = 4), penetrating ulcer with aortobronchial fistula or hematothorax (n = 4), acute type B dissection (n = 2, one with penetration, one with subacute mesenteric ischemia), and symptomatic aneurysm of the thoracic aorta (n = 1) with pain and diameter progression. 15 stent grafts were implanted (Talent n = 11, Vanguard/Stentor n = 4). Stent extension was necessary in 4 cases. In 2 cases graft extension was done during the first procedure (due to distal migration and due to the total length of the aortic aneurysm). In 2 cases graft extension was performed 5 days (due to a new aortic ulcer at the proximal stent struts) and 5 months after the initial procedure (recurrent aortobronchial fistula due to aneurysm progression). 14 of 15 implantations required general anesthesia, one symptomatic thoracic aneurysm was performed in local anesthesia and sedation. Results: 14 of 15 graft procedures were performed using the femoral or iliac approach. One procedure required aortofemoral bypass grafting due to extensive arteriosclerotic stenosis and the stent graft was inserted via the bypass graft. The orifice of the subclavian artery was crossed with bare stent struts in 4 cases without neurological complications. Median follow-up is 27 months (range 6 to 72 months). In traumatic aortic ruptures, immediate sealing of bleeding was achieved and follow-up is inconspicuous at a maximum of 72 months. In cases of aortobronchial fistulas, follow-up is satisfactory (maximum 72 months) despite the necessity for reintervention and graft extension. In one acute type B dissection retrograde dissection of the aortic arch occurred during stent release with stable disease during

  19. Impact of Weaning from Acute Dialytic Therapy on Outcomes of Chronic Kidney Disease following Urgent-Start Dialysis

    Science.gov (United States)

    Chen, Yung-Ming; Li, Wen-Yi; Wu, Vin-Cent; Wang, Yi-Cheng; Hwang, Shang-Jyh; Lin, Shih-Hwa; Wu, Kwan-Dun

    2015-01-01

    Discontinuation of acute, unplanned dialysis is always an important therapeutic goal in dialysis-requiring patients with existing chronic kidney disease. Only a limited proportion of patients could be weaned off dialysis and remained dialysis-free. Here we performed a multicenter, observational study to investigate factors associated with successful weaning from acute dialysis, and to explore the potential impact of weaning itself on outcomes of patients with chronic kidney disease following urgent-start dialysis. We recruited 440 chronic kidney disease patients with a baseline estimated glomerular filtration rate dialysis on death during the index hospitalization and death or readmission after discharge. Over 2 years, 64 of 421 (15.2%) patients who survived >1 month died, and 36 (8.6%) were removed from dialysis, with 26 (6.2%) remaining alive and dialysis-free. Logistic regression analysis found that age ≧ 65 years, ischemic acute tubular necrosis, nephrotoxic exposure, urinary obstruction, and higher predialysis estimated glomerular filtration rate and serum hemoglobin were predictors of weaning off dialysis. After adjustment for propensity scores for dialysis weaning, Cox proportional hazards models showed successful weaning from dialysis (adjusted hazard ratio 0.06; 95% confidence interval 0.01 to 0.35), along with a history of hypertension and serum albumin, were independent protectors for early death. Conversely, a history of stroke, peripheral arterial disease and cancer predicted the occurrence of early mortality. In conclusion, this prospective cohort study shows that compared to patients with chronic kidney disease who became end-stage renal disease after acute dialysis, patients who could be weaned off acute dialytic therapy were associated with reduced risk of premature death over a 2-year observation period. PMID:25856435

  20. Transcranial near-infrared laser therapy applied to promote clinical recovery in acute and chronic neurodegenerative diseases

    Science.gov (United States)

    Lapchak, Paul A

    2012-01-01

    One of the most promising methods to treat neurodegeneration is noninvasive transcranial near-infrared laser therapy (NILT), which appears to promote acute neuroprotection by stimulating mitochondrial function, thereby increasing cellular energy production. NILT may also promote chronic neuronal function restoration via trophic factor-mediated plasticity changes or possibly neurogenesis. Clearly, NILT is a treatment that confers neuroprotection or neurorestoration using pleiotropic mechanisms. The most advanced application of NILT is for acute ischemic stroke based upon extensive preclinical and clinical studies. In laboratory settings, NILT is also being developed to treat traumatic brain injury, Alzheimer’s disease and Parkinson’s disease. There is some intriguing data in the literature that suggests that NILT may be a method to promote clinical improvement in neurodegenerative diseases where there is a common mechanistic component, mitochondrial dysfunction and energy impairment. This article will analyze and review data supporting the continued development of NILT to treat neurodegenerative diseases. PMID:22145842

  1. Evidence of Acute Mycoplasma Infection in a Patient with Incomplete and Atypical Kawasaki Disease: A Case Report

    Directory of Open Access Journals (Sweden)

    M. Ebrahim

    2011-01-01

    Full Text Available The etiology of Kawasaki disease remains unknown despite extensive studies. Some researchers suggest that it is caused by an infectious agent. This is a case report where a patient with incomplete Kawasaki disease was found to have evidence compatible with acute Mycoplasma pneumoniae infection. This is one of the several case reports linking Mycoplasma pneumoniae to Kawasaki disease as a possible trigger. This is perhaps due to a superantigen or is mediated by some other mechanism. Accurate and timely testing for Mycoplasma infections is difficult and has its limitations. Despite this, Mycoplasma pneumoniae should be considered in the differential and workup for Kawasaki disease.

  2. Acute terminal ileitis, yersiniosis, and Crohn's disease: a long-term follow-up study of the relationships

    DEFF Research Database (Denmark)

    Jess, T; Jess, Per

    2001-01-01

    University Hospital during the period 1976-1998 were diagnosed as having ATI while undergoing surgery for suspected acute appendicitis. The patients were followed up, and both Yersinia titers and the development of Crohn's disease were registered. Results: Forty-four patients (83%) were tested for Yersinia...

  3. Prevalence of electrocardiographic ST-T changes during acute ischemic stroke in patients without known ischemic heart disease

    DEFF Research Database (Denmark)

    Jensen, Jesper K; Bak, Søren; Flemming Høilund-Carlsen, Poul

    2008-01-01

    We evaluated characteristics and prevalence of ST-segment depression and/or T-wave inversion in the resting electrocardiogram of 244 consecutive patients with acute ischemic stroke, but without ischemic heart disease. The prevalence of ST-T changes ranged from 13% to 16% and this is what to expect...

  4. Economic Impact of Using an Immunostimulating Agent to Prevent Severe Acute Exacerbations in Patients with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Jean-Paul Collet

    2001-01-01

    Full Text Available RATIONALE: OM-85 BV, an immunostimulant made from bacterial extracts, has been shown to reduce the risk of hospitalization for acute exacerbation in patients with chronic obstructive pulmonary disease, as well as to reduce the length of stay for all hospitalizations.

  5. Haemophilus influenzae oral vaccination for preventing acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease.

    Science.gov (United States)

    Teo, Edward; Lockhart, Kathleen; Purchuri, Sai Navya; Pushparajah, Jennifer; Cripps, Allan W; van Driel, Mieke L

    2017-06-19

    Chronic bronchitis and chronic obstructive pulmonary disease (COPD) are serious conditions in which patients are predisposed to viral and bacterial infections resulting in potentially fatal acute exacerbations. Chronic obstructive pulmonary disease is defined as a lung disease characterised by obstruction to lung airflow that interferes with normal breathing. Antibiotic therapy has not been particularly useful in eradicating bacteria such as non-typeable Haemophilus influenzae (NTHi) because they are naturally occurring flora of the upper respiratory tract in many people. However, they can cause opportunistic infection. An oral NTHi vaccine has been developed to protect against recurrent infective acute exacerbations in chronic bronchitis. To assess the effectiveness of an oral, whole-cell NTHi vaccine in protecting against recurrent episodes of acute exacerbations of chronic bronchitis and COPD in adults. To assess the effectiveness of NTHi vaccine in reducing NTHi colonising the respiratory tract during recurrent episodes of acute exacerbations of COPD. We searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (2017, Issue 1), MEDLINE (1946 to January 2017), Embase (1974 to January 2017), CINAHL (1981 to January 2017), LILACS (1985 to January 2017), and Web of Science (1955 to January 2017). We also searched trials registries and contacted authors of trials requesting unpublished data. We included randomised controlled trials comparing the effects of an oral monobacterial NTHi vaccine in adults with recurrent acute exacerbations of chronic bronchitis or COPD when there was overt matching of the vaccine and placebo groups on clinical grounds. The selection criteria considered populations aged less than 65 years and those older than 65 years. Two review authors independently assessed trial quality and extracted data from original records and publications for incidence and severity of bronchitis episodes and carriage rate of

  6. Imaging of acute aortic diseases; L'imagerie de la pathologie aortique aigue

    Energy Technology Data Exchange (ETDEWEB)

    Semlali, S.; Ennafae, I.; Mahi, M.; Benaissa, L.; Hanine, A.; Akjouj, S.; Jidal, M.; Chaouir, S. [Service d' imagerie medicale, hopital militaire Mohamed V, CHU, Rabat (Morocco)

