WorldWideScience

Sample records for computerised retinal haemorrhage

  1. White-centred retinal haemorrhages (Roth spots).

    OpenAIRE

    Ling, R.; James, B.

    1998-01-01

    Roth spots (white-centred retinal haemorrhages) were classically described as septic emboli lodged in the retina of patients with subacute bacterial endocarditis. Indeed many have considered Roth spots pathognomonic for this condition. More recent histological evidence suggests, however, that they are not foci of bacterial abscess. Instead, they are nonspecific and may be found in many other diseases. A review of the histology and the pathogenesis of these white-centred haemorrhages will be p...

  2. White-centred retinal haemorrhages (Roth spots).

    Science.gov (United States)

    Ling, R; James, B

    1998-10-01

    Roth spots (white-centred retinal haemorrhages) were classically described as septic emboli lodged in the retina of patients with subacute bacterial endocarditis. Indeed many have considered Roth spots pathognomonic for this condition. More recent histological evidence suggests, however, that they are not foci of bacterial abscess. Instead, they are nonspecific and may be found in many other diseases. A review of the histology and the pathogenesis of these white-centred haemorrhages will be provided, along with the work-up of the differential diagnosis.

  3. Retinal haemorrhage in infants with pertussis.

    Science.gov (United States)

    Raoof, Naz; Pereira, Susana; Dai, Shuan; Neutze, Jocelyn; Grant, Cameron Charles; Kelly, Patrick

    2017-12-01

    It has been hypothesised that paroxysmal coughing in infantile pertussis (whooping cough) could produce retinal haemorrhages identical to those seen in abusive head trauma. We aimed to test this hypothesis. This is a prospective study of infants hospitalised with pertussis in Auckland, New Zealand, from 2009 to 2014. The clinical severity of pertussis was categorised. All infants recruited had retinal examination through dilated pupils by the paediatric ophthalmology service using an indirect ophthalmoscope. Forty-eight infants with pertussis, aged 3 weeks to 7 months, were examined after a mean of 18 days of coughing. Thirty-nine had severe pertussis and nine had mild pertussis. All had paroxysmal cough, and all were still coughing at the time of examination. No retinal haemorrhages were seen. We found no evidence to support the hypothesis that pertussis may cause the pattern of retinal haemorrhages seen in abusive head trauma in infants. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Computerising documentation

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    The nuclear power generation industry is faced with public concern and government pressures over safety, efficiency and risk. Operators throughout the industry are addressing these issues with the aid of a new technology - technical document management systems (TDMS). Used for strategic and tactical advantage, the systems enable users to scan, archive, retrieve, store, edit, distribute worldwide and manage the huge volume of documentation (paper drawings, CAD data and film-based information) generated in building, maintaining and ensuring safety in the UK's power plants. The power generation industry has recognized that the management and modification of operation critical information is vital to the safety and efficiency of its power plants. Regulatory pressure from the Nuclear Installations Inspectorate (NII) to operate within strict safety margins or lose Site Licences has prompted the need for accurate, up-to-data documentation. A document capture and management retrieval system provides a powerful cost-effective solution, giving rapid access to documentation in a tightly controlled environment. The computerisation of documents and plans is discussed in this article. (Author)

  5. Computerised Axial Tomography (CAT)

    Science.gov (United States)

    1990-06-01

    Ministry of’ Defence, Defence Research Information Centre, UK. Computerised Axial Tomography ( CAT ) Report Secufty C"uMiauion tide Onadtiicadon (U. R, Cor S...DRIC T 8485 COMPUTERISED AXIAL TOMOGRAPHY ( CAT ) F.P. GENTILE, F. SABETTA, V. TRO1* ISS R 78/4.Rome, 1.5 Mlarch 1978 (from Italian) B Distribution(f...dello Radiazioni ISSN 0390--6477 F.P. GENTILE, F. SABETTA. V. TROI Computerised Axial Tomography ( CAT ) March 15, 1978). This paper is a review of

  6. Intracranial haemorrhage

    African Journals Online (AJOL)

    of the brain the haemorrhage is referred to as an .... The bleed is in the left basal ganglia most often originating in the putamen. Fig. 3. This 26-year-old patient presented with sudden-onset headache, right-sided ..... Early surgery versus initial.

  7. Emergency admissions for major haemorrhage associated with direct oral anticoagulants.

    Science.gov (United States)

    Bouget, Jacques; Oger, Emmanuel

    2015-12-01

    To describe the population admitted in an emergency department of a teaching hospital for severe bleeding associated with direct oral anticoagulants (DOAC). During a three-year period (2012-2014) patients older than 16 years were prospectively identified by haemorrhagic symptoms from computerised requests. At least one of the following criteria defined major haemorrhage: haemorrhagic shock, unstable haemodynamic, need for transfusion or haemostatic procedure, or a life threatening location. Fifty four patients, 23 receiving dabigatran, 30 rivaroxaban and one apixaban were included, 2 in 2012, 35 in 2013 and 17 in 2014. Median age was 84 years (range 63-99) with a sex ratio of 1.16. Haemorrhagic complications were gastrointestinal (n=27), intracranial (n=12) or miscellaneous (n=15). Indication of DOAC was stroke prevention in atrial fibrillation in 49 cases and deep vein thrombosis in 5 cases. Hospitalization was required for 45 patients (83%) with a mean length of stay of 8.5 days. Sixteen patients needed intensive care. Reversal therapy was prescribed in 11 patients. At 1 month, overall mortality was 24%, reaching 41.7% for intracranial haemorrhage. Among surviving patients, DOAC was stopped in 10 cases, continued in 17 patients and switched for other antithrombotic in 17 patients. Our study contributes to the post marketing surveillance of major haemorrhagic complications associated with DOAC. It takes part to the knowledge about the course of this severe event in emergencies. Careful awareness in risk benefit assessment, especially in elderly, is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Viral Haemorrhagic Septicaemia Virus

    DEFF Research Database (Denmark)

    Olesen, Niels Jørgen; Skall, Helle Frank

    2013-01-01

    This chapter covers the genetics (genotypes and serotypes), clinical signs, host species, transmission, prevalence, diagnosis, control and prevention of viral haemorrhagic septicaemia virus.......This chapter covers the genetics (genotypes and serotypes), clinical signs, host species, transmission, prevalence, diagnosis, control and prevention of viral haemorrhagic septicaemia virus....

  9. Comparisons between written and computerised patient histories

    NARCIS (Netherlands)

    Quaak, Martien; Westerman, R. Frans; van Bemmel, Jan H.

    1987-01-01

    Patient histories were obtained from 99 patients in three different ways: by a computerised patient interview (patient record), by the usual written interview (medical record), and by the transcribed record, which was a computerised version of the medical record. Patient complaints, diagnostic

  10. Hereditary haemorrhagic telangiectasia

    DEFF Research Database (Denmark)

    Kjeldsen, A D; Vase, P; Green, A

    1999-01-01

    Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited disease characterized by telangiectatic lesions. The disease manifestations are variable and include epistaxis, gastrointestinal bleeding, pulmonary arteriovenous malformations and cerebral arteriovenous malformations. Early...

  11. Late onset retinoblastoma presenting with vitreous haemorrhage

    DEFF Research Database (Denmark)

    Bagger, Mette; Prause, Jan Ulrik; Heegard, Steffen

    2012-01-01

    in the retina. A vascularized gelatinous mass was revealed after vitrectomy. Later the patient developed white cysts in the anterior chamber and histological findings were indicative of a retinoblastoma. The patient was enucleated and the diagnosis of retinoblastoma was confirmed. Intraocular surgery in young...... people with unknown retinoblastoma enhances the risk of metastasis development, orbital recurrence and death. Unexplained vitreous haemorrhage can obscure the view of a tumour but ultrasonic findings of a retinal mass calls for further imaging e.g. through MRI. The case illustrates the importance...

  12. Prophylactic ethamsylate for periventricular haemorrhage.

    OpenAIRE

    Cooke, R W; Morgan, M E

    1984-01-01

    Drug prophylaxis with ethamsylate for periventricular haemorrhage in very low birthweight infants significantly reduced the incidence of periventricular haemorrhage in survivors. A reduction in abnormalities at follow up and in insertion of ventriculoperitoneal shunts was also noted.

  13. Sheathotomy in complicated cases of branch retinal vein occlusion

    DEFF Research Database (Denmark)

    Crafoord, S.; Karlsson, N.; Cour, M. la

    2008-01-01

    Purpose: To report the clinical experience and results of using a microsurgical technique to decompress the arteriovenous connection in complicated branch retinal vein occlusion (BRVO) combined with haemorrhage, oedema an ischaemia. Methods: We carried out a retrospective, non-randomized, interve......Purpose: To report the clinical experience and results of using a microsurgical technique to decompress the arteriovenous connection in complicated branch retinal vein occlusion (BRVO) combined with haemorrhage, oedema an ischaemia. Methods: We carried out a retrospective, non...

  14. Saving time with a computerised handbook

    International Nuclear Information System (INIS)

    Henrie, D.K.

    1993-01-01

    The DE/CAASE computerised engineering handbook (Desktop Engineering, Mahwah, NJ, USA) is a software tool designed to automate a wide variety of engineering tasks that are typically performed with an engineering handbook and hand calculator. It significantly reduces the time taken to perform these tasks. For example, instead of spending 60 minutes on determining section properties of composite sections in control room panels and other equipment by hand, it might take less than 5 minutes by using the computerised handbook. Similarly, mode shapes and frequencies of simple structures may take less than 10 minutes to calculate, compared with the hours it used to take. (author)

  15. An intragastric trichobezoar: computerised tomographic appearance.

    Directory of Open Access Journals (Sweden)

    Morris B

    2000-04-01

    Full Text Available A 26-year-old lady presented with a history of abdominal pain and distension since two months. The ultrasound examination showed an epigastric mass, which was delineated as a filling defect in the stomach on barium studies. The computerised tomographic scan showed a gastric mass with pockets of air in it, without post-contrast enhancement. This case highlights the characteristic appearance on computerised tomography of a bezoar within the stomach, a feature that is not commonly described in medical literature.

  16. Haemorrhagic pituitary tumours

    International Nuclear Information System (INIS)

    Lazaro, C.M.; Philippine General Hospital, Manila; Guo, W.Y.; Sami, M.; Hindmarsch, T.; Ericson, K.; Hulting, A.L.; Wersaell, J.

    1994-01-01

    In a group of 69 patients with pituitary tumours, 12 were found to have evidence of intratumoral haemorrhage on MRI, characterized by high signal intensity on short TR/TE sequences. This was verified in all but 1 patient. The majority of the bleedings occurred in macroadenomas. Five (42%) were prolactinomas and 4 (33%) were non-functioning adenomas. There were 2 GH- and 1 ACTH-secreting tumours. All 5 patients with prolactinomas were on bromocriptine medication. Two of the patients had a clinical picture of pituitary apoplexy. The haemorrhage was not large enough to prompt surgery in any of the patients. However, surgical verification of the diagnosis was obtained in 5 cases, while 6 patients were examined with follow-up MRI. (orig.)

  17. Ebola haemorrhagic fever

    Science.gov (United States)

    Feldmann, Heinz; Geisbert, Thomas W

    2012-01-01

    Ebola viruses are the causative agents of a severe form of viral haemorrhagic fever in man, designated Ebola haemorrhagic fever, and are endemic in regions of central Africa. The exception is the species Reston Ebola virus, which has not been associated with human disease and is found in the Philippines. Ebola virus constitutes an important local public health threat in Africa, with a worldwide effect through imported infections and through the fear of misuse for biological terrorism. Ebola virus is thought to also have a detrimental effect on the great ape population in Africa. Case-fatality rates of the African species in man are as high as 90%, with no prophylaxis or treatment available. Ebola virus infections are characterised by immune suppression and a systemic inflammatory response that causes impairment of the vascular, coagulation, and immune systems, leading to multiorgan failure and shock, and thus, in some ways, resembling septic shock. PMID:21084112

  18. Computerised tomography in tuberculous Addison's disease

    International Nuclear Information System (INIS)

    Perry, M.C.; Eason, R.J.; Croxson, M.S.

    1983-01-01

    The important contribution computerised tomography played in the diagnosis of tuberculous Addison's disease is described. While conventional radiographic methods of demonstrating this disease are often unhelpful, C.T. is an excellent technique for demonstrating the morphology of normal and abnormal adrenal glands

  19. Haemorrhage from Pancreatic Pseudocysts Presenting as Upper Gastrointestinal Haemorrhage

    Directory of Open Access Journals (Sweden)

    Giuseppe Garcea

    2004-04-01

    Full Text Available Haemorrhage is a rare but frequently fatal complication of pancreatic pseudocysts. The high mortality associated with pancreatic haemorrhage makes prompt and aggressive management essential. Occasionally, haemorrhage may present atypically, leading to delay in its diagnosis and management. This report details a case of pancreatic haemorrhage presenting as an upper gastrointestinal bleed and discusses the subsequent management. When managing patients with pancreatic pseudocysts who present with the stigmata of upper gastrointestinal bleeding, the possibility that the bleeding originates from the pancreas must always be borne in mind.

  20. Results of laser treatment for sub-retinal neovascular membranes

    African Journals Online (AJOL)

    1990-09-01

    Sep 1, 1990 ... haemonhagic detachment of the retinal pigment epithelium and sensory· retina produced by exudation from these new vessels.I-l This exudative and sometimes haemorrhagic process often leads to severe and permanent loss of central vision because of sub-retinal fibrovascular organisation.2 Progressive.

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

    NARCIS (Netherlands)

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

    2008-01-01

    A female neonate delivered at term developed hypovolemic shock due to a subgaleal haemorrhage, i.e. extracranial bleeding between the galea aponeurotica and the cranial periosteum. The subgaleal haemorrhage was most likely the result of a traumatic vacuum extraction. The patient was treated with

  2. Postpartum haemorrhage: prevention

    OpenAIRE

    Chelmow, David

    2008-01-01

    Loss of more than 500 mL of blood is usually caused by failure of the uterus to contract fully after delivery of the placenta, and occurs in over 10% of deliveries with a 1% mortality rate worldwide. Other causes of postpartum haemorrhage include retained placental tissue, lacerations to the genital tract and coagulation disorders.Uterine atony is more likely in women who have had a general anaesthetic or oxytocin, an over-distended uterus, a prolonged or precipitous labour, or who are of ...

  3. Postpartum haemorrhage: prevention

    OpenAIRE

    Chelmow, David

    2011-01-01

    Loss of more than 500 mL of blood is usually caused by failure of the uterus to contract fully after delivery of the placenta, and occurs in over 10% of deliveries, with a 1% mortality worldwide. Other causes of postpartum haemorrhage include retained placental tissue, lacerations to the genital tract, and coagulation disorders.Uterine atony is more likely in women who have had a general anaesthetic or oxytocin, an over-distended uterus, a prolonged or precipitous labour, or who are of hig...

  4. Haemorrhage in intracranial tuber- culosis

    African Journals Online (AJOL)

    CASE REPORT. 16. SA JOURNAL OF RADIOLOGY • July 2005. Haemorrhage in intracranial tuber- culosis. M Modi. FCRad (SA), MMed. Department of Radiation Sciences ... wall where granulomatous inflamma- tion (Fig. 2, arrow) was present in the adventitia. A specific site of origin for the subarachnoid haemorrhage was.

  5. Postpartum haemorrhage: prevention.

    Science.gov (United States)

    Chelmow, David

    2011-04-04

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

  6. Traumatic primary brain stem haemorrhage

    International Nuclear Information System (INIS)

    Andrioli, G.C.; Zuccarello, M.; Trincia, G.; Fiore, D.L.; De Caro, R.

    1983-01-01

    We report 36 cases of post-traumatic 'primary brain stem haemorrhage' visualized by the CT scan and confirmed at autopsy. Clinical experience shows that many technical factors influence the inability to visualize brain stem haemorrhages. Experimental injection of fresh blood into the pons and midbrain of cadavers shows that lesions as small as 0.25 ml in volume may be visualized. The volume and the anatomical configuration of traumatic lesions of the brain stem extended over a rostro-caudal direction, and their proximity to bony structures at the base of the skull are obstacles to the visualization of brain stem haemorrhages. (Author)

  7. [Reliability of Primary Care computerised medication records].

    Science.gov (United States)

    García-Molina Sáez, Celia; Urbieta Sanz, Elena; Madrigal de Torres, Manuel; Piñera Salmerón, Pascual; Pérez Cárceles, María D

    2016-03-01

    To quantify and to evaluate the reliability of Primary Care (PC) computerised medication records of as an information source of patient chronic medications, and to identify associated factors with the presence of discrepancies. A descriptive cross-sectional study. General Referral Hospital in Murcia. Patients admitted to the cardiology-chest diseases unit, during the months of February to April 2013, on home treatment, who agreed to participate in the study. Evaluation of the reliability of Primary Care computerised medication records by analysing the concordance, by identifying discrepancies, between the active medication in these records and that recorded in pharmacist interview with the patient/caregiver. Identification of associated factors with the presence of discrepancies was analysed using a multivariate logistic regression. The study included a total of 308 patients with a mean of 70.9 years (13.0 SD). The concordance of active ingredients was 83.7%, and this decreased to 34.7% when taking the dosage into account. Discrepancies were found in 97.1% of patients. The most frequent discrepancy was omission of frequency (35.6%), commission (drug added unjustifiably) (14.6%), and drug omission (12.7%). Age older than 65 years (1.98 [1.08 to 3.64]), multiple chronic diseases (1.89 [1.04 to 3.42]), and have a narcotic or psychotropic drug prescribed (2.22 [1.16 to 4.24]), were the factors associated with the presence of discrepancies. Primary Care computerised medication records, although of undoubted interest, are not be reliable enough to be used as the sole source of information on patient chronic medications when admitted to hospital. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  8. Intracerebral haemorrhage after carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Boesen, J

    1987-01-01

    Among 662 consecutive carotid endarterectomies eight cases of postoperative ipsilateral intracerebral haemorrhage were identified, occurring into brain areas which, preoperatively were without infarction. As blood pressures across the stenosis were routinely measured during surgery, the internal...

  9. Software for computerised analysis of cardiotocographic traces.

    Science.gov (United States)

    Romano, M; Bifulco, P; Ruffo, M; Improta, G; Clemente, F; Cesarelli, M

    2016-02-01

    Despite the widespread use of cardiotocography in foetal monitoring, the evaluation of foetal status suffers from a considerable inter and intra-observer variability. In order to overcome the main limitations of visual cardiotocographic assessment, computerised methods to analyse cardiotocographic recordings have been recently developed. In this study, a new software for automated analysis of foetal heart rate is presented. It allows an automatic procedure for measuring the most relevant parameters derivable from cardiotocographic traces. Simulated and real cardiotocographic traces were analysed to test software reliability. In artificial traces, we simulated a set number of events (accelerations, decelerations and contractions) to be recognised. In the case of real signals, instead, results of the computerised analysis were compared with the visual assessment performed by 18 expert clinicians and three performance indexes were computed to gain information about performances of the proposed software. The software showed preliminary performance we judged satisfactory in that the results matched completely the requirements, as proved by tests on artificial signals in which all simulated events were detected from the software. Performance indexes computed in comparison with obstetricians' evaluations are, on the contrary, not so satisfactory; in fact they led to obtain the following values of the statistical parameters: sensitivity equal to 93%, positive predictive value equal to 82% and accuracy equal to 77%. Very probably this arises from the high variability of trace annotation carried out by clinicians. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Ebolavirus and Haemorrhagic Syndrome

    Directory of Open Access Journals (Sweden)

    Gerald A. Matua

    2015-05-01

    Full Text Available The Ebola virus is a highly virulent, single-stranded ribonucleic acid virus which affects both humans and apes and has fast become one of the world’s most feared pathogens. The virus induces acute fever and death, with haemorrhagic syndrome occurring in up to 90% of patients. The known species within the genus Ebolavirus are Bundibugyo, Sudan, Zaïre, Reston and Taï Forest. Although endemic in Africa, Ebola has caused worldwide anxiety due to media hype and concerns about its international spread, including through bioterrorism. The high fatality rate is attributed to unavailability of a standard treatment regimen or vaccine. The disease is frightening since it is characterised by rapid immune suppression and systemic inflammatory response, causing multi-organ and system failure, shock and often death. Currently, disease management is largely supportive, with containment efforts geared towards mitigating the spread of the virus. This review describes the classification, morphology, infective process, natural ecology, transmission, epidemic patterns, diagnosis, clinical features and immunology of Ebola, including management and epidemic containment strategies.

  11. Subarachnoid Haemorrhage and Sports.

    Science.gov (United States)

    Sousa Nanji, Liliana; Melo, Teresa P; Canhão, Patrícia; Fonseca, Ana Catarina; Ferro, José Manuel

    2015-01-01

    Some cases of subarachnoid haemorrhage (SAH) have been associated with vigorous physical activity, including sports. Our research aimed to describe the association between SAH and sports and to identify the types of sports that were more frequently found as precipitating factors in a tertiary single-centre SAH register. We retrieved information from a prospectively collected SAH registry and reviewed discharge notes of acute SAH patients admitted to the Stroke Unit of Hospital de Santa Maria, Lisbon, between 1995 and 2014. Out of 738 patients included in the analysis, 424 (57.5%) cases of SAH were preceded by physical activity. Nine cases (1.2%) were associated with sports, namely running (2 cases), aerobics (2 cases), cycling, body balance, dance, surf and windsurf. Patients with SAH while practicing sports were younger than controls (average age 43.1 vs. 57.0 years; p = 0.007). In 1 patient, there was a report of trauma to the neck. Patients in the sports group only had Hunt and Hess scale grades 1 (11.1%) or 2 (88.9%) at admission, while patients in the control group had a wider distribution in severity. Our findings indicate that SAH precipitated by sports is not very frequent and is uncommonly related to trauma. Patients who suffered SAH associated with sports were younger and apparently had a milder clinical presentation.

  12. Ebolavirus and Haemorrhagic Syndrome.

    Science.gov (United States)

    Matua, Gerald A; Van der Wal, Dirk M; Locsin, Rozzano C

    2015-05-01

    The Ebola virus is a highly virulent, single-stranded ribonucleic acid virus which affects both humans and apes and has fast become one of the world's most feared pathogens. The virus induces acute fever and death, with haemorrhagic syndrome occurring in up to 90% of patients. The known species within the genus Ebolavirus are Bundibugyo, Sudan, Zaïre, Reston and Taï Forest. Although endemic in Africa, Ebola has caused worldwide anxiety due to media hype and concerns about its international spread, including through bioterrorism. The high fatality rate is attributed to unavailability of a standard treatment regimen or vaccine. The disease is frightening since it is characterised by rapid immune suppression and systemic inflammatory response, causing multi-organ and system failure, shock and often death. Currently, disease management is largely supportive, with containment efforts geared towards mitigating the spread of the virus. This review describes the classification, morphology, infective process, natural ecology, transmission, epidemic patterns, diagnosis, clinical features and immunology of Ebola, including management and epidemic containment strategies.

  13. Multitasking in non-computerised and computerised versions of the Breakfast Task in healthy adult aging

    OpenAIRE

    Kozlowska, Maria Teresa

    2010-01-01

    Older adults demonstrate poor performance on standard executive tests. However, age-related deficits have been found only on a number of more realistic executive tests. The present study investigated age effects in multitasking, requiring a range of executive, as well as non-executive, cognitive functions. Previous study by Craik and Bialystok (2006) showed impaired performance of older adults on a computerised multitasking test, which simulated cooking breakfast. Participants were instructed...

  14. Retinitis Pigmentosa.

    Science.gov (United States)

    Carr, Ronald E.

    1979-01-01

    The author describes the etiology of retinitis pigmentosa, a visual dysfunction which results from progressive loss of the retinal photoreceptors. Sections address signs and symptoms, ancillary findings, heredity, clinical diagnosis, therapy, and research. (SBH)

  15. Retinitis Pigmentosa

    Science.gov (United States)

    ... Linked Retinoschisis (XLRS) X-Linked Retinitis Pigmentosa (XLRP) Usher Syndrome Other Retinal Diseases Glossary News & Research News & Research ... degenerate. Forms of RP and related diseases include Usher syndrome, Leber congenital amaurosis, and Bardet-Biedl syndrome, among ...

  16. Retinal Diseases

    Science.gov (United States)

    ... Linked Retinoschisis (XLRS) X-Linked Retinitis Pigmentosa (XLRP) Usher Syndrome Other Retinal Diseases Glossary News & Research News & Research ... central portion of the retina called the macula. Usher Syndrome Usher syndrome is an inherited condition characterized by ...

  17. Debating the utility of computerised neurocognitive testing in the ...

    African Journals Online (AJOL)

    computerised neurocognitive baseline testing in the sports concus- sion context,. 1 ... testing for athletes at this time is scientifically unfounded, financially irresponsible and .... medical management in respect of the sports concussive injury. It.

  18. THE PREVALENCE OF INTRAVENTRICULAR HAEMORRHAGE

    African Journals Online (AJOL)

    Esem

    haemorrhage in preterm infants with birth weight 1.5kg and less was 34.2% in ... case fatality rate was 85.7% for those with grade 4 in the first three days of life. ... with case fatality rates of more than 45% (2007 and 2008 NICU ward statistics).

  19. Computerisation of procedures. Lessons learned and future perspectives

    International Nuclear Information System (INIS)

    O'Hara, J.; Pirus, D.; Nilsen, S.; Bisio, R.; Hulsund, J.-E.; Zhang, W.

    2003-07-01

    The computerisation of the procedures has been investigated for several years. Even though guidelines for such computerisation have been proposed, there is a need to extend and revise these guidelines. In this report, we look at what has been achieved so far, both within the Halden Project as well as within other organisations related to nuclear power plants. These experiences are often related to testing of particular computerised procedure systems either in research laboratories or in nuclear utilities. These activities have accumulated a body of general knowledge on the subject, as documented in other 'lessons learned' reports of the past. This report will extend this accepted body of knowledge. Furthermore, we identify the unresolved problems that need to be further studied to make usable computerised procedures for the future. The report identifies selected qualities that should be reinforced to make computerised procedure systems better. In particular, the integration aspect is emphasised. A flexible integration with the operator tasks and the remaining interfaces of the control room is important. Unless this integration is accomplished, the computerised procedures will not be functional. Another aspect of integration is combination with other systems inclusive those systems that deal with the plant documentation, electronic or paper based. This kind of integration is important to the safe and reliable operation of the plant. Good integration with plant documentation is instrumental in creating reliable QA of the procedures that covers the whole life cycle of the procedure. (Author). 48 refs., 12 figs., 2 tabs

  20. Prototype models for the MOIRA computerised system

    Energy Technology Data Exchange (ETDEWEB)

    Monte, Luigi [ENEA, Centro Ricerche Casaccia, Rome (Italy). Dipt. Ambiente; Hakanson, Lars [Uppsala, Univ. (Sweden). Institute of Earth Sciences; Brittain, John [Oslo, Univ. (Norway). Zoological Museum

    1997-06-01

    The main aim of the present report is to describe selected models and the principles of the Decision Analysis theory that will be applied to develop the model-based computerised system `MOIRA`. A dose model and a model for predicting radiocaesium migration in lakes and the effects of countermeasures to reduce the contamination levels in the components of lacustrine system are described in detail. The principles for developing prototype models for predicting the migration of {sup 90}Sr in lake abiotic and biotic components are discussed. The environmental models described in the report are based on the use of `collective parameters` which due to mutual compensation effects of different phenomena occurring in complex systems, show low variability when the environmental conditions change. Use of such `collective parameters` not only increases the predictive power of the models, but also increases the practical applicability of the model. Among the main results described in the report, the development of an objective hierarchy table for evaluating the effectiveness of a countermeasure when the economic, social and ecological impacts are accounted for, deserves special attention.

  1. Retinal Vasculitis

    Science.gov (United States)

    Rosenbaum, James T.; Sibley, Cailin H.; Lin, Phoebe

    2016-01-01

    Purpose of review Ophthalmologists and rheumatologists frequently miscommunicate in consulting on patients with retinal vasculitis. This report seeks to establish a common understanding of the term, retinal vasculitis, and to review recent papers on this diagnosis. Recent findings 1) The genetic basis of some rare forms of retinal vascular disease have recently been described. Identified genes include CAPN5, TREX1, and TNFAIP3; 2) Behçet’s disease is a systemic illness that is very commonly associated with occlusive retinal vasculitis; 3) retinal imaging including fluorescein angiography and other newer imaging modalities has proven crucial to the identification and characterization of retinal vasculitis and its complications; 4) although monoclonal antibodies to IL-17A or IL-1 beta failed in trials for Behçet’s disease, antibodies to TNF alpha, either infliximab or adalimumab, have demonstrated consistent benefit in managing this disease. Interferon treatment and B cell depletion therapy via rituximab may be beneficial in certain types of retinal vasculitis. Summary Retinal vasculitis is an important entity for rheumatologists to understand. Retinal vasculitis associated with Behçet’s disease responds to monoclonal antibodies that neutralize TNF, but the many other forms of non-infectious retinal vasculitis may require alternate therapeutic management. PMID:26945335

  2. Detection of left ventricular thrombi by computerised tomography

    International Nuclear Information System (INIS)

    Nair, C.K.; Sketch, M.H.; Mahoney, P.D.; Lynch, J.D.; Mooss, A.N.; Kenney, N.P.

    1981-01-01

    Sixteen patients suspected of having left ventricular mural thrombi were studied. All had suffered transmural myocardial infarction. Fifteen patients had a ventricular aneurysm. One had had systemic emboli. The mean length of time between the myocardial infarction and the study was 14.8 months, with a range of one month to 79 months. All patients underwent computerised tomography of the heart, M-mode echocardiography (M-mode), and two-dimensional echocardiography (2-D). Eight patients underwent left ventricular cineangiography. Five patients had surgical confirmation. Computerised tomography, two-dimensional, and M-mode echocardiography predicted left ventricular mural thrombi in 10, eight, and one of the 16 patients, respectively. Left ventricular cineangiography predicted left ventricular mural thrombi in four out of eight patients. Computerised tomography and left ventricular cineangiography correctly predicted the presence or absence of left ventricular thrombi in all five patients who underwent operation. In the same group, however, two-dimensional and M-mode echocardiography failed to predict the presence of thrombi in one and three patients, respectively. Among the 11 patients without surgical confirmation, one, in whom no left ventricular thrombi were shown by M-mode and two-dimensional echocardiography, was found to have thrombi on computerised tomography. In another, two-dimensional echocardiography was positive but this finding was not confirmed either by computerised tomography or by left ventricular angiography. (author)

  3. Retinal vasculitis.

    Science.gov (United States)

    Abu El-Asrar, Ahmed M; Herbort, Carl P; Tabbara, Khalid F

    2005-12-01

    Retinal vasculitis is a sight-threatening intraocular inflammation affecting the retinal vessels. It may occur as an isolated ocular condition, as a manifestation of infectious or neoplastic disorders, or in association with a systemic inflammatory disease. The search for an underlying etiology should be approached in a multidisciplinary fashion based on a thorough history, review of systems, physical examination, and laboratory evaluation. Discrimination between infectious and noninfectious etiologies of retinal vasculitis is important because their treatment is different. This review is based on recently published articles on retinal vasculitis and deals with its clinical diagnosis, its link with systemic diseases, and its laboratory investigation.

  4. Hepatitis C in haemorrhagic obstetrical emergencies

    International Nuclear Information System (INIS)

    Khaskheli, M.; Baloch, S.

    2014-01-01

    Objective: To determine the maternal health and fetal outcome in hepatitis C with obstetrical haemorrhagic emergencies. Study Design: An observational study. Place and Duration of Study: Department of Obstetrics and Gynaecology Unit-I, Liaquat University of Medical and Health Sciences Hospital, Hyderabad, Sindh, from January 2009 to December 2010. Methodology: All the women admitted during the study period with different obstetrical haemorrhagic emergencies were included. On virology screening, hepatitis C screening was done on all. The women with non-haemorrhagic obstetrical emergencies were excluded. Studied variables included demographic characteristics, the nature of obstetrical emergency, haemorrhagic conditions and maternal and fetal morbidity and mortality. The data was analyzed on SPSS version 20. Results: More frequent obstetrical haemorrhagic emergencies were observed with hepatitis C positive in comparison with hepatitis C negative cases including post-partum haemorrhage in 292 (80.88%) and ante-partum haemorrhage in 69 (19.11%) cases. Associated morbidities seen were disseminated intravascular coagulation in 43 (11.91%) and shock in 29 (8.03%) cases with hepatitis C positive. Fetal still birth rate was 37 (10.24%) in hepatitis C positive cases. Conclusion: Frequency of maternal morbidity and mortality and perinatal mortality was high in obstetrical haemorrhagic emergencies with hepatitis C positive cases. (author)

  5. Bilateral spontaneous adrenal haemorrhage complicating acute pancreatitis

    International Nuclear Information System (INIS)

    Pianta, M.; Varma, D. K.

    2007-01-01

    Bilateral adrenal haemorrhage is an event that mandates prompt diagnosis and treatment to prevent primary adrenocortical insufficiency and potential death. Presentation can be non-specific and incidentally diagnosed with imaging alone, primarily CT. We present a case of acute pancreatitis with spontaneous bilateral adrenal haemorrhage and briefly discuss imaging and treatment implications

  6. Ultrasonically detectable cerebellar haemorrhage in preterm infants.

    LENUS (Irish Health Repository)

    McCarthy, Lisa Kenyon

    2011-07-01

    To determine the frequency and pattern of cerebellar haemorrhage (CBH) on routine cranial ultrasound (cUS) imaging in infants of ≤32 weeks gestation, and to investigate how extremely preterm infants with CBH differ from those with severe intraventricular haemorrhage (IVH).

  7. Desmopressin Acetate in Intracranial Haemorrhage

    Directory of Open Access Journals (Sweden)

    Thomas Kapapa

    2014-01-01

    Full Text Available Introduction. The secondary increase in the size of intracranial haematomas as a result of spontaneous haemorrhage or trauma is of particular relevance in the event of prior intake of platelet aggregation inhibitors. We describe the effect of desmopressin acetate as a means of temporarily stabilising the platelet function. Patients and Methods. The platelet function was analysed in 10 patients who had received single (N=4 or multiple (N=6 doses of acetylsalicylic acid and 3 patients (control group who had not taken acetylsalicylic acid. All subjects had suffered intracranial haemorrhage. Analysis was performed before, half an hour and three hours after administration of desmopressin acetate. Statistical analysis was performed by applying a level of significance of P≤0.05. Results. (1 Platelet function returned to normal 30 minutes after administration of desmopressin acetate. (2 The platelet function worsened again after three hours. (3 There were no complications related to electrolytes or fluid balance. Conclusion. Desmopressin acetate can stabilise the platelet function in neurosurgical patients who have received acetylsalicylic acid prior to surgery without causing transfusion-related side effects or a loss of time. The effect is, however, limited and influenced by the frequency of drug intake. Further controls are needed in neurosurgical patients.

  8. Do Computerised Training Programmes Designed to Improve Working Memory Work?

    Science.gov (United States)

    Apter, Brian J. B.

    2012-01-01

    A critical review of working memory training research during the last 10 years is provided. Particular attention is given to research that has attempted to investigate the efficacy of commercially marketed computerised training programmes such as "Cogmed" and "Jungle Memory". Claimed benefits are questioned on the basis that research methodologies…

  9. Computerised Accounting Software; A Curriculum That Enhances an Accounting Programme

    Science.gov (United States)

    Machera, Robert P.; Machera, Precious C.

    2017-01-01

    There has been an outcry in commerce and industry about students who fail to perform in the accounting department due to lack of "practical accounting skills". It is from this background that the researchers were motivated to investigate the impact of a Computerised Accounting Software Curriculum that enhances an Accounting Programme. At…

  10. Debating the utility of computerised neurocognitive testing in the ...

    African Journals Online (AJOL)

    The purpose of this article was to contribute to an argument regarding the utility of computerised baseline and follow-up neurocognitive testing within the sports concussion arena. Heated debate around this issue via a number of contributions has appeared recently in the journal Current Sports Medicine Reports, with its use ...

  11. Computerised decision support systems for healthcare professionals: an interpretative review.

    Science.gov (United States)

    Cresswell, Kathrin; Majeed, Azeem; Bates, David W; Sheikh, Aziz

    2012-01-01

    Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted. We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997-2010). The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS) Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations. Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits. Whilst the potential of clinical decision support systems in improving, in particular, practitioner performance is considerable, such technology may

  12. Chaetomium retinitis.

    Science.gov (United States)

    Tabbara, Khalid F; Wedin, Keith; Al Haddab, Saad

    2010-01-01

    To report a case of Chaetomium atrobrunneum retinitis in a patient with Hodgkin lymphoma. We studied the ocular manifestations of an 11-year-old boy with retinitis. Biomicroscopy, ophthalmoscopy, and fundus photography were done. Magnetic resonance imaging of the brain was performed. A vitreous biopsy was subjected to viral, bacterial, and fungal cultures. Vitreous culture grew C. atrobrunneum. Magnetic resonance imaging showed multiple cerebral lesions consistent with an infectious process. The patient was given intravenous voriconazole and showed improvement of the ocular and central nervous system lesions. We report a case of central nervous system and ocular lesions by C. atrobrunneum. The retinitis was initially misdiagnosed as cytomegaloviral retinitis. Vitreous biopsy helped in the early diagnosis and prompt treatment of a life- and vision-threatening infection.

  13. Retinitis pigmentosa

    Science.gov (United States)

    ... treatments for retinitis pigmentosa, including the use of DHA, which is an omega-3 fatty acid. Other ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 630. ...

  14. Cytomegalovirus retinitis

    Science.gov (United States)

    ... have weakened immune systems as a result of: HIV/AIDS Bone marrow transplant Chemotherapy Drugs that suppress the immune system Organ transplant Symptoms Some people with CMV retinitis have no symptoms. ...

  15. Retinal Detachment

    Science.gov (United States)

    ... to your brain. It provides the sharp, central vision needed for reading, driving, and seeing fine detail. A retinal detachment lifts or pulls the retina from its normal position. It can occur at ...

  16. Clinical practice guidelines in intracerebral haemorrhage.

    Science.gov (United States)

    Rodríguez-Yáñez, M; Castellanos, M; Freijo, M M; López Fernández, J C; Martí-Fàbregas, J; Nombela, F; Simal, P; Castillo, J; Díez-Tejedor, E; Fuentes, B; Alonso de Leciñana, M; Alvarez-Sabin, J; Arenillas, J; Calleja, S; Casado, I; Dávalos, A; Díaz-Otero, F; Egido, J A; Gállego, J; García Pastor, A; Gil-Núñez, A; Gilo, F; Irimia, P; Lago, A; Maestre, J; Masjuan, J; Martínez-Sánchez, P; Martínez-Vila, E; Molina, C; Morales, A; Purroy, F; Ribó, M; Roquer, J; Rubio, F; Segura, T; Serena, J; Tejada, J; Vivancos, J

    2013-05-01

    Intracerebral haemorrhage accounts for 10%-15% of all strokes; however it has a poor prognosis with higher rates of morbidity and mortality. Neurological deterioration is often observed during the first hours after onset and determines poor prognosis. Intracerebral haemorrhage, therefore, is a neurological emergency which must be diagnosed and treated properly as soon as possible. In this guide we review the diagnostic procedures and factors that influence the prognosis of patients with intracerebral haemorrhage and we establish recommendations for the therapeutic strategy, systematic diagnosis, acute treatment and secondary prevention for this condition. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  17. Nutritional management in Ebola haemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Kamon Chaiyasit

    2015-06-01

    Full Text Available Ebola haemorrhagic fever is a viral infection causing a major health problem worldwide. In this short article, the authors briefly review and discuss on the nutritional management (energy, protein, fat and micronutrient in management of Ebola infection.

  18. Aetiology and treatment of severe postpartum haemorrhage

    DEFF Research Database (Denmark)

    Edwards, Hellen

    2017-01-01

    This thesis is comprised of three studies focusing on severe postpartum haemorrhage (PPH). PPH is a major cause of maternal morbidity and mortality worldwide. Risk factors include retained placenta, prolonged duration of the third stage of labour, previous caesarean section, and operative vaginal...... delivery. Occurrence and development of PPH are, however, unpredictable and can sometimes give rise to massive haemorrhage or even hysterectomy and maternal death. Severe haemorrhage can lead to coagulopathy causing further haemorrhage and requiring substitution with blood transfusions. The aim...... had a cardiac arrest, and a total of 128 women (52%) required a hysterectomy. Hysterectomy was associated with increased blood loss, increased number of blood transfusions, a higher fresh frozen plasma to red blood cell ratio (p=0.010), and an increased number of red blood cells before first platelet...

  19. Clinical features of Hereditary Haemorrhagic Telangiectasia

    NARCIS (Netherlands)

    Hosman, A.E.

    2017-01-01

    Hereditary Haemorrhagic Telangiectasia (HHT), also known as Rendu-Osler-Weber disease (ROW), is an autosomal dominant disease with multi-systemic vascular dysplasia characterized by mucocutaneous telangiectasia, arteriovenous malformations and recurrent spontaneous epistaxis (nosebleeds). Most cases

  20. Calcium antagonists for aneurysmal subarachnoid haemorrhage

    NARCIS (Netherlands)

    Dorhout Mees, S. M.; Rinkel, G. J. E.; Feigin, V. L.; Algra, A.; van den Bergh, W. M.; Vermeulen, M.; van Gijn, J.

    2007-01-01

    BACKGROUND: Secondary ischaemia is a frequent cause of poor outcome in patients with subarachnoid haemorrhage (SAH). Its pathogenesis has been incompletely elucidated, but vasospasm probably is a contributing factor. Experimental studies have suggested that calcium antagonists can prevent or reverse

  1. Hypopituitarism is uncommon after aneurysmal subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Klose, Marianne; Brennum, Jannick; Poulsgaard, Lars

    2010-01-01

    Aneurysmal subarachnoid haemorrhage (SAH) has recently been reported as a common cause of chronic hypopituitarism, and introduction of routine neuroendocrine screening has been advocated. We aimed at estimating the risk of hypopituitarism after SAH using strict criteria including confirmatory...

  2. Computerised image analysis of biocrystallograms originating from agricultural products

    DEFF Research Database (Denmark)

    Andersen, Jens-Otto; Henriksen, Christian B.; Laursen, J.

    1999-01-01

    Procedures are presented for computerised image analysis of iocrystallogram images, originating from biocrystallization investigations of agricultural products. The biocrystallization method is based on the crystallographic phenomenon that when adding biological substances, such as plant extracts...... on up to eight parameters indicated strong relationships, with R2 up to 0.98. It is concluded that the procedures were able to discriminate the seven groups of images, and are applicable for biocrystallization investigations of agricultural products. Perspectives for the application of image analysis...

  3. European research priorities for intracerebral haemorrhage

    DEFF Research Database (Denmark)

    Steiner, Thorsten; Petersson, Jesper; Al-Shahi Salman, Rustam

    2011-01-01

    Over 2 million people are affected by intracerebral haemorrhage (ICH) worldwide every year, one third of them dying within 1 month, and many survivors being left with permanent disability. Unlike most other stroke types, the incidence, morbidity and mortality of ICH have not declined over time...... and disability. The European Research Network on Intracerebral Haemorrhage EURONICH is a multidisciplinary academic research collaboration that has been established to define current research priorities and to conduct large clinical studies on all aspects of ICH....

  4. Conservative management of primary postpartum haemorrhage

    International Nuclear Information System (INIS)

    Naqvi, S.; Makhdoom, T.

    2004-01-01

    Severe postpartum haemorrhage (PPH) is a serious obstetrical emergency. Two cases of severe PPH due to uterine atony are described which were managed by uterine packing with sterile ribbon gauze by vaginal route under general anesthesia. Along with supportive measures, it resulted in marked improvement in controlling haemorrhage and infectious morbidity. This is an effective treatment for severe PPH and should be practiced at tertiary care level in woman who wishes to preserve fertility. (author)

  5. Computerised decision support systems for healthcare professionals: an interpretative review

    Directory of Open Access Journals (Sweden)

    Kathrin Cresswell

    2013-03-01

    Full Text Available Purpose Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted.Methods We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997–2010. The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations.Results Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits.Conclusions Whilst the potential of clinical decision support systems in improving, in particular

  6. Retinal Detachment

    Directory of Open Access Journals (Sweden)

    Adnan Riaz, MD

    2018-04-01

    Full Text Available History of present illness: A 58-year-old female presented to the emergency department reporting six days of progressive, atraumatic left eye vision loss. Her symptoms started with the appearance of dark spots and “spider webs,” and then progressed to darkening of vision in her left eye. She reports mild pain since yesterday. Her review of symptoms was otherwise negative. Ocular physical examination revealed normal external appearance, intact extraocular movements, and visual acuities of 20/25 OD and light/dark sensitivity OS. Fluorescein uptake was negative and slit lamp exam was unremarkable. Significant findings: Bedside ocular ultrasound revealed a serpentine, hyperechoic membrane that appeared tethered to the optic disc posteriorly with hyperechoic material underneath. These findings are consistent with retinal detachment (RD and associated retinal hemorrhage. Discussion: The retina is a layer of organized neurons that line the posterior portion of the posterior chamber of the eye. RD occurs when this layer separates from the underlying epithelium, resulting in ischemia and progressive photoreceptor degeneration, with potentially rapid and permanent vision loss if left untreated.1 Risk factors include advanced age, male sex (60%, race (Asians and Jews, and myopia and lattice degeneration.2 Bedside ultrasound (US performed by emergency physicians provides a valuable tool that has been used by ophthalmologists for decades to evaluate intraocular disease.1,3 Findings on bedside ultrasound consistent with RD include a hyperechoic membrane floating in the posterior chamber. RD usuallyremain tethered to the optic disc posteriorly and do not cross midline, a feature distinguishing them from posterior vitreous detachments. Associated retinal hemorrhage, seen as hyperechoic material under the retinal flap, can often be seen.1,2 US can also distinguish between “mac-on” and “mac-off” detachments. If the retina is still attached to the

  7. Retinal detachment and retinal holes in retinitis pigmentosa sine pigmento.

    Science.gov (United States)

    Csaky, K; Olk, R J; Mahl, C F; Bloom, S M

    1991-01-01

    Retinal detachment and retinal holes in two family members with retinitis pigmentosa sine pigmento are reported. We believe these are the first such cases reported in the literature. We describe the presenting symptoms and management, including cryotherapy, scleral buckling procedure, and sulfur hexafluoride injection (SF6), resulting in stable visual acuity in one case and retinal reattachment and improved visual acuity in the other case.

  8. Emergency percutaneous transcatheter embolisation of acute arterial haemorrhage.

    LENUS (Irish Health Repository)

    Keeling, A N

    2010-09-01

    The purpose of this study was to review indications, source of haemorrhage, method of embolisation and clinical outcome in patients referred to Interventional Radiology for the emergency management of acute arterial haemorrhage.

  9. Retinitis pigmentosa

    Directory of Open Access Journals (Sweden)

    Hamel Christian

    2006-10-01

    Full Text Available Abstract Retinitis pigmentosa (RP is an inherited retinal dystrophy caused by the loss of photoreceptors and characterized by retinal pigment deposits visible on fundus examination. Prevalence of non syndromic RP is approximately 1/4,000. The most common form of RP is a rod-cone dystrophy, in which the first symptom is night blindness, followed by the progressive loss in the peripheral visual field in daylight, and eventually leading to blindness after several decades. Some extreme cases may have a rapid evolution over two decades or a slow progression that never leads to blindness. In some cases, the clinical presentation is a cone-rod dystrophy, in which the decrease in visual acuity predominates over the visual field loss. RP is usually non syndromic but there are also many syndromic forms, the most frequent being Usher syndrome. To date, 45 causative genes/loci have been identified in non syndromic RP (for the autosomal dominant, autosomal recessive, X-linked, and digenic forms. Clinical diagnosis is based on the presence of night blindness and peripheral visual field defects, lesions in the fundus, hypovolted electroretinogram traces, and progressive worsening of these signs. Molecular diagnosis can be made for some genes, but is not usually performed due to the tremendous genetic heterogeneity of the disease. Genetic counseling is always advised. Currently, there is no therapy that stops the evolution of the disease or restores the vision, so the visual prognosis is poor. The therapeutic approach is restricted to slowing down the degenerative process by sunlight protection and vitaminotherapy, treating the complications (cataract and macular edema, and helping patients to cope with the social and psychological impact of blindness. However, new therapeutic strategies are emerging from intensive research (gene therapy, neuroprotection, retinal prosthesis.

  10. Intrapituitary fluid levels following haemorrhage: MRI appearances in 13 cases

    International Nuclear Information System (INIS)

    Lenthall, R.K.; Dean, J.R.; Jeffree, M.A.; Bartlett, J.R.

    1999-01-01

    Demonstration of fluid levels on MRI is well recognised in cerebral haematomas, tumours and cysts. The occurrence of fluid levels within haemorrhagic pituitary tumours has not previously been described in detail. Evidence of haemorrhage was identified in 27 of 125 pituitary tumours. Fluid levels occurred in 13 of these haemorrhagic tumours. No association with histological type was identified. Recognised risk factors for haemorrhage were identified in half of the cases. (orig.) (orig.)