    2010-09-15

    We report a review of computed tomography (CT) and magnetic resonance (MR) imaging findings in acute aortic syndrome. Contrast-enhanced multidetector CT is a highly accurate imaging method for determining the cause of acute aortic syndrome. (authors)

  7. Elucidating the impact of low doses of nano-formulated benznidazole in acute experimental Chagas disease.

    Directory of Open Access Journals (Sweden)

    Marcela S Rial

    2017-12-01

    Full Text Available Chagas disease is a neglected parasitic infection caused by the protozoan Trypanosoma cruzi (T. cruzi that affects more than 6 million people, mainly in Latin America. Benznidazole is still the drug of choice in many countries to treat it in spite of its dosage regimen and adverse side effects such as such as allergic dermatitis, peripheral neuropathy and anorexia. Thus, novel, safer, and more efficacious treatments for such neglected infection are urgently required.In this study, the efficacy of orally administered low doses of benznidazole (BNZ nanoparticles was evaluated during the acute phase in mice infected with T. cruzi Nicaragua (TcN that were immunosuppressed during the chronic stage of the disease. Moreover, the production of T. cruzi-specific antibodies, cardiac tissue inflammation and reactive oxygen species generation by Vero cells treated with both BNZ nanoparticles (BNZ-nps and raw BNZ (R-BNZ were also evaluated.T. cruzi infected mice treated with 10, 25 or 50 mg/kg/day of BNZ-nps survived until euthanasia (92 days post infection (dpi, while only 15% of infected untreated mice survived until the end of the experiment. PCR analysis of blood samples taken after induction of immunosuppression showed that a dosage of 25 mg/kg/day rendered 40% of the mice PCR-negative. The histological analysis of heart tissue showed a significant decrease in inflammation after treatments with 25 and 50 mg/kg/day, while a similar inflammatory damage was observed in both infected mice treated with R-BNZ (50 mg/kg/day and untreated mice. In addition, only BNZ-nps treated mice led to lower levels of T. cruzi-specific antibodies to 50-100%. Finally, mammalian Vero cells treated with BNZ-nps or R-BNZ lead to a significant increase in ROS production.Based on these findings, this research highlights the in-vitro/in-vivo efficacy of nanoformulated BNZ against T. cruzi acute infections in immunosuppressed and non-immunosuppressed mice and provides further

  8. The path to chronic kidney disease following acute kidney injury: a neonatal perspective.

    Science.gov (United States)

    Chaturvedi, Swasti; Ng, Kar Hui; Mammen, Cherry

    2017-02-01

    The risk of acute kidney injury (AKI) in hospitalized critically ill neonatal populations without primary renal disease continues to be high, in both term and premature infants. Observational studies have revealed high rates of chronic kidney disease (CKD) in survivors of neonatal AKI. Proposed mechanisms underlying the progression of CKD following AKI include nephron loss and hyperfiltration, vascular insufficiency and maladaptive repair mechanisms. Other factors, including prematurity and low birth weight, have an independent relationship with the development of CKD, but they may also be positive effect modifiers in the relationship of AKI and CKD. The large degree of heterogeneity in the literature on AKI in the neonatal population, including the use of various AKI definitions and CKD outcomes, has hampered the medical community's ability to properly assess the relationship of AKI and CKD in this vulnerable population. Larger prospective cohort studies with control groups which utilize recently proposed neonatal AKI definitions and standardized CKD definitions are much needed to properly quantify the risk of CKD following an episode of AKI. Until there is further evidence to guide us, we recommend that all neonates with an identified episode of AKI should have an appropriate longitudinal follow-up in order to identify CKD at its earliest stages.

  9. Minimal residual disease detection in Tunisian B-acute lymphoblastic leukemia based on immunoglobulin gene rearrangements

    Directory of Open Access Journals (Sweden)

    S. Besbes

    Full Text Available IGH gene rearrangement and IGK-Kde gene deletion can be used as molecular markers for the assessment of B lineage acute lymphoblastic leukemia (B-ALL. Minimal residual disease detected based on those markers is currently the most reliable prognosis factor in B-ALL. The aim of this study was to use clonal IGH/IGK-Kde gene rearrangements to confirm B-ALL diagnosis and to evaluate the treatment outcome of Tunisian leukemic patients by monitoring the minimal residual disease (MRD after induction chemotherapy. Seventeen consecutive newly diagnosed B-ALL patients were investigated by multiplex PCR assay and real time quantitative PCR according to BIOMED 2 conditions. The vast majority of clonal VH-JH rearrangements included VH3 gene. For IGK deletion, clonal VK1f/6-Kde recombinations were mainly identified. These rearrangements were quantified to follow-up seven B-ALL after induction using patient-specific ASO. Four patients had an undetectable level of MRD with a sensitivity of up to 10-5. This molecular approach allowed identification of prognosis risk group and adequate therapeutic decision. The IGK-Kde and IGH gene rearrangements might be used for diagnosis and MRD monitoring of B-ALL, introduced for the first time in Tunisian laboratories.

  10. Comparison of three acute stress models for simulating the pathophysiology of stress-related mucosal disease.

    Science.gov (United States)

    Saxena, Bhagawati; Singh, Sanjay

    2017-05-30

    Stress-related mucosal disease (SRMD) is highly prevalent in intensive care patients leading to increasing treatment cost and mortality. SRMD is a disease elusive of ideal treatment. Evaluation of drugs is very pertinent for the efficient and safe treatment of SRMD. It relies mainly on in vivo screening models. There are various stress models, and till date, none of them is validated for simulating the SRMD pathophysiology. The present study aims to choose the best model, which reproduce pathophysiology of SRMD, among previously established stress models. This study evaluates ulcer index, hexosamine content, microvascular permeability, and gastric content in three acute stress models (cold-restraint, restraint, and water immersion restraint). Macroscopic pictures of the ulcerogenic stomach explain that in contrast to other models, cold-restraint stress (CRS) exposure produced marked ulcers on the fundic area of the stomach. Results of the present study depicted that each stress model significantly increased ulcer index, microvascular permeability and decreased hexosamine level, however, the maximum in the case of CRS-exposed rats. Total acidity and pH of the gastric content remains unchanged in all the stress models. On the contrary, the gastric volume significantly decreased only in case of CRS, while unchanged in other stress models. The overall results revealed that the CRS resembles the pathophysiology of SRMD closely. It is the best and feasible model among all the models to evaluate drugs for the treatment of SRMD.

  11. Carotid versus coronary atherosclerosis burdens in acute compared with chronic symptomatic coronary artery disease.

    Science.gov (United States)

    LeBlanc, Stéphanie; Bibeau, Karine; Bertrand, Olivier F; Lévesque, Valérie; Deschênes St-Pierre, Béatrice; Pibarot, Philippe; Després, Jean-Pierre; Larose, Eric

    2017-08-01

    Prediction of coronary events remains elusive. Carotid atherosclerosis may be a surrogate for coronary risk, as carotid and coronary diseases occur simultaneously - albeit at times with a weak association - depending on clinical presentation. We investigated carotid and coronary atherosclerosis in men with new-onset unstable coronary artery disease (CAD) presenting with acute ST-segment elevation myocardial infarction (STEMI) vs. long-standing severe chronic stable angina (CSA). Bilateral carotid artery and 3-vessel coronary artery atherosclerosis burdens were measured within 1 month, respectively, by 3D-volumetric carotid magnetic resonance imaging and coronary angiography-derived modified CASS-50 score. Men with STEMI (n = 50) and long-standing CSA (n = 50), matched for age, were enrolled (58.6 ± 8.8 years). All of them had carotid atherosclerosis. Atherosclerosis burden was greater in the carotid arteries of STEMI vs. CSA (wall volume: 196.2 ± 44.4 vs. 169.2 ± 38.0 mm3/4 mm, p = 0.002), but greater in the coronary arteries of CSA vs. STEMI (modified CASS-50 score: 3 vs. 1, p < 0.0001). Normalized wall index (NWI) of internal carotid was associated with modified CASS-50 score in STEMI (ρ = 0.40, p = 0.022) and in CSA (ρ = -0.39, p = 0.031). Carotid atherosclerosis was observed in all CAD patients, and atherosclerosis burden in carotid and in coronary arteries varied according to clinical presentation.

  12. Proteomic analysis of mitral valve in Lewis rat with acute rheumatic heart disease.

    Science.gov (United States)

    Li, Wenting; Zeng, Zhiyu; Gui, Chun; Zheng, Huilei; Huang, Weiqiang; Wei, Heng; Gong, Danping

    2015-01-01

    Rheumatic heart disease (RHD) makes a heavy burden in human lives and economy. The proteomic analysis of acute rheumatic heart disease (ARHD) can provide precious data to study RHD at the early stages, but no one has looked into. So based on our early research we applied the method of continuous GAS stimulation on Lewis rats to duplicate the animal model of ARHD. And the mitral valves of rats in control group (n=10) and ARHD group (n=10) were selected for proteomic analysis of ARHD with the iTRAQ labeling based 2D LC-ESI-MS/MS quantitative technology. We identified 3931 proteins in valve tissue out of which we obtained 395 differentially expressed proteins containing 176 up-regulated proteins and 119 down-regulated proteins. Changes in levels of GAPDH (6.793 times higher than the control group) and CD9 (2.63 times higher than the control group) were confirmed by Western blot or immunohistochemistry. The differentially expressed proteins such as GAPDH, CD9, myosin, collagen and RAC1 may be potential biomarkers for ARHD. Moreover, the mitral valve protein profile shed light on further understanding and investigating ARHD.

  13. Acute tubulointerstitial nephritis with severe renal impairment associated with multisystem IgG4-related disease

    Directory of Open Access Journals (Sweden)

    Rafael Coimbra Ferreira Beltrame

    Full Text Available Abstract The IgG4-related disease has a wide clinical spectrum where multiple organs can be affected, and the diagnosis depends on typical histopathological findings and an elevated IgG4 expression in plasma cells in the affected tissue. We describe the clinical presentation and evolution of a patient with acute tubulointerstitial nephritis, severe kidney failure and systemic manifestations such as lymphadenomegaly and chronic pancreatitis. The diagnosis was confirmed by the clinical picture and kidney and lymph node histopathology, in which immunohistochemistry of the lymphoid tissue showed policlonality and increased expression of IgG4, with a IgG4/total IgG ratio > 80%. The patient was treated with prednisone at a dose of 60 mg/day, followed by mycophenolate mofetil, and showed clinical and renal function improvement at 6 months of follow-up. The high index of suspicion of IgG4-related disease with multisystem involvement and the early treatment of this condition are essential to improve the prognosis of affected patients.

  14. Acute Phase Proteins and their Potential Role as an Indicator for Fish Health and in Diagnosis of Fish Diseases.

    Science.gov (United States)

    Roy, Suvra; Kumar, Vikash; Kumar, Vikas; Behera, B K

    2017-01-01

    The acute phase proteins are biochemically and functionally unrelated protein predominantly synthesized in the liver. The local inflammatory cells i.e. macrophages and neutrophils secretes various cytokines like IL-1, IL-6, IL-8 (interleukins) and TNF-α into bloodstream in response to injury and tissue damage, which stimulate hepatocytes to produce protein and release them into the circulation; these proteins are called as acute phase protein (e.g. C-reactive protein (CRP), serum amyloid A (SAA), metal binding protein, lysozyme, lectin, etc.). The acute phase proteins are involved in variety of defence related activities e.g., inactivation of proteolytic enzymes, preventing the distribution of infectious agents (i.e. either by destruction of microorganism or making microbial cell suitable for cell response by modifying surface targets) and restoration of damage tissue and healthy condition. A number of well-known acute phase proteins have disease prognosis importance and change in the APPs level reflects the presence and intensity of inflammation during infection or injury. Further studies are still necessary to develop our knowledge in diagnostic importance of different acute phase proteins in fish and more efforts are needed to differentiate the APPs levels in case of viral, bacterial and parasitic diseases. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  15. Host immune response and acute disease in a zebrafish model of francisella pathogenesis

    Science.gov (United States)

    Vojtech, L.N.; Sanders, G.E.; Conway, C.; Ostland, V.; Hansen, J.D.

    2009-01-01

    Members of the bacterial genus Francisella are highly virulent and infectious pathogens. New models to study Francisella pathogenesis in evolutionarily distinct species are needed to provide comparative insight, as the mechanisms of host resistance and pathogen virulence are not well understood. We took advantage of the recent discovery of a novel species of Francisella to establish a zebrafish/Francisella comparative model of pathogenesis and host immune response. Adult zebraflsh were susceptible to acute Francisella-induced disease and suffered mortality in a dose-dependent manner. Using immunohistochemical analysis, we localized bacterial antigens primarily to lymphoid tissues and livers of zebraflsh following infection by intraperitoneal injection, which corresponded to regions of local cellular necrosis. Francisella sp. bacteria replicated rapidly in these tissues beginning 12 h postinfection, and bacterial titers rose steadily, leveled off, and then decreased by 7 days postinfection. Zebraflsh mounted a significant tissue-specific proinflammatory response to infection as measured by the upregulation of interleukin-l?? (IL-1??), gamma interferon, and tumor necrosis factor alpha mRNA beginning by 6 h postinfection and persisting for up to 7 days postinfection. In addition, exposure of zebraflsh to heat-killed bacteria demonstrated that the significant induction of IL-?? was highly specific to live bacteria. Taken together, the pathology and immune response to acute Francisella infection in zebraflsh share many features with those in mammals, highlighting the usefulness of this new model system for addressing both general and specific questions about Francisella host-pathogen interactions via an evolutionary approach. Copyright ?? 2009, American Society for Microbiology. All Rights Reserved.

  16. Clinical and pulmonary functions profiling of patients with chronic obstructive pulmonary disease experiencing frequent acute exacerbations

    Directory of Open Access Journals (Sweden)

    Prem Parkash Gupta

    2018-01-01

    Full Text Available Purpose: The present study aimed at clinical and pulmonary functions profiling of patients with chronic obstructive pulmonary disease (COPD to anticipate future exacerbations. Methods: The study included 80 COPD patients; 40 patients had ≥2 acute exacerbations during preceding 1 year (frequent exacerbation [FECOPD] group and 40 patients had <2 acute exacerbations during preceding 1 year (infrequent exacerbation [I-FECOPD] group. Clinical profile, sputum microbiology, blood gas analysis, spirometric indices, and diffusion capacity (transfer test variables were assessed. Groups' comparison was performed using an independent t-test for numeric scale parameters and Chi-square test for nominal parameters. Pearson's and Spearman's correlation coefficients were derived for numeric scale parameters and numeric nominal parameters, respectively. Multinomial logistic regression analysis was done using SPSS software. Results: FECOPD group contained younger patients than in I-FECOPD group although the difference was not statistically significant. There was no significant difference between two groups regarding smoking pack-years and duration of illness. FECOPD group had significantly more expectoration score and Modified Medical Research Council dyspnea scores. Cough score and wheeze score did not differ significantly between two groups. More patients in FECOPD group (12/40 vs. 4/40 had lower airway bacterial colonization. Arterial blood gas parameters were more deranged in FECOPD group. Spirometric indices (forced expiratory volume during 1st s as well as transfer test (both diffusing capacity for carbon monoxide and transfer coefficient of the lung values were significantly reduced in FECOPD group. Conclusions: The patients in FECOPD group had clinical, spirometric, and transfer test profiling suggestive of a severe COPD phenotype, the recognition will help in predicting future exacerbations and a better management.

  17. Recurrent acute otitis media and gastroesophageal reflux disease in children. is there an association?

    Science.gov (United States)

    Kotsis, George P; Nikolopoulos, Thomas P; Yiotakis, Ioannis E; Papacharalampous, George X; Kandiloros, Dimitrios C

    2009-10-01

    To investigate whether there is a relationship between gastroesophageal reflux disease (GERD) and recurrent acute otitis media (RAOM) in infants and children. Possible risk factors are also explored. 221 consecutive children who had symptoms and signs associated with GERD and had undergone a prolonged ambulatory 24-h esophageal pH-monitoring. Thirty-four children were excluded from the study due to age, neurological deficits, congenital abnormalities, immunodeficiency syndromes or other chronic systemic disorders. The remaining 187 children (96 boys and 91 girls), aged between 40 days and 33 months (mean age of 18.3 months) were assigned into three groups according to their Reflux Index (RI%). Group A: 49 children (26.2%) without GERD (control group); Group B: 78 children (41.7%) with low to moderate RI; and Group C: 60 children (32.1%) with severe GERD. Parental interviews and personal medical files of the National Health System were used for data collection. However, episodes of acute otitis media were taken into account only if they were diagnosed by a physician. The follow-up period ranged from 6 to 8 years in order to cover the peaks of otitis media incidence in childhood. The results revealed that 6 children from Group A (12.24%), 11 from Group B (14.1%) and 19 from Group C (31.67%) presented episodes of RAOM. The difference was statistically significant (p=0.01). Furthermore, in children who received anti-reflux treatment, the incidence of RAOM substantially decreased and eventually became approximate to that of the control Group A (12.32%). Logistic regression revealed that the strongest risk factor for recurrent otitis media was severe GERD (odds ratio, 4), then attendance at day-care centres (odds ratio, 3), followed by allergies (odds ratio, 2.7). Severe GERD could be implicated in the multifactorial etiology of RAOM in infants and children.