  11. Non-invasive imaging of retinal blood flow in myeloproliferative neoplasms

    DEFF Research Database (Denmark)

    Willerslev, Anne; Hansen, Mathias M; Klefter, Oliver Niels

    2017-01-01

    PURPOSE: To study the circulation in the retinal vessels in patients with blood dyscrasia due to myeloproliferative neoplasms using non-invasive retinal imaging. METHODS: Prospective consecutive case series of seven treatment-naïve patients with chronic myeloid leukaemia (n = 2), polycythemia vera...... present at baseline in patients with chronic myeloid leukaemia and were replaced by normal patterns at follow-up. Retinopathy, in the form of cotton-wool spots and retinal haemorrhages, was found at presentation in the two patients with chronic myeloid leukaemia and in one patient with polycythemia vera...

  12. Computerised CBT for depressed adolescents: Randomised controlled trial.

    Science.gov (United States)

    Smith, Patrick; Scott, Rebecca; Eshkevari, Ertimiss; Jatta, Fatoumata; Leigh, Eleanor; Harris, Victoria; Robinson, Alex; Abeles, Paul; Proudfoot, Judy; Verduyn, Chrissie; Yule, William

    2015-10-01

    Depression in adolescents is a common and impairing problem. Effective psychological therapies for depression are not accessed by most adolescents. Computerised therapy offers huge potential for improving access to treatment. To test the efficacy of Stressbusters, a Computerised-CBT (C-CBT) programme for depression in young people. Multi-site, schools-based, RCT of C-CBT compared to Waiting List, for young people (N = 112; aged 12-16) with significant symptoms of depression, using multiple-informants (adolescents, parents, teachers), with follow-up at 3 and 6 months. Relative to being on a Waiting List, C-CBT was associated with statistically significant and clinically meaningful improvements in symptoms of depression and anxiety according to adolescent self-report; and with a trend towards improvements in depression and anxiety according to parent-report. Improvements were maintained at follow-up. Treatment gains were similar for boys and girls across the participating age range. Treatment effect was partially mediated by changes in ruminative thinking. Teachers rated adolescents as having few emotional or behavioural problems, both before and after intervention. C-CBT had no detectable effect on academic attainment. In the month after intervention, young people who received C-CBT had significantly fewer absences from school than those on the Waiting List. C-CBT shows considerable promise for the treatment of mild-moderate depression in adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Computerised analysis of facial emotion expression in eating disorders

    Science.gov (United States)

    2017-01-01

    Background Problems with social-emotional processing are known to be an important contributor to the development and maintenance of eating disorders (EDs). Diminished facial communication of emotion has been frequently reported in individuals with anorexia nervosa (AN). Less is known about facial expressivity in bulimia nervosa (BN) and in people who have recovered from AN (RecAN). This study aimed to pilot the use of computerised facial expression analysis software to investigate emotion expression across the ED spectrum and recovery in a large sample of participants. Method 297 participants with AN, BN, RecAN, and healthy controls were recruited. Participants watched film clips designed to elicit happy or sad emotions, and facial expressions were then analysed using FaceReader. Results The finding mirrored those from previous work showing that healthy control and RecAN participants expressed significantly more positive emotions during the positive clip compared to the AN group. There were no differences in emotion expression during the sad film clip. Discussion These findings support the use of computerised methods to analyse emotion expression in EDs. The findings also demonstrate that reduced positive emotion expression is likely to be associated with the acute stage of AN illness, with individuals with BN showing an intermediate profile. PMID:28575109

  14. Computerised analysis of facial emotion expression in eating disorders.

    Science.gov (United States)

    Leppanen, Jenni; Dapelo, Marcela Marin; Davies, Helen; Lang, Katie; Treasure, Janet; Tchanturia, Kate

    2017-01-01

    Problems with social-emotional processing are known to be an important contributor to the development and maintenance of eating disorders (EDs). Diminished facial communication of emotion has been frequently reported in individuals with anorexia nervosa (AN). Less is known about facial expressivity in bulimia nervosa (BN) and in people who have recovered from AN (RecAN). This study aimed to pilot the use of computerised facial expression analysis software to investigate emotion expression across the ED spectrum and recovery in a large sample of participants. 297 participants with AN, BN, RecAN, and healthy controls were recruited. Participants watched film clips designed to elicit happy or sad emotions, and facial expressions were then analysed using FaceReader. The finding mirrored those from previous work showing that healthy control and RecAN participants expressed significantly more positive emotions during the positive clip compared to the AN group. There were no differences in emotion expression during the sad film clip. These findings support the use of computerised methods to analyse emotion expression in EDs. The findings also demonstrate that reduced positive emotion expression is likely to be associated with the acute stage of AN illness, with individuals with BN showing an intermediate profile.

  15. Risk of subarachnoid haemorrhage in first degree relatives of patients with subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Gaist, D; Vaeth, M; Tsiropoulos, I

    2000-01-01

    OBJECTIVE: To estimate the risk of occurrence of subarachnoid haemorrhage in first degree relatives (parents, siblings, children) of patients with subarachnoid haemorrhage. DESIGN: Population based cohort study using data from the Danish National Discharge Registry and the Central Person Registry......, standardised for age, sex, and calendar period. This process was repeated for patients discharged from neurosurgery units, as diagnoses from these wards had high validity (93%). RESULTS: 18 patients had a total of 19 first degree relatives with subarachnoid haemorrhage during the study period, corresponding...... to a standardised incidence ratio of 2.9 (95% confidence interval 1.9 to 4.6). Patients discharged from neurosurgery wards had a higher standardised incidence ratio (4.5, 2.7 to 7.3). CONCLUSIONS: First degree relatives of patients with subarachnoid haemorrhage have a threefold to fivefold increased risk...

  16. Antithrombotic drugs and subarachnoid haemorrhage risk

    DEFF Research Database (Denmark)

    Pottegård, A; García Rodríguez, L A; Poulsen, F R

    2015-01-01

    The study objective was to investigate the relationship between use of antithrombotic drugs and subarachnoid haemorrhage (SAH). We identified patients discharged from Danish neurosurgery units with a first-ever SAH diagnosis in 2000 to 2012 (n=5,834). For each case, we selected 40 age-, sex...

  17. Total Body Opacification 'Technique Neonatal Adrenal Haemorrhage

    African Journals Online (AJOL)

    1971-12-11

    Dec 11, 1971 ... A case is reported illustrating the possible usefulness of total body opacification in the diagnosis of neonatal adrenal haemorrhage. To derive maximum benefit from this principle, the routine use of an early film coupled with high dosage is urged whenever an intravenous pyelogram is performed for ...

  18. Cyclophosphamide induced Haemorrhagic Cystitis; a review of ...

    African Journals Online (AJOL)

    Cyclophosphamide is an akylating agent widely used in the management of both malignant and non neoplastic disorders. We undertook this review to assess the advancement in knowledge regarding the aetiopathogenesis and current management approaches of haemorrhagic cystitis resulting from the use of ...

  19. Sanitation of viral haemorrhagic septicaemia (VHS)

    DEFF Research Database (Denmark)

    Olesen, Niels Jørgen

    1998-01-01

    A sanitation programme for stamping-out viral haemorrhagic septicaemia (VHS) was implemented in Denmark in 1965. The programme has resulted in a dramatic reduction in the number of infected rainbow trout farms, from approximate to 400 to 26. The programme is carried out on a voluntary basis...

  20. The Prevalence of Intraventricular Haemorrhage and Associated ...

    African Journals Online (AJOL)

    The Prevalence of Intraventricular Haemorrhage and Associated Risk Factors in Preterm Neonates in the Neonatal Intensive Care Unit at the University Teaching ... any-IVH generated at the time of analysis was used in determining the prevalence of IVH and also as the dependent variable in multivariate logistic regression.

  1. Computerised respiratory sounds can differentiate smokers and non-smokers.

    Science.gov (United States)

    Oliveira, Ana; Sen, Ipek; Kahya, Yasemin P; Afreixo, Vera; Marques, Alda

    2017-06-01

    Cigarette smoking is often associated with the development of several respiratory diseases however, if diagnosed early, the changes in the lung tissue caused by smoking may be reversible. Computerised respiratory sounds have shown to be sensitive to detect changes within the lung tissue before any other measure, however it is unknown if it is able to detect changes in the lungs of healthy smokers. This study investigated the differences between computerised respiratory sounds of healthy smokers and non-smokers. Healthy smokers and non-smokers were recruited from a university campus. Respiratory sounds were recorded simultaneously at 6 chest locations (right and left anterior, lateral and posterior) using air-coupled electret microphones. Airflow (1.0-1.5 l/s) was recorded with a pneumotachograph. Breathing phases were detected using airflow signals and respiratory sounds with validated algorithms. Forty-four participants were enrolled: 18 smokers (mean age 26.2, SD = 7 years; mean FEV 1 % predicted 104.7, SD = 9) and 26 non-smokers (mean age 25.9, SD = 3.7 years; mean FEV 1 % predicted 96.8, SD = 20.2). Smokers presented significantly higher frequency at maximum sound intensity during inspiration [(M = 117, SD = 16.2 Hz vs. M = 106.4, SD = 21.6 Hz; t(43) = -2.62, p = 0.0081, d z  = 0.55)], lower expiratory sound intensities (maximum intensity: [(M = 48.2, SD = 3.8 dB vs. M = 50.9, SD = 3.2 dB; t(43) = 2.68, p = 0.001, d z  = -0.78)]; mean intensity: [(M = 31.2, SD = 3.6 dB vs. M = 33.7,SD = 3 dB; t(43) = 2.42, p = 0.001, d z  = 0.75)] and higher number of inspiratory crackles (median [interquartile range] 2.2 [1.7-3.7] vs. 1.5 [1.2-2.2], p = 0.081, U = 110, r = -0.41) than non-smokers. Significant differences between computerised respiratory sounds of smokers and non-smokers have been found. Changes in respiratory sounds are often the earliest sign of disease. Thus, computerised respiratory sounds

  2. Construction Of A Computerised Information-Processing Test Battery

    Directory of Open Access Journals (Sweden)

    Johann M. Schepers

    2002-09-01

    Full Text Available The primary goal of the study was to construct a computerised information-processing test battery to measure choice reaction time for up to and including six bits of information, to measure discrimination reaction time with regard to colour patterns and form patterns, to measure rate of information processing with regard to perceptual stimuli and conceptual reasoning, and to develop a suitable scoring system for the respective tests. The battery of tests was applied to 58 pilots. Opsomming Die hoofdoel van die studie was om ‘n gerekenariseerde inligtingverwerkingstoets-battery te konstrueer om keusereaksietyd tot en met ses bis inligting te meet, om diskriminasie-reaksietyd ten opsigte van kleurpatrone en vormpatrone te meet, om tempo van inligtingverwerking ten opsigte van perseptuele stimuli en konseptuele redenering te meet en om ‘n gepaste nasienstelsel vir die onderskeie toetse te ontwikkel. Die battery toetse is op 58 vlieëniers toegepas

  3. Missed retinal breaks in rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    Brijesh Takkar

    2016-12-01

    Full Text Available AIM: To evaluate the causes and associations of missed retinal breaks (MRBs and posterior vitreous detachment (PVD in patients with rhegmatogenous retinal detachment (RRD. METHODS: Case sheets of patients undergoing vitreo retinal surgery for RRD at a tertiary eye care centre were evaluated retrospectively. Out of the 378 records screened, 253 were included for analysis of MRBs and 191 patients were included for analysis of PVD, depending on the inclusion criteria. Features of RRD and retinal breaks noted on examination were compared to the status of MRBs and PVD detected during surgery for possible associations. RESULTS: Overall, 27% patients had MRBs. Retinal holes were commonly missed in patients with lattice degeneration while missed retinal tears were associated with presence of complete PVD. Patients operated for cataract surgery were significantly associated with MRBs (P=0.033 with the odds of missing a retinal break being 1.91 as compared to patients with natural lens. Advanced proliferative vitreo retinopathy (PVR and retinal bullae were the most common reasons for missing a retinal break during examination. PVD was present in 52% of the cases and was wrongly assessed in 16%. Retinal bullae, pseudophakia/aphakia, myopia, and horse shoe retinal tears were strongly associated with presence of PVD. Traumatic RRDs were rarely associated with PVD. CONCLUSION: Pseudophakic patients, and patients with retinal bullae or advanced PVR should be carefully screened for MRBs. Though Weiss ring is a good indicator of PVD, it may still be over diagnosed in some cases. PVD is associated with retinal bullae and pseudophakia, and inversely with traumatic RRD.

  4. A rare cause of fatal intracranial haemorrhage.

    LENUS (Irish Health Repository)

    Neligan, A

    2012-01-31

    INTRODUCTION: We report the case of a 53-year-old farmer with a 5-day history of severe headache, photophobia and neck stiffness. Full blood count (platelets 173), coagulation screen were normal throughout. Liver function tests remained normal apart from an elevated gamma-GT (156). CT Brain was normal. CSF analysis showed a WCC of 454\\/mm(3) (60% lymphocytes), elevated CSF protein (1.42 g\\/l) and a normal CSF glucose. He was commenced on IV antibiotics and IV acyclivor and improved. On day 3 of admission, he complained of a sudden severe headache, became unresponsive (GCS 3\\/15). INVESTIGATIONS: CT Brain showed a massive left intraventricular haemorrhage. He died 4 days later. Subsequent serum serology for leptospirosis was positive. A repeat sample taken 4 days post-admission, showed a rising IgM indicating active leptospirosis. Detailed pathological examination confirmed intracerebral haemorrhage with normal cerebral vasculature. CONCLUSION: Leptospirosis is a rare cause of intracerebral haemorrhage even in the absence of coagulopathy.

  5. Severe Crimean-Congo haemorrhagic fever presented with massive retroperitoneal haemorrhage that recovered without antiviral treatment

    DEFF Research Database (Denmark)

    Gharabaghi, Mehrnaz Asadi; Chinikar, Sadegh; Ghiasi, Seyyed Mojtaba

    2011-01-01

    Crimean-Congo haemorrhagic fever (CCHF) is a tickborne viral zoonosis with up to 50% mortality in humans caused by CCHF virus belonging to the genus Nairovirus, family Bunyaviridae. The geographical distribution of CCHF cases corresponds closely with the distribution of principle tick vectors...... that is species of Hyaloma. The disease presents with non-specific febrile symptoms, but progress to a serious haemorrhagic syndrome that, soon after, a full blown multi organ failure may develop with prominent features of liver damage and bleeding diathesis. The authors present a case of a 39-year-old man...

  6. Efficacy of b-lynch brace suture in postpartum haemorrhage

    International Nuclear Information System (INIS)

    Tarique, S.; Wazir, S.; Moeen, G.

    2011-01-01

    Massive uncontrolled haemorrhage after childbirth is the leading cause of maternal death in developing countries. Postpartum haemorrhage is traditionally defined as blood loss of more than 500 ml after vaginal delivery and more than 1000 ml after caesarean section, but intraoperative estimation of blood loss is inaccurate. Uterine atony alone accounts for 75 - 90% of PPH. To estimate the effectiveness and safety of B-Lynch brace Suture in the management of primary postpartum haemorrhage (PPH). (author)

  7. Haemorrhage in pregnancy: information given to women in Chiradzulu (Malawi

    Directory of Open Access Journals (Sweden)

    H Kapyepye

    2006-09-01

    Full Text Available Advising women on , haemorrhage in pregnancy could, be viewed, as an integral aspect of maternal health care in M alawi. The WHO (1999 confirmed, that haemorrhage in pregnancy was not only a direct reason for maternal mortality but also a major cause of maternal death. The question on the nature of information that midwives and traditional birth attendants (referred to as TBA’s in the Chiradzulu district in Malawi gave with regard to haemorrhage in pregnancy, therefore arose. Research available focused on the women’s knowledge about the complications of pregnancy but not on the nature of information women received from midwives and TBA’s. This study explored and described the nature of information that was given to rural women in the Chiradzulu district by the midwives and TBA’s regarding haemorrhage in pregnancy. The findings revealed that although both the midwives and TBA’s included important information about haemorrhage in pregnancy, there were deficiencies in some critical areas. Examples of these deficiencies were the definition of haemorrhage in pregnancy; the predisposing factors for antepartum and postpartum haemorrhage and deficiencies in the nature of information on the management and referral of haemorrhaging patients. The findings provided insights into the nature of the information that was provided to the women regarding haemorrhage in pregnancy in the Chiradzulu district in Malawi. Thereafter guidelines were developed for the provision of this information. Finally a follow-up study was recommended after implementation of these guidelines in the district to evaluate the change in the nature of the information communicated to patients regarding haemorrhage by midwives and TBA’s. In this study, haemorrhage during pregnancy referred to the perinatal phase, including antepartum, intrapartum and postpartum haemorrhage.

  8. Adult adrenal haemorrhage: an unrecognised complication of renal vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Loke, T.K.L. E-mail: lokekl@ha.org.hk

    2001-07-01

    There are many predisposing factors for neonatal adrenal haemorrhage but the causative factors are different in adults. Several cases of neonatal adrenal haemorrhage have been reported in association with renal vein thrombosis. This complication has not been documented in the adults. The presence of an adrenal mass in the setting of renal vein thrombosis should raise the possibility of adrenal haemorrhage even though this is extremely uncommon in adults.

  9. Intraocular pressure asymmetry-Topcon Computerised Tonometer CT-20.

    Science.gov (United States)

    Ntim-Amponsah, C T

    1997-01-01

    The Topcon Computerised Tonometer CT-20, a non-contact tonometer (NCT), was used to measure intraocular pressure (IOP) in mmHg in 1,226 subjects above the age of 30 years with no ocular pathology. The mean IOP was 14.41 mmHg and the standard deviation 3.43. The mean IOP far was higher in female (14.60) than male (14.22). This gender difference in the mean IOP was significant; t stat = 2.69, P < 0.5. Right IOP exceeded left IOP and this was highly significant in both male (t stat 4.03) and female (t stat 5.64) p < 0.01. This IOP asymmetry approximates a normal distribution. The mean of the differences (right-left IOP) and standard deviation for all subjects were 0.57 and 2.26 respectively. The range for the differences was- 10 to 10 mmHg. Asymmetry was greater in females than males (t stat = 2.05, p < 0.05). Knowledge of these statistics will help in decisions concerning glaucoma screening with NCT.

  10. Pituitary apoplexy with optic tract oedema and haemorrhage in a patient with idiopathic thrombocytopenic purpura

    International Nuclear Information System (INIS)

    Lenthall, R.; Jaspan, T.

    2001-01-01

    Bilateral optic tract oedema, left optic tract haemorrhage and subarachnoid haemorrhage occurred in a 70-year-old man with pituitary apoplexy associated with idiopathic thrombocytopenic purpura. Left optic tract haemorrhage was confirmed on MRI. (orig.)

  11. Dengue Haemorrhagic Fever presenting as Acute Abdomen

    OpenAIRE

    Al-Araimi, Hanaa; Al-Jabri, Amal; Mehmoud, Arshad; Al-Abri, Seif

    2011-01-01

    We describe a case of a 38 year-old Sri Lankan female who was referred to the surgeon on call with a picture of acute abdomen. She presented with a three-day history of fever, headache, abdominal pain and diarrhoea; however, the physical examination was not consistent with acute abdomen. Her platelet count was 22 ×109/L. A diagnosis of dengue haemorrhagic fever (DHF) was made and dengue serology was positive. Dengue epidemics have been associated with a variety of gastrointestinal symptoms an...

  12. Haemorrhagic SLE In A Young Male

    Directory of Open Access Journals (Sweden)

    Rajagopal R

    2002-01-01

    Full Text Available Systemic lupus erythematous (SLE is a systemic autoimmune disease that tends to occur in early adult life. The peak age of onset of the first symptom or sign in females is about 38 years and later in men, at about 44 years. Females outnumber men in this illness in a ratio of about 8 : 1. Cutaneous lesions in male have not been properly investigated and some studies in male with SLE have shown that the illness may present with atypical skin lesions. A case of SLE in a 20 year male who developed sudden onset of haemorrhagic vesiculobullous butterfly rash is described.

  13. Bipallidal haemorrhage after ethylene glycol intoxication

    Energy Technology Data Exchange (ETDEWEB)

    Caparros-Lefebvre, D.; Policard, J.; Rigal, M. [CHU Pointe a Pitre, Service de Neurologie, Lille (France); Sengler, C. [CHU Pointe a Pitre, Laboratoire de Pharmaco-Toxicologie, Guadeloupe (France); Benabdallah, E. [CHU Pointe a Pitre, Service de Radiologie, Guadeloupe (France); Colombani, S. [Centre d' Imagerie medicale, Martinique (France)

    2005-02-01

    Acute or subacute bipallidal lesion, an uncommon radiological feature produced by metabolic disorders or poisoning, has never been attributed to ethylene glycol (EG) intoxication. This 50-year-old Afro-Caribbean alcoholic man had unexplained loss of consciousness. Blood tests showed osmolar gap. Drug screening was positive for EG at 6.06 mmol/l. Brain CT revealed bilateral pallidal haemorrhage. Pallidal haematoma, which could be related to deposition of oxalate crystals issued from EG metabolism, should lead to toxicological screening. (orig.)

  14. Bipallidal haemorrhage after ethylene glycol intoxication

    International Nuclear Information System (INIS)

    Caparros-Lefebvre, D.; Policard, J.; Rigal, M.; Sengler, C.; Benabdallah, E.; Colombani, S.

    2005-01-01

    Acute or subacute bipallidal lesion, an uncommon radiological feature produced by metabolic disorders or poisoning, has never been attributed to ethylene glycol (EG) intoxication. This 50-year-old Afro-Caribbean alcoholic man had unexplained loss of consciousness. Blood tests showed osmolar gap. Drug screening was positive for EG at 6.06 mmol/l. Brain CT revealed bilateral pallidal haemorrhage. Pallidal haematoma, which could be related to deposition of oxalate crystals issued from EG metabolism, should lead to toxicological screening. (orig.)

  15. European research priorities for intracerebral haemorrhage

    DEFF Research Database (Denmark)

    Steiner, Thorsten; Petersson, Jesper; Al-Shahi Salman, Rustam

    2011-01-01

    and disability. The European Research Network on Intracerebral Haemorrhage EURONICH is a multidisciplinary academic research collaboration that has been established to define current research priorities and to conduct large clinical studies on all aspects of ICH........ No standardised diagnostic workup for the detection of the various underlying causes of ICH currently exists, and the evidence for medical or surgical therapeutic interventions remains limited. A dedicated European research programme for ICH is needed to identify ways to reduce the burden of ICH-related death...

  16. Primary postpartum haemorrhage at the university of Port Harcourt ...

    African Journals Online (AJOL)

    Background: Postpartum haemorrhage (PPH) is a leading global cause of severe maternal morbidity and mortality. Approximately 14 million women suffer postpartum haemorrhage annually and at least 128,000 of these women bleed to death. Most of these deaths, which occur within four hours of delivery and are as a ...

  17. Molecular diagnosis of Haemorrhagic Septicaemia - A Review

    Directory of Open Access Journals (Sweden)

    Ranjan Rajeev

    2011-08-01

    Full Text Available Pasteurella multocida is associated with hemorrhagic septicaemia in cattle and buffaloes, pneumonic pasteurellosis in sheep and goats, fowl cholera in poultry, atrophic rhinitis in pigs and snuffles in rabbits. Haemorrhagic septicaemia is caused by Pasteurella multocida type B:2, B:2,5 and B:5 in Asian countries and type E:2 in African countries. Pasteurella multocida have five types of capsular serotype i.e. type A, B, D, E and F. Diagnosis of the disease is mainly based on the clinical sign and symptom, post mortem findings. Confirmatory diagnosis is done by isolation and identification of causative agent. A variety of laboratory diagnostic techniques have been developed over the years for pasteurellosis and used routinely in the laboratory. Among these techniques molecular techniques of diagnosis is most important. This technique not only gives diagnosis but it also provides information regarding capsular type of Pasteurella multocida. Techniques which are used for molecular diagnosis of haemorrhagic septicaemia are PCR based diagnosis, Restriction endonuclease analysis (REA, Ribotyping, Colony hybridization assay, Filled alternation gel electrophoresis (FAGE, Detection of Pasteurella multocida by Real Time PCR. Among these techniques real time PCR is most sensitive and specific. [Vet. World 2011; 4(4.000: 189-192

  18. Late haemorrhagic disease of the newborn.

    Science.gov (United States)

    Zengin, Emine; Sarper, Nazan; Türker, Gülcan; Corapçioğlu, Funda; Etuş, Volkan

    2006-09-01

    Late haemorrhagic disease of the newborn (HDN) can occur owing to a lack of vitamin K prophylaxis, as a manifestation of an underlying disorder or idiopatically from the 8th day to 12 weeks after birth. Eight infants admitted to Kocaeli University Hospital with nine episodes of late HDN between January 2002 and April 2005 were evaluated retrospectively from hospital records. The median age at presentation was 46 (26-111) days. All the infants were born at full-term to healthy mothers and were exclusively breast-fed. All had an uneventful perinatal history, except one who had meconium aspiration. Four patients had received no vitamin K prophylaxis and another three had uncertain histories. At presentation, six had intracranial bleeding and the remainder had bleeding either from the venepuncture site or the gastro-intestinal tract. The presenting signs and symptoms were irritability, vomiting, bulging or full fontanelle, convulsions and diminished or absent neonatal reflexes. Galactosaemia was detected in a 2-month-old infant with prolonged jaundice. There was no surgery-related mortality or complications but one survived for only 2 days on ventilatory support following surgery. Only one of the six survivors had severe neurological sequelae. Late HDN frequently presents with intracranial haemorrhage, leading to high morbidity and mortality. HDN can be the manifestation of an underlying metabolic disorder. Vitamin K prophylaxis of the newborn should be routine in developing countries.

  19. Olivary degeneration after cerebellar or brain stem haemorrhage: MRI

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, A. (Dept. of Radiology, Kyushu Univ. Hospital, Fukuoka (Japan) Dept. of Radiology, Kyushu Rosai Hospital, Kitakyushu (Japan)); Hasuo, K. (Dept. of Radiology, Kyushu Univ. Hospital, Fukuoka (Japan)); Uchida, K. (Dept. of Radiology, Kyushu Rosai Hospital, Kitakyushu (Japan)); Matsumoto, S. (Dept. of Radiology, Kyushu Univ. Hospital, Fukuoka (Japan)); Tsukamoto, Y. (Dept. of Radiology, Kyushu Rosai Hospital, Kitakyushu (Japan)); Ohno, M. (Dept. of Radiology, Kyushu Rosai Hospital, Kitakyushu (Japan)); Masuda, K. (Dept. of Radiology, Kyushu Univ. Hospital, Fukuoka (Japan))

    1993-05-01

    Magnetic resonance (MR) images of seven patients with olivary degeneration caused by cerebellar or brain stem haemorrhages were reviewed. In four patients with cerebellar haemorrhage, old haematomas were identified as being located in the dentate nucleus; the contralateral inferior olivary nuclei were hyperintense on proton-density- and T2-weighted images. In two patients with pontine haemorrhages, the old haematomas were in the tegmentum and the ipsilateral inferior olivary nuclei, which were hyperintense. In one case of midbrain haemorrhage, the inferior olivary nuclei were hyperintense bilaterally. The briefest interval from the ictus to MRI was 2 months. Hypertrophic olivary nuclei were observed only at least 4 months after the ictus. Olivary degeneration after cerebellar or brain stem haemorrhage should not be confused with ischaemic, neoplastic, or other primary pathological conditions of the medulla. (orig.)

  20. Magnetic resonance imaging of central nervous system haemorrhage

    International Nuclear Information System (INIS)

    Silberstein, M.; Hennessy, O.

    1993-01-01

    The variable magnetic resonance imaging appearances of central nervous system haemorrhage, both intra- and extra-axial, are described. These will vary with the type of image contrast (T1 or T2 weighting), the nature of the imaging sequence (spin-echo or gradient-echo) and the time from onset of haemorrhage. Magnetic resonance imaging is a useful technique for imaging haemorrhage in the central nervous system as it yields temporal information about haematoma development, and it is the only non-invasive means of imaging intraspinal haemorrhage. However, in the imaging of haematomas within 24 h of onset and in subarachnoid haemorrhage computed tomography is the investigation of choice. 13 refs., 6 figs

  1. The computerised procedure system COPMA and its user interface

    International Nuclear Information System (INIS)

    Krogsaeter, M.; Larsen, J.; Nilsen, S.; Oewre, F.

    1990-01-01

    At the OECD Halden Reactor Project, the COPMA system has been developed in order to investigate whether procedures can be executed more safety and efficiently if they are computerised, i.e. if the operator uses a CRT-based system instead of written manuals. Procedures are entered in a procedure data base using PED, a procedure editor. Each procedure is given a textual as well as a graphical representation. For the textual representation, the language PROLA is used, a language which has been designed for simple procedure specification. The COPMA online system lets the operator execute procedures that are stored in the procedure data base. The operator interface is a screen divided into non-overlapping windows each serving a different purpose. All commands to the system are given by moving a mouse device around and clicking buttons on top of the mouse. A procedure consists of steps, each step containing a number of instructions. The operator works on one activity at a time, an activity to be seen as a procedure instance. A graph shows the overall procedure (or activity) structure in a window and activity execution is traced in the graph. Another windows shows the instructions of the step currently being executed. The operator steps through the activity by selecting whether and how to execute the listed instructions. COPMA can maintain the status of several activities in parallel, so that the operator can easily switch between different activities. COPMA is linked to a PWR nuclear simulator over Ethernet using the TCP/IP protocol. This gives a number of advantages as compared to conventional written procedures, especially the fact that COPMA can help collect data from the procedure data base automatically

  2. A computerised automatic pellet inspection unit for FBTR fuel

    International Nuclear Information System (INIS)

    Ramakumar, M.S.; Mahule, K.N.; Ghosh, J.K.; Venkatesh, D.

    1984-01-01

    Physical inspection and certification of nuclear reactor fuel element components is an activity demanding utmost imagination and skill in devising accurate measuring systems. There is also need for remote handling, automation, rapid processing and inspection data print out when dealing with reactor fuel material. This report deals with an automatic computerised fuel pellet inspection system that has been developed in Radiometallurgy Division, B.A.R.C. to carry out dimensional and weight measurements on fuel pellets for the Fast Breeder Test Reactor (FBTR) at Kalpakkam near Madras. The system consists of several subsystems each developed especially for a specific purpose and as such items are not available off the shelf from manufacturers in India. If a general approach is adopted towards the report, there are many innovations and ideas that can be used in the automatic inspection of a variety of products in industry. As the system is fairly involved the report does not attempt to deal with detailed description of the equipment. The function of the system is to accept a certain quantity of fuel pellets in a bowl feeder, separate the pellets rejected owing to their exceeding dimensional and weight limits and form columns of accepted pellets. Dimensional and weight limits can be set as required and all inspection data are presented in a printed format. The system processes pellets at the rate of 15 per minute. The entire system can be run by operators with no special skills. The unit is currently in use for the inspection of mixed carbide fuel pellets for FBTR. (author)

  3. Computerised sepsis protocol management. Description of an early warning system.

    Science.gov (United States)

    de Dios, Begoña; Borges, Marcio; Smith, Timothy D; Del Castillo, Alberto; Socias, Antonia; Gutiérrez, Leticia; Nicolás, Jordi; Lladó, Bartolomé; Roche, Jose A; Díaz, Maria P; Lladó, Yolanda

    2018-02-01

    New strategies need to be developed for the early recognition and rapid response for the management of sepsis. To achieve this purpose, the Multidisciplinary Sepsis Team (MST) developed the Computerised Sepsis Protocol Management (PIMIS). The aim of this study was to evaluate the convenience of using PIMIS, as well as the activity of the MST. An analysis was performed on the data collected from solicited MST consultations (direct activation of PIMIS by attending physician or telephone request) and unsolicited ones (by referral from the microbiology laboratory or an automatic referral via the hospital vital signs recording software [SIDCV]), as well as the hospital department, source of infection, treatment recommendation, and acceptance of this. Of the 1,581 first consultations, 65.1% were solicited consultations (84.1% activation of PIMIS and 15.9% by telephone). The majority of unsolicited consultations were generated by the microbiology laboratory (95.2%), and 4.8% from the SIDCV. Referral from solicited consultations were generated sooner (5.63days vs 8.47days; P<.001) and came from clinical specialties rather than from the surgical ward (73.0% vs 39.1%; P<.001). A recommendation was made for antimicrobial prescription change in 32% of first consultations. The treating physician accepted 78.1% of recommendations. The high rate of solicited consultations and acceptance of recommended prescription changes suggest that a MST is seen as a helpful resource, and that PIMIS software is perceived to be useful and convenient to use, as it is the main source of referral. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  4. Cyborg practices: call-handlers and computerised decision support systems in urgent and emergency care.

    Science.gov (United States)

    Pope, Catherine; Halford, Susan; Turnbull, Joanne; Prichard, Jane

    2014-06-01

    This article draws on data collected during a 2-year project examining the deployment of a computerised decision support system. This computerised decision support system was designed to be used by non-clinical staff for dealing with calls to emergency (999) and urgent care (out-of-hours) services. One of the promises of computerised decisions support technologies is that they can 'hold' vast amounts of sophisticated clinical knowledge and combine it with decision algorithms to enable standardised decision-making by non-clinical (clerical) staff. This article draws on our ethnographic study of this computerised decision support system in use, and we use our analysis to question the 'automated' vision of decision-making in healthcare call-handling. We show that embodied and experiential (human) expertise remains central and highly salient in this work, and we propose that the deployment of the computerised decision support system creates something new, that this conjunction of computer and human creates a cyborg practice.

  5. Automated microaneurysm detection algorithms applied to diabetic retinopathy retinal images

    Directory of Open Access Journals (Sweden)

    Akara Sopharak

    2013-07-01

    Full Text Available Diabetic retinopathy is the commonest cause of blindness in working age people. It is characterised and graded by the development of retinal microaneurysms, haemorrhages and exudates. The damage caused by diabetic retinopathy can be prevented if it is treated in its early stages. Therefore, automated early detection can limit the severity of the disease, improve the follow-up management of diabetic patients and assist ophthalmologists in investigating and treating the disease more efficiently. This review focuses on microaneurysm detection as the earliest clinically localised characteristic of diabetic retinopathy, a frequently observed complication in both Type 1 and Type 2 diabetes. Algorithms used for microaneurysm detection from retinal images are reviewed. A number of features used to extract microaneurysm are summarised. Furthermore, a comparative analysis of reported methods used to automatically detect microaneurysms is presented and discussed. The performance of methods and their complexity are also discussed.

  6. An Algorithm to Detect the Retinal Region of Interest

    Science.gov (United States)

    Şehirli, E.; Turan, M. K.; Demiral, E.

    2017-11-01

    Retina is one of the important layers of the eyes, which includes sensitive cells to colour and light and nerve fibers. Retina can be displayed by using some medical devices such as fundus camera, ophthalmoscope. Hence, some lesions like microaneurysm, haemorrhage, exudate with many diseases of the eye can be detected by looking at the images taken by devices. In computer vision and biomedical areas, studies to detect lesions of the eyes automatically have been done for a long time. In order to make automated detections, the concept of ROI may be utilized. ROI which stands for region of interest generally serves the purpose of focusing on particular targets. The main concentration of this paper is the algorithm to automatically detect retinal region of interest belonging to different retinal images on a software application. The algorithm consists of three stages such as pre-processing stage, detecting ROI on processed images and overlapping between input image and obtained ROI of the image.

  7. Focal retinal phlebitis.

    Science.gov (United States)

    Hoang, Quan V; Freund, K Bailey; Klancnik, James M; Sorenson, John A; Cunningham, Emmett T; Yannuzzi, Lawrence A

    2012-01-01

    To report three cases of solitary, focal retinal phlebitis. An observational case series. Three eyes in three patients were noted to have unilateral decreased vision, macular edema, and a focal retinal phlebitis, which was not at an arteriovenous crossing. All three patients developed a branch retinal vein occlusion at the site of inflammation. These patients had no other evidence of intraocular inflammation, including vitritis, retinitis, retinal vasculitis, or choroiditis, nor was there any systemic disorder associated with inflammation, infection, or coagulation identified. Focal retinal phlebitis appears to be an uncommon and unique entity that produces macular edema and ultimately branch retinal vein occlusion. In our patients, the focal phlebitis and venous occlusion did not occur at an arteriovenous crossing, which is the typical site for branch retinal venous occlusive disease. This suggests that our cases represent a distinct clinical entity, which starts with a focal abnormality in the wall of a retinal venule, resulting in surrounding exudation and, ultimately, ends with branch retinal vein occlusion.

  8. Factors affecting the occurrence of symptomatic intracerebral haemorrhage after intravenous thrombolysis depending on the haemorrhage definition.

    Science.gov (United States)

    Sledzińska-Dźwigał, M; Sobolewski, Piotr; Szczuchniak, W

    2013-01-01

    Symptomatic intracerebral haemorrhage (sICH) remains the most feared complication of systemic thrombolysis in patients with ischaemic stroke. The aim of the study was to analyze the impact of different factors on the occurrence of sICH, depending on definition used. We retrospectively evaluated the influence of several factors on the occurrence of sICH (according to definitions used in ECASS2, SITS-MOST and NINDS studies) in 200 patients treated with systemic thrombolysis from 2006 to 2011. Multivariate analysis of impact of individual variables on the occurrence of haemorrhagic transformation (HT) and parenchymal haemorrhage type 2 (PH2) were performed. Haemorrhagic transformation occurred in 35 cases (17.5%). SICH was found in 10 cases according to ECASS2, in 7 cases according to SITS and in 13 cases according to NINDS. Older age was related to higher risk of sICH, regardless which definition was used (ECASS2: p = 0.014, SITS-MOST: p = 0.048, NINDS: p = 0.008), and female sex was related to higher risk of sICH according to NINDS and ECASS2 definition (p = 0.002 and p = 0.04, respectively). Blood glucose level and high NIHSS score (> 14 pts) were found as risk factor of sICH in ECASS2 definition (p = 0.044 and p = 0.03, respectively). In multivariate logistic regression higher NIHSS scores were associated with HT independent of age, gender and glucose level (p = 0.012). Multivariate analysis showed no impact of age, gender, severity of stroke and glucose level on presence of PH2. Definition of sICH can determine variables that are related to a high risk of this complication. In our study most factors correlated with sICH using the ECASS2 definition.

  9. Viral haemorrhagic fever and vascular alterations.

    Science.gov (United States)

    Aleksandrowicz, P; Wolf, K; Falzarano, D; Feldmann, H; Seebach, J; Schnittler, H

    2008-02-01

    Pathogenesis of viral haemorrhagic fever (VHF) is closely associated with alterations of the vascular system. Among the virus families causing VHF, filoviruses (Marburg and Ebola) are the most fatal, and will be focused on here. After entering the body, Ebola primarily targets monocytes/macrophages and dendritic cells. Infected dendritic cells are largely impaired in their activation potency, likely contributing to the immune suppression that occurs during filovirus infection. Monocytes/macrophages, however, immediately activate after viral contact and release reasonable amounts of cytokines that target the vascular system, particularly the endothelial cells. Some underlying molecular mechanisms such as alteration of the vascular endothelial cadherin/catenin complex, tyrosine phosphorylation, expression of cell adhesion molecules, tissue factor and the effect of soluble viral proteins released from infected cells to the blood stream will be discussed.

  10. Filoviral haemorrhagic fevers: A threat to Zambia?

    Directory of Open Access Journals (Sweden)

    Katendi Changula

    2012-06-01

    Full Text Available Filoviral haemorrhagic fevers (FVHF are caused by agents belonging to Filoviridae family, Ebola and Marburg viruses. They are amongst the most lethal pathogens known to infect humans. Incidence of FVHF outbreaks are increasing, with affected number of patients on the rise. Whilst there has been no report yet of FVHF in Zambia, its proximity to Angola and Democratic Republic of Congo, which have recorded major outbreaks, as well as the open borders, increased trade and annual migration of bats between these countries, puts Zambia at present and increased risk. Previous studies have indicated bats as potential reservoir hosts for filoviruses. An increasing population with an increasing demand for resources has forced incursion into previously uninhabited land, potentially bringing them into contact with unknown pathogens, reservoir hosts and/or amplifying hosts. The recent discovery of a novel arenavirus, Lujo, highlights the potential that every region, including Zambia, has for being the epicentre or primary focus for emerging and re-emerging infections. It is therefore imperative that surveillance for potential emerging infections, such as viral haemorrhagic fevers be instituted. In order to accomplish this surveillance, rapid detection, identification and monitoring of agents in patients and potential reservoirs is needed. International co-operation is the strategy of choice for the surveillance and fight against emerging infections. Due to the extensive area in which filoviral infections can occur, a regional approach to surveillance activities is required, with regional referral centres. There is a need to adopt shared policies for the prevention and control of infectious diseases. There is also need for optimisation of currently available tests and development of new diagnostic tests, in order to have robust, highly sensitive and specific diagnostic tests that can be used even where there are inadequate laboratories and diagnostic services.

  11. Retinal detachment following endophthalmitis.

    Science.gov (United States)

    Nelsen, P T; Marcus, D A; Bovino, J A

    1985-08-01

    Fifty-five consecutive patients with a clinical diagnosis of bacterial endophthalmitis were reviewed. All patients were treated with systemic, periocular, topical, and intravitreal antibiotics. In addition, 33 of the patients underwent a pars plana vitrectomy. Nine retinal detachments occurred within six months of initial diagnosis. The higher frequency of retinal detachment in the vitrectomy group (21%) as compared to those patients managed without vitrectomy (9%) may be explained by a combination of surgical complications and the increased severity of endophthalmitis in the vitrectomy group. The two patients who developed retinal detachment during vitrectomy surgery rapidly progressed to no light perception. Conversely, the repair of retinal detachments diagnosed postoperatively had a good prognosis.

  12. Retinal oximetry in patients with ischaemic retinal diseases

    DEFF Research Database (Denmark)

    Rilvén, Sandra; Torp, Thomas Lee; Grauslund, Jakob

    2017-01-01

    The retinal oximeter is a new tool for non-invasive measurement of retinal oxygen saturation in humans. Several studies have investigated the associations between retinal oxygen saturation and retinal diseases. In the present systematic review, we examine whether there are associations between...... retinal oxygen saturation and retinal ischaemic diseases. We used PubMed and Embase to search for retinal oxygen saturation and retinal ischaemic diseases. Three separate searches identified a total of 79 publications. After two levels of manual screening, 10 studies were included: six about diabetic...... retinopathy (DR) and four about retinal vein occlusion. No studies about retinal artery occlusion were included. In diabetes, all studies found that increases in retinal venous oxygen saturation (rvSatO2 ) were associated with present as well as increasing levels of DR. Four of six studies also found...

  13. Experience of the Irish National Centre for hereditary haemorrhagic telangiectasia 2003-2008.

    LENUS (Irish Health Repository)

    Ni Bhuachalla, C F

    2012-01-31

    Hereditary haemorrhagic telangiectasia (HHT) is a group of autosomal dominant disorders of vascular structure. The Irish National Centre for HHT at the Mercy University Hospital, Cork, Ireland was founded in 2003. From 2003 to 2008, screening of 164 patients with contrast echocardiography, thoracic computerised tomography (CT) and cerebral magnetic resonance imaging (MRI) has identified 88 patients with definite HHT, 72 (82%) of whom had epistaxis, 70 (80%) had telangiectasia and 81 (92%) had a first-degree relative with HHT. We sought to describe the manifestations of HHT in an Irish population and to determine differences between internationally reported data. The HHT patient database was analysed to describe demographics, clinical manifestations and interventional procedures performed in all referred patients. Contrast echocardiography and\\/or CT were performed in 86 patients with definite HHT, identifying 27 patients (31%) with pulmonary arteriovenous malformations (pAVMs). Nineteen patients with single or multiple pAVMs had 28 embolisation procedures performed, with 1-6 pAVMs embolised per procedure. Cerebral MRI was performed in 78 (89%) patients and 2 (2.3%) had cerebral arteriovenous malformations (cAVMs). HHT prevalence is thought to be 1 in 2500-8000, suggesting that there are many undiagnosed cases in Irish patients. Internationally published data suggest a prevalence of 15-35% for pAVMs and 10-23% for cAVMs in patients with HHT. While the prevalence of pAVMs in our group is consistent with these data, the prevalence of cAVMs is considerably lower, suggesting that Irish patients with HHT may differ genotypically and phenotypically from those in other countries.

  14. Optimised performance of industrial high resolution computerised tomography

    International Nuclear Information System (INIS)

    Maangaard, M.

    2000-01-01

    The purpose of non-destructive evaluation (NDE) is to acquire knowledge of the investigated sample. Digital x-ray imaging techniques such as radiography or computerised tomography (CT) produce images of the interior of a sample. The obtained image quality determines the possibility of detecting sample related features, e.g. details and flaws. This thesis presents a method of optimising the performance of industrial X-ray equipment for the imaging task at issue in order to obtain images with high quality. CT produces maps of the X-ray linear attenuation of the sample's interior. CT can produce two dimensional cross-section images or three-dimensional images with volumetric information on the investigated sample. The image contrast and noise depend on both the investigated sample and the equipment and settings used (X-ray tube potential, X-ray filtration, exposure time, etc.). Hence, it is vital to find the optimal equipment settings in order to obtain images of high quality. To be able to mathematically optimise the image quality, it is necessary to have a model of the X-ray imaging system together with an appropriate measure of image quality. The optimisation is performed with a developed model for an X-ray image-intensifier-based radiography system. The model predicts the mean value and variance of the measured signal level in the collected radiographic images. The traditionally used measure of physical image quality is the signal-to-noise ratio (SNR). To calculate the signal-to-noise ratio, a well-defined detail (flaw) is required. It was found that maximising the SNR leads to ambiguities, the optimised settings found by maximising the SNR were dependent on the material in the detail. When CT is performed on irregular shaped samples containing density and compositional variations, it is difficult to define which SNR to use for optimisation. This difficulty is solved by the measures of physical image quality proposed here, the ratios geometry

  15. Streptococcus sanguinis meningitis following endoscopic ligation for oesophageal variceal haemorrhage.

    Science.gov (United States)

    Liu, Yu-Ting; Lin, Chin-Fu; Lee, Ya-Ling

    2013-05-01

    We report a case of acute purulent meningitis caused by Streptococcus sanguinis after endoscopic ligation for oesophageal variceal haemorrhage in a cirrhotic patient without preceding symptoms of meningitis. Initial treatment with flomoxef failed. The patient was cured after 20 days of intravenous penicillin G. This uncommon infection due to S. sanguinis adds to the long list of infectious complications among patients with oesophageal variceal haemorrhage.

  16. An Unusual Case of Bilateral Vitreous Haemorrhage following Snake Bite

    Directory of Open Access Journals (Sweden)

    Vipul Bhandari

    2013-01-01

    Full Text Available A-45-year-old man presented to us with diminution of vision in both eye following snake bite. On examination vision in the right eye (RE was 6/36 and vision in left eye (LE was hand movement positive and fundus examination revealed a subhyloid haemorrhage, left eye showed vitreous haemorrhage. Patient was advised bed rest, vitamin C tablets and oral steroids.

  17. [Hereditary haemorrhagic telangiectasia diagnosed in connection with a traffic accident].

    Science.gov (United States)

    Sivapalan, Pradeesh; Demény, Ann Kathrin; Almind, Merete; Kjeldsen, Anette Drøhse

    2014-02-17

    Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by vascular dysplasia and haemorrhage. It is manifested by mucocutaneous telangiec-tases and arteriovenous malformations in organs such as lungs, liver and brain. We present a case of HHT. A 16-year-old patient with a history of recurrent epistaxis was admitted to the local hospital with chest pain and desaturation. A CT scan revealed pulmonary arteriovenous malformations.

  18. Computerised Attention Training for Children with Intellectual and Developmental Disabilities: A Randomised Controlled Trial

    Science.gov (United States)

    Kirk, Hannah E.; Gray, Kylie M.; Ellis, Kirsten; Taffe, John; Cornish, Kim M.

    2016-01-01

    Background: Children with intellectual and developmental disabilities (IDD) experience heightened attention difficulties which have been linked to poorer cognitive, academic and social outcomes. Although, increasing research has focused on the potential of computerised cognitive training in reducing attention problems, limited studies have…

  19. Effectiveness of a Computerised Working Memory Training in Adolescents with Mild to Borderline Intellectual Disabilities

    Science.gov (United States)

    Van der Molen, M. J.; Van Luit, J. E. H.; Van der Molen, M. W.; Klugkist, I.; Jongmans, M. J.