  18. Accuracy of gestalt perception of acute chest pain in predicting coronary artery disease.

    Science.gov (United States)

    das Virgens, Cláudio Marcelo Bittencourt; Lemos, Laudenor; Noya-Rabelo, Márcia; Carvalhal, Manuela Campelo; Cerqueira Junior, Antônio Maurício Dos Santos; Lopes, Fernanda Oliveira de Andrade; de Sá, Nicole Cruz; Suerdieck, Jéssica Gonzalez; de Souza, Thiago Menezes Barbosa; Correia, Vitor Calixto de Almeida; Sodré, Gabriella Sant'Ana; da Silva, André Barcelos; Alexandre, Felipe Kalil Beirão; Ferreira, Felipe Rodrigues Marques; Correia, Luís Cláudio Lemos

    2017-03-26

    To test accuracy and reproducibility of gestalt to predict obstructive coronary artery disease (CAD) in patients with acute chest pain. We studied individuals who were consecutively admitted to our Chest Pain Unit. At admission, investigators performed a standardized interview and recorded 14 chest pain features. Based on these features, a cardiologist who was blind to other clinical characteristics made unstructured judgment of CAD probability, both numerically and categorically. As the reference standard for testing the accuracy of gestalt, angiography was required to rule-in CAD, while either angiography or non-invasive test could be used to rule-out. In order to assess reproducibility, a second cardiologist did the same procedure. In a sample of 330 patients, the prevalence of obstructive CAD was 48%. Gestalt's numerical probability was associated with CAD, but the area under the curve of 0.61 (95%CI: 0.55-0.67) indicated low level of accuracy. Accordingly, categorical definition of typical chest pain had a sensitivity of 48% (95%CI: 40%-55%) and specificity of 66% (95%CI: 59%-73%), yielding a negligible positive likelihood ratio of 1.4 (95%CI: 0.65-2.0) and negative likelihood ratio of 0.79 (95%CI: 0.62-1.02). Agreement between the two cardiologists was poor in the numerical classification (95% limits of agreement = -71% to 51%) and categorical definition of typical pain (Kappa = 0.29; 95%CI: 0.21-0.37). Clinical judgment based on a combination of chest pain features is neither accurate nor reproducible in predicting obstructive CAD in the acute setting.

  19. A pilot study of eptifibatide for treatment of acute pain episodes in sickle cell disease.

    Science.gov (United States)

    Desai, Payal C; Brittain, Julia E; Jones, Susan K; McDonald, Adam; Wilson, Douglas R; Dominik, Rosalie; Key, Nigel S; Parise, Leslie V; Ataga, Kenneth I

    2013-09-01

    The contribution of platelet activation to the pathogenesis of sickle cell disease (SCD) remains uncertain. We evaluated the safety and efficacy of eptifibatide, a synthetic peptide inhibitor of the αIIbβ3 receptor, in SCD patients during acute painful episodes. In this single site, double-blind, placebo-controlled trial, eligible patients with SCD admitted for acute painful episodes were randomized to receive eptifibatide or placebo at a ratio of 2:1. Thirteen patients (SS - 10, Sβ(0) - 2, SC - 1) were randomized to receive either eptifibatide (N=9; 6 females; median age - 25years) or placebo (N=4; 3 females; median age - 31years). In the intent-to-treat analysis, there were no major bleeding episodes in either the eptifibatide or placebo arms (point estimate of difference: 0.00, 95% CI; -0.604, 0.372). There was one minor bleeding episode in the eptifibatide arm (point estimate of difference for any bleeding: 0.11, 95% CI: -0.502, 0.494). There was no significant difference in the proportion of patients with thrombocytopenia between the treatment groups (point estimate of difference: 0.11, 95% CI: -0.587, 0.495). There were no differences in the median times to discharge, median times to crisis resolution or the median total opioid use. In this small study, eptifibatide appeared to be safe, but did not improve the times to crisis resolution or hospital discharge. Adequately powered studies are required to evaluate the safety and efficacy of eptifibatide in SCD. Clinicaltrials.gov Identifier: NCT00834899. © 2013.

  20. Proposal for the standardization of flow cytometry protocols to detect minimal residual disease in acute lymphoblastic leukemia

    Directory of Open Access Journals (Sweden)

    Maura Rosane Valério Ikoma

    2015-12-01

    Full Text Available ABSTRACT Minimal residual disease is the most powerful predictor of outcome in acute leukemia and is useful in therapeutic stratification for acute lymphoblastic leukemia protocols. Nowadays, the most reliable methods for studying minimal residual disease in acute lymphoblastic leukemia are multiparametric flow cytometry and polymerase chain reaction. Both provide similar results at a minimal residual disease level of 0.01% of normal cells, that is, detection of one leukemic cell in up to 10,000 normal nucleated cells. Currently, therapeutic protocols establish the minimal residual disease threshold value at the most informative time points according to the appropriate methodology employed. The expertise of the laboratory in a cancer center or a cooperative group could be the most important factor in determining which method should be used. In Brazil, multiparametric flow cytometry laboratories are available in most leukemia treatment centers, but multiparametric flow cytometry processes must be standardized for minimal residual disease investigations in order to offer reliable and reproducible results that ensure quality in the clinical application of the method. The Minimal Residual Disease Working Group of the Brazilian Society of Bone Marrow Transplantation (SBTMO was created with that aim. This paper presents recommendations for the detection of minimal residual disease in acute lymphoblastic leukemia based on the literature and expertise of the laboratories who participated in this consensus, including pre-analytical and analytical methods. This paper also recommends that both multiparametric flow cytometry and polymerase chain reaction are complementary methods, and so more laboratories with expertise in immunoglobulin/T cell receptor (Ig/TCR gene assays are necessary in Brazil.

  1. Proposal for the standardization of flow cytometry protocols to detect minimal residual disease in acute lymphoblastic leukemia

    Science.gov (United States)

    Ikoma, Maura Rosane Valério; Beltrame, Miriam Perlingeiro; Ferreira, Silvia Inês Alejandra Cordoba Pires; Souto, Elizabeth Xisto; Malvezzi, Mariester; Yamamoto, Mihoko

    2015-01-01

    Minimal residual disease is the most powerful predictor of outcome in acute leukemia and is useful in therapeutic stratification for acute lymphoblastic leukemia protocols. Nowadays, the most reliable methods for studying minimal residual disease in acute lymphoblastic leukemia are multiparametric flow cytometry and polymerase chain reaction. Both provide similar results at a minimal residual disease level of 0.01% of normal cells, that is, detection of one leukemic cell in up to 10,000 normal nucleated cells. Currently, therapeutic protocols establish the minimal residual disease threshold value at the most informative time points according to the appropriate methodology employed. The expertise of the laboratory in a cancer center or a cooperative group could be the most important factor in determining which method should be used. In Brazil, multiparametric flow cytometry laboratories are available in most leukemia treatment centers, but multiparametric flow cytometry processes must be standardized for minimal residual disease investigations in order to offer reliable and reproducible results that ensure quality in the clinical application of the method. The Minimal Residual Disease Working Group of the Brazilian Society of Bone Marrow Transplantation (SBTMO) was created with that aim. This paper presents recommendations for the detection of minimal residual disease in acute lymphoblastic leukemia based on the literature and expertise of the laboratories who participated in this consensus, including pre-analytical and analytical methods. This paper also recommends that both multiparametric flow cytometry and polymerase chain reaction are complementary methods, and so more laboratories with expertise in immunoglobulin/T cell receptor (Ig/TCR) gene assays are necessary in Brazil. PMID:26670404

  2. Dynamics of peripheral blood lymphocyte subpopulations in the acute and subacute phase of Legionnaires' disease.

    Directory of Open Access Journals (Sweden)

    Cornelis P C de Jager

    Full Text Available STUDY OBJECTIVE: Absolute lymphocytopenia is recognised as an important hallmark of the immune response to severe infection and observed in patients with Legionnaires' disease. To explore the immune response, we studied the dynamics of peripheral blood lymphocyte subpopulations in the acute and subacute phase of LD. METHODS AND RESULTS: EDTA-anticoagulated blood was obtained from eight patients on the day the diagnosis was made through detection of L. pneumophila serogroup 1 antigen in urine. A second blood sample was obtained in the subacute phase. Multiparametric flow cytometry was used to calculate lymphocyte counts and values for B-cells, T-cells, NK cells, CD4+ and CD8+ T-cells. Expression of activation markers was analysed. The values obtained in the subacute phase were compared with an age and gender matched control group. Absolute lymphocyte count (×10⁹/l, median and range significantly increased from 0.8 (0.4-1.6 in the acute phase to 1.4 (0.8-3.4 in the subacute phase. B-cell count showed no significant change, while T-cell count (×10⁶/l, median and range significantly increased in the subacute phase (495 (182-1024 versus 979 (507-2708, p = 0.012 as a result of significant increases in both CD4+ and CD8+ T-cell counts (374 (146-629 versus 763 (400-1507, p = 0.012 and 119 (29-328 versus 224 (107-862, p = 0.012. In the subacute phase of LD, significant increases were observed in absolute counts of activated CD4+ T-cells, naïve CD4+ T-cells and memory CD4+ T-cells. In the CD8+ T-cell compartment, activated CD8+ T-cells, naïve CD8+ T-cell and memory CD8+ T-cells were significantly increased (p<0.05. CONCLUSION: The acute phase of LD is characterized by absolute lymphocytopenia, which recovers in the subacute phase with an increase in absolute T-cells and re-emergence of activated CD4+ and CD8+ T cells. These observations are in line with the suggested role for T-cell activation in the immune response to LD.

  3. Cosmogenic beryllium cycling in a natural forest setting

    Science.gov (United States)

    Conyers, Grace

    10Bemet, or cosmogenic beryllium, has a long half-life of 1.4 million years and quick adsorption on soil particles, which may make it ideal for dating soil erosion in historical context. However, there are questions on about the fundamental assumptions of the retentivity of 10Bemet. This manuscript explores these assumptions and the context of nutrient cycling in a natural forest setting. To see if 10Bemet was being cycled through the trees, and at what rate, we looked at the[10Bemet ] in the soil, 4 species of trees, and their leaves. The isotopic ratio 10Be/9Be in all four tree species was comparable to the soil on which they grow, ranging from 6-8 x 10 -9. However, there was one exception with hickory (Carya spp.) which strongly bioaccumulate beryllium with an average of 0.38 ppm dry weight in the wood. Abscised hickory leaves have a higher [Be] of 2.0 ppm, over 10 times higher than in the soil. Using standard allometric equations relating tree biomass to trunk diameter, and assuming that belowground biomass has the same [Be] as aboveground, we calculate that hickory trees at our site contain approximately 1% of the total 10Bemet under their canopy and that ~10% of this Be is cycled annually by leaf abscission. It is not clear at this point what fraction of litterfall Be is recycled into the plant, returned to the soil, or carried to groundwater as organic chelates. Hickory trees occupy an average of ~10% of the oak-hickory forest area. Assuming that trees are randomly distributed, that litterfall Be is returned to the soil, and maintaining a constant 10Bemet budget over time for simplicity, then more than half of all 10Be met in the forest soil will have passed through a hickory tree over the past 10 ky. Fully 90% of all 10Bemet will pass through a hickory tree over a period of ~25 ky. It is clear that hickory trees can transport a sizable fraction of the total 10Bemet in their nutrient cycle, and that they may be responsible for landscape-scale Be mobility.

  4. Acute intermittent porphyria: studies of the severe homozygous dominant disease provides insights into the neurologic attacks in acute porphyrias.

    Science.gov (United States)

    Solis, Constanza; Martinez-Bermejo, Antonio; Naidich, Thomas P; Kaufmann, Walter E; Astrin, Kenneth H; Bishop, David F; Desnick, Robert J

    2004-11-01

    Acute intermittent porphyria (AIP), due to half-normal hydroxymethylbilane synthase activity,is characterized by acute life-threatening neurologic attacks whose etiology remains unclear. To date, only 3 patients confirmed to have homozygous dominant AIP (HD-AIP) have been described (hydroxymethylbilane synthase genotypes R167Q/R167Q and R167W/R173Q). To investigate the genetic, biochemical, clinical, and neuroradiologic features of a severely affected infant with HD-AIP. Clinical, imaging, and genotype/phenotype studies were performed. The proband, homoallelic for hydroxymethylbilane synthase mutation R167W, had approximately 1% of normal hydroxymethylbilane synthase activity, elevated porphyrins and porphyrin precursors, severe psychomotor delay, and central and peripheral neurologic manifestations. When expressed in vitro, the R167W mutant enzyme had less than 2% of normal activity but was markedly unstable, consistent with the proband's severe phenotype. Mitochondrial respiratory chain enzymes were normal. Neuroradiologic studies revealed a unique pattern of deep cerebral white matter injury, with relative preservation of the corpus callosum, anterior limb of the internal capsule, cerebral gray matter, and infratentorial structures. This severely affected patient with HD-AIP expanded the phenotypic spectrum of HD-AIP. His brain magnetic resonance imaging studies suggested selective cerebral oligodendrocyte postnatal involvement in HD-AIP, whereas most structures developed prenatally were intact. These findings indicate that the neurologic manifestations result from porphyrin precursor toxicity rather than heme deficiency and suggest that porphyrin precursor toxicity is primarily responsible for the acute neurologic attacks in heterozygous AIP and other porphyrias.

  5. Minimal residual disease eradication with epigenetic therapy in core binding factor acute myeloid leukemia.

    Science.gov (United States)

    Ragon, Brittany Knick; Daver, Naval; Garcia-Manero, Guillermo; Ravandi, Farhad; Cortes, Jorge; Kadia, Tapan; Oran, Betul; Ohanian, Maro; Ferrajoli, Alessandra; Pemmaraju, Naveen; Kantarjian, Hagop M; Borthakur, Gautam

    2017-09-01

    Recurrent translocations, t(8;21) or inv(16), in core binding factor acute myeloid leukemia (CBF-AML) are amenable to monitoring for minimal residual disease (MRD) with reverse transcriptase polymerase chain reaction (RTPCR). Despite a favorable prognosis, disease relapse remains the single cause of treatment failure in CBF-AML. Fusion products of these translocations recruit epigenetic silencing complexes resulting in hematopoietic maturation arrest. We hypothesized that maintenance therapy with hypomethylating agents (HMA), including decitabine (DAC) and azacitidine (AZA) after induction/consolidation, can be used for MRD elimination to ultimately prolong relapse free survival. Real-time quantitative (RTPCR) trends were reviewed in 23 patients (median age 53 years) with CBF-AML that received HMA therapy following induction/consolidation with fludarabine, cytarabine, and G-CSF (FLAG) with low dose gemtuzumab or idarubicin (NCT00801489). Of the 23 patients evaluated, 17 had a detectable RTPCR at HMA initiation. Five patients had progressive disease and a notable increase in RTPCR values over 1-2 cycles of HMA therapy. Twelve patients did not fail HMA and had a median RTPCR at HMA initiation of 0.06 (range, 0.01-0.91). Unlike the HMA failure subset, 11 of these patients had a reduction in RTPCR after the first or second cycle of HMA. Our data suggests that CBF-AML patients with low levels of RTPCR (between 0.01 and 0.05) at the conclusion of induction/consolidation chemotherapy benefit most from maintenance HMA, particularly those that have a reduction in the RTPCR within the first two cycles of HMA therapy. © 2017 Wiley Periodicals, Inc.

  6. Vitamin D deficiency aggravates chronic kidney disease progression after ischemic acute kidney injury.

    Directory of Open Access Journals (Sweden)

    Janaína Garcia Gonçalves

    Full Text Available Despite a significant improvement in the management of chronic kidney disease (CKD, its incidence and prevalence has been increasing over the years. Progressive renal fibrosis is present in CKD and involves the participation of several cytokines, including Transforming growth factor-β1 (TGF-β1. Besides cardiovascular diseases and infections, several studies show that Vitamin D status has been considered as a non-traditional risk factor for the progression of CKD. Given the importance of vitamin D in the maintenance of essential physiological functions, we studied the events involved in the chronic kidney disease progression in rats submitted to ischemia/reperfusion injury under vitamin D deficiency (VDD.Rats were randomized into four groups: Control; VDD; ischemia/reperfusion injury (IRI; and VDD+IRI. At the 62 day after sham or IRI surgery, we measured inulin clearance, biochemical variables and hemodynamic parameters. In kidney tissue, we performed immunoblotting to quantify expression of Klotho, TGF-β, and vitamin D receptor (VDR; gene expression to evaluate renin, angiotensinogen, and angiotensin-converting enzyme; and immunohistochemical staining for ED1 (macrophages, type IV collagen, fibronectin, vimentin, and α-smooth mucle actin. Histomorphometric studies were performed to evaluate fractional interstitial area.IRI animals presented renal hypertrophy, increased levels of mean blood pressure and plasma PTH. Furthermore, expansion of the interstitial area, increased infiltration of ED1 cells, increased expression of collagen IV, fibronectin, vimentin and α-actin, and reduced expression of Klotho protein were observed. VDD deficiency contributed to increased levels of plasma PTH as well as for important chronic tubulointerstitial changes (fibrosis, inflammatory infiltration, tubular dilation and atrophy, increased expression of TGF-β1 and decreased expression of VDR and Klotho protein observed in VDD+IRI animals.Through inflammatory

  7. Francisella philomiragia Bacteremia in a Patient with Acute Respiratory Insufficiency and Acute-on-Chronic Kidney Disease.

    Science.gov (United States)

    Relich, Ryan F; Humphries, Romney M; Mattison, H Reid; Miles, Jessica E; Simpson, Edward R; Corbett, Ian J; Schmitt, Bryan H; May, M

    2015-12-01

    Francisella philomiragia is a very uncommon pathogen of humans. Diseases caused by it are protean and have been reported largely in near-drowning victims and those with chronic granulomatous disease. We present a case of F. philomiragia pneumonia with peripheral edema and bacteremia in a renal transplant patient and review the diverse reports of F. philomiragia infections.

  8. In-pile thermocycling testing and post-test analysis of beryllium divertor mockups

    Energy Technology Data Exchange (ETDEWEB)

    Giniatulin, R.; Mazul, I. [Efremov Inst., St. Petersburg (Russian Federation); Melder, R.; Pokrovsky, A.; Sandakov, V.; Shiuchkin, A.