    2010-01-01

    Background: The goal of this study is to evaluate the effectiveness of a computerised working memory (WM) training on memory, response inhibition, fluid intelligence, scholastic abilities and the recall of stories in adolescents with mild to borderline intellectual disabilities attending special education. Method: A total of 95 adolescents with…

  20. A New Computerised Advanced Theory of Mind Measure for Children with Asperger Syndrome: The ATOMIC

    Science.gov (United States)

    Beaumont, Renae B.; Sofronoff, Kate

    2008-01-01

    This study examined the ability of children with Asperger Syndrome (AS) to attribute mental states to characters in a new computerised, advanced theory of mind measure: The Animated Theory of Mind Inventory for Children (ATOMIC). Results showed that children with AS matched on IQ, verbal comprehension, age and gender performed equivalently on…

  1. Sample preparation and scanning protocol for computerised analysis of root length and diameter

    NARCIS (Netherlands)

    Bouma, T.J.; Nielsen, K.F.; Koutstaal, B.P.

    2000-01-01

    Root length and diameter distribution are important characteristics to be considered when describing and comparing root systems. Root length and root-diameter distribution may be obtained in two ways: by microscopical measurements, which are laborious, or by computerised analysis, which is fast but

  2. Effectiveness of a computerised working memory training in adolescents with mild to borderline intellectual disabilities

    NARCIS (Netherlands)

    van der Molen, M.J.; van Luit, J.E.H.; van der Molen, M.W.; Klugkist, I.; Jongmans, M.J.

    2010-01-01

    Background: The goal of this study is to evaluate the effectiveness of a computerised working memory (WM) training on memory, response inhibition, fluid intelligence, scholastic abilities and the recall of stories in adolescents with mild to borderline intellectual disabilities attending special

  3. Postpartum haemorrhage: a preventable cause of maternal mortality

    International Nuclear Information System (INIS)

    Shaheen, B.; Hassan, L.

    2007-01-01

    To assess the preventable predictors of severe postpartum haemorrhage and the adverse outcome associated with it. All the admitted patients who developed severe postpartum haemorrhage (>1500 ml) were included in the study. Clinical and sociodemographic data was obtained along with results of investigations to categorize the complications encountered. Odds ratio (OR) and 95% confidence intervals were determined. During the study period, 75 out of 4683 obstetrical admissions, developed severe postpartum haemorrhage (1.6 %). About 65% of the patients were admitted with some other complications including obstructed labour, antepartum haemorrhage and eclampsia. The risk factors were grand multiparity (OR=3.4), pre-eclampsia (OR=2.75), antepartum haemorrhage (OR=13.35), active labour of more than 10 hours (OR=46.92), twin delivery (OR=3.25), instrumental delivery (OR=8.62) and caesarean section (OR=9.74). Maternal mortality in these cases was 2.66% and residual morbidity being 40%. Birth attendant other than doctor and delivery outside the study unit were significantly associated with the adverse outcome in these patients. Maternal outcome associated with postpartum haemorrhage is a function of care given during labour and postnatal period with early diagnosis and management of the complication and its risk factors, being the key of good maternal outcome. (author)

  4. Evidence-based management of epistaxis in hereditary haemorrhagic telangiectasia.

    Science.gov (United States)

    Syed, I; Sunkaraneni, V S

    2015-05-01

    There are currently no guidelines in the UK for the specific management of hereditary haemorrhagic telangiectasia related epistaxis. The authors aimed to review the literature and provide an algorithm for the management of hereditary haemorrhagic telangiectasia related epistaxis. The Medline and Embase databases were interrogated on 15 November 2013 using the search items 'hereditary haemorrhagic telangiectasia' (title), 'epistaxis' (title) and 'treatment' (title and abstract), and limiting the search to articles published in English. A total of 46 publications were identified, comprising 1 systematic review, 2 randomised, controlled trials, 27 case series, 9 case reports, 4 questionnaire studies and 3 in vitro studies. There is a lack of high-level evidence for the use of many of the available treatments for the specific management of epistaxis in hereditary haemorrhagic telangiectasia. Current management should be based on a multidisciplinary team approach involving both a hereditary haemorrhagic telangiectasia physician and an ENT surgeon, especially when systemic therapy is being considered. The suggested treatment algorithm considers that the severity of epistaxis merits intervention at different levels of the treatment ladder. The patient should be assessed using a reproducible validated assessment tool, for example an epistaxis severity score, to guide treatment. More research is required, particularly in the investigation of topical agents targeting the development and fragility of telangiectasiae in hereditary haemorrhagic telangiectasia.

  5. Dorzolamide increases retinal oxygen tension after branch retinal vein occlusion

    DEFF Research Database (Denmark)

    Noergaard, Michael Hove; Bach-Holm, Daniella; Scherfig, Erik

    2008-01-01

    To study the effect of dorzolamide on the preretinal oxygen tension (RPO(2)) in retinal areas affected by experimental branch retinal vein occlusion (BRVO) in pigs.......To study the effect of dorzolamide on the preretinal oxygen tension (RPO(2)) in retinal areas affected by experimental branch retinal vein occlusion (BRVO) in pigs....

  6. Current diagnostic approaches to subarachnoid haemorrhage

    International Nuclear Information System (INIS)

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

    2005-01-01

    Over the past decade, significant advances have been made in the field of subarachnoid haemorrhage (SAH). Prompt diagnosis with high-resolution CT and intensive critical care support remain key aspects of good patient management. Early identification and definitive treatment of underlying ruptured aneurysms is generally advocated to reduce the risk of re-bleeding, a complication with high mortality and morbidity. Although intra-arterial digital subtraction angiography (DSA) is still considered the gold standard for sourcing aneurysms, CT angiography, especially with the evolution of multi-slice technology, is slowly gaining acceptance as a rapid, accessible and minimally invasive method which appears likely to replace DSA as first-line modality in the future. Furthermore, the advent of Guglielmi detachable coils and the ISAT trial have revolutionised the treatment of ruptured aneurysms, with a significant trend towards endovascular coiling away from operative clipping. Improvements in clinical experience, coiling technology and assistive devices now allow interventionalists to potentially treat the majority of aneurysms, including wide-necked or complex lesions. The uncertain long-term results of coiling, however, still fuel strong debate and controversy. This review summarises current diagnostic approaches to SAH from a radiological perspective, with an emphasis on aneurysmal SAH and an evidence-based approach to the role of imaging and interventional radiology in diagnosis, treatment and follow-up. (orig.)

  7. Current diagnostic approaches to subarachnoid haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    U-King-Im, Jean Marie; Koo, Brendan; Trivedi, Rikin A.; Higgins, Nicholas J.; Tay, Keng Y.; Cross, Justin J.; Antoun, Nagui M.; Gillard, Jonathan H. [Addenbrooke' s Hospital, University Department of Radiology, Cambridge (United Kingdom)

    2005-06-01

    Over the past decade, significant advances have been made in the field of subarachnoid haemorrhage (SAH). Prompt diagnosis with high-resolution CT and intensive critical care support remain key aspects of good patient management. Early identification and definitive treatment of underlying ruptured aneurysms is generally advocated to reduce the risk of re-bleeding, a complication with high mortality and morbidity. Although intra-arterial digital subtraction angiography (DSA) is still considered the gold standard for sourcing aneurysms, CT angiography, especially with the evolution of multi-slice technology, is slowly gaining acceptance as a rapid, accessible and minimally invasive method which appears likely to replace DSA as first-line modality in the future. Furthermore, the advent of Guglielmi detachable coils and the ISAT trial have revolutionised the treatment of ruptured aneurysms, with a significant trend towards endovascular coiling away from operative clipping. Improvements in clinical experience, coiling technology and assistive devices now allow interventionalists to potentially treat the majority of aneurysms, including wide-necked or complex lesions. The uncertain long-term results of coiling, however, still fuel strong debate and controversy. This review summarises current diagnostic approaches to SAH from a radiological perspective, with an emphasis on aneurysmal SAH and an evidence-based approach to the role of imaging and interventional radiology in diagnosis, treatment and follow-up. (orig.)

  8. Leukaemic infiltration and cytomegalovirus retinitis in a patient with acute T-cell lymphoblastic leukaemia in complete remission.

    Science.gov (United States)

    Saldaña Garrido, J D; Martínez Rubio, M; Carrión Campo, R; Moya Moya, M A; Rico Sergado, L

    2017-03-01

    A 43-year-old woman in remission from T- cell acute lymphoblastic leukaemia was referred to our hospital with suspected leukaemic retinitis. The funduscopic examination of her left eye revealed multifocal yellow-white peripheral retinitis and retinal haemorrhage. The patient was treated for cytomegalovirus retinitis after an extended haematological investigation showed no abnormalities. Initial improvement was followed by papillitis in the left eye and motility restriction in the right eye. Magnetic resonance and lumbar puncture confirmed leukaemia relapse. Specific treatment was initiated with complete resolution. Ocular involvement may precede haematological leukaemia relapse. Physicians should be alerted when ocular symptoms appear in these cases. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Early surgical treatment of retinal hemangioblastomas.

    Science.gov (United States)

    van Overdam, Koen A; Missotten, Tom; Kilic, Emine; Spielberg, Leigh H

    2017-02-01

    To evaluate the clinical course after early surgical treatment with excision of retinal hemangioblastomas (RHs) before development of major complications. Interventional case series of four eyes (four patients) with a peripheral RH that had not yet been treated by laser or cryotherapy prior to surgery. All eyes underwent 23-gauge vitrectomy with lesion excision. One patient underwent ligation of the feeder vessel prior to lesion excision. Best-corrected visual acuity and clinical course were assessed during a follow-up period of at least 4 years. Four patients (mean age 27.3 years; range 19-32) were included, of whom two had von Hippel-Lindau syndrome. Visual acuity improved in three patients (mean 4.8 lines; range 3-10) and remained stable at 0.0 logMAR in one patient. There were no intraoperative complications. Postoperative complications included transient mild vitreous haemorrhage (n = 2), and local epiretinal membrane formation at the excision location (n = 1). At 4 years postoperatively, there were no long-term complications. There was one case of a new lesion, which was effectively treated with laser. Vitrectomy with RH excision seems to be an effective approach for larger RHs and could be considered an early treatment option in selected cases. Postoperative complications were limited in scope of this case series. Important points to consider during vitrectomy are effective closure of feeder and draining vessels as well as complete removal of posterior hyaloid and epiretinal membranes in order to avoid postoperative vitreous haemorrhage and proliferative vitreoretinopathy. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  10. Differential diagnosis of retinal vasculitis.

    Science.gov (United States)

    Abu El-Asrar, Ahmed M; Herbort, Carl P; Tabbara, Khalid F

    2009-10-01

    Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings.

  11. Fulminant intravascular lymphomatosis mimicking acute haemorrhagic leukoencephalopathy.

    Science.gov (United States)

    Marino, D; Sicurelli, F; Cerase, A; Tripodi, S; Cintorino, M; Lazzi, S; Federico, A

    2012-09-15

    Intravascular lymphomatosis (IVL) is a rare non-Hodgkin's lymphoma, usually of B cell lineage, characterized by massive angiotropic growth. The clinical presentation of IVL may include changes in mental status, non-localizing neurological deficits, seizures, fever of unknown origin and skin changes. Because of its rarity and the absence of specific diagnostic procedures except for cerebral biopsy, diagnosis is often postmortem. Brain MRI usually shows non-specific abnormalities. The purpose of this case report is to increase the knowledge of clinical and neuroimaging features of IVL by describing the findings observed in a 71-year-old patient. A 71-year-old male was admitted for right hemiparesis, acute cognitive impairment and febricula. A bone marrow biopsy resulted normal. He then developed a rapid progressive impairment of his mental status and left hemisoma motor seizures. Brain CT and MRI were interpreted as consistent with acute haemorrhagic leukoencephalopathy (AHLE), including multiple areas of restricted diffusion without gadolinium enhancement and a small focal area of gadolinium enhancement in the left temporal lobe white matter. The patient died within a few days and the autopsy led to the diagnosis of IVL. IVL may present with a variety of clinical signs and symptoms, including stroke and hemiparesis. IVL may mimic AHLE at brain MRI. However, the evidence of multiple areas of restricted diffusion without gadolinium enhancement and of a small area of gadolinium enhancement could have led to the correct diagnosis. IVL should be added to the differential diagnosis of AHLE at brain MRI. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. Massive retroperitoneal haemorrhage after extracorporeal shock wave lithotripsy (ESWL).

    Science.gov (United States)

    Inoue, Hiromasa; Kamphausen, Thomas; Bajanowski, Thomas; Trübner, Kurt

    2011-01-01

    A 76-year-old male suffering from nephrolithiasis developed a shock syndrome 5 days after extracorporal shock wave lithotripsy (ESWL). CT scan of the abdomen showed massive haemorrhage around the right kidney. Although nephrectomy was performed immediately, the haemorrhage could not be controlled. Numerous units of erythrocytes were transfused, but the patient died. The autopsy revealed massive retroperitoneal haemorrhage around the right kidney. The kidney showed a subcapsular haematoma and a rupture of the capsule. The right renal artery was dissected. The inferior vena cava was lacerated. Accordingly, a hemorrhagic shock as the cause of death was determined, which might mainly have resulted from the laceration of the inferior vena cava due to ESWL. ESWL seems to be a relatively non-invasive modality, but one of its severe complications is perirenal hematoma. The injuries of the blood vessels might have been caused by excessive shock waves. Subsequently, anticoagulation therapy had been resumed 3 days after EWSL, which might have triggered the haemorrhage. Physicians should note that a haemorrhage after an ESWL can occur and they should pay attention to the postoperative management in aged individuals especially when they are under anticoagulation therapy.

  13. [Fatal alveolar haemorrhage following a "bang" of cannabis].

    Science.gov (United States)

    Grassin, F; André, M; Rallec, B; Combes, E; Vinsonneau, U; Paleiron, N

    2011-09-01

    The new methods of cannabis consumption (home made water pipe or "bang") may be responsible for fatal respiratory complications. We present a case, with fatal outcome, of a man of 19 years with no previous history other than an addiction to cannabis using "bang". He was admitted to intensive care with acute dyspnoea. A CT scan showed bilateral, diffuse alveolar shadowing. He was anaemic with an Hb of 9.3g/l. Bronchoalveolar lavage revealed massive alveolar haemorrhage. Investigations for infection and immunological disorder were negative and toxicology was negative except for cannabis. Antibiotic treatment was given and favourable progress allowed early discharge. Death occurred 15 days later due to alveolar haemorrhage following a further "bang" of cannabis. Autopsy showed toxic alveolar haemorrhage. The probable mechanism is pulmonary damage due to acid anhydrides released by the incomplete combustion of cannabis in contact with plastic. These acids have a double effect on the lungs: a direct toxicity with severe inflammation of the mucosa leading to alveolar haemorrhage and subsequently the acid anhydrides may lead to the syndrome of intra-alveolar haemorrhage and anaemia described in occupational lung diseases by Herbert in Oxford in 1979. It manifests itself by haemoptysis and intravascular haemolysis. We draw attention to the extremely serious potential consequences of new methods of using cannabis, particularly the use of "bang" in homemade plastic materials. Copyright © 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  14. Retinal Detachment Vision Simulator

    Science.gov (United States)

    ... Feb 20, 2018 Gene Therapy May Be a Game-Changer for People With Inherited Retinal Disease Dec 19, 2017 ... the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

  15. Learning about Retinitis Pigmentosa

    Science.gov (United States)

    Skip to main content Learning about Retinitis Pigmentosa Enter Search Term(s): Español Research Funding An Overview Bioinformatics Current Grants Education and Training Funding Extramural Research ...

  16. [A computerised clinical decision-support system for the management of depression in Primary Care].

    Science.gov (United States)

    Aragonès, Enric; Comín, Eva; Cavero, Myriam; Pérez, Víctor; Molina, Cristina; Palao, Diego

    Despite its clinical relevance and its importance as a public health problem, there are major gaps in the management of depression. Evidence-based clinical guidelines are useful to improve processes and clinical outcomes. In order to make their implementation easier these guidelines have been transformed into computerised clinical decision support systems. In this article, a description is presented on the basics and characteristics of a new computerised clinical guideline for the management of major depression, developed in the public health system in Catalonia. This tool helps the clinician to establish reliable and accurate diagnoses of depression, to choose the best treatment a priori according to the disease and the patient characteristics. It also emphasises the importance of systematic monitoring to assess the clinical course, and to adjust therapeutic interventions to the patient's needs at all times. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  17. The computerised accountancy system (MYDAS) for irradiated components in RNL's Mayfair Laboratory at Culcheth

    International Nuclear Information System (INIS)

    Stansfield, R.G.; Baker, A.R.

    1985-09-01

    The computerised Mayfair Accountancy System (MYDAS) has been developed to account for irradiated components in the Mayfair Laboratory at Culcheth and supersedes a card-index system. The computerised system greatly improves the availability of the data held and it ensures, by means of extensive data validation programs, that the data accurately represent the current inventory of irradiated components in the Laboratory. The system has been implemented on the Risley ICL 2966 main-frame computer and uses an IDMS database to store the data. The computer is accessed through the facilities of the Transaction Processing Management System (TPMS) providing rapid and secure access to the database from several visual display units and printers simultaneously. (author)

  18. MOIRA: a computerised decision support system for the management of radionuclide contaminated freshwater ecosystems

    International Nuclear Information System (INIS)

    Gallego, Eduardo; Brittain, John E.; Hakanson, Lars; Heling, Rudie; Hofman, Dmitry; Monte, Luigi

    2004-01-01

    The radiation dose resulting from contamination of freshwater ecosystems due to the release of radioactive substances into the environment may be reduced by applying suitable countermeasures. Despite their benefits, intervention strategies may have detrimental effects of economic, ecological and social nature. Thus, it is of paramount importance to assess, by objective criteria, the global cost-benefit balance of different options. The MOIRA project (A MOdel based computerised system for management support to Identify optimal remedial strategies for Restoring radionuclide contaminated Aquatic ecosystems) has developed a user-friendly, computerised tool that will allow decision makers to choose optimal intervention strategies for freshwater ecosystems with different contamination scenarios. The aim of the paper is to briefly describe the main components of the MOIRA system and to demonstrate its application using real case based scenarios. (author)

  19. Vesical Artery Embolization in Haemorrhagic Cystitis in Children

    Energy Technology Data Exchange (ETDEWEB)

    García-Gámez, Andrés, E-mail: agargamez@gmail.com; Bermúdez Bencerrey, Patricia, E-mail: PBERMUDE@clinic.ub.es [Hospital Clinic (Spain); Brio-Sanagustin, Sonia, E-mail: sbrio@santpau.cat [Hospital de la Santa Creu y Sant Pau (Spain); Guerrero Vara, Rubén, E-mail: rguerrerov@santpau.cat [Hospital Clinic (Spain); Sisinni, Luisa, E-mail: lsisinni@santpau.cat [Hospital de la Santa Creu y Sant Pau (Spain); Stuart, Sam, E-mail: sam.stuart@gosh.nhs.uk; Roebuck, Derek, E-mail: Derek.Roebuck@gosh.nhs.uk [Great Ormond Street Hospital for Children (United Kingdom); Gómez Muñoz, Fernando, E-mail: FEGOMEZ@clinic.ub.es [Hospital Clinic (Spain)

    2016-07-15

    Haemorrhagic cystitis is an uncommon and, in its severe form, potentially life-threatening complication of haematopoietic stem cell transplantation or cancer therapy in children. The severe form involves macroscopic haematuria with blood clots, urinary obstruction and/or renal impairment. There are many therapeutic options to treat acute haemorrhage, but only recombinant factor VII has a high level of clinical evidence in children. Supraselective vesical artery embolization (SVAE) is an increasingly used therapeutic procedure for controlling haemorrhage in adults, but is less commonly used in children. This might be due to several factors, such as the invasive nature of the procedure, lack of appropriate medical experience and possible long-term side effects. We present three cases of children successfully treated by means of effective SVAE.

  20. Neurosurgical management of L-asparaginase induced haemorrhagic stroke.

    LENUS (Irish Health Repository)

    Ogbodo, Elisha

    2012-01-01

    The authors describe a case of L-asparaginase induced intracranial thrombosis and subsequent haemorrhage in a newly diagnosed 30-year-old man with acute lymphoblastic leukaemia who was successfully managed by surgical intervention. At presentation, he had a Glasgow Coma Score of 7\\/15, was aphasic and had dense right hemiplegia. Neuroimaging revealed an acute anterior left middle cerebral artery infarct with parenchymal haemorrhagic conversion, mass effect and subfalcine herniation. He subsequently underwent left frontal craniotomy and evacuation of large frontal haematoma and decompressive craniectomy for cerebral oedema. Six months postoperatively he underwent titanium cranioplasty. He had made good clinical recovery and is currently mobilising independently with mild occasional episodes of expressive dysphasia, difficulty with fine motor movement on the right side, and has remained seizure free. This is the first documented case of L-asparaginase induced haemorrhagic stroke managed by neurosurgical intervention. The authors emphasise the possible role of surgery in managing chemotherapy induced intracranial complications.

  1. The value of MRI in angiogram-negative intracranial haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Renowden, S.A. (Dept. of Neuroradiology, Radcliffe Infirmary, Oxford (United Kingdom)); Molyneux, A.J. (Dept. of Neuroradiology, Radcliffe Infirmary, Oxford (United Kingdom)); Anslow, P. (Dept. of Neuroradiology, Radcliffe Infirmary, Oxford (United Kingdom)); Byrne, J.V. (Dept. of Neuroradiology, Radcliffe Infirmary, Oxford (United Kingdom))

    1994-08-01

    In one year, cerebral angiograms were performed for intracranial haemorrhage (ICH) on 334 patients. No cause for haemorrhage could be identified in 41 (12 %), 30 of whom had predominantly subarachnoid (SAH) and 11 predominantly parenchymal haemorrhage (PH). These patients were prospectively examined by cranial MRI 1-6 weeks after the ictus. The MRI studies were positive in 7 patients (17 %). In the 30 patients examined after SAH, 2 studies were positive, showing an aneurysm in one case and a brain stem lesion of uncertain aetiology in the other. In those examined after PH, cavernous angiomas were shown in 2, a tumour in 1 and a vascular malformation in another; useful diagnostic information was thus obtained in 36 % of this group. (orig.)

  2. Trends in monitoring patients with aneurysmal subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Springborg, J B; Frederiksen, H-J; Eskesen, V

    2005-01-01

    After aneurysmal subarachnoid haemorrhage (SAH), the clinical outcome depends upon the primary haemorrhage and a number of secondary insults in the acute post-haemorrhagic period. Some secondary insults are potentially preventable but prevention requires prompt recognition of cerebral or systemic...... implemented monitoring system provides answers but it also raises valuable new questions challenging our current understanding of the brain injury after SAH....... complications. Currently, several neuro-monitoring techniques are available; this review describes the most frequently used techniques and discusses indications for their use, and their value in diagnosis and prognosis. None of the techniques, when considered in isolation, has proved sufficient after SAH...... with the conventional monitoring systems, for example intracranial pressure measurements, transcranial Doppler ultrasound and modern neuro-imaging, direct assessment of biochemical markers by intracerebral microdialysis is promising in the advancement of neurointensive care of patients with SAH. A successfully...

  3. Spontaneous haemorrhage and rupture of third ventricular colloid cyst.

    LENUS (Irish Health Repository)

    Ogbodo, Elisha

    2012-01-01

    Acute bleeding within a colloid cyst of the third ventricle represents a rare event causing sudden increase in the cyst volume that may lead to acute hydrocephalus and rapid neurological deterioration. We report a case of spontaneous rupture of haemorrhagic third ventricular colloid cyst and its management. A 77-year-old ex-smoker presented with unsteady gait, incontinence and gradually worsening confusion over a 3-week period. Brain CT scan findings were highly suggestive of a third ventricular colloid cyst with intraventricular rupture. He underwent cyst excision and histopathology, which confirmed the radiological diagnosis with evidence of haemorrhage within the cyst. A ventriculo peritoneal shunt was performed for delayed hydrocephalus. Surgical management of these patients must include emergency ventriculostomy followed by prompt surgical removal of the haemorrhagic cyst.

  4. What are the current therapeutic options for haemorrhagic strokes

    International Nuclear Information System (INIS)

    Khan, M.; Kamal, A.K.

    2010-01-01

    The Factor Seven for Acute Haemorrhagic Stroke Trial (FAST) and Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trial (INTERACT). Intracerebral haemorrhage (ICH) is the most devastating form of stroke carrying a mortality of up to 40% at one month. In our part of the world the levels of uncontrolled hypertension pose a greater risk of ICH for our population where ICH is about 30% of all strokes compared to 14% in developed countries. There is evidence to suggest that haematoma expansion occurs in as many as 70% of patients. This expansion translates into increased disability and death. Most of this expansion is within the initial three hours. Also early elevation of blood pressure (BP) is very common after ICH and many studies have highlighted an association between elevated BP post ICH and poor outcomes. The reason for this is postulated to be an increase in both the size of the haematoma and perilesional oedema. (author)

  5. International prospective observational study of upper gastrointestinal haemorrhage: Does weekend admission affect outcome?

    DEFF Research Database (Denmark)

    Murray, Iain A.; Dalton, Harry R.; Stanley, Adrian J.

    2017-01-01

    Introduction Out of hours admissions have higher mortality for many conditions but upper gastrointestinal haemorrhage studies have produced variable outcomes. Methods Prospective study of 12 months consecutive admissions of upper gastrointestinal haemorrhage from four international high volume...

  6. Comparing three methods of computerised cognitive training for older adults with subclinical cognitive decline.

    Science.gov (United States)

    Gooding, Amanda L; Choi, Jimmy; Fiszdon, Joanna M; Wilkins, Kirsten; Kirwin, Paul D; van Dyck, Christopher H; Devanand, Davangere; Bell, Morris D; Rivera Mindt, Monica

    2016-10-01

    Cognitive rehabilitation for mild cognitive impairment (MCI) and early Alzheimer's disease is readily available to the geriatric population. Initial evidence suggests that techniques incorporating motivational strategies to enhance treatment engagement may provide more benefit than computerised training alone. Seventy four adults with subclinical cognitive decline were randomly assigned to computerised cognitive training (CCT), Cognitive Vitality Training (CVT), or an Active Control Group (ACG), and underwent neuropsychological evaluations at baseline and four-month follow-up. Significant differences were found in changes in performance on the Modified Mini Mental State Examination (mMMSE) and measures of verbal learning and memory across treatment groups. Experimental groups showed greater preservation of functioning on the mMMSE than the ACG group, the CVT group performed better than the ACG group on one measure of verbal learning and both measures of verbal memory, and the CCT group performed better than the ACG group on one measure of verbal learning and one measure of verbal memory. There were no significant group differences between the CVT and CCT groups on measures of verbal learning or memory. It was concluded that computerised cognitive training may offer the most benefit when incorporated into a therapeutic milieu rather than administered alone, although both appear superior to more generic forms of cognitive stimulation.

  7. A systematic review of computerised serious educational games about alcohol and other drugs for adolescents.

    Science.gov (United States)

    Rodriguez, Daniel M; Teesson, Maree; Newton, Nicola C

    2014-03-01

    Serious educational games (SEG) have been shown to be effective in educating young people about a range of topics, including languages and maths. This paper identifies the use of computerised SEGs in education about alcohol and other drugs and reviews their impact on the prevention of alcohol and drug use. The Cochrane Library, EMBASE, MEDLINE, ERIC, Scopus, psychINFO, pubMED and DRUG databases were searched in February 2013. Additional publications were obtained from the reference lists of the relevant papers. Studies were included if they described an evaluation of a computerised SEG that targeted alcohol and/or other drugs and had been trialled with adolescents. Eight SEGs were identified targeting tobacco, alcohol, cannabis, methamphetamine, ecstasy, inhalants, cocaine and opioids. Six reported positive outcomes in terms of increased content knowledge and two reported increased negative attitudes towards the targeted drugs. Only one reported a decrease in the frequency of drug use. This is the first review of the efficacy of computerised SEGs for alcohol and other drugs for adolescents. Results suggest that SEGs can increase content knowledge of alcohol and other drugs. Evidence concerning impacts on negative attitudes and alcohol and drug use is limited, with few studies examining these outcomes. © 2013 Australasian Professional Society on Alcohol and other Drugs.

  8. Perforated ileal duplication cyst with haemorrhagic pseudocyst formation

    International Nuclear Information System (INIS)

    Hwang, Im Kyung; Kim, Bong Soo; Kim, Heung Chul; Lee, In Sun; Hwang, Woo Chul; Namkung, Sook

    2003-01-01

    Duplication cysts of the gastrointestinal tract are rare congenital abnormalities. Ectopic gastric mucosa, which can be found in duplications, may cause peptic ulceration, gastrointestinal bleeding or perforation. We report a 1-year-old boy with a perforated ileal duplication cyst with haemorrhagic pseudocyst formation caused by peptic ulceration of the duplication cyst. It presented a snowman-like appearance consisting of a small, thick-walled, true enteric cyst and a large, thin-walled haemorrhagic pseudocyst on US and CT. It is an unusual manifestation of a duplication cyst, which has not been reported in the English language literature. (orig.)

  9. Progressive outer retinal necrosis-like retinitis in immunocompetent hosts.

    Science.gov (United States)

    Chawla, Rohan; Tripathy, Koushik; Gogia, Varun; Venkatesh, Pradeep

    2016-08-10

    We describe two young immunocompetent women presenting with bilateral retinitis with outer retinal necrosis involving posterior pole with centrifugal spread and multifocal lesions simulating progressive outer retinal necrosis (PORN) like retinitis. Serology was negative for HIV and CD4 counts were normal; however, both women were on oral steroids at presentation for suspected autoimmune chorioretinitis. The retinitis in both eyes responded well to oral valaciclovir therapy. However, the eye with the more fulminant involvement developed retinal detachment with a loss of vision. Retinal atrophy was seen in the less involved eye with preservation of vision. Through these cases, we aim to describe a unique evolution of PORN-like retinitis in immunocompetent women, which was probably aggravated by a short-term immunosuppression secondary to oral steroids. 2016 BMJ Publishing Group Ltd.

  10. Retroperitoneal Haematoma in a Patient with Dengue Haemorrhagic Fever: A Rare Case Report.

    Science.gov (United States)

    Singh, Jasminder; Singh, Harpreet; Sukhija, Gagandeep; Jagota, Ruchi; Bala, Saroj

    2016-11-01

    Dengue Haemorrhagic Fever (DHF) has diverse manifestations ranging from asymptomatic petechial skin haemorrhages to life threatening cerebral, pulmonary, gastrointestinal and genitourinary haemorrhages. However, the association of spontaneous retroperitoneal haematomas with DHF is not well documented in literature. We report a rare case of spontaneous retroperitoneal haematoma complicating DHF.

  11. Retinal shows its true colours

    DEFF Research Database (Denmark)

    Coughlan, N. J.A.; Adamson, B. D.; Gamon, L.

    2015-01-01

    Retinal is one of Nature's most important and widespread chromophores, exhibiting remarkable versatility in its function and spectral response, depending on its protein environment. Reliable spectroscopic and photochemical data for the isolated retinal molecule are essential for calibrating theor...

  12. Retinal findings in membranoproliferative glomerulonephritis

    Directory of Open Access Journals (Sweden)

    Ahmad M. Mansour

    2017-09-01

    Conclusions and importance: Drusen remain the ocular stigmata for MPGN occuring at an early age. The retinal disease is progressive with gradual thickening of Bruch's membrane and occurrence of retinal pigment epithelium detachment.

  13. PI3 kinase inhibition improves vascular malformations in mouse models of hereditary haemorrhagic telangiectasia.

    Science.gov (United States)

    Ola, Roxana; Dubrac, Alexandre; Han, Jinah; Zhang, Feng; Fang, Jennifer S; Larrivée, Bruno; Lee, Monica; Urarte, Ana A; Kraehling, Jan R; Genet, Gael; Hirschi, Karen K; Sessa, William C; Canals, Francesc V; Graupera, Mariona; Yan, Minhong; Young, Lawrence H; Oh, Paul S; Eichmann, Anne

    2016-11-29

    Activin receptor-like kinase 1 (ALK1) is an endothelial serine-threonine kinase receptor for bone morphogenetic proteins (BMPs) 9 and 10. Inactivating mutations in the ALK1 gene cause hereditary haemorrhagic telangiectasia type 2 (HHT2), a disabling disease characterized by excessive angiogenesis with arteriovenous malformations (AVMs). Here we show that inducible, endothelial-specific homozygous Alk1 inactivation and BMP9/10 ligand blockade both lead to AVM formation in postnatal retinal vessels and internal organs including the gastrointestinal (GI) tract in mice. VEGF and PI3K/AKT signalling are increased on Alk1 deletion and BMP9/10 ligand blockade. Genetic deletion of the signal-transducing Vegfr2 receptor prevents excessive angiogenesis but does not fully revert AVM formation. In contrast, pharmacological PI3K inhibition efficiently prevents AVM formation and reverts established AVMs. Thus, Alk1 deletion leads to increased endothelial PI3K pathway activation that may be a novel target for the treatment of vascular lesions in HHT2.

  14. Intra-arterial nimodipine for cerebral vasospasm after subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Bashir, Asma; Andresen, Morten; Bartek, Jiri

    2016-01-01

    Intra-arterial nimodipine (IAN) has shown a promising effect on cerebral vasospasm (CV) after aneurysmal subarachnoid haemorrhage. At our institution, Rigshospitalet, IAN treatment has been used since 2009, but the short- and long-term clinical efficacy of IAN has not yet been assessed. The purpo...

  15. Review of Primary Postpartum Haemorrhage in Sagamu, Nigeria ...

    African Journals Online (AJOL)

    Out of these deliveries, 76 had primary postpartum haemorrhage (PPH), giving a prevalence of 3.1%. Uterine atony and genital tract trauma were the main causes of the primary PPH. Associated factors were prolonged second and third stages of labour, induction and augmentation of labour with oxytocin and instrumental ...

  16. New trends in the management of postpartum haemorrhage | Dyer ...

    African Journals Online (AJOL)

    New trends in the management of postpartum haemorrhage. ... Africa is poor access to basic obstetric care, blood products and basic commodities, such as electricity, for the refrigeration of blood and drugs such as oxytocin.1 Nevertheless, there are many areas where management, and hence outcomes, could be improved.

  17. Expression of VP60 gene from rabbit haemorrhagic disease virus ...

    African Journals Online (AJOL)

    The VP60 gene from rabbit haemorrhagic disease virus (RHDV) YL strain in Northeast of China, under control of the ats1A promoter from Rubisco small subunit genes of Arabidopsis thaliana, was introduced into the transfer deoxyribonucleic acid (T-DNA) region of plant transfer vector pCAMBIA1300 and transferred to ...

  18. Haemorrhagic Vaginal Discharge Following Ovariectomy in a Three ...

    African Journals Online (AJOL)

    Haemorrhagic Vaginal Discharge Following Ovariectomy in a Three Year Old Domestic Short-haired Cat. RA Ajadi, OO Adebayo, TA Ajadi. Abstract. Nigerian Veterinary Journal, VOL:33 (1) 403-406. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  19. Risk of transmission of viral haemorrhagic fevers and the insecticide ...

    African Journals Online (AJOL)

    ... of transmission of viral haemorrhagic fevers and the insecticide susceptibility status of Ae. aegypti in some sites in Accra, Ghana. Design: Larval surveys were carried to inspect containers within households and estimate larval indices and adult Aedes mosquitoes were collected using human landing collection technique.

  20. Prenatal MR imaging features of isolated cerebellar haemorrhagic lesions

    International Nuclear Information System (INIS)

    Martino, Francesca; Malova, Mariya; Ramenghi, Luca A.; Cesaretti, Claudia; Parazzini, Cecilia; Doneda, Chiara; Righini, Andrea; Rossi, Andrea

    2016-01-01

    Prenatal features of isolated cerebellar haemorrhagic lesions have not been sufficiently characterised. We aimed to better define their MR imaging characteristics, documenting the location, extension, evolution stage and anatomic sequelae, and to better understand cerebellar haemorrhage pathophysiology. We screened our foetal MR imaging database (3200 cases) for reports of haemorrhagic lesions affecting only the cerebellum (without any supratentorial bleeding or other clastic lesions), defined as one of the following: T2-weighted hypointense or mixed hypo-/hyperintense signal; rim of T2-weighted hypointense signal covering the surface of volume-reduced parenchyma; T1-weighted hyperintense signal; increased DWI signal. Seventeen cases corresponded to the selection criteria. All lesions occurred before the 26th week of gestation, with prevalent origin from the peripheral-caudal portion of the hemispheres and equal frequency of unilateral/bilateral involvement. The caudal vermis appeared affected in 2/3 of cases, not in all cases confirmed postnatally. Lesions evolved towards malformed cerebellar foliation. The aetiology and pathophysiology were unknown, although in a subset of cases intra- and extracranial venous engorgement seemed to play a key role. Onset from the peripheral and caudal portion of the hemispheres seems characteristic of prenatal cerebellar haemorrhagic lesions. Elective involvement of the peripheral germinal matrix is hypothesised. (orig.)

  1. Relationship between lunar cycle and haemorrhagic complication rate in surgery.

    Science.gov (United States)

    Raposio, Edoardo; Caruana, Giorgia; Santi, Pierluigi; Cafiero, Ferdinando

    2017-08-01

    The aim of this study was to evaluate a possible relationship between lunar cycles and haemorrhagic complication rate in surgery. The possible relationship between moon phases and surgical outcome was tested by evaluating the haemorrhagic complication rate for 18,760 patients who underwent surgery between January 2001 and December 2008 at the National Institute for Cancer Research in Genoa. A total of 103 lunar phases were considered using Chi-square (χ 2 ) test analysis, and patients were allocated a surgery date. One hundred and sixty-seven haemorrhagic complications were observed. Three hundred and nine new moon phase days were analysed and 12 incidences of complications detected, with a 3.9% complication rate per day. In the waxing moon phase, 1184.5 d were analysed with 68 incidences of complications at a daily rate of 5.7%. In the full moon phase there was a 4.9% complication rate per day (15 incidences in 309 d), whereas in the waning moon phase, the 6% percentage rate per day resulted from 72 incidences in 1184.5 d. No statistically significant correlations were found between moon cycles and postoperative haemorrhagic complications (p = .50).

  2. Periventricular-intraventricular haemorrhage in low-birth-weight ...

    African Journals Online (AJOL)

    The prevalence of periventricular-intraventricular haemorrhage (PV-IVH) aInong very-low-birthweight infants at Baragwanath Hospital has not been well docwnented. In this prospective study, a total of 282 live-born infants with birth weights of 1 000 - 1 749 g were studied over a 41/2-month period. Every infant had at least ...

  3. Tranexamic acid for control of haemorrhage in acute promyelocytic leukaemia

    NARCIS (Netherlands)

    Avvisati, G.; ten Cate, J. W.; Büller, H. R.; Mandelli, F.

    1989-01-01

    In a double-blind study, 12 consecutive patients with acute promyelocytic leukaemia were randomised either to tranexamic acid (TA group) or to placebo (control group) for 6 days to see whether inhibition of fibrinolysis would reduce haemorrhage and transfusion requirements. The total study period

  4. Considerable delay in diagnosis and acute management of subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Larsen, Carl Christian; Eskesen, Vagn; Hauerberg, John

    2010-01-01

    Rebleeding from subarachnoid haemorrhage (SAH) usually occurs within the first six hours after the initial bleeding. Rebleeding can be prevented effectively with tranexamic acid (TXA). Although a broad consensus has evolved that SAH should be treated as an emergency, it is likely that delays do...

  5. CT and MRI of haemorrhage into intracranial neuromas

    Energy Technology Data Exchange (ETDEWEB)

    Asari, S. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan)); Katayama, S. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan)); Itoh, T. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan)); Tsuchida, S. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan)); Ohmoto, T. (Dept. of Neurological Surgery, Okayama Univ. Medical School, Okayama City (Japan))

    1993-04-01

    Six patients with haemorrhage into intracranial neuromas were studied by computed tomography (CT) and magnetic resonance imaging (MRI) at 0.5 T with spin-echo pulse sequences. The nature of the tumour and the presence of a haematoma were confirmed by surgery and microscopic examination in all cases. Four neuromas arose from the acoustic nerves and two from the trigeminal. Four of the six patients suffered from sudden onset or rapid worsening of symptoms including headache, vertigo and/or hemifacial motor and sensory disturbances. CT in the acute stage revealed a hyperdense area or a fluid-fluid level (FFL). The hyperdense area disappeared on CT repeated in the chronic stage. On MRI in subacute and chronic stages the haemorrhage showed hyperintensity on both T1 and T2 weighting in five cases examined between 16 and 46 days after the onset, and isointensity on T1 weighting and an FFL on T2 weighting in one case examined 12 days after the onset of symptoms. A well-defined low intensity rim indicating prior haemorrhage was observed on T2-weighted images in three cases. MRI was more effectie than CT in detecting haemorrhage into the tumours and in staging it. (orig.)

  6. Marburg haemorrhagic fever: A rare but fatal disease

    African Journals Online (AJOL)

    The causative virus is the Marburgvirus of the Filoviridae family. The disease is clinically indistinguishable from Ebola haemorrhagic fever though the latter's causative agent is unrelated. Transmission of the Marburgvirus is via close contact with blood or other body fluids (faeces, vomitus, urine and respiratory secretions) ...

  7. Uterine artery embolization: an effective treatment for intractable obstetric haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Hong, T.-M.; Tseng, H.-S. E-mail: hstseng@vghtpe.gov.tw; Lee, R.-C.; Wang, J.-H.; Chang, C.-Y

    2004-01-01

    AIM: To present the findings of uterine artery embolization (UAE) in the management of obstetric haemorrhage. MATERIALS AND METHODS: From October 1999 to February 2003, 10 women with postpartum haemorrhage (n=7) and post-abortion haemorrhage with placenta accreta (n=3), were referred to our department for pelvic angiography and possible arterial embolization. RESULTS: Angiography revealed engorged and tortuous uterine arteries in all patients; and contrast medium extravasation in three patients. Eight patients (three with and five without detectable active bleeding) then underwent bilateral UAE. Medium-sized (250-355 {mu}m) polyvinyl alcohol particles were injected via a coaxial catheter into the uterine arteries, followed by gelatin sponge pieces via a 4 F Cobra catheter. Microcoil devascularization was also performed in the two patients with visible, active bleeding. The vaginal bleeding resolved in all patients, without any ischaemic complications. At follow-up, all patients who underwent UAE had normal menstruation; three of them subsequently gave birth to full-term healthy babies. CONCLUSION: Selective UAE by the coaxial method is safe and effective to control obstetric haemorrhage, with the potential to preserve fertility.

  8. Prospective study of sentinel headache in aneurysmal subarachnoid haemorrhage.

    NARCIS (Netherlands)

    Linn, F.H.H.; Wijdicks, E.F.M.; Graaf, Y. van der; Weerdesteyn-van Vliet, F.A.C.; Bartelds, A.I.M.; Gijn, J. van

    1994-01-01

    Retrospective surveys of patients with subarachnoid haemorrhage suggest that minor episodes with sudden headache (warning leaks) may precede rupture of an aneurysm, and that early recognition and surgery might lead to improved outcome. We studied 148 patients with sudden and severe headache

  9. Post-tonsillectomy haemorrhage following traditional uvulectomy in ...

    African Journals Online (AJOL)

    routinely performed in children due to the traditional belief that an elongated uvula is responsible for all throat problems, including suffocation during sleep in the neonatal period. Occasionally, it is done during ethnic identification ritual practices.2 The commonest complications following this procedure include haemorrhage,.

  10. Haemorrhage in the labyrinth caused by anticoagulant therapy: case report

    International Nuclear Information System (INIS)

    Callonnec, F.; Gerardin, E.; Thiebot, J.; Marie, J.P.; Andrieu Guitrancourt, J.; Marsot-Dupuch, K.

    1999-01-01

    We report a patient who experienced a severe vertiginous episode with bilateral tinnitus and progressive right-sided hearing loss. She had Marfan's disease and was on anticoagulant treatment. The fluid in the labyrinth gave higher signal than cerebrospinal fluid on T1-weighted images, suggesting haemorrhage. The radiological follow-up is discussed. (orig.)

  11. Haemorrhage in the labyrinth caused by anticoagulant therapy: case report

    Energy Technology Data Exchange (ETDEWEB)

    Callonnec, F; Gerardin, E; Thiebot, J [Department of Radiology, Rouen University Hospital, 1 rue de Germont, F-76031 Rouen cedex (France); Marie, J P; Andrieu Guitrancourt, J [Department of Otolaryngology, Rouen University Hospital (France); Marsot-Dupuch, K [Department of Radiology, St. Antoine, Paris University Hospital (France)

    1999-06-01

    We report a patient who experienced a severe vertiginous episode with bilateral tinnitus and progressive right-sided hearing loss. She had Marfan`s disease and was on anticoagulant treatment. The fluid in the labyrinth gave higher signal than cerebrospinal fluid on T1-weighted images, suggesting haemorrhage. The radiological follow-up is discussed. (orig.) With 2 figs., 11 refs.

  12. Life threatening vaginal haemorrhage from coital laceration in a post ...

    African Journals Online (AJOL)

    Case report: A 55-year-old woman who presented as an emergency with haemorrhagic shock following vaginal bleeding from consensual coitus is presented. She was resuscitated with intravenous fluids and blood transfusions. The vaginal laceration of about 5 cm on the right side of the posterior fornix was sutured ...

  13. Haemorrhagic pseudocyst of the pancreatic tail causing acute ...

    African Journals Online (AJOL)

    Haemorrhagic pseudocyst of the pancreatic tail causing acute abdominal pain in a 12-year-old girl. Rolf P. Dahmen a,c. , Gerhard Stuhldreier b. , Hartmut Bindewald c and Malte Weinrich a,c. Pancreatic disorders are a relatively uncommon event in children, particularly the development of pancreatic pseudocysts. The most ...

  14. Hypopituitarism after subarachnoid haemorrhage, do we know enough?

    NARCIS (Netherlands)

    L. Khajeh (Ladbon); K. Blijdorp (Karin); S.J.C.M.M. Neggers (Bas); G.M. Ribbers (Gerard); D.W.J. Dippel (Diederik); F. van Kooten (Fop)

    2014-01-01

    textabstractBackground: Fatigue, slowness, apathy and decrease in level of activity are common long-term complaints after a subarachnoid haemorrhage (SAH). They resemble the symptoms frequently found in patients with endocrine dysfunction. Pituitary dysfunction may be the result of SAH or its

  15. Bioelectronic retinal prosthesis

    Science.gov (United States)

    Weiland, James D.

    2016-05-01

    Retinal prosthesis have been translated to clinical use over the past two decades. Currently, two devices have regulatory approval for the treatment of retinitis pigmentosa and one device is in clinical trials for treatment of age-related macular degeneration. These devices provide partial sight restoration and patients use this improved vision in their everyday lives to navigate and to detect large objects. However, significant vision restoration will require both better technology and improved understanding of the interaction between electrical stimulation and the retina. In particular, current retinal prostheses do not provide peripheral visions due to technical and surgical limitations, thus limiting the effectiveness of the treatment. This paper reviews recent results from human implant patients and presents technical approaches for peripheral vision.

  16. Probabilistic retinal vessel segmentation

    Science.gov (United States)

    Wu, Chang-Hua; Agam, Gady

    2007-03-01

    Optic fundus assessment is widely used for diagnosing vascular and non-vascular pathology. Inspection of the retinal vasculature may reveal hypertension, diabetes, arteriosclerosis, cardiovascular disease and stroke. Due to various imaging conditions retinal images may be degraded. Consequently, the enhancement of such images and vessels in them is an important task with direct clinical applications. We propose a novel technique for vessel enhancement in retinal images that is capable of enhancing vessel junctions in addition to linear vessel segments. This is an extension of vessel filters we have previously developed for vessel enhancement in thoracic CT scans. The proposed approach is based on probabilistic models which can discern vessels and junctions. Evaluation shows the proposed filter is better than several known techniques and is comparable to the state of the art when evaluated on a standard dataset. A ridge-based vessel tracking process is applied on the enhanced image to demonstrate the effectiveness of the enhancement filter.

  17. Comparison of serum lipid profile in ischaemic and haemorrhagic stroke

    International Nuclear Information System (INIS)

    Mehmood, A.; Sharif, M.A.

    2010-01-01

    To compare serum lipid profile between patients of ischaemic and haemorrhagic strokes. Study Design: Cross sectional, comparative study. Place and Duration of Study: Military Hospital, Rawalpindi, from August 2004 to February 2005. Methodology: Patients with diagnosis of stroke comprising 100 consecutive patients each of ischaemic and haemorrhagic strokes were included in the study while patients on lipid lowering therapy were excluded from study. To determine the subtype of stroke, clinical examination followed by CT scan of brain was done. A serum sample after 8 hours of overnight fasting was taken on the next day of admission for both groups of patients. Total serum cholesterol, triglycerides, LDL cholesterol, VLDL-cholesterol and HDL-cholesterol was determined, using enzymatic colorimetric method. Statistical analysis was done by comparison of lipid profile in two subgroups, using proportion test for any significant difference. Results: The mean age at presentation of patients with stroke was 64.2+-12 years with a male to female ratio of 3.6:1. In 100 ischaemic stroke patients, raised serum total cholesterol was seen in 42, triglyceride in 04, LDL-cholesterol in 05 and VLDL-cholesterol in 07 patients. Serum HDL-cholesterol was below the normal reference in 31 cases. On the other hand, serum total cholesterol and triglycerides was raised in 05 patients each, LDL-cholesterol in 09 and VLDL-cholesterol in 03 patients of haemorrhagic stroke. Serum HDL-cholesterol was below normal in 04 patients of haemorrhagic stroke. On comparison, there were significantly greater number of patients with raised serum cholesterol and low HDL-cholesterol in ischaemic stroke than haemorrhagic stroke (p < 0.05). No statistical significance was found on comparing serum values of ischaemic and haemorrhagic stroke for triglycerides, LDL-cholesterol and VLDL-cholesterol. Conclusion: Ischaemic stroke patients had high serum total cholesterol and lower HDL-cholesterol levels as compared to

  18. Sector retinitis pigmentosa.

    Science.gov (United States)

    Van Woerkom, Craig; Ferrucci, Steven

    2005-05-01

    Retinitis pigmentosa (RP) is one of the most common hereditary retinal dystrophies and causes of visual impairment affecting all age groups. The reported incidence varies, but is considered to be between 1 in 3,000 to 1 in 7,000. Sector retinitis pigmentosa is an atypical form of RP that is characterized by regionalized areas of bone spicule pigmentation, usually in the inferior quadrants of the retina. A 57-year-old Hispanic man with a history of previously diagnosed retinitis pigmentosa came to the clinic with a longstanding symptom of decreased vision at night. Bone spicule pigmentation was found in the nasal and inferior quadrants in each eye. He demonstrated superior and temporal visual-field loss corresponding to the areas of the affected retina. Clinical measurements of visual-field loss, best-corrected visual acuity, and ophthalmoscopic appearance have remained stable during the five years the patient has been followed. Sector retinitis pigmentosa is an atypical form of RP that is characterized by bilateral pigmentary retinopathy, usually isolated to the inferior quadrants. The remainder of the retina appears clinically normal, although studies have found functional abnormalities in these areas as well. Sector RP is generally considered a stationary to slowly progressive disease, with subnormal electro-retinogram findings and visual-field defects corresponding to the involved retinal sectors. Management of RP is very difficult because there are no proven methods of treatment. Studies have shown 15,000 IU of vitamin A palmitate per day may slow the progression, though this result is controversial. Low vision rehabilitation, long wavelength pass filters, and pedigree counseling remain the mainstay of management.

  19. Hyperhomocysteinemia in chronic alcoholism: A case with retinal manifestations.

    Science.gov (United States)

    Palmero-Fernández, L; Fernández-Treguerres, F; Santos-Bueso, E; Sáenz-Francés, F; Martínez-de-la-Casa, J M; García-Feijóo, J; García-Sánchez, J

    2014-08-01

    An alcoholic patient with loss of vision in his right eye and a peripapillar haemorrhage, who then presented with a venous thrombosis. Blood analysis revealed hyperhomocysteinemia with coagulation parameters within the normal range. In the follow-up he developed a bilateral optic neuropathy. An increase in homocysteine levels is common in alcoholics, and it has been considered a vascular risk factor. Folic acid and vitamins B6 and B12 deficiency may lead to hyperhomocysteinemia, as they participate in its metabolism. When presented with a retinal occlusive disease or ischemic optic neuropathy in young patients, coagulation disorders and elevated levels of homocysteine should be ruled out. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  20. Case Report of Optic Disc Drusen with Simultaneous Peripapillary Subretinal Hemorrhage and Central Retinal Vein Occlusion

    Directory of Open Access Journals (Sweden)

    David Zhiwei Law

    2014-01-01

    Full Text Available A 52-year-old Chinese gentleman presented with right eye floaters and photopsia over one week. His visual acuities were 20/20 bilaterally. Posterior segment examination showed a right eye swollen optic disc and central retinal vein occlusion (CRVO associated with an area of subretinal hemorrhage adjacent to the optic disc. Fundus fluorescein (FA and indocyanine green angiographies (ICGA of the right eye did not demonstrate choroidal neovascularization (CNV, polypoidal choroidal vasculopathy (PCV, or retinal ischemia. Ultrasound B-scan revealed optic disc drusen (ODD. In view of good vision and absence of CNV, he was managed conservatively with spontaneous resolution after two months. Commonly, ODD may directly compress and mechanically rupture subretinal vessels at the optic disc, resulting in peripapillary subretinal hemorrhage, as was likely the case in our patient. Mechanical impairment of peripapillary circulation also results in retinal ischemia and may trigger the development of choroidal neovascularization (CNV and/or polypoidal choroidal vasculopathy (PCV, leading to subretinal haemorrhage. Compromise in central venous outflow with increased retinal central venous pressure from the direct mechanical effects of enlarging ODD results in central retinal vein occlusion (CRVO. Patients with subretinal hemorrhage and CRVO from ODD should be monitored closely for the development of potentially sight-threatening complications.

  1. Antifibrinolytic drugs for treating primary postpartum haemorrhage.

    Science.gov (United States)

    Shakur, Haleema; Beaumont, Danielle; Pavord, Sue; Gayet-Ageron, Angele; Ker, Katharine; Mousa, Hatem A

    2018-02-20

    Postpartum haemorrhage (PPH) - heaving bleeding within the first 24 hours after giving birth - is one of the main causes of death of women after childbirth. Antifibrinolytics, primarily tranexamic acid (TXA), have been shown to reduce bleeding in surgery and safely reduces mortality in trauma patients with bleeding without increasing the risk of adverse events.An earlier Cochrane review on treatments for primary PPH covered all the various available treatments - that review has now been split by types of treatment. This new review concentrates only on the use of antifibrinolytic drugs for treating primary PPH. To determine the effectiveness and safety of antifibrinolytic drugs for treating primary PPH. We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (28 May 2017) and reference lists of retrieved studies. Randomised controlled trials (RCTs), including cluster-randomised trials of antifibrinolytic drugs (aprotinin, TXA, epsilon-aminocaproic acid (EACA) and aminomethylbenzoic acid, administered by whatever route) for primary PPH in women.Participants in the trials were women after birth following a pregnancy of at least 24 weeks' gestation with a diagnosis of PPH, regardless of mode of birth (vaginal or caesarean section) or other aspects of third stage management.We have not included quasi-randomised trials, or cross-over studies. Studies reported as abstracts have not been included if there was insufficient information to allow assessment of risk of bias.In this review we only identified studies looking at TXA. Two review authors independently extracted data from each study using an agreed form. We entered data into Review Manager software and checked for accuracy.For key review outcomes, we rated the quality of the evidence as 'high', 'moderate', 'low' or 'very low' according to the GRADE approach. Three trials (20,412 women) met our inclusion criteria. Two trials

  2. Uterine massage for preventing postpartum haemorrhage.

    Science.gov (United States)

    Hofmeyr, G Justus; Abdel-Aleem, Hany; Abdel-Aleem, Mahmoud A

    2013-07-01

    Postpartum haemorrhage (PPH) (bleeding from the genital tract after childbirth) is a major cause of maternal mortality and disability, particularly in under-resourced areas. In these settings, uterotonics are often not accessible. There is a need for simple, inexpensive techniques which can be applied in low-resourced settings to prevent and treat PPH. Uterine massage is recommended as part of the routine active management of the third stage of labour. However, it is not known whether it is effective. If shown to be effective, uterine massage would represent a simple intervention with the potential to have a major effect on PPH and maternal mortality in under-resourced settings. To determine the effectiveness of uterine massage after birth and before or after delivery of the placenta, or both, to reduce postpartum blood loss and associated morbidity and mortality. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 April 2013). All published, unpublished and ongoing randomised controlled trials comparing uterine massage alone or in addition to uterotonics before or after delivery of the placenta, or both, with non-massage. Two researchers independently considered trials for eligibility, assessed risk of bias and extracted the data using the agreed form. Data were checked for accuracy. The effect of uterine massage commenced before or after placental delivery were first assessed separately, and then the combined for an overall result. This review included two randomised controlled trials. The first trial included 200 women who were randomised to receive uterine massage or no massage following delivery of the placenta, after active management of the third stage of labour including use of oxytocin. The numbers of women with blood loss more than 500 mL was small, with no statistically significant difference (risk ratio (RR) 0.52, 95% confidence interval (CI) 0.16 to 1.67). There were no cases of retained placenta in either group. The mean

  3. Nanomaterials and Retinal Toxicity

    Science.gov (United States)

    The neuroretina should be considered as a potential site of nanomaterial toxicity. Engineered nanomaterials may reach the retina through three potential routes of exposure including; intra­ vitreal injection of therapeutics; blood-borne delivery in the retinal vasculature an...

  4. System requirements for a computerised patient record information system at a busy primary health care clinic

    Directory of Open Access Journals (Sweden)

    PJ Blignaut

    2001-09-01

    Full Text Available A prototyping approach was used to determine the essential system requirements of a computerised patient record information system for a typical township primary health care clinic. A pilot clinic was identified and the existing manual system and business processes in this clinic was studied intensively before the first prototype was implemented. Interviews with users, incidental observations and analysis of actual data entered were used as primary techniques to refine the prototype system iteratively until a system with an acceptable data set and adequate functionalities were in place. Several non-functional and user-related requirements were also discovered during the prototyping period.

  5. Cauda equina syndrome complicating ankylosing spondylitis: use of electromyography and computerised tomography in diagnosis.

    Science.gov (United States)

    Young, A; Dixon, A; Getty, J; Renton, P; Vacher, H

    1981-06-01

    A case of the cauda equina syndrome complicating ankylosing spondylitis (AS) is described. An unusual feature of this case was the relapsing and remitting nature of the condition, but there is sufficient evidence to explain the clinical picture on the basis of a recurrent intraspinal inflammatory process. The clinical and radiological features are similar to those of a further 28 reported in the literature. An electromyogram (EMG) proved important in defining the extent of neurological involvement. Computerised tomography (CT) showed marked laminar erosion and no bony exit foramen encroachment. We believe that the clinical diagnosis of this condition can be adequately confirmed with plain radiology, EMG, and CT scan.

  6. Peripapillary retinal thermal coagulation following electrical injury

    Directory of Open Access Journals (Sweden)

    Manjari Tandon

    2013-01-01

    Full Text Available In this study, we have presented the case report of a 20 year old boy who suffered an electric injury shock, following which he showed peripapillary retinal opacification and increased retinal thickening that subsequently progressed to retinal atrophy. The fluorescein angiogram revealed normal retinal circulation, thus indicating thermal damage to retina without any compromise to retinal circulation.

  7. The integration of computerised accounting in the accounting curriculum as an educational learning curve for students entering the business world

    Directory of Open Access Journals (Sweden)

    Elmarie Papageorgiou

    2014-06-01

    Full Text Available At universities, educating students on real-life practices is one of the key drivers in a changing academic environment. Academic institutions encourage the study of the learning environment and ensure that appropriate strategies are in place for educating students. A first-year Accounting I student stated the importance of computerised accounting: ‘Computerised accounting is used in the workplace and therefore using it in varsity, grants students a view on how things will be after completion of their respective degrees.’ Accordingly, the purpose of this study was to empirically investigate the perceived acquisition of information technology (IT knowledge and determine the skills required for students to convert the knowledge gained into actions as a learning curve for accounting students entering the business world. The results indicated that students’ knowledge of Accounting I increased with the integration of computerised Accounting in the Accounting I Curriculum.

  8. BIlateral juxtapapillary retinal capillary haemangioma: Usefulness of aflibercept in the management of its complications.

    Science.gov (United States)

    Campos Polo, R; Rubio Sánchez, C; García Guisado, D M; Díaz Luque, M J

    2017-10-01

    A 45 year-old man with a history of adrenal phaeochromocytoma presented with a subretinal juxtapapillary haemorrhage on his left eye and a small asymptomatic vascular tumour in the contralateral eye. With the mentioned findings, the patient was diagnosed with bilateral retinal capillary haemangioma in the context of a von Hippel Lindau disease. Intravitreal aflibercept was prescribed, with a good outcome of the disease. Many treatments have been proposed for the management of juxtapapillary retinal capillary haemangioma with variable results. Intravitreal aflibercept can be a useful treatment with a good safety profile. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Characterizing amide proton transfer imaging in haemorrhage brain lesions using 3T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Ha-Kyu [Philips Korea, Seoul (Korea, Republic of); Korea Basic Science Institute, Chungcheongbuk-do (Korea, Republic of); Han, Kyunghwa [Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, Seodaemun-gu, Seoul (Korea, Republic of); Yonsei University College of Medicine, Yonsei Biomedical Research Institute, Seoul (Korea, Republic of); Zhou, Jinyuan [Johns Hopkins University School of Medicine, Division of MRI Research, Department of Radiology, Baltimore, MD (United States); Zhao, Yansong [Philips Healthcare, MR Clinical Science, Cleveland, OH (United States); Choi, Yoon Seong; Lee, Seung-Koo; Ahn, Sung Soo [Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, Seodaemun-gu, Seoul (Korea, Republic of)

    2017-04-15

    The aim of this study was to characterize amide proton transfer (APT)-weighted signals in acute and subacute haemorrhage brain lesions of various underlying aetiologies. Twenty-three patients with symptomatic haemorrhage brain lesions including tumorous (n = 16) and non-tumorous lesions (n = 7) were evaluated. APT imaging was performed and analyzed with magnetization transfer ratio asymmetry (MTR{sub asym}). Regions of interest were defined as the enhancing portion (when present), acute or subacute haemorrhage, and normal-appearing white matter based on anatomical MRI. MTR{sub asym} values were compared among groups and components using a linear mixed model. MTR{sub asym} values were 3.68 % in acute haemorrhage, 1.6 % in subacute haemorrhage, 2.65 % in the enhancing portion, and 0.38 % in normal white matter. According to the linear mixed model, the distribution of MTR{sub asym} values among components was not significantly different between tumour and non-tumour groups. MTR{sub asym} in acute haemorrhage was significantly higher than those in the other regions regardless of underlying pathology. Acute haemorrhages showed high MTR{sub asym} regardless of the underlying pathology, whereas subacute haemorrhages showed lower MTR{sub asym} than acute haemorrhages. These results can aid in the interpretation of APT imaging in haemorrhage brain lesions. (orig.)

  10. Peripheral retinal degenerations and the risk of retinal detachment.

    Science.gov (United States)

    Lewis, Hilel

    2003-07-01

    To review the degenerative diseases of the peripheral retina in relationship with the risk to develop a rhegmatogenous retinal detachment and to present recommendations for use in eyes at increased risk of developing a retinal detachment. Focused literature review and author's clinical experience. Retinal degenerations are common lesions involving the peripheral retina, and most of them are clinically insignificant. Lattice degeneration, degenerative retinoschisis, cystic retinal tufts, and, rarely, zonular traction tufts, can result in a rhegmatogenous retinal detachment. Therefore, these lesions have been considered for prophylactic therapy; however, adequate studies have not been performed to date. Well-designed, prospective, randomized clinical studies are necessary to determine the benefit-risk ratio of prophylactic treatment. In the meantime, the evidence available suggests that most of the peripheral retinal degenerations should not be treated except in rare, high-risk situations.

  11. FETOMATERNAL HAEMORRHAGE – DIFFERENTIAL DIAGNOSIS – CASE REPORT

    Directory of Open Access Journals (Sweden)

    Jadranka Domazet-Fink

    2002-07-01

    Full Text Available Background. There are several different causes for fetomaternal haemorrhage. Sinusoidal pattern, which is relatively characteristic for fetal anaemia, may in its final stages completely disappear. Differential diagnosis of silent trace of cardiotocogram with late decelerations is quite difficult to solve.Case report. A case of unusual injury of a pregnant woman is described. The injury led to fetomaternal haemorrhage. Typical sinusoidal pattern cardiotocogram was not seen and the differential diagnosis was hard to determine. Because of prompt intervention and efficient postnatal therapy the child and mother are both well. The dilemmas in regards to differential diagnosis are being discussed.Conclusions. It is important to be very careful in history taking even if the situation is urgent. If there is no explanation for pathological cardiotocogram, decision must be made according to pregnant woman’s wishes. Kleihauer-Betke test, which is easy to perform and gives much information, is described.

  12. Clinical presentation of late haemorrhagic disease of newborn

    International Nuclear Information System (INIS)

    Majeed, R.; Memon, Y.; Majeed, F.

    2008-01-01

    To observe the clinical presentation of late haemorrhagic disease of the newborn (LHDNB), and clinical improvement after the administration of vitamin K/sub 1/. This is a prospective descriptive study. All the children older than seven days who presented with bleeding were admitted in pediatrics ward of Isra University Hyderabad from April 2006 to April 2007 were included. Data collection was done by means of detailed proforma. Analysis was done on SPSS version 11. Thirty five cases were included. Commonest site of bleeding was subcutaneous followed by oral and injection site. Mean age of late haemorrhagic disease of newborn was 109 days and minimum age of presentation was 28 days. Common clinical presentations were irritability, convulsions, poor reflexes and poor feeding. Mostly recovery was within 24 hours after vit K. Late HDN results in severe hemorrhage especially hemorrhage in the central nervous system. Administration of Vitamin K (1mg, 1M) at birth can present these severe complications. (author)

  13. Therapeutic management of Crimean-Congo haemorrhagic fever.

    Science.gov (United States)

    de la Calle-Prieto, Fernando; Martín-Quirós, Alejandro; Trigo, Elena; Mora-Rillo, Marta; Arsuaga, Marta; Díaz-Menéndez, Marta; Arribas, José Ramón

    2017-06-29

    Crimean-Congo haemorrhagic fever has been reported in more than 30 countries in Africa, Asia, the Middle East and Eastern Europe, with an increasing incidence in recent years, especially in Europe. Because no specific treatments have demonstrated efficacy, supportive treatment is essential, as well as the provision of a centre with the appropriate means to guarantee the safety of its healthcare professionals. Laboratory monitoring of thrombocytopenia, severe coagulopathy or liver failure is of critical importance. Patients with Crimean-Congo haemorrhagic fever should be admitted to High Level Isolation Units where appropriate biocontainment procedures can prevent nosocomial transmission through infected fluids or accidents with contaminated material. In case of high-risk exposures, early administration of ribavirin should be considered. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  14. The role of fibrinogen and haemostatic assessment in postpartum haemorrhage

    DEFF Research Database (Denmark)

    Wikkelsø, Anne Juul

    2015-01-01

    Pregnancy is a state of hypercoagulobility that might be an evolutionary way of protecting parturients from exsanguination following child birth. Observational studies suggest an association between a low level of fibrinogen (coagulation factor I) at the start of postpartum haemorrhage (PPH....... Paper III was based on two national Danish registries evaluating the predictability of postpartum blood transfusion. Prediction was found difficult. However, retained placental parts seemed to be the strongest predictor. Since this diagnosis is made very late and often in association with the onset...... describes the protocol for a RCT of early fibrinogen supplementation in women with severe postpartum haemorrhage. Several practical, ethical and trial management challenges need to be addressed when conducting independent clinical research involving parturients with severe bleeding, placebo...

  15. Dengue Haemorrhagic Encephalitis: Rare Case Report with Review of Literature.

    Science.gov (United States)

    Kutiyal, Aditya Singh; Malik, Chetanya; Hyanki, Gitika

    2017-07-01

    Dengue is an endemic arboviral infection prevalent especially in tropical countries including Southern and Southeast Asia. Central Nervous System (CNS) involvement in dengue infection is uncommon. Haemorrhagic encephalitis is a rare presentation in dengue. This is a case of a 58-year-old male who presented with fever, petechial rash and altered sensorium. Dengue serology IgM was reactive and MRI brain was suggestive of haemorrhagic encephalitis. Patient was managed in Intensive Care Unit (ICU) but eventually succumbed to his illness. We report this fatal outcome of a common viral infection with unusual neurological presentation to propose an association between dengue and neurotropism and the need to look at dengue infection beyond its classical features.

  16. A Q fever case mimicking crimean-congo haemorrhagic fever

    Directory of Open Access Journals (Sweden)

    O Karabay

    2011-01-01

    Full Text Available Coxiella burnetii is the bacterium that causes Q fever. Human infection is mainly transmitted from cattle, goats and sheep. The disease is usually self-limited. Pneumonia and hepatitis are the most common clinical manifestations. In this study, we present a case of Q fever from the western part of Turkey mimicking Crimean-Congo haemorrhagic fever (CCHF in terms of clinical and laboratory findings.

  17. Ligation of internal iliac arteries for control of pelvic haemorrhage.

    Directory of Open Access Journals (Sweden)

    Nandanwar Y

    1993-10-01

    Full Text Available This is a retrospective review of the internal iliac ligations (IAL done over a period of 3 years. Both gynaecological and obstetric cases were considered. A total of 46 ligations were performed. The additional treatment required was hysterectomy to control haemorrhage. Intra-and post-operative complications were noted. A comparative review of the effectiveness of IAL in different situations is done and alternative modalities of treatment are considered.

  18. Haemorrhagic enteritis seroconversion in turkey breeders: field observations

    Directory of Open Access Journals (Sweden)

    Raffaella Ceruti

    2010-01-01

    Full Text Available Seroconversion to viral haemorrhagic enteritis (HE was studied in seven flocks of turkey breeders (17.974 birds in total, after 20 weeks of the onset of egg production. They showed no clinical signs, and mortality rate was normal. However, the infection caused a drop in egg production lasting about five weeks (-2.32 eggs laid during this period, but had no effect on hatching parameters.

  19. Endovascular control of haemorrhagic urological emergencies: an observational study

    Directory of Open Access Journals (Sweden)

    Thorpe Peter

    2006-09-01

    Full Text Available Abstract Background Transarterial embolisation (TAE is an effective method in control of haemorrhage irrespective of the nature of urological emergency. As the technique and technology have evolved, it is now possible to perform highly selective embolisation. The aim of this study was to critically appraise feasibility and efficacy of therapeutic TAE in control of haemorrhagic urological emergencies using selective and non-selective embolisation. Specifically, we aimed to assess the impact of timing of embolisation on the requirement of blood transfusion and long-term morphological and functional follow-up of embolised organs. Methods This is a single institutional observational study carried out between March 1992 and March 2006. Records of all patients who underwent selective and non-selective angioembolisation to control bleeding in urological emergencies were reviewed. Data on success rate, periprocedural complications, timing of embolisation, requirement of blood transfusion and the long-term morphological and functional outcomes of embolised organs was recorded. Results Fourteen patients underwent endovascular control of bleeding as a result of trauma, iatrogenic injury and spontaneous perinephric haemorrhage during a period of 14 years. All these patients would have required emergency open surgery without the option of embolisation procedure. The mean time between the first presentation and embolisation was 22 hours (range 30 minutes to 60 hours. Mean pre-embolisation transfusion requirement was 6.8 units (range 0–22 units. None of the patients with successful embolisation required post-procedural blood transfusion. Permanent haemostasis was achieved in all but one patient, who required emergency nephrectomy. There were no serious procedure related post-embolisation complications. Conclusion Endovascular control using transarterial angioembolisation is an effective method for managing haematuria or haemorrhage in urological emergencies

  20. Surgical Trial in Lobar Intracerebral Haemorrhage (STICH II Protocol

    Directory of Open Access Journals (Sweden)

    Rowan Elise N

    2011-05-01

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

  1. Acute haemorrhagic oedema of infancy with bullae and koebnerisation

    OpenAIRE

    Mohd Sazlly Lim, S; Shamsudin, N

    2014-01-01

    A 5-month-old Malay boy presented with purpuric papules and plaques on the face and extremities accompanied by fever, coryzal symptoms and bilateral lower limb oedema. There were also bullous linear purpuric lesions on the right upper limb. Blood and culture tests were normal. Histopathological tests showed leucocytoclastic vasculitis, confirming the diagnosis of acute haemorrhagic oedema of infancy. The patient achieved complete recovery after 2 weeks with no recurrence.

  2. Acute haemorrhagic oedema of infancy with bullae and koebnerisation

    Directory of Open Access Journals (Sweden)

    Norashikin Shamsudin

    2014-08-01

    Full Text Available A 5-month-old Malay boy presented with purpuric papules and plaques on the face and extremities accompanied by fever, coryzal symptoms and bilateral lower limb oedema. There were also bullous linear purpuric lesions on the right upper limb. Blood and culture tests were normal. Histopathological tests showed leucocytoclastic vasculitis, confirming the diagnosis of acute haemorrhagic oedema of infancy. The patient achieved complete recovery after 2 weeks with no recurrence.

  3. Clinical and cost-effectiveness of computerised cognitive behavioural therapy for depression in primary care: Design of a randomised trial

    Directory of Open Access Journals (Sweden)

    Severens Johan L

    2008-06-01

    Full Text Available Abstract Background Major depression is a common mental health problem in the general population, associated with a substantial impact on quality of life and societal costs. However, many depressed patients in primary care do not receive the care they need. Reason for this is that pharmacotherapy is only effective in severely depressed patients and psychological treatments in primary care are scarce and costly. A more feasible treatment in primary care might be computerised cognitive behavioural therapy. This can be a self-help computer program based on the principles of cognitive behavioural therapy. Although previous studies suggest that computerised cognitive behavioural therapy is effective, more research is necessary. Therefore, the objective of the current study is to evaluate the (cost- effectiveness of online computerised cognitive behavioural therapy for depression in primary care. Methods/Design In a randomised trial we will compare (a computerised cognitive behavioural therapy with (b treatment as usual by a GP, and (c computerised cognitive behavioural therapy in combination with usual GP care. Three hundred mild to moderately depressed patients (aged 18–65 will be recruited in the general population by means of a large-scale Internet-based screening (N = 200,000. Patients will be randomly allocated to one of the three treatment groups. Primary outcome measure of the clinical evaluation is the severity of depression. Other outcomes include psychological distress, social functioning, and dysfunctional beliefs. The economic evaluation will be performed from a societal perspective, in which all costs will be related to clinical effectiveness and health-related quality of life. All outcome assessments will take place on the Internet at baseline, two, three, six, nine, and twelve months. Costs are measured on a monthly basis. A time horizon of one year will be used without long-term extrapolation of either costs or quality of life

  4. [Carbetocin versus Oxytocin during caesarean section for preventing postpartum haemorrhage].

    Science.gov (United States)

    Pizzagalli, F; Agasse, J; Marpeau, L

    2015-05-01

    The aim of the study was to compare the effectiveness of Carbetocin versus Oxyotcin during caesarean section for preventing postpartum haemorrhage. Prospective observational study (before/after design). Five hundred and forty patients who received an injection of Oxytocin were compared to 262 patients with single injection of 100 micrograms of Carbetocin. The primary outcome was to compare the differential hematocrit level between pre- and postoperative blood samples. The secondary outcome was to compare differential hemoglobin level and the use of complementary therapies for postpartum haemorrhage. We did not find any difference between the Oxytocin and Carbetocin groups on differential hematocrit level. There was no difference between the groups regarding the use of additionnal therapies (Sulproston injections, blood transfusions and surgery methods). The rate of postpartum haemorrhage was similar in the two groups (18.7% vs 21.6%; P=0.33). We found a lower percentage of patients with differential of hemoglobin level between 2 g/dL and 4 g/dL in the Carbetocin group (6.5% vs 15.6%, Poxytocin. Carbetocin seems to reduce the need for postoperative intravenous iron injection. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  5. Post eclamptic aneurysmal rupture subarachnoid haemorrhage diagnosed in the puerperium

    International Nuclear Information System (INIS)

    Coolen, Teresa

    2006-01-01

    The incidence of subarachnoid and/or intracerebral haemorrhage in women during pregnancy is rare. The risk depends on the stage of pregnancy, but seems to be highest during the late third trimester, during delivery and in the puerperium. Headache can be a symptom of both preeclampsia, subarachnoid haemorrhage and other pathologies or conditions. It is essential for pregnant women with a suspected ruptured aneurysm to be investigated and treated without delay, irrespective of fear of harm to the foetus, to avoid complications from aneurysm rupture. This case study presents a 39-year-old woman who was 35 weeks and 3 days pregnant with known preeclampsia. She endured a headache for the three days leading up to the delivery with associated diplopia on the third day, but these symptoms were thought to be related to her preeclampsia. Over the three hours following childbirth, her headache became more severe and she suffered from vomiting, loss of vision, torticollis and seizures. Computed tomography (CT) of her head revealed a subarachnoid haemorrhage while CT angiography of the Circle of Willis failed to reveal an aneurysm and 4-vessel angiography only demonstrated an area slightly suspicious for the presence of an aneurysm. 3D rotational angiography clearly demonstrated a 1-2 mm aneurysm superior to the left terminal internal carotid artery. In this case, 3D rotational angiography proved to be a valuable additional technique. This patient underwent surgery for her ruptured aneurysm and has made an excellent recovery

  6. The SMile Card: a computerised data card for multiple sclerosis patients. SMile Card Scientific Board.

    Science.gov (United States)

    Mancardi, G L; Uccelli, M M; Sonnati, M; Comi, G; Milanese, C; De Vincentiis, A; Battaglia, M A

    2000-04-01

    The SMile Card was developed as a means for computerising clinical information for the purpose of transferability, accessibility, standardisation and compilation of a national database of demographic and clinical information about multiple sclerosis (MS) patients. In many European countries, centres for MS are organised independently from one another making collaboration, consultation and patient referral complicated. Only the more highly advanced clinical centres, generally located in large urban areas, have had the possibility to utilise technical possibilities for improving the organisation of patient clinical and research information, although independently from other centres. The information system, developed utilising the Visual Basic language for Microsoft Windows 95, stores information via a 'smart card' in a database which is initiated and updated utilising a microprocessor, located at each neurological clinic. The SMile Card, currently being tested in Italy, permits patients to carry with them all relevant medical information without limitations. Neurologists are able to access and update, via the microprocessor, the patient's entire medical history and MS-related information, including the complete neurological examination and laboratory test results. The SMile Card provides MS patients and neurologists with a complete computerised archive of clinical information which is accessible throughout the country. In addition, data from the SMile Card system can be exported to other database programs.

  7. Developing an item bank to measure the coping strategies of people with hereditary retinal diseases.

    Science.gov (United States)

    Prem Senthil, Mallika; Khadka, Jyoti; De Roach, John; Lamey, Tina; McLaren, Terri; Campbell, Isabella; Fenwick, Eva K; Lamoureux, Ecosse L; Pesudovs, Konrad

    2018-05-05

    Our understanding of the coping strategies used by people with visual impairment to manage stress related to visual loss is limited. This study aims to develop a sophisticated coping instrument in the form of an item bank implemented via Computerised adaptive testing (CAT) for hereditary retinal diseases. Items on coping were extracted from qualitative interviews with patients which were supplemented by items from a literature review. A systematic multi-stage process of item refinement was carried out followed by expert panel discussion and cognitive interviews. The final coping item bank had 30 items. Rasch analysis was used to assess the psychometric properties. A CAT simulation was carried out to estimate an average number of items required to gain precise measurement of hereditary retinal disease-related coping. One hundred eighty-nine participants answered the coping item bank (median age = 58 years). The coping scale demonstrated good precision and targeting. The standardised residual loadings for items revealed six items grouped together. Removal of the six items reduced the precision of the main coping scale and worsened the variance explained by the measure. Therefore, the six items were retained within the main scale. Our CAT simulation indicated that, on average, less than 10 items are required to gain a precise measurement of coping. This is the first study to develop a psychometrically robust coping instrument for hereditary retinal diseases. CAT simulation indicated that on an average, only four and nine items were required to gain measurement at moderate and high precision, respectively.

  8. AN ALGORITHM TO DETECT THE RETINAL REGION OF INTEREST

    Directory of Open Access Journals (Sweden)

    E. Şehirli

    2017-11-01

    Full Text Available Retina is one of the important layers of the eyes, which includes sensitive cells to colour and light and nerve fibers. Retina can be displayed by using some medical devices such as fundus camera, ophthalmoscope. Hence, some lesions like microaneurysm, haemorrhage, exudate with many diseases of the eye can be detected by looking at the images taken by devices. In computer vision and biomedical areas, studies to detect lesions of the eyes automatically have been done for a long time. In order to make automated detections, the concept of ROI may be utilized. ROI which stands for region of interest generally serves the purpose of focusing on particular targets. The main concentration of this paper is the algorithm to automatically detect retinal region of interest belonging to different retinal images on a software application. The algorithm consists of three stages such as pre-processing stage, detecting ROI on processed images and overlapping between input image and obtained ROI of the image.

  9. Retinitis pigmentosa and deafness.

    OpenAIRE

    Mills, R P; Calver, D M

    1987-01-01

    Seventeen patients with retinitis pigmentosa (RP) have been investigated audiologically. Of 9 found to have a significant hearing loss, 6 were examples of Usher's syndrome; these patients had a cochlear pattern of hearing loss. The other 3 were examples of Senior's syndrome, Kearne-Sayre syndrome and Lawrence-Moon-Biedle syndrome respectively. Two of these patients had absent stapedius reflexes. It is suggested that patients with different RP-deafness syndromes may have lesions in different p...

  10. Inherited Retinal Degenerative Disease Registry

    Science.gov (United States)

    2017-09-13

    Eye Diseases Hereditary; Retinal Disease; Achromatopsia; Bardet-Biedl Syndrome; Bassen-Kornzweig Syndrome; Batten Disease; Best Disease; Choroidal Dystrophy; Choroideremia; Cone Dystrophy; Cone-Rod Dystrophy; Congenital Stationary Night Blindness; Enhanced S-Cone Syndrome; Fundus Albipunctatus; Goldmann-Favre Syndrome; Gyrate Atrophy; Juvenile Macular Degeneration; Kearns-Sayre Syndrome; Leber Congenital Amaurosis; Refsum Syndrome; Retinitis Pigmentosa; Retinitis Punctata Albescens; Retinoschisis; Rod-Cone Dystrophy; Rod Dystrophy; Rod Monochromacy; Stargardt Disease; Usher Syndrome

  11. Outcomes in bullous retinal detachment

    Directory of Open Access Journals (Sweden)

    Sarah P. Read

    2017-06-01

    Conclusions and importance: GRTs are an uncommon cause of retinal detachment. While pars plana vitrectomy with tamponade is standard in GRT management, there is variability in the use of scleral buckling and PFO in these cases. This is in contrast to retinal dialysis where scleral buckle alone can yield favorable results. Though a baseball ocular trauma is common, retinal involvement is rare compared to other sports injuries such as those occurring with tennis, soccer and golf. Sports trauma remains an important cause of retinal injury and patients should be counseled on the need for eye protection.

  12. Retinal Thickening and Photoreceptor Loss in HIV Eyes without Retinitis.

    Directory of Open Access Journals (Sweden)

    Cheryl A Arcinue

    Full Text Available To determine the presence of structural changes in HIV retinae (i.e., photoreceptor density and retinal thickness in the macula compared with age-matched HIV-negative controls.Cohort of patients with known HIV under CART (combination Antiretroviral Therapy treatment were examined with a flood-illuminated retinal AO camera to assess the cone photoreceptor mosaic and spectral-domain optical coherence tomography (SD-OCT to assess retinal layers and retinal thickness.Twenty-four eyes of 12 patients (n = 6 HIV-positive and 6 HIV-negative were imaged with the adaptive optics camera. In each of the regions of interest studied (nasal, temporal, superior, inferior, the HIV group had significantly less mean cone photoreceptor density compared with age-matched controls (difference range, 4,308-6,872 cones/mm2. A different subset of forty eyes of 20 patients (n = 10 HIV-positive and 10 HIV-negative was included in the retinal thickness measurements and retinal layer segmentation with the SD-OCT. We observed significant thickening in HIV positive eyes in the total retinal thickness at the foveal center, and in each of the three horizontal B-scans (through the macular center, superior, and inferior to the fovea. We also noted that the inner retina (combined thickness from ILM through RNFL to GCL layer was also significantly thickened in all the different locations scanned compared with HIV-negative controls.Our present study shows that the cone photoreceptor density is significantly reduced in HIV retinae compared with age-matched controls. HIV retinae also have increased macular retinal thickness that may be caused by inner retinal edema secondary to retinovascular disease in HIV. The interaction of photoreceptors with the aging RPE, as well as possible low-grade ocular inflammation causing diffuse inner retinal edema, may be the key to the progressive vision changes in HIV-positive patients without overt retinitis.

  13. Bilateral adrenal cystic neuroblastoma with superior vena cava syndrome and massive intracystic haemorrhage

    International Nuclear Information System (INIS)

    Pinarli, Faruk Guclu; Danaci, Murat; Diren, Baris; Tander, Burak; Rizalar, Riza; Dagdemir, Ayhan; Acar, Sabri

    2004-01-01

    Bilateral cystic adrenal tumours are a rare presentation of neuroblastoma. Intratumoural haemorrhage is a frequent finding in neuroblastoma, but is rarely symptomatic. We present an 11-month-old girl with predominantly cystic bilateral neuroblastomas and distant lymph-node metastasis. Massive intracystic haemorrhage and superior vena cava (SVC) syndrome were ominous prognostic factors, leading to death. Large tumours with intracystic haemorrhage might require a conservative approach. (orig.)

  14. Super selective transcatheter angiographic embolization: an effective and prophylactic treatment for massive obstetric haemorrhage

    International Nuclear Information System (INIS)

    Zhou Yiming; Zhai Renyou; Qian Xiaojun; Wei Baojie; Gao Kun; Zhang Shilong; Liu Jinmei; Zhang Qiuhong; Jiang Lei

    2008-01-01

    Objective: To discuss the effect and safety of transcatheter angiographic embolization (TAE)for managing massive obstetric haemorrhage. Methods: 17 cases of obstetric massive haemorrhage or with haemorrhage tendency were treated with TAE. Among them 14 cases had haemorrhage already, including 10 cases after abortion, caesarean section or normal labor and other 4 of hydatidiform mole. 3 cases with obstetric haemorrhage tendency included 2 cases of placenta praevia and 1 case of cervical pregnancy. Selective catheterization into bilateral uterine arteries or internal iliac arteries for DSA, showed the cause and location of the haemorrhage and then embolized with gelfoam sponge chips (1-3 mm) or Polyvinyl Alcohol(PVA); and part of the cases with MTX through uterine arterial perfusion. Results: The successful rate of catheterization was 100%. The achievement in 14 cases showed no active haemorrhage immediately after the procedure and no vaginal bleeding after 1-5 days. In 3 prophylactic cases before abortion or uterine curettage, obstetric massive haemorrhage occurred in 1 case, but not so in other 2 cases. Conclusions: TAE is an effective treatment for obstetric massive haemorrhage, with the advantages of minimal trauma, fast and definite treating effect and less complications. Prophylactical application for high risk patients can reduce the bleeding and mortality. (authors)

  15. Effectiveness of a computerised assessment tool to prompt individuals with diabetes to be more active in consultations

    DEFF Research Database (Denmark)

    Barnard, Katharine D.; Cradock, Sue; Parkin, Tracy

    2007-01-01

    The objective of this study was to assess whether using a computerised touch screen assessment tool prior to outpatient consultation makes patients more active in the consultation. In a non-randomised control group design, immediately after consultations, which were recorded, patients and profess...

  16. Clinical effectiveness of online computerised cognitive-behavioural therapy without support for depression in primary care: randomised trial

    NARCIS (Netherlands)

    de Graaf, L.E.; Gerhards, S.A.H.; Arntz, A.; Riper, H.; Metsemakers, J.F.M.; Evers, S.M.; Severens, J.L.; Widdershoven, G.A.M.; Huibers, M.J.H.

    2009-01-01

    BACKGROUND: Computerised cognitive-behavioural therapy (CCBT) might offer a solution to the current undertreatment of depression. AIMS: To determine the clinical effectiveness of online, unsupported CCBT for depression in primary care. METHOD: Three hundred and three people with depression were

  17. Re-evaluation of Magnetic Resonance and Computerised Tomographic Imaging in Neuro-Ophthalmic Patients in an Academic Centre

    NARCIS (Netherlands)

    Koekoek, Clarence G. J.; Meiners, Linda C.; Pott, Jan Willem R.

    The aim of the study is to report the frequency of missed diagnoses on magnetic resonance and computerised tomographic imaging in neuro-ophthalmic patients who were referred to an academic ophthalmology department, with apparent normal imaging. The authors included all neuro-ophthalmic patients,

  18. Retinal astrocytoma in a dog.

    Science.gov (United States)

    Kuroki, Keiichi; Kice, Nathan; Ota-Kuroki, Juri

    2017-09-01

    A miniature schnauzer dog presenting with hyphema and glaucoma of the right eye had a retinal neoplasm. Neoplastic cells stained positively for glial fibrillary acidic protein, vimentin, and S-100 and largely negatively for oligodendrocyte transcription factor 2 by immunohistochemistry. The clinical and histopathological features of canine retinal astrocytomas are discussed.

  19. Non-syndromic retinitis pigmentosa

    NARCIS (Netherlands)

    Verbakel, S.K. (Sanne K.); R.A.C. van Huet (Ramon A. C.); C.J.F. Boon (Camiel); A.I. Hollander (Anneke); R.W.J. Collin (Rob); C.C.W. Klaver (Caroline); C. Hoyng (Carel); R. Roepman (Ronald); B.J. Klevering (Jeroen)

    2018-01-01

    textabstractRetinitis pigmentosa (RP) encompasses a group of inherited retinal dystrophies characterized by the primary degeneration of rod and cone photoreceptors. RP is a leading cause of visual disability, with a worldwide prevalence of 1:4000. Although the majority of RP cases are non-syndromic,

  20. Retinal Imaging and Image Analysis

    Science.gov (United States)

    Abràmoff, Michael D.; Garvin, Mona K.; Sonka, Milan

    2011-01-01

    Many important eye diseases as well as systemic diseases manifest themselves in the retina. While a number of other anatomical structures contribute to the process of vision, this review focuses on retinal imaging and image analysis. Following a brief overview of the most prevalent causes of blindness in the industrialized world that includes age-related macular degeneration, diabetic retinopathy, and glaucoma, the review is devoted to retinal imaging and image analysis methods and their clinical implications. Methods for 2-D fundus imaging and techniques for 3-D optical coherence tomography (OCT) imaging are reviewed. Special attention is given to quantitative techniques for analysis of fundus photographs with a focus on clinically relevant assessment of retinal vasculature, identification of retinal lesions, assessment of optic nerve head (ONH) shape, building retinal atlases, and to automated methods for population screening for retinal diseases. A separate section is devoted to 3-D analysis of OCT images, describing methods for segmentation and analysis of retinal layers, retinal vasculature, and 2-D/3-D detection of symptomatic exudate-associated derangements, as well as to OCT-based analysis of ONH morphology and shape. Throughout the paper, aspects of image acquisition, image analysis, and clinical relevance are treated together considering their mutually interlinked relationships. PMID:22275207

  1. Ethical issues related to computerised family medical histories in sickle cell disease: Inforare.

    Science.gov (United States)

    Franrenet, Sandra; Duchange, Nathalie; Galactéros, Fréderic; Quantin, Catherine; Cohen, Olivier; Nzouakou, Ruben; Sudraud, Sophie; Hervé, Christian; Moutel, Grégoire

    2010-10-01

    The Inforare project aims to set up a system for the sharing of clinical and familial data, in order to study how genes are related to the severity of sickle cell disease. While the computerisation of clinical records represents a valuable research goal, an ethical framework is necessary to guarantee patients' protection and their rights in this developing field. Issues relating to patient information during the Inforare study were analysed by the steering committee. Several major concerns were discussed by the committee and formalized in the patients' information letter: educating patients to aid the recruitment of family members, rules of confidentiality and the disclosure of aggregate, individual and unexpected research results. This paper presents the main issues addressed.

  2. Dosimetry and Image Quality in Control Studies in Computerised Tomography Realized to Paediatric Patients

    International Nuclear Information System (INIS)

    Hernandez, M. R.; Gamboa-deBuen, I.; Dies, P.; Rickards, J.; Ruiz, C.

    2008-01-01

    Computerised tomography (CT) is a favourite method of medical diagnosis. Its use has thus increased rapidly throughout the world, particularly in studies relating to children. However to avoid administering unnecessarily high doses of radiation to paediatric patients it is important to have correct dose reference levels to minimize risk. The research is being developed within the public health sector at the Hospital Infantil de Mexico ''Dr. Federico Gomez.'' We measured the entrance surface air kerma (K P ) in paediatric patients, during the radiological studies of control in CT (studies of head, thorax and abdomen). Phantom was used to evaluate image quality as the tomograph requires a high resolution image in order to operate at its optimum level

  3. Geospatial Data for Computerisation of Public Administration in the Czech Republic

    Science.gov (United States)

    Cada, V.; Mildorf, T.

    2011-08-01

    The main aim of the eGovernment programme in the Czech Republic is to enhance the efficiency of public administration. The Digital Map of Public Administration (DMVS) should be composed of digital orthophotographs of the Czech Republic, digital and digitised cadastral maps, digital purpose cadastral map (ÚKM) and a technical map of municipality, if available. The DMVS project is a part of computerisation of public administration in the Czech Republic. The project enhances the productivity of government administration and also simplifies the processes between citizens and public administration. The DMVS project, that should be compliant with the INSPIRE (Infrastructure for Spatial Information in the European Community) initiative, generates definite demand for geodata on the level of detail of land data model. The user needs that are clearly specified and required are not met due to inconsistencies in terminology, data management and level of detail.

  4. Micro-computerised tomography optimisation for the measurement of bone mineral density around titanium dental implants

    International Nuclear Information System (INIS)

    Park, C.; Swain, M.; Duncan, W.

    2010-01-01

    Titanium dental implants (screws) are commonly used to replace missing teeth by forming a biological union with bone ('osseointegration'). Micro-computerised tomography (μCT) may be useful for measuring bone mineral density around dental implants. Major issues arise because of various artefacts that occur with polychromatic X-rays associated bench type instruments that may compromise interpretation of the observations. In this study various approaches to minimise artefacts such as; beam hardening, filtering and edge effects are explored with a homogeneous polymeric material, Teflon, with and without an implant present. The implications of the limitations of using such polychromatic μCT systems to quantify bone mineral density adjacent to the implant are discussed. (author)

  5. Spectrophotometric retinal oximetry in pigs

    DEFF Research Database (Denmark)

    Traustason, Sindri; Kiilgaard, Jens Folke; Karlsson, Robert

    2013-01-01

    PURPOSE: To assess the validity of spectrophotometric retinal oximetry, by comparison to blood gas analysis and intra-vitreal measurements of partial pressure of oxygen (pO2). METHODS: Female domestic pigs were used for all experiments (n=8). Oxygen fraction in inspired air was changed using...... a mixture of room air, pure oxygen and pure nitrogen, ranging from 5% to 100% oxygen. Femoral arterial blood gas analysis and retinal oximetry was performed at each level of inspiratory oxygen fraction. Retinal oximetry was performed using a commercial instrument, the Oxymap Retinal Oximeter T1 (Oxymap ehf...... arterial oxygen saturation and the optical density ratio over retinal arteries revealed an approximately linear relationship (R(2) = 0.74, p = 3.4 x 10(-9)). In order to test the validity of applying the arterial calibration to veins, we compared non-invasive oximetry measurements to invasive pO2...

  6. New Therapeutic Possibilities of the Post-Irradiation Haemorrhagic Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Pospisil, J.; Dienstbier, Z. [Institute of Biophysics and Nuclear Medicine, Faculty of General Medicine, Charles University, Prague, Czechoslovak Socialist Republic (Czech Republic); Skala, E. [Central Military Hospital, Prague-Stresovice, Czechoslovak Socialist Republic (Czech Republic)

    1969-10-15

    Haemorrhagic diathesis is one of the dominant symptoms of acute post-irradiation lesion. Haemorrhagic syndrome is caused by the disturbance of haemocoagulation during simultaneous lesion of the vascular system. In our study we have tried to affect the post-irradiation haemocoagulation disturbance. Epsilon- amino-caproic acid (EACA) administered between the 8{sup th} and the 18{sup th} day (0.4 g/kg per day) to whole- body irradiated dogs (600 R) partially regulated the post-irradiation disturbance of haemocoagulation. The favourable effect of EACA was verified by in vitro experiments in which the blood of irradiated dogs was used. A repeated administration of EACA in the dose of 0.4 g/kg per day to whole-body irradiated rats (600 R) did not substantially affect the post-irradiation changes in the number of white blood elements; however, its administration to healthy animals caused lymphocytosis. In whole-body irradiated dogs (600 R) we have found lower levels of EACA in the blood up to the 8 day following irradiation as compared with healthy dogs after oral application of EACA. The whole-body irradiation of mice did not increase the acute toxicity of EACA. The daily administration of 0.4 g EACA/kg to whole-body irradiated mice (600 and 700 R) did not change the mortality induced by irradiation. The authors consider EACA to be a suitable compound for a complex therapy of radiation sickness. The administration of para-amino-methyl-benzoic acid (PAMBA), in spite of a certain improvement of postirradiation haemocoagulation disturbance, is less efficient. Our recent experiments with ellagic acid which significantly affects the post-traumatic haemorrhage in whole-body irradiated rats seem to be very promising. (author)

  7. Prevention of postpartum haemorrhage with the oxytocin analogue carbetocin.

    Science.gov (United States)

    Rath, Werner

    2009-11-01

    Postpartum haemorrhage is the leading cause of maternal mortality worldwide: 67-80% of cases are caused by uterine atony. Preventive measures include prophylactic drug use to aid uterine contraction after delivery, thus avoiding severe blood loss and reducing maternal morbidity and mortality. Carbetocin is a synthetic analogue of oxytocin with a half-life approximately 4-10 times longer than that reported for oxytocin. It combines the safety and tolerability profile of oxytocin with the sustained uterotonic activity of injectable ergot alkaloids. Furthermore, carbetocin can be administered as a single dose injection either intravenously or intramuscularly rather than as an infusion over several hours as is the case with oxytocin. Carbetocin is currently indicated for prevention of uterine atony after delivery by caesarean section in spinal or epidural anaesthesia. Data from three randomised controlled trials in caesarean delivery and a meta-analysis indicate that carbetocin significantly reduces the need for additional uterotonic agents or uterine massage to prevent excessive bleeding compared with placebo or oxytocin. The risk of headache, tremor, hypotension, flushing, nausea, abdominal pain, pruritus and feeling of warmth was similar in women who received carbetocin or oxytocin. The findings from two more recent double-blind randomised trials and one retrospective study suggest that carbetocin may also represent a good alternative to conventional uterotonic agents for prevention of postpartum haemorrhage after vaginal deliveries. A reduced need for additional uterotonics was observed with carbetocin vs. oxytocin in high-risk women and carbetocin was at least as effective as syntometrine in low-risk women. In these studies of vaginal deliveries, carbetocin was associated with a low incidence of adverse effects and demonstrated a better tolerability profile than syntometrine. Carbetocin had a long duration of action compared with intravenous oxytocin alone and a

  8. Management of symptomatic thrombocytopenia associated with dengue haemorrhagic fever

    International Nuclear Information System (INIS)

    Jameel, T.; Saleem, I.U.; Mehmood, K.; Tanvir, I.; Saadia, A.