    1998-01-01

    The main damaging factors which impact the ITER divertor components are neutron irradiation, cyclic surface heat loads and hydrogen environment. One of the important questions in divertor mockups development is the reliability of beryllium/copper joints and the beryllium resistance under neutron irradiation and thermal cycling. This work presents the experiment, where neutron irradiation and thermocyclic heat loads were applied simultaneously for two beryllium/copper divertor mockups in a nuclear reactor channel to simulate divertor operational conditions. Two mockups with different beryllium grades were mounted facing each other with the tantalum heater placed between them. This device was installed in the active zone of the nuclear reactor SM-2 (Dimitrovgrad, Russia) and the tantalum block was heated by neutron irradiation up to a high temperature. The main part of the heat flux from the tantalum surface was transported to the beryllium surface through hydrogen, as a result the heat flux loaded two mockups simultaneously. The mockups were cooled by reactor water. The device was lowered to the active zone so as to obtain the heating regime and to provide cooling lifted. This experiment was performed under the following conditions: tantalum heater temperature - 1950degC; hydrogen environment -1000 Pa; surface heat flux density -3.2 MW/m{sup 2}; number of thermal cycles (lowering and lifting) -101; load time in each cycle - 200-5000 s; dwell time (no heat flux, no neutrons) - 300-2000 s; cooling water parameters: v - 1 m/s, Tin - 50degC, Pin - 5 MPa; neutron fluence -2.5 x 10{sup 20} cm{sup -2} ({approx}8 years of ITER divertor operation from the start up). The metallographic analysis was performed after experiment to investigate the beryllium and beryllium/copper joint structures, the results are presented in the paper. (author)

  9. Risk factors associated with the introduction of acute clinical infectious bursal disease among Danish broiler chickens in 1998

    DEFF Research Database (Denmark)

    Flensburg, Mimi Folden; Ersbøll, Annette Kjær; Jørgensen, Poul Henrik

    2002-01-01

    from each unaffected farm. The resulting numbers of cases and controls used for statistical analyses were 16 and 61, respectively. Statistically significant associations were seen between the initial 16 Danish cases of acute clinical IBD in 1998 and certain hatcheries, age of parent birds and a certain......The objective of the present study was to investigate risk factors associated with the introduction of acute clinical infectious bursal disease (IBD) among Danish broiler chickens in 1998. Data on 218 flocks were collected from hatcheries, abattoirs, farmers and veterinarians; 49 of the flocks had...

  10. CpG promoter methylation status is not a prognostic indicator of gene expression in beryllium challenge.

    Science.gov (United States)

    Tooker, Brian C; Ozawa, Katherine; Newman, Lee S

    2016-05-01

    Individuals exposed to beryllium (Be) may develop Be sensitization (BeS) and progress to chronic beryllium disease (CBD). Recent studies with other metal antigens suggest epigenetic mechanisms may be involved in inflammatory disease processes, including granulomatous lung disorders and that a number of metal cations alter gene methylation. The objective of this study was to determine if Be can exert an epigenetic effect on gene expression by altering methylation in the promoter region of specific genes known to be involved in Be antigen-mediated gene expression. To investigate this objective, three macrophage tumor mouse cell lines known to differentially produce tumor necrosis factor (TNF)-α, but not interferon (IFN)-γ, in response to Be antigen were cultured with Be or controls. Following challenges, ELISA were performed to quantify induced TNFα and IFNγ expression. Bisulfate-converted DNA was evaluated by pyrosequencing to quantify CpG methylation within the promoters of TNFα and IFNγ. Be-challenged H36.12J cells expressed higher levels of TNFα compared to either H36.12E cells or P388D.1 cells. However, there were no variations in TNFα promoter CpG methylation levels between cell lines at the six CpG sites tested. H36.12J cell TNFα expression was shown to be metal-specific by the induction of significantly more TNFα when exposed to Be than when exposed to aluminum sulfate, or nickel (II) chloride, but not when exposed to cobalt (II) chloride. However, H36.12J cell methylation levels at the six CpG sites examined in the TNFα promoter did not correlate with cytokine expression differences. Nonetheless, all three cell lines had significantly more promoter methylation at the six CpG sites investigated within the IFNγ promoter (a gene that is not expressed) when compared to the six CpG sites investigated in the TNFα promoter, regardless of treatment condition (p methylation may be necessary to allow expression of metal-induced TNFα and that promoter

  11. Acute leukemia presenting with extramedullary diseases and completely normal hemogram: an extremely unusual manifestation unique to pre-B ALL.

    Science.gov (United States)

    Chen, Chih-Cheng; Weng, Hsu-Huei; Hwang, Cih-En; Lu, Chang-Hsien; Chen, Ping-Tsung; Gau, Jyh-Pyng

    2010-09-01

    Acute lymphoblastic leukemia (ALL) is a clonal hematological disease characterized by inadequate normal hematopoiesis secondary to excessive proliferation of leukemic blasts and their impaired differentiation. As a result, patients usually manifest symptoms related to bone marrow failure. It's very uncommon for ALL patients to present with normal hemogram. Herein, we describe two patients who presented with excruciating bone pain at orthopedic clinics. Osteopathy involving multiple bones was noted initially, but acute leukemia was never considered as one of the differential diagnoses because of the completely normal hemogram in both cases. Consequently, the diagnosis of leukemia was slightly delayed. Upon literature review, we found that ALL patients with solely extramedullary diseases and nearly normal hemogram had exclusively pre-B disease. We also propose a putative hypothesis for this interesting finding.

  12. Cerebral blood flow and liver function in patients with encephalopathy due to acute and chronic liver diseases

    DEFF Research Database (Denmark)

    Almdal, T; Schroeder, T; Ranek, L

    1989-01-01

    The purpose of the present investigation was to study changes in cerebral blood flow (CBF) in hepatic encephalopathy, to ascertain whether this was related to the changes in liver function and whether these changes gave any prognostic information. CBF, determined by the intravenous xenon-133 method......, and liver functions, assessed by the prothrombin index, bilirubin concentration, and the galactose elimination capacity, were studied in patients with acute fulminant liver failure and in patients with encephalopathy due to chronic liver diseases--that is, cirrhosis of various etiologies. The CBF range...... any differences between patients with acute or chronic liver diseases or the different degrees of hepatic encephalopathy. In conclusion, a marked reduction of the CBF was seen in hepatic encephalopathy, irrespective of the etiology of the disease....

  13. Longitudinal Transcriptome Analysis Reveals a Sustained Differential Gene Expression Signature in Patients Treated for Acute Lyme Disease

    Directory of Open Access Journals (Sweden)

    Jerome Bouquet

    2016-02-01

    Full Text Available Lyme disease is a tick-borne illness caused by the bacterium Borrelia burgdorferi, and approximately 10 to 20% of patients report persistent symptoms lasting months to years despite appropriate treatment with antibiotics. To gain insights into the molecular basis of acute Lyme disease and the ensuing development of post-treatment symptoms, we conducted a longitudinal transcriptome study of 29 Lyme disease patients (and 13 matched controls enrolled at the time of diagnosis and followed for up to 6 months. The differential gene expression signature of Lyme disease following the acute phase of infection persisted for at least 3 weeks and had fewer than 44% differentially expressed genes (DEGs in common with other infectious or noninfectious syndromes. Early Lyme disease prior to antibiotic therapy was characterized by marked upregulation of Toll-like receptor signaling but lack of activation of the inflammatory T-cell apoptotic and B-cell developmental pathways seen in other acute infectious syndromes. Six months after completion of therapy, Lyme disease patients were found to have 31 to 60% of their pathways in common with three different immune-mediated chronic diseases. No differential gene expression signature was observed between Lyme disease patients with resolved illness to those with persistent symptoms at 6 months post-treatment. The identification of a sustained differential gene expression signature in Lyme disease suggests that a panel of selected human host-based biomarkers may address the need for sensitive clinical diagnostics during the “window period” of infection prior to the appearance of a detectable antibody response and may also inform the development of new therapeutic targets.

  14. Longitudinal Transcriptome Analysis Reveals a Sustained Differential Gene Expression Signature in Patients Treated for Acute Lyme Disease

    Science.gov (United States)

    Bouquet, Jerome; Soloski, Mark J.; Swei, Andrea; Cheadle, Chris; Federman, Scot; Billaud, Jean-Noel; Rebman, Alison W.; Kabre, Beniwende; Halpert, Richard; Boorgula, Meher

    2016-01-01

    ABSTRACT Lyme disease is a tick-borne illness caused by the bacterium Borrelia burgdorferi, and approximately 10 to 20% of patients report persistent symptoms lasting months to years despite appropriate treatment with antibiotics. To gain insights into the molecular basis of acute Lyme disease and the ensuing development of post-treatment symptoms, we conducted a longitudinal transcriptome study of 29 Lyme disease patients (and 13 matched controls) enrolled at the time of diagnosis and followed for up to 6 months. The differential gene expression signature of Lyme disease following the acute phase of infection persisted for at least 3 weeks and had fewer than 44% differentially expressed genes (DEGs) in common with other infectious or noninfectious syndromes. Early Lyme disease prior to antibiotic therapy was characterized by marked upregulation of Toll-like receptor signaling but lack of activation of the inflammatory T-cell apoptotic and B-cell developmental pathways seen in other acute infectious syndromes. Six months after completion of therapy, Lyme disease patients were found to have 31 to 60% of their pathways in common with three different immune-mediated chronic diseases. No differential gene expression signature was observed between Lyme disease patients with resolved illness to those with persistent symptoms at 6 months post-treatment. The identification of a sustained differential gene expression signature in Lyme disease suggests that a panel of selected human host-based biomarkers may address the need for sensitive clinical diagnostics during the “window period” of infection prior to the appearance of a detectable antibody response and may also inform the development of new therapeutic targets. PMID:26873097

  15. Pre-transplantation minimal residual disease with cytogenetic and molecular diagnostic features improves risk stratification in acute myeloid leukemia.