    2010-01-01

    Introduction: Immune - mediated destruction of platelets is thought to be the mechanism of thrombocytopenia seen after the viraemic phase of dengue haemorrhagic fever (DHF). Immuno - suppressants such as steroids, immune globulin and Anti D immune globulin are effective in the treatment of this type of immune thrombocytopenic purpura. Objective: To evaluate the efficacy of oral Prednisolone in the rate of resolution of thrombocytopenia and monitoring of complications in patients recovering from Dengue haemorrhagic fever. Method: A controlled study was carried out on diagnosed cases Dengue haemorrhagic patients presenting with sever thrombocytopenia and symptoms like confluent ecchymosis, epistaxis and purpuric rashes. In study was conducted in Ittefaq hospital (trust) Lahore, during the period of October to December 2008. Treatment group received steroids in two forms i.e. first line therapy prednisolone (1 mg / kg) orally or as second line therapy of initial I/V high dose (prednisolone) in pulse doses i.e. 40 mg / bd for four days and later oral prednisolone as in first line therapy with omeprazole 20 mg / bd in addition to standard treatment. Control group received standard supportive care only. Results: A total of 341 suspected patients were admitted in hospital. Serological diagnosis was confirmed in 166 patients. CBC revealed platelet count . 100 x 109 / l in 106 patients. A group of symptomatic febrile patients have platelet count < 20 x 109 / l was selected for therapeutic intervention. first line therapy (oral prednisolone was stated in 43 patients. In Fourteen patients second line therapy (high dose dexamethasone pulse) therapy was instituted. Seven of them attained complete response whereas two patients achieved partial response. Four patients were shifted to Anti D therapy. Three deaths occurred during our study. Rest of all the patients improved and were discharged in due course of time. Conclusion: This small scale preliminary study shows promising

  9. Haemorrhagic acoustic neuroma with features of a vascular malformation. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Benhaiem-Sigaux, N. [Dept. of Pathology, Hopital Henri Mondor, Creteil (France); Ricolfi, F. [Dept. of Neuroradiology, Henri Mondor Hospital, Creteil (France); Torres-Diaz, A.; Keravel, Y. [Dept. of Neurosurgery, Henri Mondo Hospital, Creteil (France); Poirier, J. [Dept. of Histology, Pitie-Salpetriere Hospital, Paris (France)

    1999-10-01

    A 55-year-old man with hearing loss presented with vertigo and vomiting. CT tomography and MRI demonstrated a cerebellopontine angle mass with foci of haemorrhage. An angiomatous tumour, with large abnormal veins adhering to the capsule, was completely removed. Histologically, the tumour was an acoustic neuroma with abnormal vascularisation and limited intratumoral haemorrhage. (orig.)

  10. A composite neurobehavioral test to evaluate acute functional deficits after cerebellar haemorrhage in rats.

    Science.gov (United States)

    McBride, Devin W; Nowrangi, Derek; Kaur, Harpreet; Wu, Guangyong; Huang, Lei; Lekic, Tim; Tang, Jiping; Zhang, John H

    2018-03-01

    Cerebellar haemorrhage accounts for 5-10% of all intracerebral haemorrhages and leads to severe, long-lasting functional deficits. Currently, there is limited research on this stroke subtype, which may be due to the lack of a suitable composite neuroscoring system specific for cerebellar injury in rodents. The purpose of this study is to develop a comprehensive composite neuroscore test for cerebellar injury using a rat model of cerebellar haemorrhage. Sixty male Sprague-Dawley rats were subjected to either sham surgery or cerebellar haemorrhage. Twenty-four hours post-injury, neurological behaviour was evaluated using 17 cost-effective and easy-to-perform tests, and a composite neuroscore was developed. The composite neuroscore was then used to assess functional recovery over seven days after cerebellar haemorrhage. Differences in the composite neuroscore deficits for the mild and moderate cerebellar haemorrhage models were observed for up to five days post-ictus. Until now, a composite neuroscore for cerebellar injury was not available for rodent studies. Herein, using mild and moderate cerebellar haemorrhage rat models a composite neuroscore for cerebellar injury was developed and used to assess functional deficits after cerebellar haemorrhage. This composite neuroscore may also be useful for other cerebellar injury models.

  11. Three-dimensional reconstruction and volumetry of intracranial haemorrhage and its mass effect

    International Nuclear Information System (INIS)

    Strik, H.M.; Baehr, M.; Borchert, H.; Fels, C.; Knauth, M.; Rienhoff, O.; Verhey, J.F.

    2005-01-01

    Intracerebral haemorrhage still causes considerable disability and mortality. The studies on conservative and operative management are inconclusive, probably due to inexact volumetry of the haemorrhage. We investigated whether three-dimensional (3-D), voxel-based volumetry of the haemorrhage and its mass effect is feasible with routine computed tomography (CT) scans. The volumes of the haemorrhage, ventricles, midline shift, the intracranial volume and ventricular compression in CT scans of 12 patients with basal ganglia haemorrhage were determined with the 3-D slicer software. Indices of haemorrhage and intracranial or ventricular volume were calculated and correlated with the clinical data. The intended measures could be determined with an acceptable intra-individual variability. The 3-D volumetric data tended to correlate better with the clinical course than the conventionally assessed distance of midline shift and volume of haemorrhage. 3-D volumetry of intracranial haemorrhage and its mass effect is feasible with routine CT examination. Prospective studies should assess its value for clinical studies on intracranial space-occupying diseases. (orig.)

  12. Haemorrhagic acoustic neuroma with features of a vascular malformation. A case report

    International Nuclear Information System (INIS)

    Benhaiem-Sigaux, N.; Ricolfi, F.; Torres-Diaz, A.; Keravel, Y.; Poirier, J.

    1999-01-01

    A 55-year-old man with hearing loss presented with vertigo and vomiting. CT tomography and MRI demonstrated a cerebellopontine angle mass with foci of haemorrhage. An angiomatous tumour, with large abnormal veins adhering to the capsule, was completely removed. Histologically, the tumour was an acoustic neuroma with abnormal vascularisation and limited intratumoral haemorrhage. (orig.)

  13. Acute haemorrhagic diarrhoea syndrome in dogs: 108 cases.

    Science.gov (United States)

    Mortier, F; Strohmeyer, K; Hartmann, K; Unterer, S

    2015-06-13

    No prospective studies including large numbers of dogs with acute haemorrhagic diarrhoea syndrome (AHDS) are published so far. The aim of this case-control study was to describe signalment, history, clinical signs, laboratory values and course of disease in dogs with AHDS. Dogs (108) with idiopathic acute haemorrhagic diarrhoea (schnauzer and Maltese. The syndrome was more likely to occur during winter. Vomiting preceded the onset of bloody diarrhoea in 80 per cent of dogs and haematemesis was observed in half of those cases. Median AHDS index at presentation was 12 (range 3-17). Haematocrit was generally high (median 57.1 per cent; range 33-76 per cent), but exceeded 60 per cent only in 31.4 per cent of dogs. Haematocrit of 48.1 per cent of dogs was above reference range, as was monocyte (50.0 per cent), segmented (59.6 per cent) and band neutrophil count (45.2 per cent). A rapid clinical improvement occurred during the first 48 hours. British Veterinary Association.

  14. Genetic population structure of marine viral haemorrhagic septicaemia virus (VHSV)

    DEFF Research Database (Denmark)

    Snow, M.; Bain, N.; Black, J.

    2004-01-01

    The nucleotide sequences of a specific region of the nucleoprotein gene were compared in order to investigate the genetic population structure of marine viral haemorrhagic septicaemia virus (VHSV). Analysis of the sequence from 128 isolates of diverse geographic and host origin renders this the m......The nucleotide sequences of a specific region of the nucleoprotein gene were compared in order to investigate the genetic population structure of marine viral haemorrhagic septicaemia virus (VHSV). Analysis of the sequence from 128 isolates of diverse geographic and host origin renders...... this the most comprehensive molecular epidemiological study of marine VHSV conducted to date. Phylogenetic analysis of nucleoprotein gene sequences confirmed the existence of the 4 major genotypes previously identified based on N- and subsequent G-gene based analyses. The range of Genotype I included subgroups...... of isolates associated with rainbow trout aquaculture (Genotype la) and those from the Baltic marine environment (Genotype Ib) to emphasise the relatively close genetic relationship between these isolates. The existence of an additional genotype circulating within the Baltic Sea (Genotype II) was also...

  15. Role of canine circovirus in dogs with acute haemorrhagic diarrhoea.

    Science.gov (United States)

    Anderson, A; Hartmann, K; Leutenegger, C M; Proksch, A L; Mueller, R S; Unterer, S

    2017-06-03

    Canine circovirus (CanineCV) has been detected in some dogs with severe haemorrhagic diarrhoea, but its pathogenic role is unclear. This study evaluated a suspected association between the presence of CanineCV and acute haemorrhagic diarrhoea syndrome (AHDS) in dogs. The prevalence of CanineCV in dogs with AHDS was compared with that in healthy dogs and those infected with canine parvovirus (CPV). Additionally, time to recovery and mortality rate were compared between CanineCV-positive and CanineCV-negative dogs. Faecal samples of dogs with AHDS (n=55), healthy dogs (n=66) and dogs infected with CPV (n=54) were examined by two real-time TaqMan PCR assays targeting the replicase and capsid genes of CanineCV. CanineCV was detected in faecal samples of two dogs with AHDS, three healthy controls and seven dogs infected with CPV. Among the three groups, there was no significant difference in prevalence of CanineCV. CPV-infected animals that were coinfected with CanineCV had a significantly higher mortality rate compared with those negative for CanineCV. CanineCV does not appear to be the primary causative agent of AHDS in dogs, but might play a role as a negative co-factor in disease outcome in dogs with CPV infection. British Veterinary Association.

  16. Condom Tamponade in the Management of Primary Postpartum Haemorrhage: A Report of three cases in Ghana.

    Science.gov (United States)

    Maya, Ernest T; Buntugu, Kennedy A; Aki, Lovelace; Srofenyoh, Emmanuel K

    2015-09-01

    Postpartum haemorrhage is one of the major causes of maternal mortality worldwide. The leading cause of primary postpartum haemorrhage is uterine atony and active management of the third stage of labour with oxytocin is recommended for preventing primary postpartum haemorrhage. Parenteral oxytocin is also the drug of choice for medical management of postpartum haemorrhage secondary to uterine atony. Condom uterine balloon tamponade is .a low cost technique that can be used as a second-line option for treatment. We report retrospectively three cases of primary PPH secondary to uterine atony which were managed successfully with condom tamponade. Condom tamponade is effective in managing post partum haemorrhage secondary to uterine atony and we advocate for the training of all skilled attendants on how to insert the condom tamponade.

  17. Valved or valveless ventriculoperitoneal shunting in the treatment of post-haemorrhagic hydrocephalus

    DEFF Research Database (Denmark)

    Andreasen, Trine Hjorslev; Holst, Anders Vedel; Lilja, Alexander

    2016-01-01

    BACKGROUND: Implant infection and obstruction are major complications for ventriculoperitoneal shunts in patients with post-haemorrhagic hydrocephalus. In an effort to (1) reduce the incidence of these complications, (2) reduce the rate of shunt failure and (3) shorten the duration of neurosurgical...... hospitalisation, we have implemented valveless ventriculoperitoneal shunts at our department for adult patients with post-haemorrhagic hydrocephalus and haemorrhagic cerebrospinal fluid at the time of shunt insertion. METHODS: All adult patients (>18 years old) treated for post-haemorrhagic hydrocephalus.......3 %, p = 0.02), but a higher rate of overdrainage (10.3 % vs 2.6 %, p = 0.04). CONCLUSION: The use of a valveless shunting for patients with post-haemorrhagic hydrocephalus results in shorter duration of neurosurgical hospitalisation and lower rate of shunt infection, although these advantages should...

  18. A CASE REPORT OF RETINAL VASCULITIS IN SYSTEMIC LUPUS ERYTHEMATOSUS

    Directory of Open Access Journals (Sweden)

    Shivakumar Mallappa

    2017-09-01

    Full Text Available PRESENTATION OF CASE A 25-year-old patient presented with complaints of swelling of both the eyes, which was insidious in onset, painless and was gradually progressive since last 1 week, which was associated with painless gradually progressive diminution of vision. She also complained of painful oral ulcers and few rashes over the face involving the cheeks and forehead since one week. She gave a history of typhoid fever 1 month back, which was associated with difficulty in breathing and swallowing. On examination, vision in both eyes were reduced to counting fingers from 2 metres with pinhole improvement of 6/24. Anterior segment showed periorbital oedema, swollen eyelids along with congestive conjunctiva and grade 2 chemosis. Cornea was clear with no cataractous changes of lens in both the eyes. Pupil was round, regular and reactive for both the eyes. Schirmer's test showed 12 mm and 10 mm wetting of the paper after 5 minutes for right and left eye respectively, which indicated mild dryness of eyes. Fluorescein staining was normal confirming absence of any corneal epithelial defect. Diplopia charting, noncontact tonometry and perimetry findings were within normal limits. On fundoscopy, there was severe arteriolar attenuation along with presence of few cotton wool spots, hard exudates bilaterally and mild tortuosity of vessels in left eye without any signs of vitreous haemorrhage or retinal detachment. Bscan and OCT scanning findings were normal without any signs of haemorrhage or detachment. On fluorescein angiography, there was capillary dropout, vessel wall staining and leakage from vessels. Systemic examination was normal with no palpable lymphadenopathy.

  19. Anti-vascular endothelial growth factor for prevention of postoperative vitreous cavity haemorrhage after vitrectomy for proliferative diabetic retinopathy.

    Science.gov (United States)

    Smith, Jonathan M; Steel, David H W

    2015-08-07

    surgery, the incidence of vitreous cavity washout or revision vitrectomy at six months, adverse effects of intervention (cataract, iris rubeosis and rubeotic glaucoma, retinal detachment, increased inflammation and systemic side effects), quality of life measures performed at least six months following vitrectomy, and density of POVCH. The current review included 12 RCTs that looked at the pre- or intraoperative use of intravitreal bevacizumab to prevent postoperative vitreous haemorrhage during pars plana vitrectomy for complications of PDR. The studies were conducted in a variety of countries (three from Iran, two from Italy, two from Egypt, and the remaining from South Korea, USA, Mexico, Pakistan, and Japan). The inclusion criteria for entry into the studies were standard complications of proliferative retinopathy: non-clearing vitreous haemorrhage, tractional retinal detachment involving the macula, or combined tractional rhegmatogenous detachment. The included studies randomised a total of 654 eyes. The average age of the participants was 54 years.We identified methodological issues in all included studies. Risk of bias was highest for masking of participants and investigators (four studies were an 'open label' design), and a number of studies were unclear when describing randomisation methods and sequence allocation.Participants receiving intravitreal bevacizumab in addition to pars plana vitrectomy were less likely to experience early POVCH (grade 2) compared to people undergoing pars plana vitrectomy alone (risk ratio (RR) 0.28, 95% confidence interval (CI) 0.08 to 0.96, 2 studies, 144 eyes, high-quality evidence). This corresponds to an absolute effect of 130 fewer people (95% CI 167 fewer to 7 fewer) with early POVCH per 1000 people when treated with intravitreal bevacizumab. We saw similar results for all grades of POVCH (RR 0.35, 95% CI 0.23 to 0.53, 9 studies, 512 eyes) and when excluding cases where assessment of outcome was impossible due to presence of

  20. Bilateral patching in retinal detachment: fluid mechanics and retinal "settling".

    Science.gov (United States)

    Foster, William J

    2011-07-20

    When a patient suffers a retinal detachment and surgery is delayed, it is known clinically that bilaterally patching the patient may allow the retina to partially reattach or "settle." Although this procedure has been performed since the 1860s, there is still debate as to how such a maneuver facilitates the reattachment of the retina. Finite element calculations using commercially available analysis software are used to elucidate the influence of reduction in eye movement caused by bilateral patching on the flow of subretinal fluid in a physical model of retinal detachment. It was found that by coupling fluid mechanics with structural mechanics, a physically consistent explanation of increased retinal detachment with eye movements can be found in the case of traction on the retinal hole. Large eye movements increase vitreous traction and detachment forces on the edge of the retinal hole, creating a subretinal vacuum and facilitating increased subretinal fluid. Alternative models, in which intraocular fluid flow is redirected into the subretinal space, are not consistent with these simulations. The results of these simulations explain the physical principles behind bilateral patching and provide insight that can be used clinically. In particular, as is known clinically, bilateral patching may facilitate a decrease in the height of a retinal detachment. The results described here provide a description of a physical mechanism underlying this technique. The findings of this study may aid in deciding whether to bilaterally patch patients and in counseling patients on pre- and postoperative care.

  1. Genetics Home Reference: retinitis pigmentosa

    Science.gov (United States)

    ... A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons. ... in known genes account for 58% of autosomal dominant retinitis pigmentosa (adRP). Adv Exp Med Biol. 2008; ...

  2. Automated detection of retinal disease.

    Science.gov (United States)

    Helmchen, Lorens A; Lehmann, Harold P; Abràmoff, Michael D

    2014-11-01

    Nearly 4 in 10 Americans with diabetes currently fail to undergo recommended annual retinal exams, resulting in tens of thousands of cases of blindness that could have been prevented. Advances in automated retinal disease detection could greatly reduce the burden of labor-intensive dilated retinal examinations by ophthalmologists and optometrists and deliver diagnostic services at lower cost. As the current availability of ophthalmologists and optometrists is inadequate to screen all patients at risk every year, automated screening systems deployed in primary care settings and even in patients' homes could fill the current gap in supply. Expanding screens to all patients at risk by switching to automated detection systems would in turn yield significantly higher rates of detecting and treating diabetic retinopathy per dilated retinal examination. Fewer diabetic patients would develop complications such as blindness, while ophthalmologists could focus on more complex cases.

  3. Advances in Retinal Optical Imaging

    Directory of Open Access Journals (Sweden)

    Yanxiu Li

    2018-04-01

    Full Text Available Retinal imaging has undergone a revolution in the past 50 years to allow for better understanding of the eye in health and disease. Significant improvements have occurred both in hardware such as lasers and optics in addition to software image analysis. Optical imaging modalities include optical coherence tomography (OCT, OCT angiography (OCTA, photoacoustic microscopy (PAM, scanning laser ophthalmoscopy (SLO, adaptive optics (AO, fundus autofluorescence (FAF, and molecular imaging (MI. These imaging modalities have enabled improved visualization of retinal pathophysiology and have had a substantial impact on basic and translational medical research. These improvements in technology have translated into early disease detection, more accurate diagnosis, and improved management of numerous chorioretinal diseases. This article summarizes recent advances and applications of retinal optical imaging techniques, discusses current clinical challenges, and predicts future directions in retinal optical imaging.

  4. Prophylactic treatment of retinal breaks

    DEFF Research Database (Denmark)

    Blindbæk, Søren Leer; Grauslund, Jakob

    2015-01-01

    Prophylactic treatment of retinal breaks has been examined in several studies and reviews, but so far, no studies have successfully applied a systematic approach. In the present systematic review, we examined the need of follow-up after posterior vitreous detachment (PVD) - diagnosed by slit...... published before 2012. Four levels of screening identified 13 studies suitable for inclusion in this systematic review. No meta-analysis was conducted as no data suitable for statistical analysis were identified. In total, the initial examination after symptomatic PVD identified 85-95% of subsequent retinal......-47% of cases, respectively. The cumulated incidence of RRD despite prophylactic treatment was 2.1-8.8%. The findings in this review suggest that follow-up after symptomatic PVD is only necessary in cases of incomplete retinal examination at presentation. Prophylactic treatment of symptomatic retinal breaks...

  5. Principles for the development and implementation of the moira computerised system

    Energy Technology Data Exchange (ETDEWEB)

    Monte, L [ENEA, Centro Ricerche Casaccia, Rome (Italy). Dip. Ambiente; Brittain, J E [Oslo Univ. (Norway). LFI Zoological Museum

    1999-12-31

    The present report is composed of a set of articles written by the patterns of the MOIRA project (a model based computerized system for management support to identify optimal remedial strategies for restoring radionuclide contaminated aquatic ecosystems and drainage areas). The project aims to describe and analyse computerised methodologies for the identification of the countermeasures in fresh water systems contaminated by radioactive substances. The structure of the MOIRA software and the criteria for the objective evaluation of the ecological impact of the countermeasures applied to lakes (defined by the `Lake Ecosystem Index`, which is used in the Multi attribute Decision Analysis process developed for MOIRA) are described in detail. A preliminary classification of the countermeasures in relation to their potential effectiveness and feasibility and a classification of the main European species of fishes of radioecological importance are presented. The described methodologies have been applied to the Norwegian lake Heimdalsvatn to demonstrate the feasibility of the MOIRA system. Two further articles in the report describe the principles for the development of a model for predicting the radionuclide migration from urban areas to fresh water systems and the migration of radionuclides in rivers. [Italiano] Lo scopo del presente rapporto, composto da articoli preparati dai ricercatori che partecipano al progetto MOIRA (A MODEL BASED COMPUTERISED SYSTEM FOR MANAGEMENT SUPPORT TO IDENTIFY OPTIMAL REMEDIAL STRATEGIES FOR RESTORING RADIONUCLIDE CONTAMINATED AQUATIC ECOSYSTEMS AND DRAINAGE AREAS), e` la descrizione e l`analisi delle metodologie computerizzate che consentono l`identificazione di contromisure atte a ridurre i livelli di contaminazione radioattiva di sistemi acquatici continentali. In particolare vengono descritte la struttura del software MOIRA e i criteri per una valutazione oggettiva dell`impatto ecologico delle contromisure applicate a sistem,i lacustri

  6. TEM validation of immunohistochemical staining prior to assessment of tumour angiogenesis by computerised image analysis

    International Nuclear Information System (INIS)

    Killingsworth, M.C.

    2002-01-01

    Full text: Counts of microvessel density (MVD) within solid tumours have been shown to be an independent predictor of outcome with higher counts generally associated with a worse prognosis. These assessments are commonly performed on immunoperoxidase stained (IPX) sections with antibodies to CD34, CD31 and Factor VIII-related antigen routinely used as vascular markers. Tumour vascular density is thought to reflect the demand the growing neoplasm is placing on its feeding blood supply. Vascular density also appears to be associated with spread of invasive cells to distant sites. The present study of tumour angiogenesis in prostate cancer specimens aims to assess new vessel growth in addition to MVD counts. The hypothesis being that an assessment which takes into account vascular migration and proliferation as well as the number of patent vessels present may have improved predictive power over assessments based on MVD counts alone. We are employing anti-CD34 stained IPX sections which are digitally photographed and assessed by a computerised image analysis system. Our aim is to develop parameters whereby tumour angiogenesis may be assessed at the light microscopic level and then correlated with existing histological methods of tumour assessment such as Gleason grading. In order to use IPX stained sections for angiogenic assessment validation and understanding of the anti-CD34 immunostaining pattern was necessary. This involved the following steps: i) Morphological assessment of angiogenic changes present in tumour blood vessels. Morphological changes in endothelial cells and pericytes indicative of angiogenic activation are generally below the level of resolution available with light microscopy. TEM examination revealed endothelial cell budding, pericyte retraction, basement membrane duplication and endothelial sprout formation in capillaries and venules surrounding tumour glands. This information assisted with the development of parameters by which IPX sections

  7. Principles for the development and implementation of the moira computerised system

    Energy Technology Data Exchange (ETDEWEB)

    Monte, L. [ENEA, Centro Ricerche Casaccia, Rome (Italy). Dip. Ambiente; Brittain, J.E. [Oslo Univ. (Norway). LFI Zoological Museum

    1998-12-31

    The present report is composed of a set of articles written by the patterns of the MOIRA project (a model based computerized system for management support to identify optimal remedial strategies for restoring radionuclide contaminated aquatic ecosystems and drainage areas). The project aims to describe and analyse computerised methodologies for the identification of the countermeasures in fresh water systems contaminated by radioactive substances. The structure of the MOIRA software and the criteria for the objective evaluation of the ecological impact of the countermeasures applied to lakes (defined by the `Lake Ecosystem Index`, which is used in the Multi attribute Decision Analysis process developed for MOIRA) are described in detail. A preliminary classification of the countermeasures in relation to their potential effectiveness and feasibility and a classification of the main European species of fishes of radioecological importance are presented. The described methodologies have been applied to the Norwegian lake Heimdalsvatn to demonstrate the feasibility of the MOIRA system. Two further articles in the report describe the principles for the development of a model for predicting the radionuclide migration from urban areas to fresh water systems and the migration of radionuclides in rivers. [Italiano] Lo scopo del presente rapporto, composto da articoli preparati dai ricercatori che partecipano al progetto MOIRA (A MODEL BASED COMPUTERISED SYSTEM FOR MANAGEMENT SUPPORT TO IDENTIFY OPTIMAL REMEDIAL STRATEGIES FOR RESTORING RADIONUCLIDE CONTAMINATED AQUATIC ECOSYSTEMS AND DRAINAGE AREAS), e` la descrizione e l`analisi delle metodologie computerizzate che consentono l`identificazione di contromisure atte a ridurre i livelli di contaminazione radioattiva di sistemi acquatici continentali. In particolare vengono descritte la struttura del software MOIRA e i criteri per una valutazione oggettiva dell`impatto ecologico delle contromisure applicate a sistem,i lacustri

  8. Concentric retinitis pigmentosa: clinicopathologic correlations.

    Science.gov (United States)

    Milam, A H; De Castro, E B; Smith, J E; Tang, W X; John, S K; Gorin, M B; Stone, E M; Aguirre, G D; Jacobson, S G

    2001-10-01

    Progressive concentric (centripetal) loss of vision is one pattern of visual field loss in retinitis pigmentosa. This study provides the first clinicopathologic correlations for this form of retinitis pigmentosa. A family with autosomal dominant concentric retinitis pigmentosa was examined clinically and with visual function tests. A post-mortem eye of an affected 94 year old family member was processed for histopathology and immunocytochemistry with retinal cell specific antibodies. Unrelated simplex/multiplex patients with concentric retinitis pigmentosa were also examined. Affected family members of the eye donor and patients from the other families had prominent peripheral pigmentary retinopathy with more normal appearing central retina, good visual acuity, concentric field loss, normal or near normal rod and cone sensitivity within the preserved visual field, and reduced rod and cone electroretinograms. The eye donor, at age 90, had good acuity and function in a central island. Grossly, the central region of the donor retina appeared thinned but otherwise normal, while the far periphery contained heavy bone spicule pigment. Microscopically the central retina showed photoreceptor outer segment shortening and some photoreceptor cell loss. The mid periphery had a sharp line of demarcation where more central photoreceptors were near normal except for very short outer segments and peripheral photoreceptors were absent. Rods and cones showed abrupt loss of outer segments and cell death at this interface. It is concluded that concentric retinitis pigmentosa is a rare but recognizable phenotype with slowly progressive photoreceptor death from the far periphery toward the central retina. The disease is retina-wide but shows regional variation in severity of degeneration; photoreceptor death is severe in the peripheral retina with an abrupt edge between viable and degenerate photoreceptors. Peripheral to central gradients of unknown retinal molecule(s) may be defective

  9. Unilateral retinitis pigmentosa sine pigmento.

    Science.gov (United States)

    Pearlman, J T; Saxton, J; Hoffman, G

    1976-05-01

    A patient presented with unilateral findings of night blindness shown by impaired rod function and dark adaptation, constricted visual fields with good central acuity, a barely recordable electro-retinographic b-wave, and a unilaterally impaired electro-oculogram. There were none of the pigmentary changes usually associated with retinitis pigmentosa. The unaffected right eye was normal in all respects. Therefore the case is most probably one of unilateral retinitis pigmentosa sine pigmento.

  10. Light and inherited retinal degeneration

    OpenAIRE

    Paskowitz, D M; LaVail, M M; Duncan, J L

    2006-01-01

    Light deprivation has long been considered a potential treatment for patients with inherited retinal degenerative diseases, but no therapeutic benefit has been demonstrated to date. In the few clinical studies that have addressed this issue, the underlying mutations were unknown. Our rapidly expanding knowledge of the genes and mechanisms involved in retinal degeneration have made it possible to reconsider the potential value of light restriction in specific genetic contexts. This review summ...

  11. Computerised therapies for anxiety and depression in children and young people: a systematic review and meta-analysis.

    Science.gov (United States)

    Pennant, Mary E; Loucas, Christina E; Whittington, Craig; Creswell, Cathy; Fonagy, Peter; Fuggle, Peter; Kelvin, Raphael; Naqvi, Sabrina; Stockton, Sarah; Kendall, Tim

    2015-04-01

    One quarter of children and young people (CYP) experience anxiety and/or depression before adulthood, but treatment is sometimes unavailable or inadequate. Self-help interventions may have a role in augmenting treatment and this work aimed to systematically review the evidence for computerised anxiety and depression interventions in CYP aged 5-25 years old. Databases were searched for randomised controlled trials and 27 studies were identified. For young people (12-25 years) with risk of diagnosed anxiety disorders or depression, computerised CBT (cCBT) had positive effects for symptoms of anxiety (SMD -0.77, 95% CI -1.45 to -0.09, k = 6, N = 220) and depression (SMD -0.62, 95% CI -1.13 to -0.11, k = 7, N = 279). In a general population study of young people, there were small positive effects for anxiety (SMD -0.15, 95% CI -0.26 to -0.03; N = 1273) and depression (SMD -0.15, 95% CI -0.26 to -0.03; N = 1280). There was uncertainty around the effectiveness of cCBT in children (5-11 years). Evidence for other computerised interventions was sparse and inconclusive. Computerised CBT has potential for treating and preventing anxiety and depression in clinical and general populations of young people. Further program development and research is required to extend its use and establish its benefit in children. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Design, implementation and functional aspects of the control and instrumentation systems of computerised remote operated sludge lancing equipment

    International Nuclear Information System (INIS)

    Aparna, J.; Mehra, K.S.; Sharma, B.S.V.G.; Mohan, L.R.

    2005-01-01

    The computerised and remote operated sludge lancing equipment (SLE) uses high velocity narrow water jets for dislodging and removal of hard and strongly adhesive sludge from the secondary side tube sheet of mushroom type steam generators of Indian PHWRs. During the years of plant operation, corrosion products and other solids deposit in the form of sludge on the tube sheet of steam generators. The sludge formation not only affects adversely the steam generator performance but also diminishes its service life if left unchecked

  13. Rehabilitation of awareness of deficits in patients with traumatic brain injury applying a user-friendly computerised intervention approach

    LENUS (Irish Health Repository)

    Morgan, Dr Jacinta

    2010-01-01

    Objective : Awareness of errors is an important prerequisite in rehabilitation. Few studies have investigated rehabilitation of error awareness following acquired brain injury. Pilot research has shown that receiving feedback about errors during a computerised task of sustained attention improves performance in patients who have sustained a traumatic brain injury. In this study, a computer-based intervention training programme aimed at improving error awareness was developed. \\r\

  14. The design, construction and implementation of a computerised trauma registry in a developing South African metropolitan trauma service.

    Science.gov (United States)

    Laing, G L; Bruce, J L; Aldous, C; Clarke, D L

    2014-01-01

    The Pietermaritzburg Metropolitan Trauma Service formerly lacked a robust computerised trauma registry. This made surgical audit difficult for the purpose of quality of care improvement and development. We aimed to design, construct and implement a computerised trauma registry within our service. Twelve months following its implementation, we sought to examine and report on the quality of the registry. Formal ethical approval to maintain a computerised trauma registry was obtained prior to undertaking any design and development. Appropriate commercial software was sourced to develop this project. The registry was designed as a flat file. A flat file is a plain text or mixed text and binary file which usually contains one record per line or physical record. Thereafter the registry file was launched onto a secure server. This provided the benefits of access security and automated backups. Registry training was provided to clients by the developer. The exercise of data capture was then integrated into the process of service delivery, taking place at the endpoint of patient care (discharge, transfer or death). Twelve months following its implementation, the compliance rates of data entry were measured. The developer of this project managed to design, construct and implement an electronic trauma registry into the service. Twelve months following its implementation the data were extracted and audited to assess the quality. A total of 2640 patient entries were captured onto the registry. Compliance rates were in the order of eighty percent and client satisfaction rates were high. A number of deficits were identified. These included the omission of weekend discharges and underreporting of deaths. The construction and implementation of the computerised trauma registry was the beginning of an endeavour to continue improvements in the quality of care within our service. The registry provided a reliable audit at twelve months post implementation. Deficits and limitations were

  15. A rare case of Weil's disease with alveolar haemorrhage

    Directory of Open Access Journals (Sweden)

    Abhiram Chakrabarti

    2014-05-01

    Full Text Available Leptospirosis, a disease of protean manifestations occurs sporadically throughout the year with a peak seasonal incidence during the rainy season mimicking other febrile viral illness. In the rare case, the disease leads to renal and hepatic involvement with hemorrhage which may be associated with multisystem organ dysfunction in form of pulmonary, cardiac and central nervous system, when it is known as Weil's disease. Rarely haemorrhagic manifestations are assosciated. Early diagnosis is important as sometimes the disease may be life threatening. Proper antibiotics results in dramatic improvement. We hereby presented a case that had clinical features of Weil's disease with cough, dyspnoea and haemoptysis. Leptospirosis was detected on ELISA testing. Patient was cured rapidly with antibiotics.

  16. A rare case of Weil's disease with alveolar haemorrhage.

    Science.gov (United States)

    Chakrabarti, Abhiram; Nandy, Manab; Pal, Dipankar; Mallik, Sudesna

    2014-05-01

    Leptospirosis, a disease of protean manifestations occurs sporadically throughout the year with a peak seasonal incidence during the rainy season mimicking other febrile viral illness. In the rare case, the disease leads to renal and hepatic involvement with hemorrhage which may be associated with multisystem organ dysfunction in form of pulmonary, cardiac and central nervous system, when it is known as Weil's disease. Rarely haemorrhagic manifestations are assosciated. Early diagnosis is important as sometimes the disease may be life threatening. Proper antibiotics results in dramatic improvement. We hereby presented a case that had clinical features of Weil's disease with cough, dyspnoea and haemoptysis. Leptospirosis was detected on ELISA testing. Patient was cured rapidly with antibiotics.

  17. Hereditary haemorrhagic telangiectasia: a cause of preventable morbidity and mortality.

    LENUS (Irish Health Repository)

    Brady, A P

    2012-01-31

    Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant condition whose effects are mediated through deficient blood vessel formation and regeneration, with multisystem involvement. Patients are usually aware of resulting skin telangiectasia and epistaxis, but are also exposed to dangers posed by occult vascular malformations in other organs. About 15-35% of HHT patients have pulmonary AVMs (PAVMs), 10% have cerebral AVMs (CAVMs), 25-33% suffer significant GI blood loss from GI tract telangiectasia, and an unknown but high percentage have liver involvement. In total, 10% of affected individuals die prematurely or suffer major disability from HHT, largely because of bleeding from CAVMs and PAVMs, or paradoxical embolization through PAVMs. Screening for and early intervention to treat occult PAVMs and CAVMs can largely eliminate these risks, and should be undertaken in a specialist centre. The National HHT Center in The Mercy University Hospital in Cork is the referral centre for HHT screening in Ireland.

  18. Pre-emptive treatment with fibrinogen concentrate for postpartum haemorrhage

    DEFF Research Database (Denmark)

    Wikkelsø, A J; Edwards, H M; Afshari, A

    2015-01-01

    BACKGROUND: In early postpartum haemorrhage (PPH), a low concentration of fibrinogen is associated with excessive subsequent bleeding and blood transfusion. We hypothesized that pre-emptive treatment with fibrinogen concentrate reduces the need for red blood cell (RBC) transfusion in patients...... and the fibrinogen concentration at inclusion. The primary outcome was RBC transfusion up to 6 weeks postpartum. Secondary outcomes were total blood loss, total amount of blood transfused, occurrence of rebleeding, haemoglobin ... concentrate, thereby significantly increasing fibrinogen concentration compared with placebo by 0.40 g litre(-1) (95% confidence interval, 0.15-0.65; P=0.002). Postpartum blood transfusion occurred in 25 (20%) of the fibrinogen group and 26 (22%) of the placebo group (relative risk, 0.95; 95% confidence...

  19. Eradication of viral haemorrhagic septicaemia in Danish aquaculture

    DEFF Research Database (Denmark)

    Olsen, N. J.; Skall, Helle Frank; Jensen, B. B.

    2013-01-01

    resources have been used to control and eradicate the disease. The control program included strict biosecurity and preventative measures, trade regulations, zoning and intensive inspections and laboratory testing. During the first decades of control and eradication programs the number of infected farms......Viral haemorrhagic septicaemia (VHS) virus was first isolated in Denmark in 1962, when more than half of the approximately 800 Danish fish farms were considered to be infected. Today, 50 years later, the country obtained status as EU approved VHS free zone. In the years in between very significant...... was significantly reduced while the curve flattened the last 20 years. It was only after a large and costly coordinated action in 2009-2013 including all affected areas that the country managed to free itself totally from VHS. Molecular tracing of the origin of VHSV isolates revealed that despite strict trade...

  20. Progress towards the treatment of Ebola haemorrhagic fever.

    Science.gov (United States)

    Ströher, Ute; Feldmann, Heinz

    2006-12-01

    Being highly pathogenic for human and nonhuman primates and the subject of former weapon programmes makes Ebola virus one of the most feared pathogens worldwide today. Due to a lack of licensed pre- and postexposure intervention, the current response depends on rapid diagnostics, proper isolation procedures and supportive care of case patients. Consequently, the development of more specific countermeasures is of high priority for the preparedness of many nations. Over the past years, enhanced research efforts directed to better understand virus replication and pathogenesis have identified potential new targets for intervention strategies. The authors discuss the most promising therapeutic approaches for Ebola haemorrhagic fever as judged by their efficacy in animal models. The current development in this field encourages discussions on how to move some of the experimental approaches towards clinical application.

  1. Recanalisation of spontaneously occluded vertebral artery dissection after subarachnoid haemorrhage.

    Science.gov (United States)

    Akiyama, Takenori; Onozuka, Satoshi; Horiguchi, Takashi; Yoshida, Kazunari

    2012-10-01

    Spontaneous occlusion is a rare manifestation of ruptured vertebral artery dissection (VAD). Its natural history and treatment strategy have yet to be established due to its rarity. Here, we report five lesions involving spontaneous occlusion of VAD after subarachnoid haemorrhage, among which three lesions showed recanalisation. Based on our experience and previous reports, spontaneous occlusion of ruptured VAD can be classified into two groups-one group with occlusion in the acute stage with a high incidence of recanalisation and another group with occlusion in the chronic stage with a relatively low incidence of recanalisation. The underlying mechanism is likely different in each group, and treatment strategies should also be tailored depending on the pathophysiology.

  2. The need for repeat angiography in subarachnoid haemorrhage

    International Nuclear Information System (INIS)

    Urbach, H.; Solymosi, L.; Zentner, J.

    1998-01-01

    This study was designed to assess the necessity for a second angiogram study in patients in whom initial angiography after primary subarachnoid haemorrhage (SAH) was negative. During a 12-year period, 122 of 694 patients (17.5 %) had negative initial angiograms. CT, available for 98 patients, showed a preponderance of subarachnoid blood in the perimesencephalic cisterns in 50 of 73 patients (68.5 %) in whom blood was visible on CT. Angiography, repeated in 67 patients, revealed an aneurysm in 4 (6 %): 2 had an aneurysm of the anterior communicating artery, 1 of the posterior inferior cerebellar artery, and 1 of the P2 segment of the posterior cerebral artery. CT showed subarachnoid blood in the interpeduncular and ambient cisterns in this last case, and a preponderance of subarachnoid blood outside the perimesencephalic cisterns in the remaining 3 patients. (orig.)

  3. The need for repeat angiography in subarachnoid haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Urbach, H; Solymosi, L [Department of Neuroradiology, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Zentner, J [Department of Neurosurgery, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany)

    1998-01-01

    This study was designed to assess the necessity for a second angiogram study in patients in whom initial angiography after primary subarachnoid haemorrhage (SAH) was negative. During a 12-year period, 122 of 694 patients (17.5 %) had negative initial angiograms. CT, available for 98 patients, showed a preponderance of subarachnoid blood in the perimesencephalic cisterns in 50 of 73 patients (68.5 %) in whom blood was visible on CT. Angiography, repeated in 67 patients, revealed an aneurysm in 4 (6 %): 2 had an aneurysm of the anterior communicating artery, 1 of the posterior inferior cerebellar artery, and 1 of the P2 segment of the posterior cerebral artery. CT showed subarachnoid blood in the interpeduncular and ambient cisterns in this last case, and a preponderance of subarachnoid blood outside the perimesencephalic cisterns in the remaining 3 patients. (orig.) With 2 figs., 1 tab., 32 refs.

  4. Comparison of the cardiovascular effects of meptazinol and naloxone following haemorrhagic shock in rats and cats.

    Science.gov (United States)

    Chance, E.; Paciorek, P. M.; Todd, M. H.; Waterfall, J. F.

    1985-01-01

    The cardiovascular effects of the opioid mixed agonist-antagonist, meptazinol, and the opioid antagonist, naloxone, have been evaluated in conscious rats, anaesthetized rats and anaesthetized cats following the induction of haemorrhagic shock. The mean arterial pressure of conscious rats decreased by 17-29 mmHg following a haemorrhage of 20% of blood volume. Meptazinol (17 mg kg-1, i.m.) administered after haemorrhage evoked a rapid and sustained increase in mean arterial pressure to pre-haemorrhage levels. Naloxone (10 mg kg-1, i.v.) also increased mean arterial pressure to a level significantly higher than post-haemorrhage values. Neither haemorrhage nor subsequent drug treatments evoked significant changes in the heart rates of conscious rats. In anaesthetized rats, 20% haemorrhage evoked decreases in mean arterial pressure, heart rate and cardiac output. Blood flow to the heart, skin, skeletal muscle, kidneys, spleen and liver (arterial) was decreased. Meptazinol and naloxone increased blood pressure and total peripheral resistance, but did not significantly alter heart rate or cardiac output. Hepatic arterial flow decreased further in both drug and vehicle treated groups. In addition meptazinol slightly reduced skeletal muscle flow. In anaesthetized cats 40% haemorrhage decreased mean arterial pressure by 46 +/- 3 mmHg. An intravenous infusion of either meptazinol or naloxone (cumulative 2 mg kg-1, i.v.) partially restored blood pressure. In experimental animal models of haemorrhagic shock, meptazinol has a similar cardiovascular profile to naloxone. The established analgesic activity of meptazinol may confer an advantage in some shock states. PMID:4052729

  5. The Significance of Variceal Haemorrhage in Ghana: A Retrospective Review.

    Science.gov (United States)

    Archampong, T N A; Tachi, K; Agyei, A A; Nkrumah, K N

    2015-09-01

    This study describes the burden of bleeding oesophageal varices at the main tertiary referral centre in Accra. Retrospective design to describe the endoscopic spectrum and review mortality data following acute upper gastro-intestinal bleeding at the Korle-Bu Teaching Hospital. Endoscopic data was reviewed in the Endoscopy Unit between 2007 and 2010. Mortality data was collated from the Department of Medicine between 2010 and 2013. The study questionnaire compiled clinical and demographic characteristics, endoscopic diagnoses, length of hospital admission and treatment regimens. Aetiology and time-trend analysis of mortality rates following acute upper gastro-intestinal bleeding; variceal bleeding treatment modalities. On review of the endoscopic diagnoses, gastro-oesophageal varices were identified in 21.9% of cases followed by gastritis 21.7%, duodenal ulcer, 17.0%, and gastric ulcer, 13.2%. Gastro-oesophageal varices were the predominant cause of death from acute upper gastro-intestinal haemorrhage from 46% in 2010 to 76% in 2013. Outcomes following acute upper gastro-intestinal bleeding were dismal with some 38% of fatalities occurring within the first 24 hours. Injection sclerotherapy was the dominant endoscopic modality for secondary prevention of variceal bleeding in comparison with band ligation, mainly as a result of cost and availability. At the tertiary centre in Accra, variceal bleeding is an increasingly common cause of acute upper gastro-intestinal haemorrhage in comparison with previous reviews in Ghana. Its significantly high in-hospital mortality reflects inadequate facilities to deal with this medical emergency. A strategic approach to care with endoscopic services equipped with all the necessary therapeutic interventions will be vital in improving the outcomes of variceal bleeding in Ghana.

  6. ROLE OF HYSTEROSCOPY IN THE MANAGEMENT OF SECONDARY POSTPARTUM HAEMORRHAGE

    Directory of Open Access Journals (Sweden)

    Krupa Patalay

    2016-03-01

    Full Text Available INTRODUCTION Secondary postpartum haemorrhage [PPH] or puerperal haemorrhage, though rare can sometimes cause severe morbidity needing prolonged hospitalisation. Majority of the cases can be managed medically, a few of them requiring surgical interventions. With retained placental tissue being a common cause, emptying the uterus in the puerperium can be difficult and dangerous too as the wall is soft and perforation chances are high. Hysteroscopic evaluation of the puerperal uterus gives us a better picture of the retained bits of placental tissue, and helps in complete evacuation of the tissue without causing much trauma to the fragile uterine wall. It is also more specific than ultrasonogram [USG] to rule out the presence of retained tissue. MATERIAL AND METHODS 17 patients who had secondary PPH and did not respond to the initial medical management were included in the study. Hysteroscopy was done in these cases. Definitive pathology was found in 12 cases; 7 cases had polypoidal tissue [retained bits of placenta], 3 cases had placental tissue adherent to the caesarean scar [placenta accreta] and 2 cases had submucous fibroids. RESULTS In cases which had retained placental bits, the tissue could be visualised, its exact location noted and the entire tissue could be removed without inciting much trauma to the uterine wall. In cases with placenta accreta, gentle extraction of the adherent tissue could be done without traumatising the scar. In one case which had multiple fibroids with irregular uterine cavity, hysteroscopy helped in localising the retained tissue. CONCLUSION Hysteroscopy is a useful modality in managing cases of secondary PPH, who have persistent bleeding in the postpartum period.

  7. Epidemiological study of brucellosis in eight Greek villages using a Computerised Mapping Programme

    International Nuclear Information System (INIS)

    Hadjichristodoulou, Ch.; Papatheodorou, Ch.; Soteriades, E.; Panagakos, G.; Kastritis, I.; Goutziana, G.; Charvalos, E.; Tselentis, Y.

    1999-01-01

    A Computerised Mapping Programme (CMP) was created step by step to cover all the needs of a cross sectional population survey conducted in eight villages of Fokida, a rural area of central Greece. The maps of Greece (boundary) and the topographical maps of the eight villages were created using the CMP. A volunteer sample of 1121 out of 2607 inhabitants of the study area participated in the population survey. The participants were tested for brucellosis using serological tests (ELISA and Rose Bengal) and the intradermal reaction test. A questionnaire was used to obtain information concerning the risk factors for brucellosis. The risk factors found through statistical analysis were occupation (RR: 5.81, p < 0.00001), consumption of raw milk (RR: 1.98, p < 0.001) and unpasteurized fresh cheese (RR: 2.13, p < 0.01). The same factors were indicated by the CMP. The CMP also indicated manure-contaminated playgrounds in residential yards as a potential risk factor for children. The origin and dissemination were delineated using time-space association display. The CMP proved to be a useful tool in this epidemiological study

  8. Computerised cognitive-behavioural therapy for adults with intellectual disability: randomised controlled trial.

    Science.gov (United States)

    Cooney, Patricia; Jackman, Catherine; Coyle, David; O'Reilly, Gary

    2017-08-01

    Background Despite the evidence base for computer-assisted cognitive-behavioural therapy (CBT) in the general population, it has not yet been adapted for use with adults who have an intellectual disability. Aims To evaluate the utility of a CBT computer game for adults who have an intellectual disability. Method A 2 × 3 (group × time) randomised controlled trial design was used. Fifty-two adults with mild to moderate intellectual disability and anxiety or depression were randomly allocated to two groups: computerised CBT (cCBT) or psychiatric treatment as usual (TAU), and assessed at pre-treatment, post-treatment and 3-month follow-up. Forty-nine participants were included in the final analysis. Results A significant group × time interaction was observed on the primary outcome measure of anxiety (Glasgow Anxiety Scale for people with an Intellectual Disability), favouring cCBT over TAU, but not on the primary outcome measure of depression (Glasgow Depression Scale for people with a Learning Disability). A medium effect size for anxiety symptoms was observed at post-treatment and a large effect size was observed after follow-up. Reliability of Change Indices indicated that the intervention produced clinically significant change in the cCBT group in comparison with TAU. Conclusions As the first application of cCBT for adults with intellectual disability, this intervention appears to be a useful treatment option to reduce anxiety symptoms in this population. © The Royal College of Psychiatrists 2017.

  9. Computerised Analysis of Telemonitored Respiratory Sounds for Predicting Acute Exacerbations of COPD.

    Science.gov (United States)

    Fernandez-Granero, Miguel Angel; Sanchez-Morillo, Daniel; Leon-Jimenez, Antonio

    2015-10-23

    Chronic obstructive pulmonary disease (COPD) is one of the commonest causes of death in the world and poses a substantial burden on healthcare systems and patients' quality of life. The largest component of the related healthcare costs is attributable to admissions due to acute exacerbation (AECOPD). The evidence that might support the effectiveness of the telemonitoring interventions in COPD is limited partially due to the lack of useful predictors for the early detection of AECOPD. Electronic stethoscopes and computerised analyses of respiratory sounds (CARS) techniques provide an opportunity for substantial improvement in the management of respiratory diseases. This exploratory study aimed to evaluate the feasibility of using: (a) a respiratory sensor embedded in a self-tailored housing for ageing users; (b) a telehealth framework; (c) CARS and (d) machine learning techniques for the remote early detection of the AECOPD. In a 6-month pilot study, 16 patients with COPD were equipped with a home base-station and a sensor to daily record their respiratory sounds. Principal component analysis (PCA) and a support vector machine (SVM) classifier was designed to predict AECOPD. 75.8% exacerbations were early detected with an average of 5 ± 1.9 days in advance at medical attention. The proposed method could provide support to patients, physicians and healthcare systems.

  10. Development and impact of computerised decision support systems for clinical management of depression: A systematic review.

    Science.gov (United States)

    Triñanes, Yolanda; Atienza, Gerardo; Louro-González, Arturo; de-las-Heras-Liñero, Elena; Alvarez-Ariza, María; Palao, Diego J

    2015-01-01

    One of the proposals for improving clinical practice is to introduce computerised decision support systems (CDSS) and integrate these with electronic medical records. Accordingly, this study sought to systematically review evidence on the effectiveness of CDSS in the management of depression. A search was performed in Medline, EMBASE and PsycInfo, in order to do this. The quality of quantitative studies was assessed using the SIGN method, and qualitative studies using the CASPe checklist. Seven studies were identified (3 randomised clinical trials, 3 non-randomised trials, and one qualitative study). The CDSS assessed incorporated content drawn from guidelines and other evidence-based products. In general, the CDSS had a positive impact on different aspects, such as the screening and diagnosis, treatment, improvement in depressive symptoms and quality of life, and referral of patients. The use of CDSS could thus serve to optimise care of depression in various scenarios by providing recommendations based on the best evidence available and facilitating decision-making in clinical practice. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  11. Computerised Analysis of Telemonitored Respiratory Sounds for Predicting Acute Exacerbations of COPD

    Directory of Open Access Journals (Sweden)

    Miguel Angel Fernandez-Granero

    2015-10-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is one of the commonest causes of death in the world and poses a substantial burden on healthcare systems and patients’ quality of life. The largest component of the related healthcare costs is attributable to admissions due to acute exacerbation (AECOPD. The evidence that might support the effectiveness of the telemonitoring interventions in COPD is limited partially due to the lack of useful predictors for the early detection of AECOPD. Electronic stethoscopes and computerised analyses of respiratory sounds (CARS techniques provide an opportunity for substantial improvement in the management of respiratory diseases. This exploratory study aimed to evaluate the feasibility of using: (a a respiratory sensor embedded in a self-tailored housing for ageing users; (b a telehealth framework; (c CARS and (d machine learning techniques for the remote early detection of the AECOPD. In a 6-month pilot study, 16 patients with COPD were equipped with a home base-station and a sensor to daily record their respiratory sounds. Principal component analysis (PCA and a support vector machine (SVM classifier was designed to predict AECOPD. 75.8% exacerbations were early detected with an average of 5 ± 1.9 days in advance at medical attention. The proposed method could provide support to patients, physicians and healthcare systems.

  12. Diagnostic ranking of computerised tomography in mediastinal diseases depending on their localisation

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, B.; Doppman, J.L.; Mayr, B.; Rienmueller, R.; Lissner, J.; Stelter, W.

    1981-04-01

    The diagnostic ranking and importance of computerised tomography was examined in 116 with abnormal findings in the mediastinal region, and was compared with conventional, non-invasive X-ray examinations. This method also yielded significant CT-specific additional information in the anterior mediastinum in 74.4% of the cases, in the mesomediastinum in 69.1%, in the posterior mediastinum in 79.2% in the upper thoracic aperture in 94.4% and in the paracardial region in 100% of the cases. The hilar region is an exception; in 68.8% of the cases, both methods were rated equal, whereas in 28.1% of the cases assessment via the CT method was even inferior. The specific additional information furnshed by the CT method justifies a wider application of CT in solving the following problems concerning the mediastinum: Clarification of a suspected but not yet established space-occupying growth in the mediastinum, before using invasive diagnostic methods such as mediastinoscopy and angiography; staging of an already identified primary mediastinal tumor or malignant lymphoma; in case of suspected changes in the large mediastinal vessels before employing angiography; on-target in the following diseases: bronchogenic carcinoma (because of improved pretherapeutic staging according to the TNM system), myasthenia gravis and identification of thymoma, hyperparathyroidism with suspected dystopic parathyroid glands.

  13. The diagnostic ranking of computerised tomography in mediastinal diseases depending on their localisation

    International Nuclear Information System (INIS)

    Sommer, B.; Doppman, J.L.; Mayr, B.; Rienmueller, R.; Lissner, J.; Stelter, W.

    1981-01-01

    The diagnostic ranking and importance of computerised tomography was examined in 116 with abnormal findings in the mediastinal region, and was compared with conventional, non-invasive X-ray examinations. This method also yielded significant CT-specific additional information in the anterior mediastinum in 74.4% of the cases, in the mesomediastinum in 69.1%, in the posterior mediastinum in 79.2% in the upper thoracic aperture in 94.4% and in the paracardial region in 100% of the cases. The hilar region is an exception; in 68.8% of the cases, both methods were rated equal, whereas in 28.1% of the cases assessment via the CT method was even inferior. The specific additional information furnshed by the CT method justifies a wider application of CT in solving the following problems concerning the mediastinum: Clarification of a suspected but not yet established space-occupying growth in the mediastinum, before using invasive diagnostic methods such as mediastinoscopy and angiography; staging of an already identified primary mediastinal tumor or malignant lymphoma; in case of suspected changes in the large mediastinal vessels before employing angiography; on-target in the following diseases: bronchogenic carcinoma (because of improved pretherapeutic staging according to the TNM system), myasthenia gravis and identification of thymoma, hyperparathyroidism with suspected dystopic parathyroid glands. (orig.) [de

  14. Colonoscopy and computerised tomography scan are not sufficient to localise right sided colonic lesions accurately.

    LENUS (Irish Health Repository)

    Solon, Jacqueline Gemma

    2009-11-23

    : Aim: accurate pre-operative localisation of colonic lesions is critical especially in laparoscopic colectomy where tactile localisation is absent particularly in screen-detected tumours. The study aimed to evaluate the accuracy of colonoscopy and double-contrast computerised tomography (CT) to localise lesions treated by right hemicolectomy. Method: a retrospective chart review was performed of patients treated by right hemicolectomy under the colorectal service between July 2003 and October 2006. Pre-operative tumour location determined by CT scan and colonoscopy were compared with the intra-operative and histopathologic findings. Results: of 101 patients, 73 (73%) were for adenoma or cancer, with a final diagnosis of adenocarcinoma in 59 (59%). Pre-operative localisation was inaccurate in 29% of lesions using both CT and colonoscopy. In the transverse colon colonoscopy alone was only 37.5% accurate, increasing to 62.5% when information from the CT scan was added. Conclusion: pre-operative localisation of right-sided colon cancers using colonoscopy and CT scanning is unreliable in at least 29% of cases. Inaccurate localisation of transverse colon tumours risks inadequate lymphadenectomy with an adverse cancer outcome. Pre-operative abdominal CT scan improves accuracy but endoscopic tattoo localisation should be employed routinely especially in patients undergoing laparoscopic resection.

  15. Effectiveness of a computerised working memory training in adolescents with mild to borderline intellectual disabilities.

    Science.gov (United States)

    Van der Molen, M J; Van Luit, J E H; Van der Molen, M W; Klugkist, I; Jongmans, M J

    2010-05-01

    The goal of this study is to evaluate the effectiveness of a computerised working memory (WM) training on memory, response inhibition, fluid intelligence, scholastic abilities and the recall of stories in adolescents with mild to borderline intellectual disabilities attending special education. A total of 95 adolescents with mild to borderline intellectual disabilities were randomly assigned to either a training adaptive to each child's progress in WM, a non-adaptive WM training, or to a control group. Verbal short-term memory (STM) improved significantly from pre- to post-testing in the group who received the adaptive training compared with the control group. The beneficial effect on verbal STM was maintained at follow-up and other effects became clear at that time as well. Both the adaptive and non-adaptive WM training led to higher scores at follow-up than at post-intervention on visual STM, arithmetic and story recall compared with the control condition. In addition, the non-adaptive training group showed a significant increase in visuo-spatial WM capacity. The current study provides the first demonstration that WM can be effectively trained in adolescents with mild to borderline intellectual disabilities.

  16. Determination of retinal surface area.

    Science.gov (United States)

    Nagra, Manbir; Gilmartin, Bernard; Thai, Ngoc Jade; Logan, Nicola S

    2017-09-01

    Previous attempts at determining retinal surface area and surface area of the whole eye have been based upon mathematical calculations derived from retinal photographs, schematic eyes and retinal biopsies of donor eyes. 3-dimensional (3-D) ocular magnetic resonance imaging (MRI) allows a more direct measurement, it can be used to image the eye in vivo, and there is no risk of tissue shrinkage. The primary purpose of this study is to compare, using T2-weighted 3D MRI, retinal surface areas for superior-temporal (ST), inferior-temporal (IT), superior-nasal (SN) and inferior-nasal (IN) retinal quadrants. An ancillary aim is to examine whether inter-quadrant variations in area are concordant with reported inter-quadrant patterns of susceptibility to retinal breaks associated with posterior vitreous detachment (PVD). Seventy-three adult participants presenting without retinal pathology (mean age 26.25 ± 6.06 years) were scanned using a Siemens 3-Tesla MRI scanner to provide T2-weighted MR images that demarcate fluid-filled internal structures for the whole eye and provide high-contrast delineation of the vitreous-retina interface. Integrated MRI software generated total internal ocular surface area (TSA). The second nodal point was used to demarcate the origin of the peripheral retina in order to calculate total retinal surface area (RSA) and quadrant retinal surface areas (QRSA) for ST, IT, SN, and IN quadrants. Mean spherical error (MSE) was -2.50 ± 4.03D and mean axial length (AL) 24.51 ± 1.57 mm. Mean TSA and RSA for the RE were 2058 ± 189 and 1363 ± 160 mm 2 , respectively. Repeated measures anova for QRSA data indicated a significant difference within-quadrants (P area/mm increase in AL. Although the differences between QRSAs are relatively small, there was evidence of concordance with reported inter-quadrant patterns of susceptibility to retinal breaks associated with PVD. The data allow AL to be converted to QRSAs, which will assist further

  17. Retinal pigmentary changes in chronic uveitis mimicking retinitis pigmentosa.

    Science.gov (United States)

    Sevgi, D Damla; Davoudi, Samaneh; Comander, Jason; Sobrin, Lucia

    2017-09-01

    To present retinal pigmentary changes mimicking retinitis pigmentosa (RP) as a finding of advanced uveitis. We retrospectively reviewed charts of patients without a family history of inherited retinal degenerations who presented with retinal pigment changes and signs of past or present intraocular inflammation. Comprehensive eye examination including best-corrected visual acuity, slit-lamp examination and dilated fundus examination was performed on all patients in addition to color fundus photography, optical coherence tomography, fluorescein angiography (FA), and full-field electroretinogram testing. We identified five patients with ages ranging from 33 to 66 years, who presented with RP-like retinal pigmentary changes which were eventually attributed to longstanding uveitis. The changes were bilateral in three cases and unilateral in two cases. Four of five cases presented with active inflammation, and the remaining case showed evidence of active intraocular inflammation during follow-up. This study highlights the overlapping features of advanced uveitis and RP including the extensive pigmentary changes. Careful review of possible past uveitis history, detailed examination of signs of past or present inflammation and ancillary testing, with FA often being most helpful, are required for the correct diagnosis. This is important, because intervention can prevent further damage if the cause of the pigmentary changes is destructive inflammation.

  18. Retinal detachment in paediatric patients

    International Nuclear Information System (INIS)

    Zafar, S. N.; Qureshi, N.; Azad, N.; Khan, A.

    2013-01-01

    Objective: To assess the causes of retinal detachment in children and the various operative procedures requiring vitreoretinal surgical intervention for the same. Study Design: Case series. Place and Duration of Study: Department of Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi, from January 2006 to May 2009. Methodology: A total of 281 eyes of 258 patients, (aged 0 - 18 years) who underwent vitreo-retinal surgical intervention for retinal detachment were included. Surgical log was searched for the type of retinal detachment and its causes. Frequencies of various interventions done in these patients viz. vitrectomy, scleral buckle, use of tamponading agents, laser photocoagulation and cryotherapy were noted. Results were described as descriptive statistics. Results: Myopia was the cause in 62 (22.1%) and trauma in 51 (18.1%) of the eyes. Total retinal detachment (RD) was treated in 94 (33.5%) eyes, sub total RD in 36 (12.8%), recurrent RD in 32 (11.4%), giant retinal tear in 28 (10%), tractional RD in 15 (5.3%) and exudative RD in 2 (0.7%). Prophylactic laser or cryotherapy was applied in 74 (26.3%) of the eyes. Pars plana vitrectomy (PPV) was carried out in 159 (56.6%) eyes while scleral buckle procedure was done in 129 (45.9%) eyes. Silicon oil was used in 149 (53%), perfluorocarbon liquid in 32 (11.4%) and gas tamponade in 20 (7.1%) eyes. Conclusion: The most common cause of retinal detachment in paediatric patients was myopia, followed by trauma. Total RD was more common as compared to the other types. The most common procedure adopted was pars plana vitrectomy followed by scleral buckle procedure. (author)

  19. Retinal vascular oximetry during ranibizumab treatment of central retinal vein occlusion

    DEFF Research Database (Denmark)

    Traustason, Sindri; la Cour, Morten; Larsen, Michael

    2014-01-01

    PURPOSE: To investigate the effect of intravitreal injections of the vascular endothelial growth factor inhibitor ranibizumab on retinal oxygenation in patients with central retinal vein occlusion (CRVO). METHODS: Retinal oxygen saturation in patients with CRVO was analysed using the Oxymap Retin...

  20. Noninvasive Retinal Markers in Diabetic Retinopathy

    DEFF Research Database (Denmark)

    Blindbæk, Søren Leer; Torp, Thomas Lee; Lundberg, Kristian

    2017-01-01

    The retinal vascular system is the only part of the human body available for direct, in vivo inspection. Noninvasive retinal markers are important to identity patients in risk of sight-threatening diabetic retinopathy. Studies have correlated structural features like retinal vascular caliber...... and fractals with micro- and macrovascular dysfunction in diabetes. Likewise, the retinal metabolism can be evaluated by retinal oximetry, and higher retinal venular oxygen saturation has been demonstrated in patients with diabetic retinopathy. So far, most studies have been cross-sectional, but these can only...... retinopathy and diabetic macular edema. The Department of Ophthalmology at Odense University Hospital, Denmark, has a strong tradition of studying the retinal microvasculature in diabetic retinopathy. In the present paper, we demonstrate the importance of the retinal vasculature not only as predictors of long...

  1. Mitochondrial dysfunction underlying outer retinal diseases

    DEFF Research Database (Denmark)

    Lefevere, Evy; Toft-Kehler, Anne Katrine; Vohra, Rupali

    2017-01-01

    Dysfunction of photoreceptors, retinal pigment epithelium (RPE) or both contribute to the initiation and progression of several outer retinal disorders. Disrupted Müller glia function might additionally subsidize to these diseases. Mitochondrial malfunctioning is importantly associated with outer...

  2. Decompressive craniectomy in aneurysmal subarachnoid haemorrhage for hematoma or oedema versus secondary infarction

    NARCIS (Netherlands)

    Goedemans, Taco; Verbaan, Dagmar; Coert, Bert A.; Sprengers, Marieke E. S.; van den Berg, René; Vandertop, W. Peter; van den Munckhof, Pepijn

    2017-01-01

    Decompressive craniectomy (DC) has been proposed as lifesaving treatment in aneurysmal subarachnoid haemorrhage (aSAH) patients with elevated intracranial pressure (ICP). However, data is sparse and controversy exists whether the underlying cause of elevated ICP influences neurological outcome. The

  3. Development and validation of outcome prediction models for aneurysmal subarachnoid haemorrhage : The SAHIT multinational cohort study

    NARCIS (Netherlands)

    Jaja, Blessing N R; Saposnik, Gustavo; Lingsma, Hester F.; Macdonald, Erin; Thorpe, Kevin E.; Mamdani, Muhammed; Steyerberg, Ewout W.; Molyneux, Andrew; Manoel, Airton Leonardo De Oliveira; Schatlo, Bawarjan; Hanggi, Daniel; Hasan, David M.; Wong, George K C; Etminan, Nima; Fukuda, Hitoshi; Torner, James C.; Schaller, Karl L.; Suarez, Jose I.; Stienen, Martin N.; Vergouwen, Mervyn D.I.; Rinkel, Gabriel J.E.; Spears, Julian; Cusimano, Michael D.; Todd, Michael; Le Roux, Peter; Kirkpatrick, Peter J.; Pickard, John; Van Den Bergh, Walter M.; Murray, Gordon D; Johnston, S. Claiborne; Yamagata, Sen; Mayer, Stephan A.; Schweizer, Tom A.; Macdonald, R. Loch

    2018-01-01

    Objective To develop and validate a set of practical prediction tools that reliably estimate the outcome of subarachnoid haemorrhage from ruptured intracranial aneurysms (SAH). Design Cohort study with logistic regression analysis to combine predictors and treatment modality. Setting Subarachnoid

  4. Infrastructure and clinical practice for the detection and management of trauma-associated haemorrhage and coagulopathy

    NARCIS (Netherlands)

    Driessen, A.; Schäfer, N.; Albrecht, V.; Schenk, M.; Fröhlich, M.; Stürmer, E. K.; Maegele, M.; Johansson, Pär; Ostrowski, Sisse Rye; Tuovinen, Hannele; Stensballe, Jakob; Goslings, Johann Carel; Juffermans, Nicole; Balvers, Kirsten; Gaarder, Christine; Brohi, Karim; Eaglestone, Simon; Rourke, Claire; Campbell, Helen; Curry, Nicola; Stanworth, Simon; Maegele, Marc; Stürmer, Ewa K.; Schäfer, Nadine; Driessen, Arne; Orr, Adrian; Schubert, Axel

    2015-01-01

    Early detection and management of post-traumatic haemorrhage and coagulopathy have been associated with improved outcomes, but local infrastructures, logistics and clinical strategies may differ. To assess local differences in infrastructure, logistics and clinical management of trauma-associated

  5. Magnesium for aneurysmal subarachnoid haemorrhage (MASH-2): a randomised placebo-controlled trial

    NARCIS (Netherlands)

    Dorhout Mees, Sanne M.; Algra, Ale; Vandertop, W. Peter; van Kooten, Fop; Kuijsten, Hans A. J. M.; Boiten, Jelis; van Oostenbrugge, Robert J.; Al-Shahi Salman, Rustam; Lavados, Pablo M.; Rinkel, Gabriel J. E.; van den Bergh, Walter M.

    2012-01-01

    Background Magnesium sulphate is a neuroprotective agent that might improve outcome after aneurysmal subarachnoid haemorrhage by reducing the occurrence or improving the outcome of delayed cerebral ischaemia. We did a trial to test whether magnesium therapy improves outcome after aneurysmal

  6. Recognising haemorrhagic rash in children with fever: a survey of parents' knowledge.

    Science.gov (United States)

    Aurel, M; Dubos, F; Motte, B; Pruvost, I; Leclerc, F; Martinot, A

    2011-07-01

    Early recognition and treatment of meningococcal disease improves its outcome. Haemorrhagic rash is one of the most specific signs that parents can learn to recognise. To determine the percentage of parents able to recognise a haemorrhagic rash and perform the tumbler test. 123 parents of children consulting for mild injuries were interviewed about the significance and recognition of haemorrhagic rash in febrile children. Although 88% of parents undressed their children when they were febrile, it was never to look specifically for a skin rash. Only 7% (95% CI 3% to 12%) were able to recognise a petechial rash and knew the tumbler test. Information campaigns about the significance of haemorrhagic rash and about the tumbler test are needed.

  7. Diagnostic accuracy of guys Hospital stroke score (allen score) in acute supratentorial thrombotic/haemorrhagic stroke

    International Nuclear Information System (INIS)

    Zulfiqar, A.; Toori, K. U.; Khan, S. S.; Hamza, M. I. M.; Zaman, S. U.

    2006-01-01

    A consecutive series of 103 patients, 58% male with mean age of 62 year (range 40-75 years), admitted with supratentorial stroke in our teaching hospital were studied. All patients had Computer Tomography scan brain done after clinical evaluation and application of Allen stroke score. Computer Tomography Scan confirmed thrombotic stroke in 55 (53%) patients and haemorrhagic stroke in 48 (47%) patients. Out of the 55 patients with definitive thrombotic stroke on Computer Tomography Scan, Allen stroke score suggested infarction in 67%, haemorrhage in 6% and remained inconclusive in 27% of cases. In 48 patients with definitive haemorrhagic stroke on Computer Tomography Scan, Allen stroke score suggested haemorrhage in 60%, infarction in 11% and remained inconclusive in 29% of cases. The overall accuracy of Allen stroke score was 66%. (author)

  8. Bakri balloon as a uterus preserving treatment of uncontrollable haemorrhage one month post-partum

    DEFF Research Database (Denmark)

    Bonnici, Mia; Markauskas, Algirdas; Munk, Torben

    2014-01-01

    In this case Bakri balloon was used to stop haemorrhage one month post-partum. The case introduces the use of this device outside usual indications. A 27-year-old woman was admitted several times with vaginal bleeding after caesarean section. She was treated pharmacologically and with curettage. ....... One month post-partum hysteroscopic removal of placental tissue was done. During this uncontrollable haemorrhage occurred and hysterectomy was considered. An attempt to save the uterus with Bakri balloon was made succesfully....

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

    Science.gov (United States)

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

    2013-08-29

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

  10. Risk factors for severe post partum haemorrhage in Mulago hospital, Kampala, Uganda.

    Science.gov (United States)

    Wandabwa, J; Doyle, P; Todd, J; Ononge, S; Kiondo, P

    2008-02-01

    To determine the risk factors for severe postpartum haemorrhage. A case control study. Mulago hospital labour wards, Kampala, Uganda. One hundred and six mothers with severe postpartum haemorrhage were recruited between 15th November 2001 and 30th November 2002 and were compared with 500 women who had normal delivery. The predictors for postpartum haemorrhage were co-existing hypertension (O.R 9.3, 95% CI: 1.7-51.7), chronic anaemia (OR 17.3, 95% CI: 9.5-31.7), low socio economic background (OR 5.3, 95% CI: 3.0, 9.2), past history of postpartum haemorrhage (OR 3.6, 95% CI: 1.1-11.8), previous delivery by Caesarean section (OR 7.5, 95% CI: 3.5-14.3), long birth interval of more than sixty months (OR 5.2, 95% CI: 2.1-13.0), prolonged third stage (OR 49.1, 95% CI: 8.8-342.8) and non use of oxytocics (OR 4.3%, 95% CI: 1.2-15.3). Severe postpartum haemorrhage is common in our environment and is associated with a high maternal morbidity and mortality. The determinants of postpartum haemorrhage are useful in identifying mothers at risk and together with the services of a skilled birth attendant at delivery will prevent postpartum haemorrhage and reduce the maternal morbidity and mortality associated with this condition. In our study, the following risk factors were identified: pre-existing hypertension, chronic anaemia, low socio-economic background, history of postpartum haemorrhage, previous delivery by Caesarean section, longbirth interval of more than sixty months, prolonged third stage and non use of oxytocics were found to be significant.

  11. Is arterial hypertension crucial for the development of cerebral haemorrhage in premature infants?

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Friis-Hansen, B

    1979-01-01

    Computerised tomography has revealed that more than 40% of premature neonates (birth weight smaller than 1500 g) have cerebral bleeds in the first 3 or 4 days of extrauterine life. Injection studies done at necropsy have shown that they usually originate in the capillaries of the germinal matrix....

  12. MOIRA: a computerised decision support system for the restoration of radionuclide contaminated freshwater ecosystems

    International Nuclear Information System (INIS)

    Gallego, Eduardo; Brittain, J.E.; Hakanson, Lars; Heling, Rudie; Hofman, Dmitry; Monte, Luigi

    2000-01-01

    The radiation dose resulting from contamination of freshwater ecosystems due to the release of radioactive substances into the environment may be reduced by applying suitable countermeasures. The options for intervention are wide-ranging and can be broadly grouped into three main categories: chemical, physical and social countermeasures. In some cases, a combination of actions -or even the no action- may be the optimal strategy. Despite their benefits, intervention strategies may have detrimental effects of economic, ecological and social nature. Thus, it is of paramount importance to assess, by objective criteria, the global cost-benefit balance of different options. The MOIRA project (A MOdel based computerised system for management support to Identity optimal remedial strategies for Restoring radionuclide contaminated Aquatic ecosystems, European Commission contract FI4P-CT96-0036) has developed a user-friendly, computerised tool that will allow decision makers to choose optimal intervention strategies for freshwater ecosystems with different contamination scenarios. To achieve that goal, the MOIRA software system -apart from a user-friendly interface- incorporates several innovative aspects: - eographical information system (GIS) and databases to get to get the values of the model parameters at different locations in Europe. - redictive ecosystem models for the behaviour of radionuclides (namely Cs-137 and Sr-90) in catchments, lakes and rivers, complemented with models of the effect of the countermeasures on the environmental contamination levels. These models are based on an extensive use of aggregate parameters' that summarise, in single quantities, the effects of a variety of environmental processes. Methods for critical model testing, sensitivity and uncertainty analyses have been applied to them getting a high reliability. - cosystem index (EI) to handle the influence chemical remedial measures may have on the structure, reproduction and biomass of key

  13. Retinal detachment in black South Africans

    African Journals Online (AJOL)

    low incidence of retinal detachment in black patients is not known. ... a retinal break. Predisposing factors include peripheral retinal degenerations, myopia, aphakia and trauma. Delay in presentation increases the difficulty in achieving adequate surgical ... On examination, note was taken of the visual acuity in both eyes, the ...

  14. Transcorneal Electrical Stimulation Therapy for Retinal Disease

    Science.gov (United States)

    2012-05-03

    Retinitis Pigmentosa; Macula Off; Primary Open Angle Glaucoma; Hereditary Macular Degeneration; Treated Retina Detachment; Retinal Artery Occlusion; Retinal Vein Occlusion; Non-Arthritic-Anterior-Ischemic Optic-Neuropathy; Hereditary Autosomal Dominant Optic Atrophy; Dry Age Related Macular Degeneration; Ischemic Macula Edema

  15. Diabetes and Retinal Vascular Dysfunction

    Directory of Open Access Journals (Sweden)

    Eui Seok Shin

    2014-01-01

    Full Text Available Diabetes predominantly affects the microvascular circulation of the retina resulting in a range of structural changes unique to this tissue. These changes ultimately lead to altered permeability, hyperproliferation of endothelial cells and edema, and abnormal vascularization of the retina with resulting loss of vision. Enhanced production of inflammatory mediators and oxidative stress are primary insults with significant contribution to the pathogenesis of diabetic retinopathy (DR. We have determined the identity of the retinal vascular cells affected by hyperglycemia, and have delineated the cell autonomous impact of high glucose on function of these cells. We discuss some of the high glucose specific changes in retinal vascular cells and their contribution to retinal vascular dysfunction. This knowledge provides novel insight into the molecular and cellular defects contributing to the development and progression of diabetic retinopathy, and will aid in the development of innovative, as well as target specific therapeutic approaches for prevention and treatment of DR.

  16. The effectiveness of computerised decision support on antibiotic use in hospitals: A systematic review

    Science.gov (United States)

    2017-01-01

    Background Inappropriate antimicrobial use has been shown to be an important determinant of the emergence of antimicrobial resistance (AMR). Health information technology (HIT) in the form of Computerised Decision Support (CDS) represents an option for improving antimicrobial prescribing and containing AMR. Objectives To evaluate the evidence for CDS in improving quantitative and qualitative measures of antibiotic prescribing in inpatient hospital settings. Methods A systematic literature search was conducted of articles published from inception to 20th December 2014 using eight electronic databases: MEDLINE, EMBASE, PUBMED, Web of Science, CINAHL, Cochrane Library, HMIC and PsychINFo. An updated systematic literature search was conducted from January 1st 2015 to October 1st 2016 using PUBMED. The search strategy used combinations of the following terms: (electronic prescribing) OR (clinical decision support) AND (antibiotic or antibacterial or antimicrobial) AND (hospital or secondary care or inpatient). Studies were evaluated for quality using a 10-point rating scale. Results Eighty-one studies were identified matching the inclusion criteria. Seven outcome measures were evaluated: adequacy of antibiotic coverage, mortality, volume of antibiotic usage, length of stay, antibiotic cost, compliance with guidelines, antimicrobial resistance, and CDS implementation and uptake. Meta-analysis of pooled outcomes showed CDS significantly improved the adequacy of antibiotic coverage (n = 13; odds ratio [OR], 2.11 [95% CI, 1.67 to 2.66, p ≤ 0.00001]). Also, CDS was associated with marginally lowered mortality (n = 20; OR, 0.85 [CI, 0.75 to 0.96, p = 0.01]). CDS was associated with lower antibiotic utilisation, increased compliance with antibiotic guidelines and reductions in antimicrobial resistance. Conflicting effects of CDS on length of stay, antibiotic costs and system uptake were also noted. Conclusions CDS has the potential to improve the adequacy of antibiotic

  17. A comparison of scoring models for computerised mental health screening for federal prison inmates.

    Science.gov (United States)

    Martin, Michael S; Wamboldt, Ashley D; O'Connor, Shannon L; Fortier, Julie; Simpson, Alexander I F

    2013-02-01

    There are high rates of mental disorder in correctional environments, so effective mental health screening is needed. Implementation of the computerised mental health screen of the Correctional Service of Canada has led to improved identification of offenders with mental health needs but with high rates of false positives. The goal of this study is to evaluate the use of an iterative classification tree (ICT) approach to mental health screening compared with a simple binary approach using cut-off scores on screening tools. A total of 504 consecutive admissions to federal prison completed the screen and were also interviewed by a mental health professional. Relationships between screening results and more extended assessment and clinical team discussion were tested. The ICT was more parsimonious in identifying probable 'cases' than standard binary screening. ICT was also highly accurate at detecting mental health needs (AUC=0.87, 95% CI 0.84-0.90). The model identified 118 (23.4%) offenders as likely to need further assessment or treatment, 87% of whom were confirmed cases at clinical interview. Of the 244 (48.4%) offenders who were screened out, only 9% were clinically assessed as requiring further assessment or treatment. Standard binary screening was characterised by more false positives and a comparable false negative rate. The use of ICTs to interpret screening data on the mental health of prisoners needs further evaluation in independent samples in Canada and elsewhere. This first evaluation of the application of such an approach offers the prospect of more effective and efficient use of the scarce resource of mental health services in prisons. Although not required, the use of computers can increase the ease of implementing an ICT model. Copyright © 2013 John Wiley & Sons, Ltd.

  18. Mortality Benefits of Antibiotic Computerised Decision Support System: Modifying Effects of Age

    Science.gov (United States)

    Chow, Angela L. P.; Lye, David C.; Arah, Onyebuchi A.

    2015-11-01

    Antibiotic computerised decision support systems (CDSSs) are shown to improve antibiotic prescribing, but evidence of beneficial patient outcomes is limited. We conducted a prospective cohort study in a 1500-bed tertiary-care hospital in Singapore, to evaluate the effectiveness of the hospital’s antibiotic CDSS on patients’ clinical outcomes, and the modification of these effects by patient factors. To account for clustering, we used multilevel logistic regression models. One-quarter of 1886 eligible inpatients received CDSS-recommended antibiotics. Receipt of antibiotics according to CDSS’s recommendations seemed to halve mortality risk of patients (OR 0.54, 95% CI 0.26-1.10, P = 0.09). Patients aged ≤65 years had greater mortality benefit (OR 0.45, 95% CI 0.20-1.00, P = 0.05) than patients that were older than 65 (OR 1.28, 95% CI 0.91-1.82, P = 0.16). No effect was observed on incidence of Clostridium difficile (OR 1.02, 95% CI 0.34-3.01), and multidrug-resistant organism (OR 1.06, 95% CI 0.42-2.71) infections. No increase in infection-related readmission (OR 1.16, 95% CI 0.48-2.79) was found in survivors. Receipt of CDSS-recommended antibiotics reduced mortality risk in patients aged 65 years or younger and did not increase the risk in older patients. Physicians should be informed of the benefits to increase their acceptance of CDSS recommendations.

  19. Targeted computerised tomography scanning of the ankle syndesmosis with low dose radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Kotwal, Rahul [Princess of Wales Hospital, Bridgend (United Kingdom); Rath, Narendra [Royal Gwent Hospital, Newport (United Kingdom); Paringe, Vishal; Hemmadi, Sandeep; Thomas, Rhys; Lyons, Kath [University Hospital of Wales, Cardiff (United Kingdom)

    2016-03-15

    To devise a new protocol for targeted CT scanning of the distal tibiofibular syndesmosis with minimal radiation exposure to patients. We also aimed to correlate the reduction of the syndesmosis as seen on CT scans with the functional outcome of patients. Prospective study. Forty adults undergoing surgical stabilisation of an acute distal tibiofibular syndesmosis injury were recruited. A targeted five-cut computerised tomography scan protocol was developed. The radiation exposure to the patient with this protocol was only 0.002 mSv. Scans were performed 12 weeks after surgery. The contralateral ankle of every patient was used as a control to determine the accuracy of the reduction of the syndesmosis for that individual patient. American Orthopaedic Foot and Ankle Society (AOFAS) scores were obtained at a minimum of 1 year after surgery. After considering the exclusions, 36 patients formed the study group. A wide variation was observed in the anatomy of the normal syndesmosis. If we considered a difference of more than 2 mm between the normal and injured syndesmosis relationship as significant, 15 (41.6 %) of our patients had a significant difference between the injured and normal sides. AOFAS scores were available for 13 of these patients and were good to excellent in 11(84.6 %). Our study describes a reliable new CT scanning technique for the distal tibiofibular syndesmosis using only five cuts and a low-radiation-dose protocol. Clinical correlation of the findings on the scan with functional outcomes suggests that routine post-operative CT of the syndesmosis is probably not justified. (orig.)

  20. The effectiveness of computerised decision support on antibiotic use in hospitals: A systematic review.

    Directory of Open Access Journals (Sweden)

    Christopher E Curtis

    Full Text Available Inappropriate antimicrobial use has been shown to be an important determinant of the emergence of antimicrobial resistance (AMR. Health information technology (HIT in the form of Computerised Decision Support (CDS represents an option for improving antimicrobial prescribing and containing AMR.To evaluate the evidence for CDS in improving quantitative and qualitative measures of antibiotic prescribing in inpatient hospital settings.A systematic literature search was conducted of articles published from inception to 20th December 2014 using eight electronic databases: MEDLINE, EMBASE, PUBMED, Web of Science, CINAHL, Cochrane Library, HMIC and PsychINFo. An updated systematic literature search was conducted from January 1st 2015 to October 1st 2016 using PUBMED. The search strategy used combinations of the following terms: (electronic prescribing OR (clinical decision support AND (antibiotic or antibacterial or antimicrobial AND (hospital or secondary care or inpatient. Studies were evaluated for quality using a 10-point rating scale.Eighty-one studies were identified matching the inclusion criteria. Seven outcome measures were evaluated: adequacy of antibiotic coverage, mortality, volume of antibiotic usage, length of stay, antibiotic cost, compliance with guidelines, antimicrobial resistance, and CDS implementation and uptake. Meta-analysis of pooled outcomes showed CDS significantly improved the adequacy of antibiotic coverage (n = 13; odds ratio [OR], 2.11 [95% CI, 1.67 to 2.66, p ≤ 0.00001]. Also, CDS was associated with marginally lowered mortality (n = 20; OR, 0.85 [CI, 0.75 to 0.96, p = 0.01]. CDS was associated with lower antibiotic utilisation, increased compliance with antibiotic guidelines and reductions in antimicrobial resistance. Conflicting effects of CDS on length of stay, antibiotic costs and system uptake were also noted.CDS has the potential to improve the adequacy of antibiotic coverage and marginally decrease mortality in

  1. Targeted computerised tomography scanning of the ankle syndesmosis with low dose radiation exposure

    International Nuclear Information System (INIS)

    Kotwal, Rahul; Rath, Narendra; Paringe, Vishal; Hemmadi, Sandeep; Thomas, Rhys; Lyons, Kath

    2016-01-01

    To devise a new protocol for targeted CT scanning of the distal tibiofibular syndesmosis with minimal radiation exposure to patients. We also aimed to correlate the reduction of the syndesmosis as seen on CT scans with the functional outcome of patients. Prospective study. Forty adults undergoing surgical stabilisation of an acute distal tibiofibular syndesmosis injury were recruited. A targeted five-cut computerised tomography scan protocol was developed. The radiation exposure to the patient with this protocol was only 0.002 mSv. Scans were performed 12 weeks after surgery. The contralateral ankle of every patient was used as a control to determine the accuracy of the reduction of the syndesmosis for that individual patient. American Orthopaedic Foot and Ankle Society (AOFAS) scores were obtained at a minimum of 1 year after surgery. After considering the exclusions, 36 patients formed the study group. A wide variation was observed in the anatomy of the normal syndesmosis. If we considered a difference of more than 2 mm between the normal and injured syndesmosis relationship as significant, 15 (41.6 %) of our patients had a significant difference between the injured and normal sides. AOFAS scores were available for 13 of these patients and were good to excellent in 11(84.6 %). Our study describes a reliable new CT scanning technique for the distal tibiofibular syndesmosis using only five cuts and a low-radiation-dose protocol. Clinical correlation of the findings on the scan with functional outcomes suggests that routine post-operative CT of the syndesmosis is probably not justified. (orig.)

  2. Ethnicity Recording in Primary Care Computerised Medical Record Systems: An Ontological Approach

    Directory of Open Access Journals (Sweden)

    Zayd Tippu

    2017-03-01

    Full Text Available Background Ethnicity recording within primary care computerised medical record (CMR systems is suboptimal, exacerbated by tangled taxonomies within current coding systems. Objective To develop a method for extending ethnicity identification using routinely collected data. Methods We used an ontological method to maximise the reliability and prevalence of ethnicity information in the Royal College of General Practitioner’s Research and Surveillance database. Clinical codes were either directly mapped to ethnicity group or utilised as proxy markers (such as language spoken from which ethnicity could be inferred. We compared the performance of our method with the recording rates that would be identified by code lists utilised by the UK pay for the performance system, with the help of the Quality and Outcomes Framework (QOF. Results Data from 2,059,453 patients across 110 practices were included. The overall categorisable ethnicity using QOF codes was 36.26% (95% confidence interval (CI: 36.20%–36.33%. This rose to 48.57% (CI:48.50%–48.64% using the described ethnicity mapping process. Mapping increased across all ethnic groups. The largest increase was seen in the white ethnicity category (30.61%; CI: 30.55%–30.67% to 40.24%; CI: 40.17%–40.30%. The highest relative increase was in the ethnic group categorised as the other (0.04%; CI: 0.03%–0.04% to 0.92%; CI: 0.91%–0.93%. Conclusions This mapping method substantially increases the prevalence of known ethnicity in CMR data and may aid future epidemiological research based on routine data.

  3. Patch: platelet transfusion in cerebral haemorrhage: study protocol for a multicentre, randomised, controlled trial

    Directory of Open Access Journals (Sweden)

    Dijkgraaf Marcel G

    2010-03-01

    Full Text Available Abstract Background Patients suffering from intracerebral haemorrhage have a poor prognosis, especially if they are using antiplatelet therapy. Currently, no effective acute treatment option for intracerebral haemorrhage exists. Limiting the early growth of intracerebral haemorrhage volume which continues the first hours after admission seems a promising strategy. Because intracerebral haemorrhage patients who are on antiplatelet therapy have been shown to be particularly at risk of early haematoma growth, platelet transfusion may have a beneficial effect. Methods/Design The primary objective is to investigate whether platelet transfusion improves outcome in intracerebral haemorrhage patients who are on antiplatelet treatment. The PATCH study is a prospective, randomised, multi-centre study with open treatment and blind endpoint evaluation. Patients will be randomised to receive platelet transfusion within six hours or standard care. The primary endpoint is functional health after three months. The main secondary endpoints are safety of platelet transfusion and the occurrence of haematoma growth. To detect an absolute poor outcome reduction of 20%, a total of 190 patients will be included. Discussion To our knowledge this is the first randomised controlled trial of platelet transfusion for an acute haemorrhagic disease. Trial registration The Netherlands National Trial Register (NTR1303

  4. MDCT diagnostic work-up of patients with subarachnoid haemorrhage

    International Nuclear Information System (INIS)

    Phanis, S.; Nikolopoulos, P.; Veliou, K.; Tsampoulas, C.; Efremidis, S.

    2006-01-01

    Full text: Our presentation is intended to analyze our experience over the last two years, in the expeditious work up of patients with subarachnoid haemorrhage, as well as patients whose clinical symptoms combined with radiological findings are highly suspicious of an aneurysm, acute arterial occlusion, cerebral vascular malformation, venous occlusion, dissection of the internal carotid artery or vertebral artery. 276 CT Angiographies of the brain have been performed and recorded over the last two years in our Department, on a 16 Detector Philips MX8000IDT Computed Tomograph. The patients are referred to our Department from the Emergency Department of our Hospital, as well as from Hospitals all over Northwestern Greece. The CT Angiographies are performed with examination protocols, which we will analyze thoroughly in our presentation. The primary data are then studied in workstations away from the main console of the Computed Tomograph. The study of the primary data consists in multiplanar reconstructions with the Maximum Intensity Algorithm, as well as Volume Rendering and three Dimensional Reconstruction. The stages we follow for these procedures will be presented as well as the procedures for the removal of bone structures, with the intention of the best possible angiographic results. Of the 276 patients 40 were diagnosed with an aneurysm,19 with a venous angioma, 2 with a vascular malformation, 3 with venous occlusion and 2 with dissection, a total of 66/276 with aneurysms and vascular malformations. These patients were subsequently referred to the Neurosurgery Clinic or to the Department of Interventional Radiology for further treatment. The remaining 210 patients, underwent in the following days of their hospitalization a Digital Subtraction Angiography, and in 16 (7.6%) of them a small aneurysm, 3-5 mm was diagnosed. The aneurysm was detected in a second reading of the CT Angiography in 8 patients (3.8%). The CT Angiography in patients with subarachnoid

  5. Retinal image quality during accommodation.

    Science.gov (United States)

    López-Gil, Norberto; Martin, Jesson; Liu, Tao; Bradley, Arthur; Díaz-Muñoz, David; Thibos, Larry N

    2013-07-01

    We asked if retinal image quality is maximum during accommodation, or sub-optimal due to accommodative error, when subjects perform an acuity task. Subjects viewed a monochromatic (552 nm), high-contrast letter target placed at various viewing distances. Wavefront aberrations of the accommodating eye were measured near the endpoint of an acuity staircase paradigm. Refractive state, defined as the optimum target vergence for maximising retinal image quality, was computed by through-focus wavefront analysis to find the power of the virtual correcting lens that maximizes visual Strehl ratio. Despite changes in ocular aberrations and pupil size during binocular viewing, retinal image quality and visual acuity typically remain high for all target vergences. When accommodative errors lead to sub-optimal retinal image quality, acuity and measured image quality both decline. However, the effect of accommodation errors of on visual acuity are mitigated by pupillary constriction associated with accommodation and binocular convergence and also to binocular summation of dissimilar retinal image blur. Under monocular viewing conditions some subjects displayed significant accommodative lag that reduced visual performance, an effect that was exacerbated by pharmacological dilation of the pupil. Spurious measurement of accommodative error can be avoided when the image quality metric used to determine refractive state is compatible with the focusing criteria used by the visual system to control accommodation. Real focusing errors of the accommodating eye do not necessarily produce a reliably measurable loss of image quality or clinically significant loss of visual performance, probably because of increased depth-of-focus due to pupil constriction. When retinal image quality is close to maximum achievable (given the eye's higher-order aberrations), acuity is also near maximum. A combination of accommodative lag, reduced image quality, and reduced visual function may be a useful

  6. Lesion detection in ultra-wide field retinal images for diabetic retinopathy diagnosis

    Science.gov (United States)

    Levenkova, Anastasia; Sowmya, Arcot; Kalloniatis, Michael; Ly, Angelica; Ho, Arthur

    2018-02-01

    Diabetic retinopathy (DR) leads to irreversible vision loss. Diagnosis and staging of DR is usually based on the presence, number, location and type of retinal lesions. Ultra-wide field (UWF) digital scanning laser technology provides an opportunity for computer-aided DR lesion detection. High-resolution UWF images (3078×2702 pixels) may allow detection of more clinically relevant retinopathy in comparison with conventional retinal images as UWF imaging covers a 200° retinal area, versus 45° by conventional cameras. Current approaches to DR diagnosis that analyze 7-field Early Treatment Diabetic Retinopathy Study (ETDRS) retinal images provide similar results to UWF imaging. However, in 40% of cases, more retinopathy was found outside the 7- field ETDRS fields by UWF and in 10% of cases, retinopathy was reclassified as more severe. The reason is that UWF images examine both the central retina and more peripheral regions. We propose an algorithm for automatic detection and classification of DR lesions such as cotton wool spots, exudates, microaneurysms and haemorrhages in UWF images. The algorithm uses convolutional neural network (CNN) as a feature extractor and classifies the feature vectors extracted from colour-composite UWF images using a support vector machine (SVM). The main contribution includes detection of four types of DR lesions in the peripheral retina for diagnostic purposes. The evaluation dataset contains 146 UWF images. The proposed method for detection of DR lesion subtypes in UWF images using two scenarios for transfer learning achieved AUC ≈ 80%. Data was split at the patient level to validate the proposed algorithm.

  7. Dengue fever and dengue haemorrhagic fever in adolescents and adults.

    Science.gov (United States)

    Tantawichien, Terapong

    2012-05-01

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

  8. Imaging cerebral haemorrhage with magnetic induction tomography: numerical modelling.

    Science.gov (United States)

    Zolgharni, M; Ledger, P D; Armitage, D W; Holder, D S; Griffiths, H

    2009-06-01

    Magnetic induction tomography (MIT) is a new electromagnetic imaging modality which has the potential to image changes in the electrical conductivity of the brain due to different pathologies. In this study the feasibility of detecting haemorrhagic cerebral stroke with a 16-channel MIT system operating at 10 MHz was investigated. The finite-element method combined with a realistic, multi-layer, head model comprising 12 different tissues, was used for the simulations in the commercial FE package, Comsol Multiphysics. The eddy-current problem was solved and the MIT signals computed for strokes of different volumes occurring at different locations in the brain. The results revealed that a large, peripheral stroke (volume 49 cm(3)) produced phase changes that would be detectable with our currently achievable instrumentation phase noise level (17 m degrees ) in 70 (27%) of the 256 exciter/sensor channel combinations. However, reconstructed images showed that a lower noise level than this, of 1 m degrees , was necessary to obtain good visualization of the strokes. The simulated MIT measurements were compared with those from an independent transmission-line-matrix model in order to give confidence in the results.