    Science.gov (United States)

    Oran, Betül; Jorgensen, Jeff L; Marin, David; Wang, Sa; Ahmed, Sairah; Alousi, Amin M; Andersson, Borje S; Bashir, Qaiser; Bassett, Roland; Lyons, Genevieve; Chen, Julianne; Rezvani, Katy; Popat, Uday; Kebriaei, Partow; Patel, Keyur; Rondon, Gabriela; Shpall, Elizabeth J; Champlin, Richard E

    2017-01-01

    Our aim was to improve outcome prediction after allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia by combining cytogenetic and molecular data at diagnosis with minimal residual disease assessment by multicolor flow-cytometry at transplantation. Patients with acute myeloid leukemia in first complete remission in whom minimal residual disease was assessed at transplantation were included and categorized according to the European LeukemiaNet classification. The primary outcome was 1-year relapse incidence after transplantation. Of 152 patients eligible, 48 had minimal residual disease at the time of their transplant. Minimal residual disease-positive patients were older, required more therapy to achieve first remission, were more likely to have incomplete recovery of blood counts and had more adverse risk features by cytogenetics. Relapse incidence at 1 year was higher in patients with minimal residual disease (32.6% versus 14.4%, P=0.002). Leukemia-free survival (43.6% versus 64%, P=0.007) and overall survival (48.8% versus 66.9%, P=0.008) rates were also inferior in patients with minimal residual disease. In multivariable analysis, minimal residual disease status at transplantation independently predicted 1-year relapse incidence, identifying a subgroup of intermediate-risk patients, according to the European LeukemiaNet classification, with a particularly poor outcome. Assessment of minimal residual disease at transplantation in combination with cytogenetic and molecular findings provides powerful independent prognostic information in acute myeloid leukemia, lending support to the incorporation of minimal residual disease detection to refine risk stratification and develop a more individualized approach during hematopoietic stem cell transplantation. Copyright© Ferrata Storti Foundation.

  16. Preparation of a sinterable beryllium oxide through decomposition of beryllium hydroxide (1963); Preparation d'un oxyde de beryllium frittable par decomposition de l'hydiloxyde (1963)

    Energy Technology Data Exchange (ETDEWEB)

    Bernier, M. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1963-07-01

    In the course of the present study, we have attempted to precise the factors which among the ones effective in the course of the preparation of the beryllium hydroxide and oxide and during the sintering have an influence on the final result: the density and homogeneity of the sintered body. Of the several varieties of hydroxides precipitated from a sulfate solution the {beta}-hydroxide only is always contaminated with beryllium sulfate and cannot be purified even by thorough washing. We noticed that those varieties of the hydroxide (gel, {alpha}, {beta}) have different decomposition rates; this behaviour is used to identify and even to dose the different species in ({alpha}, {beta}) mixtures. The various hydroxides transmit to the resulting oxides the shape they had when precipitated. Accordingly the history of the oxide is revealed by its behaviour during its fabrication and sintering. By comparing the results of the sintering operation with the various measurements performed on the oxide powders we are led to the conclusion that an oxide obtained from beryllium hydroxide is sinterable under vacuum if the following conditions are fulfilled: the particle size must lie between 0.1 and 0.2 {mu} and the BeSO{sub 4} content of the powder must be less than 0.25 per cent wt (expressed as SO{sub 3}/BeO). The best fitting is obtained with the oxide issued from an {alpha}-hydroxide precipitated as very small aggregates and with a low sulfur-content. We have observed that this is also the case for the oxide obtained by direct calcination of beryllium sulfate. (author) [French] Au cours de cette etude, nous avons cherche a preciser les facteurs qui, intervenant tout au long de la preparation de l'hydroxyde, puis de l'oxyde de beryllium et enfin du frittage, peuvent avoir une influence sur le resultat final: la densite et l'homogeneite du fritte. Parmi tous les hydroxydes precipites d'une solution de sulfate, seul l'hydroxyde {beta} est toujours

  17. Metabolic assessment and enteral tube feeding usage in children with acute neurological diseases.

    Science.gov (United States)

    Leite, H P; Fantozzi, G

    1998-01-01

    To report on acquired experience of metabolic support for children with acute neurological diseases, emphasizing enteral tube feeding usage and metabolic assessment, and also to recommend policies aimed towards improving its implementation. Retrospective analysis. Pediatric Intensive Care Unit of Hospital do Servidor Público Estadual de São Paulo. 44 patients consecutively admitted to the Pediatric ICU over a period of 3 years who were given nutrition and metabolic support for at least 72 hours. Head trauma, CNS infections and craniotomy post-operative period following tumor exeresis were the main diagnoses. Records of protein-energy intake, nutrient supply route, nitrogen balance and length of therapy. From a total of 527 days of therapy, single parenteral nutrition was utilized for 34.3% and single enteral tube feeding for 79.1% of that period. 61.4% of the children were fed exclusively via enteral tube feeding, 9.1% via parenteral and 39.5% by both routes. The enteral tube feeding was introduced upon admission and transpyloric placement was successful in 90% of the cases. Feeding was started 48 hours after ICU admission. The caloric goal was achieved on the 7th day after admission, and thereafter parenteral nutrition was interrupted. The maximum energy supply was 104.2 +/- 23.15 kcal/kg. The median length of therapy was 11 days (range 4-38). None of the patients on tube feeding developed GI tract bleeding, pneumonia or bronchoaspiration episodes and, of the 4 patients who were given exclusive TPN, 2 developed peptic ulcer. The initial urinary urea nitrogen was 7.11 g/m2 and at discharge 6.44 g/m2. The protein supply increased from 1.49 g/kg to 3.65 g/kg (p < 0.01). The nitrogen balance increased from--7.05 to 2.2 g (p < 0.01). Children with acute neurological diseases are hypercatabolic and have high urinary nitrogen losses. The initial negative nitrogen balance can be increased by more aggressive feeding regimes than the usual ones. Early tube feeding was

  18. Metabolic assessment and enteral tube feeding usage in children with acute neurological diseases

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    Heitor Pons Leite

    Full Text Available OBJECTIVE: To report on acquired experience of metabolic support for children with acute neurological diseases, emphasizing enteral tube feeding usage and metabolic assessment, and also to recommend policies aimed towards improving its implementation. DESIGN: Retrospective analysis. SETTING: Pediatric Intensive Care Unit of Hospital do Servidor Público Estadual de São Paulo. SUBJECTS: 44 patients consecutively admitted to the Pediatric ICU over a period of 3 years who were given nutrition and metabolic support for at least 72 hours. Head trauma, CNS infections and craniotomy post-operative period following tumor exeresis were the main diagnoses. MEASUREMENTS: Records of protein-energy intake, nutrient supply route, nitrogen balance and length of therapy. RESULTS: From a total of 527 days of therapy, single parenteral nutrition was utilized for 34.3% and single enteral tube feeding for 79.1% of that period. 61.4% of the children were fed exclusively via enteral tube feeding, 9.1% via parenteral and 39.5 % by both routes. The enteral tube feeding was introduced upon admission and transpyloric placement was successful in 90% of the cases. Feeding was started 48 hours after ICU admission. The caloric goal was achieved on the 7th day after admission, and thereafter parenteral nutrition was interrupted. The maximum energy supply was 104.2 ± 23.15 kcal/kg. The median length of therapy was 11 days (range 4-38. None of the patients on tube feeding developed GI tract bleeding, pneumonia or bronchoaspiration episodes and, of the 4 patients who were given exclusive TPN, 2 developed peptic ulcer. The initial urinary urea nitrogen was 7.11 g/m2 and at discharge 6.44 g/m2. The protein supply increased from 1.49 g/kg to 3.65 g/kg (p< 0.01. The nitrogen balance increased from -7.05 to 2.2 g (p< 0.01. CONCLUSIONS: Children with acute neurological diseases are hypercatabolic and have high urinary nitrogen losses. The initial negative nitrogen balance can be

  19. Redrawing Papez' circuit: a theory about how acute stress becomes chronic and causes disease.

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    Eggers, Arnold E

    2007-01-01

    The diseases of chronic stress include migraine, essential hypertension, depression, and the metabolic syndrome. A theory is presented to explain how acute stress becomes chronic and causes these inter-related conditions. The theory is based on a new "circuit of emotion", which is derived from Papez' famous theory of emotion. The hypothesis is as follows: There is a basic circuit of emotion which runs from the hippocampus (defined as the dentate gyrus plus the CA regions), where emotion arises, to the amygdala and from there to serotonergic pacemaker cells in the dorsal raphe nucleus (DRN). The DRN projects back to the dentate gyrus in two ways: a direct route without a stop and an indirect route via pacemaker cells in the entorhinal cortex. The purpose of the direct route is to promote neurogenesis in the subgranular zone of the dentate; the indirect route has two purposes: to imprint ongoing moments of consciousness onto new dentate cells for retention as memory and to provide a negative feedback loop for regulation of the whole process. The hippocampus, the amygdala, and the DRN all project to the hypothalamus, which are branches off the basic loop that subserve the autonomic expression of emotion. Pathologic overdrive of the DRN causes overdrive of the entorhinal cortex, which leads to excitotoxic cell death of neurons in the hippocampus involved in the negative feedback loop. The disinhibited amygdala and DRN are then free to orchestrate the syndromes of chronic stress. Recovery from chronic stress requires repopulation of the dentate gyrus and restoration of the feedback loop. Excitotoxic cell death in the hippocampus results from either extraordinary acute stress or increased susceptibility to DRN overdrive, as might be caused, for example, by genetic factors, age, high cortisol levels, or incomplete recovery from previous damage. Three goals for therapeutic intervention are identified: inhibition of pacemaker cells in the DRN (which can be targeted by