  9. Endovascular management of delayed post-pancreatectomy haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Pottier, Edwige [Beaujon Hospital, University Hospitals Paris Nord Val de Seine, Department of Radiology, Clichy, Hauts-de-Seine (France); Ronot, Maxime; Vilgrain, Valerie [Beaujon Hospital, University Hospitals Paris Nord Val de Seine, Department of Radiology, Clichy, Hauts-de-Seine (France); University Paris Diderot, Paris (France); INSERM U1149, centre de recherche biomedicale Bichat-Beaujon, CRB3, Paris (France); Gaujoux, Sebastien; Cesaretti, Manuela; Barbier, Louise [APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Department of Surgery, Clichy, Hauts-de-Seine (France); Sauvanet, Alain [University Paris Diderot, Paris (France); APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Department of Surgery, Clichy, Hauts-de-Seine (France)

    2016-10-15

    To assess the patient outcome after endovascular treatment of delayed post-pancreatectomy haemorrhage (PPH) as first-line treatment. Between January 2005 and November 2013, all consecutive patients referred for endovascular treatment of PPH were included. Active bleeding, pseudoaneurysms, collections and the involved artery were recorded on pretreatment CT. Endovascular procedures were classified as technical success (source of bleeding identified on angiogram and treated), technical failure (source of bleeding identified but incompletely treated) and abstention (no abnormality identified, no treatment performed). Factors associated with rebleeding were analysed. Sixty-nine patients (53 men) were included (mean 59 years old (32-75)). Pretreatment CT showed 27 (39 %) active bleeding. In 22 (32 %) cases, no involved artery was identified. Technical success, failure and abstention were observed in 48 (70 %), 9 (13 %) and 12 patients (17 %), respectively. Thirty patients (43 %) experienced rebleeding. Rebleeding rates were 29 %, 58 % and 100 % in case of success, abstention and failure (p < 0.001). Treatment failure/abstention was the only factor associated with rebleeding. Overall, 74 % of the patients were successfully treated by endovascular procedure(s) alone. After a first endovascular procedure for PPH, the rebleeding rate is high and depends upon the success of the procedure. Most patients are successfully treated by endovascular approach(es) alone. (orig.)

  10. Endovascular management of delayed post-pancreatectomy haemorrhage

    International Nuclear Information System (INIS)

    Pottier, Edwige; Ronot, Maxime; Vilgrain, Valerie; Gaujoux, Sebastien; Cesaretti, Manuela; Barbier, Louise; Sauvanet, Alain

    2016-01-01

    To assess the patient outcome after endovascular treatment of delayed post-pancreatectomy haemorrhage (PPH) as first-line treatment. Between January 2005 and November 2013, all consecutive patients referred for endovascular treatment of PPH were included. Active bleeding, pseudoaneurysms, collections and the involved artery were recorded on pretreatment CT. Endovascular procedures were classified as technical success (source of bleeding identified on angiogram and treated), technical failure (source of bleeding identified but incompletely treated) and abstention (no abnormality identified, no treatment performed). Factors associated with rebleeding were analysed. Sixty-nine patients (53 men) were included (mean 59 years old (32-75)). Pretreatment CT showed 27 (39 %) active bleeding. In 22 (32 %) cases, no involved artery was identified. Technical success, failure and abstention were observed in 48 (70 %), 9 (13 %) and 12 patients (17 %), respectively. Thirty patients (43 %) experienced rebleeding. Rebleeding rates were 29 %, 58 % and 100 % in case of success, abstention and failure (p < 0.001). Treatment failure/abstention was the only factor associated with rebleeding. Overall, 74 % of the patients were successfully treated by endovascular procedure(s) alone. After a first endovascular procedure for PPH, the rebleeding rate is high and depends upon the success of the procedure. Most patients are successfully treated by endovascular approach(es) alone. (orig.)

  11. Brainstem Auditory Evoked Potentials in Patients with Subarachnoid Haemorrhage

    Directory of Open Access Journals (Sweden)

    Mikhail Matveev

    2009-10-01

    Full Text Available Objective. The aim of the present study is to typify BAEPs configurations of patients with different location of lesions caused by subarachnoid haemorrhage (SAH and the ensuing complications, in view of assessing the auditory-brainstem system disturbance.Methods. The typization was performed by comparing BAEPs with standard patterns from two sets of types of BAEPs by ipsilateral and binaural stimulation and by cross-stimulation.Results. 94 BAEPs were used for collection of normal referential values: for the absolute latencies and the absolute amplitudes of waves I, II, III, IV and V; for inter-peak latencies I-III, II-III, III-V, I-V and II-V; for amplitude ratios I/V and III/V. 146 BAEPs of patients with mild SAH and 55 from patients with severe SAH, were typified. In 5 types of BAEPs out of a total of 11, the percentage of the potentials in patients with mild SAH and severe SAH differed significantly (p<0.01.Conclusions. The use of sets of types of BAEPs by ipsilateral, binaural and cross-stimulation correctly classifies the potentials in patients with mild and severe SAH.

  12. Quality of care in the management of major obstetric haemorrhage.

    LENUS (Irish Health Repository)

    Johnson, S N

    2012-02-01

    Substandard care is reported to occur in a large number of cases of major obstetric haemorrhage (MOH). A prospective audit was carried out by a multidisciplinary team at our hospital over a one year period to assess the quality of care (QOC) delivered to women experiencing MOH. MOH was defined according to criteria outlined in the Scottish Audit of Maternal Morbidity (SAMM). 31 cases were identified yielding an incidence of 3.5\\/1000 deliveries. The predominant causes were uterine atony 11 (35.4%), retained products of conception 6 (19.3%) and placenta praevia\\/accreta 6 (19.3%). Excellent initial resuscitation and monitoring was noted with a high level of senior staff input. Indicators of QOC compared favourably with the SAMM. Areas for improvement were identified. This pilot study demonstrates the feasibility of detailed prospective data collection in MOH in a busy Dublin obstetric unit with a view to developing a national audit. Standardization of definitions allows for international comparisons.

  13. Bevacizumab: an option for refractory epistaxis in hereditary haemorrhagic telangiectasia.

    Science.gov (United States)

    Amann, Arno; Steiner, Normann; Gunsilius, Eberhard

    2015-08-01

    Recurrent epistaxis in hereditary haemorrhagic telangiectasia (HHT) patients significantly decreases their quality of life. Treatment in therapy refractory patients is limited although various options have been tested so far. Herein, one patient is described that was treated for HHT for over 20 years with only intermediate benefits. As epistaxis duration and frequency increased continuously, bevacizumab 5 mg/kg was administered every 2 weeks. During the time of treatment (six doses) and up to 3 month afterwards clinical symptoms, blood pressure, cardiac output, pulmonary arterial hypertension (PAH), bleeding duration and frequency were assessed as criteria for treatment benefit. Duration and frequency of epistaxis decreased immediately after the first application resulting in reduced need of blood transfusions. After completion of six cycles, a further decrease in frequency and duration of bleeding was noted. Cardiac output and PAH decreased or remained stable, respectively, during time and after treatment. No increase in blood pressure could be found but a significant increase in heart rate was experienced after completion of all six applications. Unfortunately, the patient died due to a cerebral abscess. Bevacizumab led to an improvement of HHT related epistaxis, refractory to other treatments.

  14. ELECTROCARDIOGRAPHIC CHANGES OBSERVED IN HAEMORRHAGIC AND ISCHAEMIC CEREBROVASCULAR DISEASES

    Directory of Open Access Journals (Sweden)

    Channappa

    2016-03-01

    Full Text Available INTRODUCTION Cardiac abnormalities are relatively common after acute neurologic injury. Disturbances can vary in severity from transient ECG abnormalities to profound myocardial injury and dysfunction. CNS is involved in the generation of cardiac arrhythmias and dysfunction even in an otherwise normal myocardium. AIM To find out proportion of ECG changes observed in ischaemic and haemorrhagic stroke. MATERIALS AND METHODS The Electrocardiographs of 100 patients with acute stroke were studied to find out the types of ECG abnormalities among different types of stroke. RESULTS In our study, the most common ECG abnormalities associated with stroke were prolonged QTc interval, ST-T segment abnormalities, prominent U wave and arrhythmias. Trop-I was positive in 12.8% patients with ECG changes. Statistical significance was found in association with Trop-I positivity and ST depression. CONCLUSION Usually patients with heart disease present with arrhythmias and Ischaemic like ECG changes. But these changes are also seen most often in the patients with presenting with stroke who didn’t have any past history of heart disease. This shows that arrhythmias and ischaemic ECG abnormalities are primarily evolved due to central nervous system disorders.

  15. Acute subarachnoid haemorrhage: Is a negative CT angiogram enough?

    International Nuclear Information System (INIS)

    MacKinnon, A.D.; Clifton, A.G.; Rich, P.M.

    2013-01-01

    Aim: To determine the negative predictive value of 16 channel multisection computed tomography angiography (CTA) for detecting aneurysms in spontaneous subarachnoid haemorrhage (SAH), using digital subtraction angiography (DSA) as the reference standard. Materials and methods: The prospectively collected cerebral angiogram database of Department of Neuroradiology, Atkinson Morley Regional Neuroscience Centre was used to identify 200 consecutive patients who had undergone DSA for SAH. Of these, 176 had undergone CTA prior to DSA. Clinical details and radiology reports were correlated and images of positive investigations reviewed. Results: DSA showed one or more cerebral aneurysms in 105 (60%) patients. These were correctly reported on CTA in 100. CTA was reported negative for aneurysms in 74 patients. Of these five were false negative and had aneurysms detected on DSA. In the CTA/DSA negative group, 11 (16%) patients had classical perimesencephalic clinical syndrome and blood distribution. There were two false positives at CTA. For ruptured cerebral aneurysms, CTA had 95.2% sensitivity, 97.2% specificity, 98.1% positive predictive value, and 93.2% negative predictive value. Conclusion: The sensitivity and negative predictive value of CTA for ruptured aneurysms remains imperfect. Continued use of DSA is recommended in most patients with a negative CTA after acute SAH. Confirmation of a negative CTA result with DSA may not be routinely required in patients with perimesencephalic syndrome

  16. Classification of non-aneurysmal subarachnoid haemorrhage: CT correlation to the clinical outcome

    International Nuclear Information System (INIS)

    Nayak, S.; Kunz, A.B.; Kieslinger, K.; Ladurner, G.; Killer, M.

    2010-01-01

    Aim: To propose a new computed tomography (CT)-based classification system for non-aneurysmal subarachnoid haemorrhage (SAH), which predicts patients' discharge clinical outcome and helps to prioritize appropriate patient management. Methods and materials: A 5-year, retrospective, two-centre study was carried out involving 1486 patients presenting with SAH. One hundred and ninety patients with non-aneurysmal SAH were included in the study. Initial cranial CT findings at admission were correlated with the patients' discharge outcomes measured using the Modified Rankin Scale (MRS). A CT-based classification system (type 1-4) was devised based on the topography of the initial haemorrhage pattern. Results: Seventy-five percent of the patients had type 1 haemorrhage and all these patients had a good clinical outcome with a discharge MRS of ≤1. Eight percent of the patients presented with type 2 haemorrhage, 62% of which were discharged with MRS of ≤1 and 12% of patients had MRS 3 or 4. Type 3 haemorrhage was found in 10%, of which 16% had good clinical outcome, but 53% had moderate to severe disability (MRS 3 and 4) and 5% were discharged with severe disability (MRS 5). Six percent of patients presented with type 4 haemorrhage of which 42% of the patients had moderate to severe disability (MRS 3 and 4), 42% had severe disability and one-sixth of the patients died. Highly significant differences were found between type 1(1a and 1b) and type 2 (p = 0.003); type 2 and type 3 (p = 0.002); type 3 and type 4 (p = 0.001). Conclusion: Haemorrhages of the type 1 category are usually benign and do not warrant an extensive battery of clinical and radiological investigations. Type 2 haemorrhages have a varying prognosis and need to be investigated and managed along similar lines as that of an aneurysmal haemorrhage with emphasis towards radiological investigation. Type 3 and type 4 haemorrhages need to be extensively investigated to find an underlying cause.

  17. The computerisation of Australian general practice 1998_2001 - what did we get for AU$15 000 000?

    Directory of Open Access Journals (Sweden)

    Michael Kidd

    2002-03-01

    Full Text Available In 1998 the Commonwealth government provided AU$15 000 000 towards a three-year project to support the computerisation of Australian general practice. This initiative was carried forward by the peak national body for information technology in general practice, the General Practice Computing Group (GPCG. This paper describes the activities of the GPCG, how this money was spent, and includes the evaluation of this three-year project which has resulted in computers on the desktops of the majority of Australia's GPs.

  18. Developing the Coach Analysis and Intervention System (CAIS): establishing validity and reliability of a computerised systematic observation instrument.

    Science.gov (United States)

    Cushion, Christopher; Harvey, Stephen; Muir, Bob; Nelson, Lee

    2012-01-01

    We outline the evolution of a computerised systematic observation tool and describe the process for establishing the validity and reliability of this new instrument. The Coach Analysis and Interventions System (CAIS) has 23 primary behaviours related to physical behaviour, feedback/reinforcement, instruction, verbal/non-verbal, questioning and management. The instrument also analyses secondary coach behaviour related to performance states, recipient, timing, content and questioning/silence. The CAIS is a multi-dimensional and multi-level mechanism able to provide detailed and contextualised data about specific coaching behaviours occurring in complex and nuanced coaching interventions and environments that can be applied to both practice sessions and competition.

  19. Risk factor profile in retinal detachment

    Directory of Open Access Journals (Sweden)

    Azad Raj

    1988-01-01

    Full Text Available 150 cases of retinal detachment comprising 50 patients each of bilateral retinal detachment, unilateral retinal detachment without any retinal lesions in the fellow eve and unilateral retinal detachment with retinal lesions in the fellow eye were studied and the various associated risk factors were statistically analysed. The findings are discussed in relation to their aetiological and prognostic significance in the different types of retinal detachment. Based on these observations certain guidelines are offered which may be of value in decision making, in prophylactic detachment surgery. Tractional breaks in the superior temporal quadrant especially when symptomatic. mandate prophylactic treatment. Urgency is enhanced it′ the patient is aphakic. Associated myopia adds to the urgency. The higher incidence of initial right e′ e involvement in all groups suggests a vascular original possibly ischaemic.

  20. Intracranial haemorrhage: an incidental finding at magnetic resonance imaging in a cohort of late preterm and term infants

    Energy Technology Data Exchange (ETDEWEB)

    Sirgiovanni, Ida; Groppo, Michela; Bassi, Laura; Passera, Sofia; Schiavolin, Paola; Fumagalli, Monica; Mosca, Fabio [Universita degli Studi di Milano, Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy); Avignone, Sabrina; Cinnante, Claudia; Triulzi, Fabio [Universita degli Studi di Milano, Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (Italy); Lista, Gianluca [V. Buzzi Children' s Hospital, ICP, Neonatal Intensive Care Unit, Milan (Italy)

    2014-03-15

    Intracranial haemorrhage (ICH) in term newborns has been increasingly recognised but the occurrence in late preterm infants and the clinical presentation are still unclear. To investigate the appearance of intracranial haemorrhage at MRI in a cohort of infants born at 34 weeks' gestation or more and to correlate MRI findings with neonatal symptoms. We retrospectively reviewed neonatal brain MRI scans performed during a 3-year period. We included neonates ≥34 weeks' gestation with intracranial haemorrhage and compared findings with those in babies without intracranial haemorrhage. Babies were classified into three groups according to haemorrhage location: (1) infratentorial, (2) infra- and supratentorial, (3) infra- and supratentorial + parenchymal involvement. Intracranial haemorrhage was observed in 36/240 babies (15%). All of these 36 had subdural haemorrhage. Sixteen babies were included in group 1; 16 in group 2; 4 in group 3. All infants in groups 1 and 2 were asymptomatic except one who was affected by intraventricular haemorrhage grade 3. Among the infants in group 3, who had intracranial haemorrhage with parenchymal involvement, three of the four (75%) presented with acute neurological symptoms. Uncomplicated spontaneous vaginal delivery was reported in 20/36 neonates (56%), vacuum extraction in 4 (11%) and caesarean section in 12 (33%). Babies with intracranial haemorrhage had significantly higher gestational age (38 ± 2 weeks vs. 37 ± 2 weeks) and birth weight (3,097 ± 485 g vs. 2,803 ± 741 g) compared to babies without intracranial haemorrhage and were more likely to be delivered vaginally than by caesarian section. Mild intracranial haemorrhage (groups 1 and 2) is relatively common in late preterm and term infants, although it mostly represents an incidental finding in clinically asymptomatic babies; early neurological symptoms appear to be related to parenchymal involvement. (orig.)

  1. Intracranial haemorrhage: an incidental finding at magnetic resonance imaging in a cohort of late preterm and term infants

    International Nuclear Information System (INIS)

    Sirgiovanni, Ida; Groppo, Michela; Bassi, Laura; Passera, Sofia; Schiavolin, Paola; Fumagalli, Monica; Mosca, Fabio; Avignone, Sabrina; Cinnante, Claudia; Triulzi, Fabio; Lista, Gianluca

    2014-01-01

    Intracranial haemorrhage (ICH) in term newborns has been increasingly recognised but the occurrence in late preterm infants and the clinical presentation are still unclear. To investigate the appearance of intracranial haemorrhage at MRI in a cohort of infants born at 34 weeks' gestation or more and to correlate MRI findings with neonatal symptoms. We retrospectively reviewed neonatal brain MRI scans performed during a 3-year period. We included neonates ≥34 weeks' gestation with intracranial haemorrhage and compared findings with those in babies without intracranial haemorrhage. Babies were classified into three groups according to haemorrhage location: (1) infratentorial, (2) infra- and supratentorial, (3) infra- and supratentorial + parenchymal involvement. Intracranial haemorrhage was observed in 36/240 babies (15%). All of these 36 had subdural haemorrhage. Sixteen babies were included in group 1; 16 in group 2; 4 in group 3. All infants in groups 1 and 2 were asymptomatic except one who was affected by intraventricular haemorrhage grade 3. Among the infants in group 3, who had intracranial haemorrhage with parenchymal involvement, three of the four (75%) presented with acute neurological symptoms. Uncomplicated spontaneous vaginal delivery was reported in 20/36 neonates (56%), vacuum extraction in 4 (11%) and caesarean section in 12 (33%). Babies with intracranial haemorrhage had significantly higher gestational age (38 ± 2 weeks vs. 37 ± 2 weeks) and birth weight (3,097 ± 485 g vs. 2,803 ± 741 g) compared to babies without intracranial haemorrhage and were more likely to be delivered vaginally than by caesarian section. Mild intracranial haemorrhage (groups 1 and 2) is relatively common in late preterm and term infants, although it mostly represents an incidental finding in clinically asymptomatic babies; early neurological symptoms appear to be related to parenchymal involvement. (orig.)

  2. Retinitis Pigmentosa and Education Issues

    Science.gov (United States)

    Brown, Thomas J.

    2005-01-01

    Retinitis Pigmentosa includes a number of inherited diseases which usually result in blindness. The disease is progressive in nature and begins with the deterioration of cells in the eye responsible for peripheral vision. As the condition worsens there is a gradual loss of peripheral vision and night blindness. Proper educational planning requires…

  3. [Surgical managment of retinal detachment].

    Science.gov (United States)

    Haritoglou, C; Wolf, A

    2015-05-01

    The detachment of the neurosensory retina from the underlying retinal pigment epithelium can be related to breaks of the retina allowing vitreous fluid to gain access to the subretinal space, to exudative changes of the choroid such as tumours or inflammatory diseases or to excessive tractional forces exerted by interactions of the collagenous vitreous and the retina. Tractional retinal detachment is usually treated by vitrectomy and exudative detachment can be addressed by treatment of the underlying condition in many cases. In rhegmatogenous retinal detachment two different surgical procedures, vitrectomy and scleral buckling, can be applied for functional and anatomic rehabilitation of our patients. The choice of the surgical procedure is not really standardised and often depends on the experience of the surgeon and other more ocular factors including lens status, the number of retinal breaks, the extent of the detachment and the amount of preexisting PVR. Using both techniques, anatomic success rates of over 90 % can be achieved. Especially in young phakic patients scleral buckling offers the true advantage to prevent the progression of cataract formation requiring cataract extraction and intraocular lens implantation. Therefore, scleral buckling should be considered in selected cases as an alternative surgical option in spite of the very important technical refinements in modern vitrectomy techniques. Georg Thieme Verlag KG Stuttgart · New York.

  4. Retinal imaging and image analysis

    NARCIS (Netherlands)

    Abramoff, M.D.; Garvin, Mona K.; Sonka, Milan

    2010-01-01

    Many important eye diseases as well as systemic diseases manifest themselves in the retina. While a number of other anatomical structures contribute to the process of vision, this review focuses on retinal imaging and image analysis. Following a brief overview of the most prevalent causes of

  5. Frequency of causes of primary postpartum haemorrhage in a tertiary care hospital

    International Nuclear Information System (INIS)

    Munir, S.I.

    2015-01-01

    Objective: To study the frequency of causes of primary postpartum hemorrhage (PPH) in women managed in a tertiary care Hospital. material and Methods: The study was conducted in the department of Obstetrics and Gynecology, Unit - 1, Lady Willingdon Hospital King Edward Medical University, Lahore from July 2013 to December 2013. All the women having postpartum haemorrhage after vaginal delivery in the labour room or referred with primary postpartum haemorrhage were included in the study and were evaluated to see the frequency of postpartum haemorrhage as well as the causes of PPH in women being treated in a tertiary care unit. Results: During the study period 1344 women delivered in unit I and 250 patients developed postpartum haemorrhage giving frequency of primary postpartum haemorrhage 18.60%. Majority of the women 29.6% (n = 74) were between 26 - 30 years of age, mean and SD was 28.43 ± 4.76 years. The gestation of 55.2% (n = 138) patients was between 37 - 40 weeks. The frequency of postpartum haemorrhage in booked women during antenatal period was recorded as 25.2% (n = 63) while 74.8% (n = 187) were not booked in any health facility. Among patients who developed PPH, uterine atony was the most common cause 57.6% (n = 144), followed by genital tract teats which was 29.2% (n = 73). The rest of the causes of PPH were retained placenta in 10% (n = 25), uterine rupture in 3.6% (n = 9) and uterine inversion in 1.6% (n = 4). Conclusions: Postpartum haemorrhage is still a leading but preventable cause of maternal morbidity and mortality in our country due to under utilization of health facilities, the major cause is uterine atony followed by perineal tears. (author)

  6. Haemorrhagic snake venom metalloproteases and human ADAMs cleave LRP5/6, which disrupts cell-cell adhesions in vitro and induces haemorrhage in vivo.

    Science.gov (United States)

    Seo, Tadahiko; Sakon, Taketo; Nakazawa, Shiori; Nishioka, Asuka; Watanabe, Kohei; Matsumoto, Kaori; Akasaka, Mari; Shioi, Narumi; Sawada, Hitoshi; Araki, Satohiko

    2017-06-01

    Snake venom metalloproteases (SVMPs) are members of the a disintegrin and metalloprotease (ADAM) family of proteins, as they possess similar domains. SVMPs are known to elicit snake venom-induced haemorrhage; however, the target proteins and cleavage sites are not known. In this work, we identified a target protein of vascular apoptosis-inducing protein 1 (VAP1), an SVMP, relevant to its ability to induce haemorrhage. VAP1 disrupted cell-cell adhesions by relocating VE-cadherin and γ-catenin from the cell-cell junction to the cytosol, without inducing proteolysis of VE-cadherin. The Wnt receptors low-density lipoprotein receptor-related proteins 5 and 6 (LRP5/6) are known to promote catenin relocation, and are rendered constitutively active in Wnt signalling by truncation. Thus, we examined whether VAP1 cleaves LRP5/6 to induce catenin relocation. Indeed, we found that VAP1 cleaved the extracellular region of LRP6 and LRP5. This cleavage removes four inhibitory β-propeller structures, resulting in activation of LRP5/6. Recombinant human ADAM8 and ADAM12 also cleaved LRP6 at the same site. An antibody against a peptide including the LRP6-cleavage site inhibited VAP1-induced VE-cadherin relocation and disruption of cell-cell adhesions in cultured cells, and blocked haemorrhage in mice in vivo. Intriguingly, animals resistant to the effects of haemorrhagic snake venom express variants of LRP5/6 that lack the VAP1-cleavage site, or low-density lipoprotein receptor domain class A domains involved in formation of the constitutively active form. The results validate LRP5/6 as physiological targets of ADAMs. Furthermore, they indicate that SVMP-induced cleavage of LRP5/6 causes disruption of cell-cell adhesion and haemorrhage, potentially opening new avenues for the treatment of snake bites. © 2017 Federation of European Biochemical Societies.

  7. Effectiveness of rectal misoprostol in cessation of Post Partum Haemorrhage

    International Nuclear Information System (INIS)

    Nasreen, S.; Baqai, S.; Iftikhar, S.

    2018-01-01

    Objective: To determine the efficacy of rectal misoprostol in management of Post Partum Haemorrhage in third stage of labour. Study Design: Interventional study. Place and Duration of Study: Gynaecology and obstetrics department at PNS Shifa Hospital Karachi, from Sep 2012 to Mar 2013. Material and Methods: All singleton and multiple pregnancies of gestation 37-42 weeks, who presented in labour room to deliver and had prolonged second stage of labour (n=112) were enrolled in the study. Patients, who were having coagulopathy, abruption, placenta previa, and allergy to prostaglandins were excluded from the study. Third stage was managed actively according to hospital standard routine. Hemoglobin was measured at the time of admission and repeated after delivery in patients having PPH. Blood was estimated by weighing all gauzes and packs. If blood loss more than 500ml one hour after delivery and all traumatic causes and retained placenta were excluded, 600 mu g (3 tablets) of misoprostol were given per rectally, which were inserted up to a digit depth. After one hour total amount of blood loss was calculated. The data were then entered in a proforma and analyzed. Results: Majority (44.6%) of the women were 26-33 years of age, 8.9% had PPH with fall in hemoglobin by 1.5-2 gms/dl. Ninety percent of the patients responded to rectal misoprostol. Conclusion: Active management of third stage of labour has a definite role in the preventive of PPH. Rectal administration of misoprostol should be considered for control of PPH in low resource settings like ours as it was found effective in the study. (author)

  8. Acute intracerebral haemorrhage: grounds for optimism in management.

    Science.gov (United States)

    Delcourt, Candice; Anderson, Craig

    2012-12-01

    Spontaneous intracerebral haemorrhage (ICH) is one of the most devastating types of stroke, which has considerable disease burden in "non-white" ethnic groups where the population-attributable risks of elevated blood pressure are very high. Since the treatment of ICH remains largely supportive and expectant, nihilism and the early withdrawal of active therapy influence management decisions in clinical practice. However, approaches to management are now better defined on the basis of evidence that both survival and speed (and degree) of recovery are critically dependent on the location, size, and degree of expansion and extension into the intraventricular system of the haematoma of the ICH. Although no medical treatment has been shown to improve outcome in ICH, several promising avenues have emerged that include haemostatic therapy and intensive control of elevated blood pressure. Conversely, there is continued controversy over the role of evacuation of the haematoma of ICH via open craniotomy. Despite being an established practice for several decades, and having undergone evaluation in multiple randomised trials, there is uncertainty over which patients have the most to gain from an intervention with clear procedural risk. Minimally invasive surgery via local anaesthetic applied drill-puncture of the cranium and infusion of a thrombolytic agent is an attractive option for patients requiring critical management of the haematoma, not just in low resource settings but arguably also in specialist centres of western countries. With several ongoing clinical trials nearing completion, these treatments could enter routine practice within the next few years, further justifying the urgency of "time is brain" and that active management within well-organized, comprehensive acute stroke care units includes patients with ICH. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Lifetime risks for aneurysmal subarachnoid haemorrhage: multivariable risk stratification.

    Science.gov (United States)

    Vlak, Monique H M; Rinkel, Gabriel J E; Greebe, Paut; Greving, Jacoba P; Algra, Ale

    2013-06-01

    The overall incidence of aneurysmal subarachnoid haemorrhage (aSAH) in western populations is around 9 per 100 000 person-years, which confers to a lifetime risk of around half per cent. Risk factors for aSAH are usually expressed as relative risks and suggest that absolute risks vary considerably according to risk factor profiles, but such estimates are lacking. We aimed to estimate incidence and lifetime risks of aSAH according to risk factor profiles. We used data from 250 patients admitted with aSAH and 574 sex-matched and age-matched controls, who were randomly retrieved from general practitioners files. We determined independent prognostic factors with multivariable logistic regression analyses and assessed discriminatory performance using the area under the receiver operating characteristic curve. Based on the prognostic model we predicted incidences and lifetime risks of aSAH for different risk factor profiles. The four strongest independent predictors for aSAH, namely current smoking (OR 6.0; 95% CI 4.1 to 8.6), a positive family history for aSAH (4.0; 95% CI 2.3 to 7.0), hypertension (2.4; 95% CI 1.5 to 3.8) and hypercholesterolaemia (0.2; 95% CI 0.1 to 0.4), were used in the final prediction model. This model had an area under the receiver operating characteristic curve of 0.73 (95% CI 0.69 to 0.76). Depending on sex, age and the four predictors, the incidence of aSAH ranged from 0.4/100 000 to 298/100 000 person-years and lifetime risk between 0.02% and 7.2%. The incidence and lifetime risk of aSAH in the general population varies widely according to risk factor profiles. Whether persons with high risks benefit from screening should be assessed in cost-effectiveness studies.

  10. Chronic hypopituitarism is uncommon in survivors of aneurysmal subarachnoid haemorrhage.

    Science.gov (United States)

    Hannon, M J; Behan, L A; O'Brien, M M; Tormey, W; Javadpour, M; Sherlock, M; Thompson, C J

    2015-01-01

    The incidence of hypopituitarism after aneurysmal subarachnoid haemorrhage (SAH) is unclear from the conflicting reports in the literature. As routine neuroendocrine screening for hypopituitarism for all patients would be costly and logistically difficult, there is a need for precise data on the frequency of hypopituitarism and on factors which might predict the later development of pituitary dysfunction. We aimed to: (i) Establish the incidence of long-term hypopituitarism in patients with aneurysmal SAH. (ii) Determine whether data from patients' acute admission with SAH could predict the occurrence of long-term hypopituitarism. One hundred patients were studied prospectively from the time of presentation with acute SAH. Plasma cortisol, plasma sodium and a variety of clinical and haemodynamic parameters were sequentially measured for the first 12 days of their acute admission. Forty-one patients then underwent dynamic pituitary testing at median 15 months following SAH (range 7-30 months), with insulin tolerance test (ITT) or, if contraindicated, a glucagon stimulation test (GST) plus short synacthen test (SST). If symptoms of cranial diabetes insipidus (CDI) were present, a water deprivation test was also performed. Forty-one patients attended for follow-up dynamic pituitary testing. Although 14 of 100 had acute glucocorticoid deficiency immediately following SAH, only two of 41 had long-term adrenocorticotrophic hormone (ACTH) deficiency and four of 41 had growth hormone (GH) deficiency. None were hypothyroid or gonadotrophin deficient. None had chronic CDI or hyponatraemia. There was no association between acute glucocorticoid deficiency, acute CDI or acute hyponatraemia and long-term pituitary dysfunction. Both anterior and posterior hypopituitarism are very uncommon following SAH and are not predicted by acute clinical, haemodynamic or endocrinological parameters. Routine neuroendocrine screening is not justified in SAH patients. © 2014 John Wiley & Sons

  11. Screening for retinitis in children with probable systemic ...

    African Journals Online (AJOL)

    CMV retinitis may be prevented by timely diagnosis and treatment. This study aimed to .... retinitis are: 'a fulminant picture of retinal vasculitis and vascular sheathing with areas of yellow-white, full thickness, retinal necrosis producing retinal oedema associated ... and intravenous foscarnet as alternatives.[4] Although CMV- ...

  12. Embolization for non-variceal upper gastrointestinal tract haemorrhage: A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Mirsadraee, S.; Tirukonda, P.; Nicholson, A. [Department of Radiology, Leeds General Infirmary, Leeds (United Kingdom); Everett, S.M. [Department of Gastroenterology, Leeds General Infirmary, Leeds (United Kingdom); McPherson, S.J., E-mail: simon.mcpherson@leedsth.nhs.u [Department of Radiology, Leeds General Infirmary, Leeds (United Kingdom)

    2011-06-15

    Aim: To assess the published evidence on the endovascular treatment of non-variceal upper gastrointestinal haemorrhage. Materials and methods: An Ovid Medline search of published literature was performed (1966-2009). Non-English literature, experimental studies, variceal haemorrhage and case series with fewer than five patients were excluded. The search yielded 1888 abstracts. Thirty-five articles were selected for final analysis. Results: The total number of pooled patients was 927. The technical and clinical success of embolization ranged from 52-100% and 44-100%, respectively. The pooled mean technical/clinical success rate in primary upper gastrointestinal tract haemorrhage (PUGITH) only, trans-papillary haemorrhage (TPH) only, and mixed studies were 84%/67%, 93%/89%, and 93%/64%, respectively. Clinical outcome was adversely affected by multi-organ failure, shock, corticosteroids, transfusion, and coagulopathy. The anatomical source of haemorrhage and procedural variables did not affect the outcome. A successful embolization improved survival by 13.3 times. Retrospective comparison with surgery demonstrated equivalent mortality and clinical success, despite embolization being applied to a more elderly population with a higher prevalence of co-morbidities. Conclusions: Embolization is effective in this very difficult cohort of patients with outcomes similar to surgery.

  13. Advances in Retinal Stem Cell Biology

    Directory of Open Access Journals (Sweden)

    Andrea S Viczian

    2013-01-01

    Full Text Available Tremendous progress has been made in recent years to generate retinal cells from pluripotent cell sources. These advances provide hope for those suffering from blindness due to lost retinal cells. Understanding the intrinsic genetic network in model organisms, like fly and frog, has led to a better understanding of the extrinsic signaling pathways necessary for retinal progenitor cell formation in mouse and human cell cultures. This review focuses on the culture methods used by different groups, which has culminated in the generation of laminated retinal tissue from both embryonic and induced pluripotent cells. The review also briefly describes advances made in transplantation studies using donor retinal progenitor and cultured retinal cells.

  14. Prevalence of generalized retinal dystrophy in Denmark

    DEFF Research Database (Denmark)

    Bertelsen, Mette; Jensen, Hanne; Bregnhøj, Jesper F

    2014-01-01

    of this study was to examine the prevalence and diagnostic spectrum of generalized retinal dystrophy in the Danish population. METHODS: A population-based cross-sectional study with data from the Danish Retinitis Pigmentosa Registry that comprises all patients in Denmark with generalized retinal......PURPOSE: Generalized retinal dystrophy is a frequent cause of visual impairment and blindness in younger individuals and a subject of new clinical intervention trials. Nonetheless, there are few nation-wide population-based epidemiological data of generalized retinal dystrophy. The purpose...... and chorioretinal dystrophies from the 19th century to the present. Among 3076 registered cases, the primary diagnosis of generalized retinal dystrophy was assessed by chart review, including fundus photographs and electroretinograms. Demographic data on the Danish population were retrieved from Statistics Denmark...

  15. Automatic Vessel Segmentation on Retinal Images

    Institute of Scientific and Technical Information of China (English)

    Chun-Yuan Yu; Chia-Jen Chang; Yen-Ju Yao; Shyr-Shen Yu

    2014-01-01

    Several features of retinal vessels can be used to monitor the progression of diseases. Changes in vascular structures, for example, vessel caliber, branching angle, and tortuosity, are portents of many diseases such as diabetic retinopathy and arterial hyper-tension. This paper proposes an automatic retinal vessel segmentation method based on morphological closing and multi-scale line detection. First, an illumination correction is performed on the green band retinal image. Next, the morphological closing and subtraction processing are applied to obtain the crude retinal vessel image. Then, the multi-scale line detection is used to fine the vessel image. Finally, the binary vasculature is extracted by the Otsu algorithm. In this paper, for improving the drawbacks of multi-scale line detection, only the line detectors at 4 scales are used. The experimental results show that the accuracy is 0.939 for DRIVE (digital retinal images for vessel extraction) retinal database, which is much better than other methods.

  16. Retinal Image Preprocessing: Background and Noise Segmentation

    Directory of Open Access Journals (Sweden)

    Usman Akram

    2012-09-01

    Full Text Available Retinal images are used for the automated screening and diagnosis of diabetic retinopathy. The retinal image quality must be improved for the detection of features and abnormalities and for this purpose preprocessing of retinal images is vital. In this paper, we present a novel automated approach for preprocessing of colored retinal images. The proposed technique improves the quality of input retinal image by separating the background and noisy area from the overall image. It contains coarse segmentation and fine segmentation. Standard retinal images databases Diaretdb0, Diaretdb1, DRIVE and STARE are used to test the validation of our preprocessing technique. The experimental results show the validity of proposed preprocessing technique.

  17. [Peripheral retinal degenerations--treatment recommendations].

    Science.gov (United States)

    Joussen, A M; Kirchhof, B

    2004-10-01

    This report reviews the clinical appearance of degenerative diseases of the peripheral retina in relationship to the risk of developing a rhegmatogenous retinal detachment. We present recommendations for preventive treatment in eyes at increased risk of developing retinal detachment. Retinal degenerations are common lesions involving the peripheral retina but most of them are clinically insignificant. Lattice degeneration, degenerative retinoschisis, cystic retinal tufts, and very rarely zonular traction tufts can result in rhegmatogenous retinal detachment. Therefore, these lesions have been considered for prophylactic treatment; however, adequate studies have not been performed to date. Most of the peripheral retinal degenerations may not require treatment except in rare, high-risk situations. According to current knowledge there is no higher incidence of secondary pucker or other side effects after laser coagulation. Therefore, generous laser indication is recommended if risk factors apply.

  18. [Prophylactic treatment of retinal detachment].

    Science.gov (United States)

    Binder, S; Riss, B

    1981-08-01

    The indications for and results of prophylactic treatment of retinal detachment during a period of five years are reported and compared with the results in the literature. Half of the cases (3 out of 6 eyes) which developed a retinal detachment had been horse-shoe tears combined with a vitreous hemorrhage. For this reason a small buckle operation is recommended in these cases, to prevent further traction. Lattice degeneration should rather be observed than treated, except in special cases: This includes eyes where the fellow eye had a detachment from a lattice degeneration, cases in which one eye is blind from an uncured detachment or has no useful visual acuity, and eyes whose fellow eye has giant tears. In aphakic eyes treatment of lattice degeneration is recommended, because the incidence of detachment from these areas is high, especially in young aphakic cases. In one aphakic eye which had been photocoagulated several times the formation of a preretinal membrane was observed.

  19. Liquor circulation disturbance after subarachnoid haemorrhages - comparative pneumoencephalography and liquor scintigraphic investigations

    International Nuclear Information System (INIS)

    Menzel, J.; Georgi, P.; Krastel, A.; Deutsches Krebsforschungszentrum, Heidelberg

    1976-01-01

    Haemorrhages into the subarachnoid space often lead to instant blocking of the liquor circulation pathways with an acute increase of the intracranial pressure and acute venticular enlargement. These liquor circulation disturbances may be diagnosed by liquor scintiscanning as well as by pneumoencephalography. 165 patients were examined by both methods. The following results were obtained: liquor circulation disturbances after subarachnoid bleeding are frequent, they should be expected in 33% of all cases after spontaneous subarachnoid haemorrhages and in 68% of the cases after traumatic subarachnoid haemorrhages. The most severe form of liquor circulation distrubance may also be diagnosed by liquor scintiscanning as well as by pneumoencephalography. Liquor scintiscanning is the more exact method in cases with transitory ventricular reflux, while lumbar pneumoencephalography, in this series, is the method of choice when it comes to documenting the extent of the hydrocephalus. (GSE) [de

  20. Sudden headache, third nerve palsy and visual deficit: thinking outside the subarachnoid haemorrhage box.

    Science.gov (United States)

    Ní Chróinín, Danielle; Lambert, John

    2013-11-01

    A 75-year-old lady presented with sudden severe headache and vomiting. Examination was normal, and CT and lumbar puncture not convincing for subarachnoid haemorrhage. Shortly thereafter, she developed painless diplopia. Examination confirmed right third cranial nerve palsy plus homonymous left inferior quadrantanopia. Urgent cerebral MRI with angiography was requested to assess for a possible posterior communicating artery aneurysm, but revealed an unsuspected pituitary mass. Pituitary adenoma with pituitary apoplexy was diagnosed. Pituitary apopolexy is a syndrome comprising sudden headache, meningism, visual and/or oculomotor deficits, with an intrasellar mass. It is commonly due to haemorrhage or infarction within a pituitary adenoma. Treatment includes prompt steroid administration, and potentially surgical decompression. While subarachnoid haemorrhage is an important, well-recognised cause of sudden severe headache, other aetiologies, including pituitary apoplexy, should be considered and sought.

  1. Haemorrhage in intracerebral arteriovenous malformations: detection with MRI and comparison with clinical history

    Energy Technology Data Exchange (ETDEWEB)

    Prayer, L. (Dept. of Radiology, and MR Inst., Univ. of Vienna (Austria)); Wimberger, D (Dept. of Radiology, and MR Inst., Univ. of Vienna (Austria) Dept. of Neurology, Univ. of Vienna (Austria)); Stiglbauer, R. (Dept. of Radiology, and MR Inst., Univ. of Vienna (Austria)); Kramer, J. (Dept. of Radiology, and MR Inst., Univ. of Vienna (Austria)); Richling, B. (Dept. of Neurosurgery, Univ. of Vienna (Austria)); Bavinzski, G. (Dept. of Neurosurgery, Univ. of Vienna (Austria)); Czech, T. (Dept. of Neurosurgery, Univ. of Vienna (Austria)); Imhof, H. (Dept. of Radiology, and MR Inst., Univ. of Vienna (Austria))

    1993-01-01

    Fifty-one patients with 59 angiographically proven cerebral arteriovenous malformations (AVMs) were examined by high-field MRI to detect blood breakdown products. Results were correlated with the history of intracranial bleeding. Evidence of previous episodes of haemorrhage was seen in 10 of 12 patients (83.3%) with verified bleeding, 4 of 9 patients (44.4%) with symptoms which could suggest bleeding and in 6 of 30 patients (20%) with negative histories. Because of the known rebleeding rate and the increased risk of associated complications, identification of the subgroup who had had haemorrhage and should therefore be considered for surgery may be beneficial. MRI can make a contribution to management by demonstrating prior haemorrhage in patients with an inadequate clinical history. (orig.)

  2. Detection and classification of retinal lesions for grading of diabetic retinopathy.

    Science.gov (United States)

    Usman Akram, M; Khalid, Shehzad; Tariq, Anam; Khan, Shoab A; Azam, Farooque

    2014-02-01

    Diabetic Retinopathy (DR) is an eye abnormality in which the human retina is affected due to an increasing amount of insulin in blood. The early detection and diagnosis of DR is vital to save the vision of diabetes patients. The early signs of DR which appear on the surface of the retina are microaneurysms, haemorrhages, and exudates. In this paper, we propose a system consisting of a novel hybrid classifier for the detection of retinal lesions. The proposed system consists of preprocessing, extraction of candidate lesions, feature set formulation, and classification. In preprocessing, the system eliminates background pixels and extracts the blood vessels and optic disc from the digital retinal image. The candidate lesion detection phase extracts, using filter banks, all regions which may possibly have any type of lesion. A feature set based on different descriptors, such as shape, intensity, and statistics, is formulated for each possible candidate region: this further helps in classifying that region. This paper presents an extension of the m-Mediods based modeling approach, and combines it with a Gaussian Mixture Model in an ensemble to form a hybrid classifier to improve the accuracy of the classification. The proposed system is assessed using standard fundus image databases with the help of performance parameters, such as, sensitivity, specificity, accuracy, and the Receiver Operating Characteristics curves for statistical analysis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Inherited Retinal Degenerative Clinical Trial Network. Addendum

    Science.gov (United States)

    2013-10-01

    inherited orphan retinal degenerative diseases and dry age-related macular degeneration (AMD) through the conduct of clinical trials and other...design and conduct of effective and efficient clinical trials for inherited orphan retinal degenerative diseases and dry AMD; • Limited number and...linica l trial in the NEER network for autosomal dominant retinitis pigmentosa, and the ProgSTAR studies for Stargardt disease ) . As new interventions b

  4. Preventing postpartum haemorrhage: active management of the third stage of labour.

    Science.gov (United States)

    de Castro Parreira, Maria V B; Gomes, Nádia C Ferreira

    2013-12-01

    To review scientific publications on health to identify the main practices used for the active management of the third stage of vaginal labour and to assess their effectiveness in preventing postpartum haemorrhage. According to the World Health Organization (WHO Recommendations for the Prevention of Postpartum Haemorrhage, 2007. WHO Document Production Services, Geneva), postpartum haemorrhage is considered to be the cause of a quarter of maternal morbidity and mortality rates worldwide. In an attempt to reduce the risk of haemorrhage, a group of interventions have been introduced into clinical practice that constitute active management conduct during the third stage of labour and are recommended by the international organisations. An integrative literature review of studies on the subject in question, indexed in databases of health between the years 2006-2012, was conducted. The analysis included 13 articles, six of which were original articles and seven of which were literature reviews. Based on our data analysis, we found that most studies supported the effectiveness of active management in reducing the risk of haemorrhage, in the immediate postpartum period. Despite the fact that active management practices for the third stage of labour differ in their specific elements, in the majority of the selected studies, the interventions followed those recommended by the international organisations. The results of this review of management practices supported active management of the third stage of labour to prevent postpartum haemorrhage, with five main forms of intervention: administration of oxytocin, delayed clamping of umbilical cord, draining of placental blood, controlled cord traction and uterine massage. There is a need to determine gaps in the clinical practices of midwives in regard to the active management of third stage of labour, to update knowledge and practices with the latest scientific evidence. © 2013 John Wiley & Sons Ltd.

  5. Intensive care management of patients with severe intracerebral haemorrhage after endovascular treatment of brain arteriovenous malformations

    International Nuclear Information System (INIS)

    Keller, E.; Yonekawa, Y.; Imhof, H.G.; Tanaka, M.; Valavanis, Anton

    2002-01-01

    We studied the impact of emergency neurosurgery and intensive care on the outcome for patients with severe intracerebral haemorrhage after endovascular treatment of brain arteriovenous malformations (AVMs). We reviewed the case notes of 18 patients with severe haemorrhage after embolisation of a brain AVM between 1986 and 2001. During this period the treatment changed: before 1993, these patients were not surgically treated, and they died, while after 1994, all patients underwent emergency surgery. We established a standardised protocol for emergency treatment and intensive care in May 1998, and emergency surgery was performed as soon as possible after the onset of symptoms of haemorrhage. Postoperative intensive care was according to a standardised regime. During these 15 years, 24 out of 605 patients undergoing 1066 interventions had a haemorrhage during or after the procedure, of which 18 were severe (3% of patients, 1.7% of interventions). All patients had a severe clinical deficit (mean Glasgow coma scale 4.2); eight had uni- or bilateral mydriasis. From 1989 to April 1998 four (31%) of 13 patients died, one (7.5%) remained in a vegetative state and eight (61.5%) made a good recovery. All five patients treated between 1998 and 2001 had a favourable outcome. The mean time from onset of the symptoms of haemorrhage to reaching the operation room was 129 min between 1989 and 1998 and 24 min between 1998 and 2001. Standardised emergency treatment and intensive care with early resuscitation, minimal radiological exploration before rapid surgery improved the outcome. A short time between the onset of the symptoms of haemorrhage and evacuation of the haematoma may be the most important factor for a favourable outcome. (orig.)