  20. Decompensated liver disease complicated by acute stroke caused by multiple factors: a clinical analysis of 15 cases

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    GOU Chunyan

    2016-09-01

    Full Text Available Objective To investigate the clinical features of patients with decompensated liver disease complicated by acute stroke. Methods A retrospective analysis was performed for the clinical data of 15 patients who were hospitalized in Beijing You'an Hospital, Capital Medical University and diagnosed with decompensated liver disease complicated by acute stroke from January 2011 to December 2015, including medical history, neurological manifestations, treatment, and prognostic features. Results Among the 15 patients, 11 had acute hemorrhagic stroke (AHS, and 4 had acute ischemic stroke (AIS; among the 11 patients with AHS, 4 (36.36% had hemorrhage caused by brain metastatic tumor of liver cancer (tumor-associated stroke, and 3 (27.27% were complicated by liver failure. Among the 15 patients, 12 (80% had disturbance of consciousness as the early neurological manifestation, and the confirmed diagnosis was made based on head CT findings; the treatment mainly included symptomatic support and rehabilitation training. The patients with AHS had poor prognosis. Four (26.67% of the 15 AHS patients died, among these patients, 2 had liver failure complicated by AHS, 1 had liver cirrhosis complicated by AHS, and 1 had brain metastases complicated by AHS. Conclusion Patients with decompensated liver disease complicated by acute stroke tend to develop the manifestations of AHS, which may be related to a poor clotting mechanism and brain metastasis of liver cancer, and have poor prognosis. Head CT scan should be performed for patients with decompensated liver disease accompanied by neuropsychiatric abnormalities as early as possible to help with early diagnosis and timely treatment.

  1. Emerging coral diseases in Kāne'ohe Bay, O'ahu, Hawai'i (USA): two major disease outbreaks of acute Montipora white syndrome

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    Aeby, Greta S.; Callahan, Sean; Cox, Evelyn F.; Runyon, Christina M.; Smith, Ashley; Stanton, Frank G.; Ushijima, Blake; Work, Thierry M.

    2016-01-01

    In March 2010 and January 2012, we documented 2 widespread and severe coral disease outbreaks on reefs throughout Kāne‘ohe Bay, Hawai‘i (USA). The disease, acute Montipora white syndrome (aMWS), manifested as acute and progressive tissue loss on the common reef coral M. capitata. Rapid visual surveys in 2010 revealed 338 aMWS-affected M. capitata colonies with a disease abundance of (mean ± SE) 0.02 ± 0.01 affected colonies per m of reef surveyed. In 2012, disease abundance was significantly higher (1232 aMWS-affected colonies) with 0.06 ± 0.02 affected colonies m-1. Prior surveys found few acute tissue loss lesions in M. capitata in Kāne‘ohe Bay; thus, the high number of infected colonies found during these outbreaks would classify this as an emerging disease. Disease abundance was highest in the semi-enclosed region of south Kāne‘ohe Bay, which has a history of nutrient and sediment impacts from terrestrial runoff and stream discharge. In 2010, tagged colonies showed an average tissue loss of 24% after 1 mo, and 92% of the colonies continued to lose tissue in the subsequent month but at a slower rate (chronic tissue loss). The host-specific nature of this disease (affecting only M. capitata) and the apparent spread of lesions between M. capitatacolonies in the field suggest a potential transmissible agent. The synchronous appearance of affected colonies on multiple reefs across Kāne‘ohe Bay suggests a common underlying factor. Both outbreaks occurred during the colder, rainy winter months, and thus it is likely that some parameter(s) associated with winter environmental conditions are linked to the emergence of disease outbreaks on these reefs.

  2. The influence of chronic kidney disease and age on revascularization rates and outcomes in acute myocardial infarction - a cohort study.

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    Kotwal, Sradha; Ranasinghe, Isuru; Brieger, David; Clayton, Philip A; Cass, Alan; Gallagher, Martin

    2017-06-01

    There is a paucity of data on the complex interaction between chronic kidney disease, age and its impact on management and outcomes in acute myocardial infarction. A state based claims dataset that collects data on all hospitalizations (representing 32.3% of the Australian population) was used to identify all patients admitted with a principal diagnosis of acute myocardial infarction (ICD10 codes: I21.0-I21.4) over a four-year period. Patients were linked to the state death registry and followed until death or end of follow-up (31 December 2009). Chronic kidney disease was defined as the presence of any of 65 ICD10 diagnostic codes for chronic kidney disease. The primary outcomes were receipt of revascularization, length of hospital stay and mortality adjusted for age, comorbidities and prior revascularization at presentation. Of the 40,472 patients with acute myocardial infarction, chronic kidney disease was present in 4814 patients (11.9%). Median follow-up was 2.8 years (range 0-5.5 years). In the multivariable model, there was a marked interaction between chronic kidney disease and age ( pChronic kidney disease was a powerful marker of lower revascularization rates (median age group of 70-79 years: odds ratio 0.68; 95% confidence interval 0.59-0.78; pchronic kidney disease on length of stay (median age group of 70-79 years vs. referent age group 18-39 years: incidence rate ratio 1.41; 95% confidence interval 1.32-1.51; pChronic kidney disease is an important deterrent for the receipt of revascularization in older patients, but age is the primary determinant of length of stay and mortality.

  3. Acute Liver Failure

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    Acute liver failure Overview Acute liver failure is loss of liver function that occurs rapidly — in days or weeks — usually in a person who has no pre-existing liver disease. Acute liver failure is less common than ...

  4. Expert consensus on acute exacerbation of chronic obstructive pulmonary disease in the People's Republic of China

    Directory of Open Access Journals (Sweden)

    Cai BQ

    2014-04-01

    Full Text Available Bai-qiang Cai,1 Shao-xi Cai,2 Rong-chang Chen,3 Li-ying Cui,4 Yu-lin Feng,5 Yu-tong Gu,6 Shao-guang Huang,7 Rong-yu Liu,8 Guang-nan Liu,9 Huan-zhong Shi,10 Yi Shi,11 Yuan-lin Song,6 Tie-ying Sun,12 Chang-zheng Wang,13 Jing-lan Wang,1 Fu-qiang Wen,5 Wei Xiao,14 Yong-jian Xu,15 Xi-xin Yan,16 Wan-zhen Yao,17 Qin Yu,18 Jing Zhang,6 Jin-ping Zheng,3 Jie Liu,6 Chun-xue Bai6 1Department of Pulmonary Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 2Southern Medical University South Hospital, Guangzhou, 3The First Affiliated Hospital of Guangzhou Medical College and Guangzhou Institute of Respiratory Diseases, Guangzhou, 4Affiliate Hospital of Inner Mongolia Medical University, Huhehaote, 5Huaxi Hospital of Sichuan University, Chendu, 6Zhongshan Hospital, Shanghai Medical College, Fudan University and Shanghai Respiratory Research Institute, Shanghai, 7Ruijing Hospital of Shanghai Jiaotong University, Shanghai, 8The First Affiliated University of Anhui Medical University, Hefei, 9The First Affiliated University of Guangxi Medical University, Nanning, 10Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 11General Hospital of Nanjing Military Region, Nanjing, 12Beijing Hospital of the Ministry of Health, Beijing, 13Xinqiao Hospital, Third Military Medical University, Chongqing, 14Qilu Hospital of Shandong University, Jinan, 15Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 16The Second Affiliated Hospital of Hebei Medical University and Hebei Research Institute of Respiratory Medicine, Shijiazhuang, 17The Third Affiliated Hospital of Beijing University, Beijing, 18The First Affiliated University of Lanzhou University, Lanzhou, People's Republic of China Abstract: Chronic obstructive pulmonary disease (COPD is a common disease that severely threatens human health. Acute exacerbation of COPD (AECOPD is a major cause of

  5. [Pulmonary rehabilitation methods in the prevention of acute respiratory infections in patients with chronic obstructive pulmonary disease, the association with psycho-emotional state].

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    Tovt-Korshyns'ka, M I; Blaha, O S; Pudakova, S O; Tovt, V A

    2014-01-01

    In patients with chronic obstructive pulmonary disease stage I GOLD we revealed a significant reduction of acute respiratory infections frequency after pulmonary rehabilitation using salt aerosol therapy; however, in patients with chronic obstructive pulmonary disease stage II GOLD such a reduction we have not seen. We didn't find marked reduction of acute respiratory infections frequency also in patients with chronic obstructive pulmonary disease stage I GOLD with higher depression level.