  6. Mortality from trauma haemorrhage and opportunities for improvement in transfusion practice.

    Science.gov (United States)

    Stanworth, S J; Davenport, R; Curry, N; Seeney, F; Eaglestone, S; Edwards, A; Martin, K; Allard, S; Woodford, M; Lecky, F E; Brohi, K

    2016-03-01

    The aim of this study was to describe the prevalence, patterns of blood use and outcomes of major haemorrhage in trauma. This was a prospective observational study from 22 hospitals in the UK, including both major trauma centres and smaller trauma units. Eligible patients received at least 4 units of packed red blood cells (PRBCs) in the first 24 h of admission with activation of the massive haemorrhage protocol. Case notes, transfusion charts, blood bank records and copies of prescription/theatre charts were accessed and reviewed centrally. Study outcomes were: use of blood components, critical care during hospital stay, and mortality at 24 h, 30 days and 1 year. Data were used to estimate the national trauma haemorrhage incidence. A total of 442 patients were identified during a median enrolment interval of 20 (range 7-24) months. Based on this, the national incidence of trauma haemorrhage was estimated to be 83 per million. The median age of patients in the study cohort was 38 years and 73·8 per cent were men. The incidence of major haemorrhage increased markedly in patients aged over 65 years. Thirty-six deaths within 24 h of admission occurred within the first 3 h. At 24 h, 79 patients (17·9 per cent) had died, but mortality continued to rise even after discharge. Patients who received a cumulative ratio of fresh frozen plasma to PRBCs of at least 1 : 2 had lower rates of death than those who received a lower ratio. There were delays in administration of blood. Platelets and cryoprecipitate were either not given, or transfused well after initial resuscitation. There is a high burden of trauma haemorrhage that affects all age groups. Research is required to understand the reasons for death after the first 24 h and barriers to timely transfusion support. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

  7. Frequency of lattice degeneration and retinal breaks in the fellow eye in retinal detachment.

    Science.gov (United States)

    Lorentzen, S E

    1988-04-01

    The fellow eye of 100 consecutively admitted cases of retinal detachment was studied with three-mirror examination for the presence of lattice degeneration and retinal breaks. Lattice degeneration was found in 18% and retinal breaks in 20% of fellow eyes.

  8. Inter-Species Transmission of Viral Haemorrhagic Septicaemia Virus Between Turbot (Scophthalmus Maximus) and Rainbow Trout (Onchorhynchus Mykiss)

    DEFF Research Database (Denmark)

    Schönherz, A. A.; Lorenzen, Niels; Einer-Jensen, Katja

    2012-01-01

    Viral haemorrhagic septicaemia is a serious viral disease of teleost fish with high economic impact on the aquaculture industry. The disease is caused by the viral haemorrhagic septicaemia virus (VHSV), an RNA virus belonging to the family Rhabdoviridae. Compared to other rhabdoviruses infecting...

  9. Epistaxis and other haemorrhagic events associated with the smoking cessation medicine varenicline : a case series from two national pharmacovigilance centres

    NARCIS (Netherlands)

    Harrison-Woolrych, Mira; Harmark, Linda; Tan, Ming; Maggo, Simran; van Grootheest, Kees

    Purpose To present a case series of haemorrhagic events associated with varenicline identified from the New Zealand (NZ) and Netherlands national pharmacovigilance centres and propose a possible mechanism for these adverse events. Methods Reports of epistaxis and other haemorrhagic events (in all

  10. Retinal Cell Degeneration in Animal Models

    Directory of Open Access Journals (Sweden)

    Masayuki Niwa

    2016-01-01

    Full Text Available The aim of this review is to provide an overview of various retinal cell degeneration models in animal induced by chemicals (N-methyl-d-aspartate- and CoCl2-induced, autoimmune (experimental autoimmune encephalomyelitis, mechanical stress (optic nerve crush-induced, light-induced and ischemia (transient retinal ischemia-induced. The target regions, pathology and proposed mechanism of each model are described in a comparative fashion. Animal models of retinal cell degeneration provide insight into the underlying mechanisms of the disease, and will facilitate the development of novel effective therapeutic drugs to treat retinal cell damage.

  11. Retinal Macroglial Responses in Health and Disease

    Directory of Open Access Journals (Sweden)

    Rosa de Hoz

    2016-01-01

    Full Text Available Due to their permanent and close proximity to neurons, glial cells perform essential tasks for the normal physiology of the retina. Astrocytes and Müller cells (retinal macroglia provide physical support to neurons and supplement them with several metabolites and growth factors. Macroglia are involved in maintaining the homeostasis of extracellular ions and neurotransmitters, are essential for information processing in neural circuits, participate in retinal glucose metabolism and in removing metabolic waste products, regulate local blood flow, induce the blood-retinal barrier (BRB, play fundamental roles in local immune response, and protect neurons from oxidative damage. In response to polyetiological insults, glia cells react with a process called reactive gliosis, seeking to maintain retinal homeostasis. When malfunctioning, macroglial cells can become primary pathogenic elements. A reactive gliosis has been described in different retinal pathologies, including age-related macular degeneration (AMD, diabetes, glaucoma, retinal detachment, or retinitis pigmentosa. A better understanding of the dual, neuroprotective, or cytotoxic effect of macroglial involvement in retinal pathologies would help in treating the physiopathology of these diseases. The extensive participation of the macroglia in retinal diseases points to these cells as innovative targets for new drug therapies.

  12. Coincidence of retinitis pigmentosa and pseudoexfoliative glaucoma

    Directory of Open Access Journals (Sweden)

    Božić Marija

    2017-01-01

    Full Text Available Introduction. This is an observational case report presenting retinitis pigmentosa associated with pseudoexfoliative glaucoma. Case outline. A 69-year-old man presented with retinitis pigmentosa. On examination, pseudoexfoliative material was detected on anterior segment structures, and intraocular pressure was 26 mmHg in the right and 24 mmHg in the left eye. The patient was commenced on topical antiglaucomatous therapy (timolol + dorzolamide twice daily, latanoprost once in the evening to both eyes. Conclusion. To the best of our knowledge, this is the first reported case of retinitis pigmentosa associated with pseudoexfoliative glaucoma. Although rare, retinitis pigmentosa and glaucoma can occur in the same eye.

  13. Retinal phlebitis associated with autoimmune hemolytic anemia.

    Science.gov (United States)

    Chew, Fiona L M; Tajunisah, Iqbal

    2009-01-01

    To describe a case of retinal phlebitis associated with autoimmune hemolytic anemia. Observational case report. A 44-year-old Indian man diagnosed with autoimmune hemolytic anemia presented with a 1-week history of blurred vision in both eyes. Fundus biomicroscopy revealed bilateral peripheral retinal venous sheathing and cellophane maculopathy. Fundus fluorescent angiogram showed bilateral late leakage from the peripheral venous arcades and submacular fluid accumulation. The retinal phlebitis resolved following a blood transfusion and administration of systemic steroids. Retinopathy associated with autoimmune hemolytic anemia is not well known. This is thought to be the first documentation of retinal phlebitis occurring in this condition.

  14. Tractional retinal detachment in Usher syndrome type II.

    Science.gov (United States)

    Rani, Alka; Pal, Nikhil; Azad, Raj Vardhan; Sharma, Yog Raj; Chandra, Parijat; Vikram Singh, Deependra

    2005-08-01

    Retinal detachment is a rare complication in patients with retinitis pigmentosa. A case is reported of tractional retinal detachment in a patient with retinitis pigmentosa and sensorineural hearing loss, which was diagnosed as Usher syndrome type II. Because of the poor visual prognosis, the patient refused surgery in that eye. Tractional retinal detachment should be added to the differential diagnoses of visual loss in patients with retinitis pigmentosa.

  15. Stem Cell-Based Therapeutic Applications in Retinal Degenerative Diseases.

    OpenAIRE

    Huang Yiming; Enzmann Volker; Ildstad Suzanne T

    2011-01-01

    Retinal degenerative diseases that target photoreceptors or the adjacent retinal pigment epithelium (RPE) affect millions of people worldwide. Retinal degeneration (RD) is found in many different forms of retinal diseases including retinitis pigmentosa (RP), age-related macular degeneration (AMD), diabetic retinopathy, cataracts, and glaucoma. Effective treatment for retinal degeneration has been widely investigated. Gene-replacement therapy has been shown to improve visual function in inheri...

  16. Novel bivalent vectored vaccine for control of myxomatosis and rabbit haemorrhagic disease.

    Science.gov (United States)

    Spibey, N; McCabe, V J; Greenwood, N M; Jack, S C; Sutton, D; van der Waart, L

    2012-03-24

    A novel, recombinant myxoma virus-rabbit haemorrhagic disease virus (RHDV) vaccine has been developed for the prevention of myxomatosis and rabbit haemorrhagic disease (RHD). A number of laboratory studies are described illustrating the safety and efficacy of the vaccine following subcutaneous administration in laboratory rabbits from four weeks of age onwards. In these studies, both vaccinated and unvaccinated control rabbits were challenged using pathogenic strains of RHD and myxoma viruses, and 100 per cent of the vaccinated rabbits were protected against both myxomatosis and RHD.

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

    Energy Technology Data Exchange (ETDEWEB)

    Stahnke, M.; Davies, A.M. [Department of Radiology, Royal Orthopaedic Hospital, Woodlands, B31 2AP, Northfield, Birmingham (United Kingdom); Mangham, D.C. [Department of Pathology, Royal Orthopaedic Hospital, Woodlands, B31 2AP, Northfield, Birmingham (United Kingdom)

    2004-06-01

    We describe the radiological and pathological findings of two cases of calcific haemorrhagic bursitis, one involving the superficial infrapatellar bursa and the other the prepatellar bursa. It was the presence of dystrophic calcification within the lesion that suggested a mineralizing soft tissue sarcoma such as synovial sarcoma. As the radiographic and MR features of the two conditions can be similar but the appropriate management very different, rare calcifying haemorrhagic bursitis needs to be included in the differential diagnosis of masses adjacent to the knee joint showing calcification. (orig.)

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

    International Nuclear Information System (INIS)

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

    2004-01-01

    We describe the radiological and pathological findings of two cases of calcific haemorrhagic bursitis, one involving the superficial infrapatellar bursa and the other the prepatellar bursa. It was the presence of dystrophic calcification within the lesion that suggested a mineralizing soft tissue sarcoma such as synovial sarcoma. As the radiographic and MR features of the two conditions can be similar but the appropriate management very different, rare calcifying haemorrhagic bursitis needs to be included in the differential diagnosis of masses adjacent to the knee joint showing calcification. (orig.)

  19. Post-transfusion hypertension, convulsion and intracranial haemorrhage in beta-thalassemia major

    International Nuclear Information System (INIS)

    Masood, S.A.; Zaidi, A.

    2012-01-01

    The haematologic disorder b-thalassemia major is common in Pakistan. We describe a patient with undiagnosed thalassemia presenting with hypertension and convulsions and found to have cerebral haemorrhage on neuro-imaging. He had been transfused 2 weeks before this illness. Our experience is similar to a few case reports described in literature that were found to have cerebral haemorrhages post-mortem after a similar clinical presentation. All patients had a blood transfusion within 2 weeks prior to the presentation so association with transfusion has been proposed. We have reviewed the several mechanisms presented and discussed the findings. (author)

  20. Single-dose intravenous iron infusion or oral iron for treatment of fatigue after postpartum haemorrhage

    DEFF Research Database (Denmark)

    Holm, C; Thomsen, L L; Norgaard, A

    2017-01-01

    BACKGROUND AND OBJECTIVES: To evaluate the clinical efficacy of a single-dose intravenous infusion of iron isomaltoside compared with current treatment practice with oral iron measured by physical fatigue in women after postpartum haemorrhage. MATERIALS AND METHODS: Single-centre, open-label, ran......BACKGROUND AND OBJECTIVES: To evaluate the clinical efficacy of a single-dose intravenous infusion of iron isomaltoside compared with current treatment practice with oral iron measured by physical fatigue in women after postpartum haemorrhage. MATERIALS AND METHODS: Single-centre, open...

  1. Development of computerised adaptive testing (CAT) for the EORTC QLQ-C30 dimensions - general approach and initial results for physical functioning

    DEFF Research Database (Denmark)

    Petersen, Morten Aa; Groenvold, Mogens; Aaronson, Neil K

    2010-01-01

    Health-related quality of life (HRQOL) questionnaires should ideally be adapted to the individual patient and at the same time scores should be directly comparable across patients. This is achievable using a computerised adaptive test (CAT). Basing the CAT on an existing instrument enables measur...

  2. Changes in self-efficacy, collective efficacy and patient outcome following interprofessional simulation training on postpartum haemorrhage.

    Science.gov (United States)

    Egenberg, Signe; Øian, Pål; Eggebø, Torbjørn Moe; Arsenovic, Mirjana Grujic; Bru, Lars Edvin

    2017-10-01

    To examine whether interprofessional simulation training on management of postpartum haemorrhage enhances self-efficacy and collective efficacy and reduces the blood transfusion rate after birth. Postpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide, although it is preventable in most cases. Interprofessional simulation training might help improve the competence of health professionals dealing with postpartum haemorrhage, and more information is needed to determine its potential. Multimethod, quasi-experimental, pre-post intervention design. Interprofessional simulation training on postpartum haemorrhage was implemented for midwives, obstetricians and auxiliary nurses in a university hospital. Training included realistic scenarios and debriefing, and a measurement scale for perceived postpartum haemorrhage-specific self-efficacy, and collective efficacy was developed and implemented. Red blood cell transfusion was used as the dependent variable for improved patient outcome pre-post intervention. Self-efficacy and collective efficacy levels were significantly increased after training. The overall red blood cell transfusion rate did not change, but there was a significant reduction in the use of ≥5 units of blood products related to severe bleeding after birth. The study contributes to new knowledge on how simulation training through mastery and vicarious experiences, verbal persuasion and psychophysiological state might enhance postpartum haemorrhage-specific self-efficacy and collective efficacy levels and thereby predict team performance. The significant reduction in severe postpartum haemorrhage after training, indicated by reduction in ≥5 units of blood transfusions, corresponds well with the improvement in collective efficacy, and might reflect the emphasis on collective efforts to counteract severe cases of postpartum haemorrhage. Interprofessional simulation training in teams may contribute to enhanced prevention and

  3. Comparison of 1000-Centistoke versus 5000-Centistoke Silicone Oil in Complex Retinal Detachment Surgery.

    Science.gov (United States)

    Zafar, Shakir; Shakir, Munira; Mahmood, Syed Asaad; Amin, Saima; Iqbal, Zafar

    2016-01-01

    To compare the efficacy and complications of using 1000-centistoke versus 5000-centistoke silicone oil for complex retinal detachment repair. Case series. LRBT Tertiary Eye Hospital, Karachi, from January 2007 to June 2013. Eighty-five eyes (85 patients) presenting with superior rhegmatogenous retinal detachments associated with PVR grades B and C (involving not more than 3 clock hours) were randomized to either 1000 centistokes (n=44) or 5000 centistokes (n=41) silicone oil group. All patients underwent 23-gauge pars plana vitrectomy surgery with silicone oil intraocular tamponade. Patient data was analysed at 18 months post-operatively. IBM SPSS 21 was used for data analysis. There were 52 male and 33 female patients aged between 22 and 70 years (45.2 ±16.2). After the first surgery, successful reattachment of the retina was achieved in 67 eyes (78.8%); of which 35 eyes were in 1000-centistoke and 32 eyes in 5000-centistoke groups. Mean pre-operative Best Corrected Visual Acuity (BCVA) was 1.63 ±0.54 which was improved to a mean post-operative BCVAof 1.46 ±0.78 (1.42 ±0.74 in 1000-centistoke group; 1.49 ±0.78 in 5000 centistoke group). The 1000-centistoke group had a significantly higher frequency of oil emulsification which necessitated early removal of silicone oil. There were 66 eyes (77%) with at least one complication (34 eyes in 1000-centistoke group; 32 eyes in 5000-centistoke group) including cataract, corneal abnormalities, raised IOP, hypotony, vitreous haemorrhage and retinal redetachment. Although visual and anatomical outcomes were comparable between the two groups, the 1000-centistoke silicone oil group developed early oil emulsification necessitating its early removal.

  4. Automatic detection of diabetic retinopathy features in ultra-wide field retinal images

    Science.gov (United States)

    Levenkova, Anastasia; Sowmya, Arcot; Kalloniatis, Michael; Ly, Angelica; Ho, Arthur

    2017-03-01

    Diabetic retinopathy (DR) is a major cause of irreversible vision loss. DR screening relies on retinal clinical signs (features). Opportunities for computer-aided DR feature detection have emerged with the development of Ultra-WideField (UWF) digital scanning laser technology. UWF imaging covers 82% greater retinal area (200°), against 45° in conventional cameras3 , allowing more clinically relevant retinopathy to be detected4 . UWF images also provide a high resolution of 3078 x 2702 pixels. Currently DR screening uses 7 overlapping conventional fundus images, and the UWF images provide similar results1,4. However, in 40% of cases, more retinopathy was found outside the 7-field ETDRS) fields by UWF and in 10% of cases, retinopathy was reclassified as more severe4 . This is because UWF imaging allows examination of both the central retina and more peripheral regions, with the latter implicated in DR6 . We have developed an algorithm for automatic recognition of DR features, including bright (cotton wool spots and exudates) and dark lesions (microaneurysms and blot, dot and flame haemorrhages) in UWF images. The algorithm extracts features from grayscale (green "red-free" laser light) and colour-composite UWF images, including intensity, Histogram-of-Gradient and Local binary patterns. Pixel-based classification is performed with three different classifiers. The main contribution is the automatic detection of DR features in the peripheral retina. The method is evaluated by leave-one-out cross-validation on 25 UWF retinal images with 167 bright lesions, and 61 other images with 1089 dark lesions. The SVM classifier performs best with AUC of 94.4% / 95.31% for bright / dark lesions.

  5. Normal central retinal function and structure preserved in retinitis pigmentosa.

    Science.gov (United States)

    Jacobson, Samuel G; Roman, Alejandro J; Aleman, Tomas S; Sumaroka, Alexander; Herrera, Waldo; Windsor, Elizabeth A M; Atkinson, Lori A; Schwartz, Sharon B; Steinberg, Janet D; Cideciyan, Artur V

    2010-02-01

    To determine whether normal function and structure, as recently found in forms of Usher syndrome, also occur in a population of patients with nonsyndromic retinitis pigmentosa (RP). Patients with simplex, multiplex, or autosomal recessive RP (n = 238; ages 9-82 years) were studied with static chromatic perimetry. A subset was evaluated with optical coherence tomography (OCT). Co-localized visual sensitivity and photoreceptor nuclear layer thickness were measured across the central retina to establish the relationship of function and structure. Comparisons were made to patients with Usher syndrome (n = 83, ages 10-69 years). Cross-sectional psychophysical data identified patients with RP who had normal rod- and cone-mediated function in the central retina. There were two other patterns with greater dysfunction, and longitudinal data confirmed that progression can occur from normal rod and cone function to cone-only central islands. The retinal extent of normal laminar architecture by OCT corresponded to the extent of normal visual function in patients with RP. Central retinal preservation of normal function and structure did not show a relationship with age or retained peripheral function. Usher syndrome results were like those in nonsyndromic RP. Regional disease variation is a well-known finding in RP. Unexpected was the observation that patients with presumed recessive RP can have regions with functionally and structurally normal retina. Such patients will require special consideration in future clinical trials of either focal or systemic treatment. Whether there is a common molecular mechanism shared by forms of RP with normal regions of retina warrants further study.

  6. A computerised out-patient medical records programme based on the Summary Time-Oriented Record (STOR) System.

    Science.gov (United States)

    Cheong, P Y; Goh, L G; Ong, R; Wong, P K

    1992-12-01

    Advances in microcomputer hardware and software technology have made computerised outpatient medical records practical. We have developed a programme based on the Summary Time-Oriented Record (STOR) system which complements existing paper-based record keeping. The elements of the Problem Oriented Medical Record (POMR) System are displayed in two windows within one screen, namely, the SOAP (Subjective information, Objective information, Assessments and Plans) elements in the Reason For Encounter (RFE) window and the problem list with outcomes in the Problem List (PL) window. Context sensitive child windows display details of plans of management in the RFE window and clinical notes in the PL window. The benefits of such innovations to clinical decision making and practice based research and its medico-legal implications are discussed.

  7. [Evaluation of residual osteomuscular function using computerised movement analysis for building sector workers: specificity and technical problem].

    Science.gov (United States)

    D'Orso, M I; Centemeri, R; Latocca, R; Riva, M; Cesana, G

    2012-01-01

    Occupational Health Doctors active in building sector firms frequently have to evaluate residual workers' osteomuscular function in patients coming back to work after an accident happened during work time or free time. Definition of their specific individual work suitability is usually carried out utilizing semeiotic tests in which subjective evaluation of every single Medical Doctor is real important in definition of final results and this fact can cause legal controversies. In our research we describe the application of computerised movement analysis on 10 workers of building sector. In every patient examined this technical method has been able to study objectively the tridimensional ranges of motion of most important osteomuscular districts. The possibility to have an objective evaluation of residual osteomuscular function has a relevant importance both in definition of workers' work suitability at the moment in which they start again their activities and in possible future legal conflicts.

  8. Investigating a computerised test of the Stroop effect extended by inclusion of a third, more difficult task.

    Science.gov (United States)

    Federmann, Rolf; Goldsmith, Robert; Bäckström, Martin

    2007-04-01

    A validation study of a computerised test recently developed involving the Stroop effect, extended here by inclusion of a third, more difficult test series, is presented. Three groups of men belonging to the Swedish armed forces and adjudged to differ in their qualifications (20, 32, and 19 men of levels 1, 2, and 3, respectively) and a fourth group of 18 men convicted of serious crimes of violence were given this test, termed the Stress Strategy Test. Discriminant analysis of the test's 12 variables (four for each of the three test series) yielded a discriminant power of 65% for the total group, highest for the level 1 group (80%) and for the nonmilitary group (72%), results substantially better than obtained for the original version of the test with use of similar subject groups.

  9. Substantial reduction of inappropriate tablet splitting with computerised decision support: a prospective intervention study assessing potential benefit and harm

    Directory of Open Access Journals (Sweden)

    Quinzler Renate

    2009-06-01

    Full Text Available Abstract Background Currently ambulatory patients break one in four tablets before ingestion. Roughly 10% of them are not suitable for splitting because they lack score lines or because enteric or modified release coating is destroyed impairing safety and effectiveness of the medication. We assessed impact and safety of computerised decision support on the inappropriate prescription of split tablets. Methods We performed a prospective intervention study in a 1680-bed university hospital. Over a 15-week period we evaluated all electronically composed medication regimens and determined the fraction of tablets and capsules that demanded inappropriate splitting. In a subsequent intervention phase of 15 weeks duration for 10553 oral drugs divisibility characteristics were indicated in the system. In addition, an alert was generated and displayed during the prescription process whenever the entered dosage regimen demanded inappropriate splitting (splitting of capsules, unscored tablets, or scored tablets unsuitable for the intended fragmentation. Results During the baseline period 12.5% of all drugs required splitting and 2.7% of all drugs (257/9545 required inappropriate splitting. During the intervention period the frequency of inappropriate splitting was significantly reduced (1.4% of all drugs (146/10486; p = 0.0008. In response to half of the alerts (69/136 physicians adjusted the medication regimen. In the other half (67/136 no corrections were made although a switch to more suitable drugs (scored tablets, tablets with lower strength, liquid formulation was possible in 82% (55/67. Conclusion This study revealed that computerised decision support can immediately reduce the frequency of inappropriate splitting without introducing new safety hazards.

  10. Retinal vein occlusion: pathophysiology and treatment options

    OpenAIRE

    Karia, Niral

    2010-01-01

    Niral KariaDepartment of Ophthalmology, Southend Hospital, Prittlewell Chase, Westcliff on Sea, Essex, United KingdomAbstract: This paper reviews the current thinking about retinal vein occlusion. It gives an overview of its pathophysiology and discusses the evidence behind the various established and emerging treatment paradigms.Keywords: central, hemispheric, branch, retinal vein occlusion, visual loss

  11. Retinitis pigmentosa, Coats disease and uveitis.

    Science.gov (United States)

    Solomon, A; Banin, E; Anteby, I; Benezra, D

    1999-01-01

    To study the anamnestic immune response to retinal specific antigens of two patients suffering from a rare triad of retinitis pigmentosa, Coats disease and uveitis. 17-year-old girl presented with an acute episode of panuveitis, and her 19-year-old brother suffered from chronic uveitis. On examination, both patients showed retinal vascular changes and subretinal exudations typical of Coats disease, with bone-spicule pigmentary changes as observed in retinitis pigmentosa. All routine examinations were unrevealing. However, the peripheral lymphocytes from these two siblings gave a specific anamnestic response to retinal antigens in vitro. A stimulation index of 4.6 was obtained when the sister's lymphocytes were stimulated with interphotoreceptor binding protein, IRBP--during the acute stage of the uveitis. The brother's lymphocytes showed a stimulation index of 2.7 towards S-Ag during the chronic phase of his uveitic condition. These results indicate that autoimmunity towards retinal antigens may play some role in specific types of retinitis pigmentosa. Whether these autoimmune reactions are a primary pathological mechanism or are secondary to the extensive destruction of the photoreceptor layer resulting from the retinitis pigmentosa remains debatable.

  12. Fundus autofluorescence applications in retinal imaging

    Science.gov (United States)

    Gabai, Andrea; Veritti, Daniele; Lanzetta, Paolo

    2015-01-01

    Fundus autofluorescence (FAF) is a relatively new imaging technique that can be used to study retinal diseases. It provides information on retinal metabolism and health. Several different pathologies can be detected. Peculiar AF alterations can help the clinician to monitor disease progression and to better understand its pathogenesis. In the present article, we review FAF principles and clinical applications. PMID:26139802

  13. Fundus autofluorescence applications in retinal imaging

    Directory of Open Access Journals (Sweden)

    Andrea Gabai

    2015-01-01

    Full Text Available Fundus autofluorescence (FAF is a relatively new imaging technique that can be used to study retinal diseases. It provides information on retinal metabolism and health. Several different pathologies can be detected. Peculiar AF alterations can help the clinician to monitor disease progression and to better understand its pathogenesis. In the present article, we review FAF principles and clinical applications.

  14. Postpartum haemorrhage in midwifery care in the Netherlands: validation of quality indicators for midwifery guidelines

    NARCIS (Netherlands)

    Smit, M.; Chan, K.L.L.; Middeldorp, J.M.; van Roosmalen, J.

    2014-01-01

    Background: Postpartum haemorrhage (PPH) is still one of the major causes of severe maternal morbidity and mortality worldwide. Currently, no guideline for PPH occurring in primary midwifery care in the Netherlands is available. A set of 25 quality indicators for prevention and management of PPH in

  15. Antigenic structure of the capsid protein of rabbit haemorrhagic disease virus

    DEFF Research Database (Denmark)

    Martinez-Torrecuadrada, Jorge L.; Cortes, Elena; Vela, Carmen

    1998-01-01

    Rabbit haemorrhagic disease virus (RHDV) causes an important disease in rabbits. The virus capsid is composed of a single 60 kDa protein. The capsid protein gene was cloned in Escherichia coli using the pET3 system, and the antigenic structure of RHDV VP60 was dissected using 11 monoclonal...

  16. Nd:YAG laser hyaloidotomy for valsalva pre-macular haemorrhage.

    LENUS (Irish Health Repository)

    Kirwan, R P

    2012-02-01

    AIM: To report a case of successful drainage of a large pre-macular haemorrhage using laser photo-disruption of the posterior hyaloid membrane. MATERIALS AND METHODS: A case report. RESULTS: A 47-year-old man presented acutely to our emergency department complaining of a 24-h history of sudden onset, painless and persistent loss of vision in his left eye. Immediately before noticing this loss of vision, he had been vomiting violently from excessive alcohol intake. The left visual acuity was counting fingers. Dilated fundoscopy of the left eye revealed a large pre-macular haemorrhage which was 14 disc diametres in size. Clotting investigations were normal. A diagnosis of valsalva retinopathy was made and the patient elected to receive a prompt neodymium-doped yttrium aluminium garnet (Nd:YAG) laser posterior hyaloidotomy as an outpatient. At 1 week follow-up, the haemorrhage had drained completely into the vitreous space revealing a healthy macula and the visual acuity had improved to 6\\/12 unaided. At 6-month follow-up the left visual acuity stabilised at 6\\/9 unaided. CONCLUSION: Nd:YAG laser posterior hyaloidotomy is a useful outpatient procedure for successful clearance of large pre-macular haemorrhages that offers patients rapid recovery of visual acuity and the avoidance of more invasive intraocular surgery.

  17. Prediction of peripartum hysterectomy and end organ dysfunction in major obstetric haemorrhage.

    LENUS (Irish Health Repository)

    O'Brien, D

    2010-12-01

    The aims of this study are to determine the incidence and aetiology of major obstetric haemorrhage (MOH) in our population, to examine the success rates of medical and surgical interventions and to identify risk factors for peripartum hysterectomy and end organ dysfunction (EOD).

  18. An increase in rates of obstetric haemorrhage in a setting of high HIV seroprevalence

    Directory of Open Access Journals (Sweden)

    E Shabalala

    2017-07-01

    Full Text Available Background. Obstetric haemorrhage (OH is the leading cause of maternal mortality worldwide, although, indirectly, HIV is also a leading cause of maternal mortality in some settings with a high HIV seroprevalence. Objective. To determine the possible association between increasing rates of OH and HIV or its treatment. Methods. We conducted a retrospective chart review of women with OH at King Edward VIII Hospital, Durban, South Africa, over a 3-year period (2009 - 2011, during which the drug regimen for the prevention of mother-to-child transmission was evolving from single-dose nevirapine to antenatal zidovudine combined with intrapartum nevirapine (also referred to as dual therapy, and finally to a combination or highly active antiretroviral therapy (cART or HAART. Cases of OH (including abruptio placentae, placenta praevia, unspecified antepartum haemorrhage (APH, and postpartum haemorrhage (PPH were identified from maternity delivery records, and the relevant data extracted. Results. We analysed the records of 448 women diagnosed with OH. Even though the incidence of OH was low, the study found an increasing number of cases during the 3-year period. PPH – not APH – was associated with HIV seropositivity (odds ratio 1.84, 95% confi­dence interval 1.14 - 2.95. cART was not associated with an increased risk of haemorrhage. Conclusion. HIV was associated with a high risk of PPH, and its possible association with HIV treatment needs further research.

  19. Addison's disease due to bilateral post-traumatic adrenal haemorrhage: CT and MR findings

    International Nuclear Information System (INIS)

    Wilms, G.; Tits, J.; Vanstraelen, D.; Marchal, G.; Rigauts, H.; Baert, A.L.

    1991-01-01

    In a patient with Addison's disease, who gave a history of a severe car accident, CT showed bilateral enlargement of the adrenal glands. MRI, by demonstrating paramagnetic T1 shortening due to methaemoglobin and haemosiderin on T2-weighted images, confirmed the haemorrhagic nature of the lesions. (orig.)

  20. Use of thermography to monitor sole haemorrhages and temperature distribution over the claws of dairy cattle.

    Science.gov (United States)

    Wilhelm, K; Wilhelm, J; Fürll, M

    2015-02-07

    Subclinical laminitis, an early pathological event in the development of many claw diseases, is an important factor in the welfare and economics of high-producing dairy cows. However, the aetiology and pathogenesis of this complex claw disease are not well understood. The present study investigated to what extent thermographic examination of claws is able to give information about corium inflammation, and whether the technique may be used as a diagnostic tool for early detection of subclinical laminitis. Moreover, the temperature distribution over the individual main claws was investigated to obtain further knowledge about pressure distribution on the claws. For this purpose the claws of 123 cows were evaluated in the first week after calving as well as after the second month of lactation for presence of sole haemorrhages (a sign of subclinical laminitis). Furthermore, the ground contact area was analysed by thermography. Sole haemorrhages were significantly increased by the second month of lactation. Thermography showed clear differences between the claws of the front limbs and hindlimbs, as well as between lateral and medial claws. Although the distribution of sole haemorrhages was consistent with the pattern of the temperature distribution over the main claws, no clear correlation was found between the claw temperature after calving and the visible laminitis-like changes (sole haemorrhages) eight weeks later. British Veterinary Association.

  1. Transcatheter embolization in a haemophiliac with post-traumatic renal haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Klamut, M; Szczerbo-Trojanowska, M; Kowalewski, J; Nowakowski, A [Akademia Medyczna, Lublin (Poland)

    1979-01-01

    Percutaneous transcatheter arterial embolization was performed in a case of severe haemophilia A to control haemorrhage secondary to renal trauma. The treatment proved to be life-saving. Eighteen months follow-up revealed no evidence of hypertension, renal failure or infection.

  2. Microvascular oxygen pressure in the pig intestine during haemorrhagic shock and resuscitation

    NARCIS (Netherlands)

    Sinaasappel, M.; van Iterson, M.; Ince, C.

    1999-01-01

    1. The aim of this study was to investigate the relation between microvascular and venous oxygen pressures during haemorrhagic shock and resuscitation in the pig intestine. To this end microvascular PO2 (microPO2) was measured by quenching of Pd-porphyrin phosphorescence by oxygen and validated for

  3. Subarachnoid haemorrhage in Sweden 1987-2002 : regional incidence and case fatality rates

    NARCIS (Netherlands)

    Koffijberg, H.; Buskens, E.; Granath, F.; Adami, J.; Ekbom, A.; Rinkel, G. J. E.; Blomqvist, P.

    Background: Incidence estimates of subarachnoid haemorrhage (SAH) in Sweden vary, which may be caused by regional variations. Reliable estimates of age-specific case fatality rates are lacking. We analysed regional incidence rates and case fatality rates of SAH in Sweden. Methods: The Swedish

  4. Dose evaluation for long-term magnesium treatment in aneurysmal subarachnoid haemorrhage

    NARCIS (Netherlands)

    van Norden, A. G. W.; van den Bergh, W. M.; Rinkel, G. J. E.

    2005-01-01

    BACKGROUND: Magnesium is a neuroprotective agent that might prevent or reverse delayed cerebral ischaemia after aneurysmal subarachnoid haemorrhage (SAH). We are presently running a randomized, placebo-controlled, double blind trial with magnesium sulphate (64 mmol/day intravenously). We studied

  5. Is bacterial colonisation of the tonsillar fossa a factor in post-tonsillectomy haemorrhage?

    NARCIS (Netherlands)

    Stephens, J. C.; Georgalas, C.; Kyi, M.; Ghufoor, K.

    2008-01-01

    OBJECTIVES: To identify if there is a link between bacterial colonisation of the tonsillar fossa and post-tonsillectomy haemorrhage. STUDY DESIGN AND SETTING: Prospective non-interventional study of 105 patients who underwent tonsillectomy during a seven-month period. The study took place in a

  6. Uterine artery embolization for the management of secondary postpartum haemorrhage associated with placenta accreta

    International Nuclear Information System (INIS)

    Li, X.; Wang, Z.; Chen, J.; Shi, H.; Zhang, X.; Pan, J.; Liu, W.; Yang, N.; Jin, Z.; Lang, J.

    2012-01-01

    Aim: To evaluate the efficacy and safety of uterine artery embolization for the management of secondary postpartum haemorrhage associated with placenta accreta. Materials and methods: Between January 2005 and August 2011, 45 women with placenta accreta, which was discovered during delivery, were managed conservatively in Peking Union Medical College Hospital. They did not experience severe bleeding during delivery. Ten patients (mean age 31 ± 6.4 years) developed secondary postpartum haemorrhage and underwent uterine artery embolization. The complications, control of haemorrhage, and outcome of the placenta left inside the uterus were retrospectively reviewed. Results: All patients underwent transcatheter embolization of bilateral uterine arteries. The median time between delivery and uterine artery embolization was 11 days (range 3–76 days). The technical success rate of embolization was 100%. Bleeding was controlled in all patients during follow-up (11 ± 6.9 months; range 3–24 months), and no further bleeding occurred. One patient developed lower-extremity deep venous thrombosis after uterine artery embolization, and no other major complications occurred. The placentae that were left inside the uteri gradually decreased in size during follow-up, except in one case. Nine patients resumed normal menstruation. One patient subsequently became pregnant and had an uneventful intrauterine pregnancy carried to term. Conclusion: Uterine artery embolization is safe and effective for the management of secondary postpartum haemorrhage associated with placenta accreta.

  7. Persistent postpartum haemorrhage after failed arterial ligation: value of pelvic embolisation

    Energy Technology Data Exchange (ETDEWEB)

    Fargeaudou, Yann; Soyer, Philippe; Sirol, Marc; Boudiaf, Mourad; Dahan, Henri; Dref, Olivier le [Hopital Lariboisiere AP-HP et Universite Diderot-Paris 7, Department of Abdominal and Interventional Imaging, Paris (France); Morel, Olivier; Barranger, Emmanuel [Hopital Lariboisiere AP-HP, Department of Obstetrics and Gynecology, Paris (France); Gayat, Etienne; Mebazaa, Alexandre [Hopital Lariboisiere AP-HP, Department of Anesthesiology and Intensive Care Medicine, Paris (France)

    2010-07-15

    To evaluate the role and efficacy of pelvic embolisation in the treatment of persistent postpartum haemorrhage after failed arterial ligation and to identify the complications of this procedure in this specific population. The clinical files and angiographic examinations of 12 consecutive women (mean age 32 years) who were treated with pelvic embolisation because of persistent, severe postpartum haemorrhage after failed arterial ligation were reviewed. Angiography revealed that persistent bleeding was due to incomplete arterial ligation (n = 4) or the presence of newly developed anastomotic routes (n = 8). In 11 women, pelvic embolisation stopped the bleeding. Hysterectomy was needed in one woman with retained placenta. Two complications due to pelvic embolisation, including leg ischaemia and transient sciatic nerve ischaemia, were identified, both after internal iliac artery ligation. In women with persistent postpartum haemorrhage after failed arterial ligation, pelvic embolisation is an effective treatment in most cases. However, embolisation of the anastomotic routes that contribute to persistent bleeding may result in ischaemic complications. These potential complications reaffirm that arterial ligation should not be the favoured option for postpartum haemorrhage and that special care must be given during pelvic embolisation after failed arterial ligation. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Soyer, Philippe; Fargeaudou, Yann; Boudiaf, Mourad; Le Dref, Olivier; Rymer, Roland [Hopital Lariboisiere-AP-HP Universite Paris 7, Department of Abdominal Imaging, Paris cedex 10 (France); Morel, Olivier [Hopital Lariboisiere-AP-HP Universite Paris 7, Department of Obstetrics, Paris cedex 10 (France)

    2008-06-15

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

  9. Increased postpartum haemorrhage, the possible relation with serotonergic and other psychopharmacological drugs: a matched cohort study

    NARCIS (Netherlands)

    Heller, Hanna M.; Ravelli, Anita C. J.; Bruning, Andrea H. L.; de Groot, Christianne J. M.; Scheele, Fedde; van Pampus, Maria G.; Honig, Adriaan

    2017-01-01

    Postpartum haemorrhage is a major obstetric risk worldwide. Therefore risk factors need to be investigated to control for this serious complication. A recent systematic review and meta-analysis revealed that the use of both serotonergic and non-serotonergic antidepressants in pregnancy are

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  11. Spatio-temporal risk factors for viral haemorrhagic septicaemia (VHS) in Danish aquaculture

    DEFF Research Database (Denmark)

    Jensen, Ann Britt Bang; Ersbøll, Annette Kjær; Korsholm, Henrik

    2014-01-01

    Viral haemorrhagic septicaemia (VHS) is an economically very important fish disease in the northern hemisphere. When the VHS virus was first isolated in Denmark 50 yr ago, more than 80% of the 800 Danish fish farms were considered to be infected, but vigilant surveillance and eradication programmes...

  12. Multicentre trial of ethamsylate for prevention of periventricular haemorrhage in very low birthweight infants.

    Science.gov (United States)

    Benson, J W; Drayton, M R; Hayward, C; Murphy, J F; Osborne, J P; Rennie, J M; Schulte, J F; Speidel, B D; Cooke, R W

    1986-12-06

    The effectiveness of ethamsylate in the prevention of periventricular haemorrhage (PVH) in very low birthweight infants was evaluated by means of a multicentre, placebo-controlled, double-blind trial. In 330 infants without evidence of PVH on initial cranial ultrasound examination there was little difference between ethamsylate and placebo groups with respect to subependymal haemorrhage, but intraventricular and parenchymal haemorrhages developed in 30/162 infants (18.5%) in the treated group, compared with 50/168 (29.8%) in the control group (p less than 0.02). The incidence of intraventricular and parenchymal haemorrhage in survivors was 20/137 (14.6%) in the ethamsylate group and 37/146 (25.3%) in the controls (p less than 0.05). In 30 infants with evidence of PVH on the initial scan, ethamsylate treatment seemed to limit parenchymal extension. Analysis of the total cohort of 360 infants showed that the proportion of infants in whom an increase of two or more grades of severity of PVH was recorded during the trial was lower in the treated than in the placebo group (p less than 0.01). No adverse effects were attributed to ethamsylate therapy. The reported incidence of patent ductus arterious was lower in the treated than in the placebo group (p less than 0.02). Mortality was similar in the two groups.

  13. Improvement after treatment of hydrocephalus in aneurysmal subarachnoid haemorrhage : implications for grading and prognosis

    NARCIS (Netherlands)

    ter Laan, M; Mooij, JJA

    Two patients with aneurysmal subarachnoid haemorrhage and hydrocephalus are presented. On admission they scored E1M4V1 and E1M3Vtube on the Glasgow Coma Scale. The first patient recovered to E3M5Vtube after treatment of hydrocpehalus by extraventricular drainage. The second recovered to E2M5Vtube

  14. Bilateral Wyburn-Mason Syndrome presenting as acute subarachnoid haemorrhage - a very rare congenital neurocutaneuos disorder

    DEFF Research Database (Denmark)

    Cortnum, Søren Ole Stigaard; Sørensen, Preben; Andresen, J

    2008-01-01

    . Wyburn-Mason syndrome is a very rare congenital neurocutaneuos disorder comprising of vascular malformations of the retina, ipsilateral cerebral AVMs and occasionally lesions in the oronasopharyngeal area. Subarachnoid haemorrhage associated with Wyburn-Mason syndrome has been described in only 5...

  15. Treatment of Laryngeal Telangiectatic Lesions in a Patient Diagnosed with Hereditary Haemorrhagic Telangiectasia

    DEFF Research Database (Denmark)

    Kjeldsen, Anette Drøhse; Printz, Trine; Slot Mehlum, Camilla

    2015-01-01

    Abstract We here present a case concerning a 69 year old female patient with Hereditary Haemorrhagic Telangiectasia (HHT). She was suffering from hoarseness due to a telangiectatic lesion on the right vocal cord. The lesion was treated with laser and the voice improved markedly, which is document...

  16. Mitral endocarditis due to Rothia aeria with cerebral haemorrhage and femoral mycotic aneurysms, first French description

    Directory of Open Access Journals (Sweden)

    R. Collarino

    2016-09-01

    Full Text Available Rothia aeria is a Rothia species from the Micrococcaceae family. We report here the first French R. aeria endocarditis complicated by brain haemorrhage and femoral mycotic aneurysms. Altogether, severity and antimicrobial susceptibility should make us consider the management of R. aeria endocarditis as Staphylococcus aureus methicillin-susceptible endocarditis.

  17. The efficacy of fibrinogen concentrate compared with cryoprecipitate in major obstetric haemorrhage - an observational study.

    LENUS (Irish Health Repository)

    Ahmed, S

    2012-10-01

    Fibrinogen replacement is critical in major obstetric haemorrhage (MOH). Purified, pasteurised fibrinogen concentrate appears to have benefit over cryoprecipitate in ease of administration and safety but is unlicensed in pregnancy. In July 2009, the Irish Blood Transfusion Service replaced cryoprecipitate with fibrinogen.

  18. The role of haemorrhage and exudate detection in automated grading of diabetic retinopathy.

    Science.gov (United States)

    Fleming, Alan D; Goatman, Keith A; Philip, Sam; Williams, Graeme J; Prescott, Gordon J; Scotland, Graham S; McNamee, Paul; Leese, Graham P; Wykes, William N; Sharp, Peter F; Olson, John A

    2010-06-01

    Automated grading has the potential to improve the efficiency of diabetic retinopathy screening services. While disease/no disease grading can be performed using only microaneurysm detection and image-quality assessment, automated recognition of other types of lesions may be advantageous. This study investigated whether inclusion of automated recognition of exudates and haemorrhages improves the detection of observable/referable diabetic retinopathy. Images from 1253 patients with observable/referable retinopathy and 6333 patients with non-referable retinopathy were obtained from three grading centres. All images were reference-graded, and automated disease/no disease assessments were made based on microaneurysm detection and combined microaneurysm, exudate and haemorrhage detection. Introduction of algorithms for exudates and haemorrhages resulted in a statistically significant increase in the sensitivity for detection of observable/referable retinopathy from 94.9% (95% CI 93.5 to 96.0) to 96.6% (95.4 to 97.4) without affecting manual grading workload. Automated detection of exudates and haemorrhages improved the detection of observable/referable retinopathy.

  19. Erythropoietin in the cerebrospinal fluid of patients with aneurysmal subarachnoid haemorrhage originates from the brain

    DEFF Research Database (Denmark)

    Springborg, Jacob Bertram; Sonne, Bjarne; Frederiksen, Hans Jørgen

    2003-01-01

    Recent years' research has revealed a specific, neuroprotective erythropoietin (EPO) system in the central nervous system (CNS) that is upregulated by hypoxia. The presence and dynamics of EPO in the cerebrospinal fluid (CSF) of patients with subarachnoid haemorrhage (SAH) has not been investigated...

  20. Magnesium therapy after aneurysmal subarachnoid haemorrhage a dose-finding study for long term treatment

    NARCIS (Netherlands)

    van den Bergh, W. M.; Albrecht, K. W.; Berkelbach van der Sprenkel, J. W.; Rinkel, G. J. E.

    2003-01-01

    BACKGROUND: Magnesium is a neuroprotective agent which might prevent or reverse delayed cerebral ischemia (DCI) after aneurysmal subarachnoid haemorrhage (SAH). Although the dosage for short-term magnesium therapy is well established, there is lack of knowledge on the dosage for extended use of

  1. Computational Intelligence Method for Early Diagnosis Dengue Haemorrhagic Fever Using Fuzzy on Mobile Device

    Directory of Open Access Journals (Sweden)

    Salman Afan

    2014-03-01

    Full Text Available Mortality from Dengue Haemorrhagic Fever (DHF is still increasing in Indonesia particularly in Jakarta. Diagnosis of the dengue shall be made as early as possible so that first aid can be given in expectation of decreasing death risk. The Study will be conducted by developing expert system based on Computational Intelligence Method. On the first year, study will use the Fuzzy Inference System (FIS Method to diagnose Dengue Haemorrhagic Fever particularly in Mobile Device consist of smart phone. Expert system application which particularly using fuzzy system can be applied in mobile device and it is useful to make early diagnosis of Dengue Haemorrhagic Fever that produce outcome faster than laboratory test. The evaluation of this application is conducted by performing accuracy test before and after validation using data of patient who has the Dengue Haemorrhagic Fever. This expert system application is easy, convenient, and practical to use, also capable of making the early diagnosis of Dengue Haemorraghic to avoid mortality in the first stage.

  2. Aneurysm occlusion in elderly patients with aneurysmal subarachnoid haemorrhage : a cost-utility analysis

    NARCIS (Netherlands)

    Koffijberg, H.; Buskens, E.; Rinkel, G. J. E.

    Background Aneurysm occlusion after subarachnoid haemorrhage (SAH) aims to improve outcome by reducing the rebleeding risk. With increasing age, overall prognosis decreases, and the complications of aneurysm occlusion increase. The balance of risks for aneurysm occlusion in elderly SAH patients in

  3. The effects of continuous prostacyclin infusion on regional blood flow and cerebral vasospasm following subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Rasmussen, Rune; Wetterslev, Jørn; Stavngaard, Trine

    2012-01-01

    One of the main causes of mortality and morbidity following subarachnoid haemorrhage (SAH) is the development of cerebral vasospasm, a frequent complication arising in the weeks after the initial bleeding. Despite extensive research, to date no effective treatment of vasospasm exists. Prostacycli...

  4. Necrosis and haemorrhage of the putamen in methanol poisoning shown on MRI

    International Nuclear Information System (INIS)

    Kuteifan, K.; Gutbub, A.M.; Laplatte, G.; Oesterle, H.; Tajahmady, T.

    1998-01-01

    Methanol, a highly toxic substance, is used as an industrial solvent and in automobile antifreeze. Acute methanol poisoning produces severe metabolic acidosis and serious neurologic sequelae. We describe a 50-year-old woman with accidental methanol intoxication who was in a vegetative state. MRI showed haemorrhagic necrosis of the putamina and oedema in the deep white matter. (orig.)

  5. Spontaneous subarachnoid haemorrhage and outcome--results from Tan Tock Seng Hospital, Singapore.

    Science.gov (United States)

    Wong, S H; Yeo, T T; Seow, W T; Tan, K K; Ong, P L

    1999-07-01

    To ascertain the number of cases of spontaneous (aneurysmal) subarachnoid haemorrhage presenting to Tan Tock Seng Hospital, Singapore, over a one year period, the demographics of the patients involved, their treatment and their eventual outcome. A retrospective study from June 1995 to June 1996. There were 62 patients admitted over this period with an average of 5 patients per month. Their ages ranged from 9 to 85 years with a mean of 54 years. All 62 patients underwent 4-vessel cerebral angiograms. Forty-three patients (69%) underwent clipping of their aneurysms. Twelve patients (19%) had negative angiograms. Four patients (6%) underwent coiling of their aneurysms via interventional neuroradiology techniques. Patients with subarachnoid haemorrhage of Grades 1 to 3 on the WFNS (World Federation of Neurological Surgeons) grading had a favourable outcome (Glasgow Outcome Score of 4 and 5) in 85% of the cases. The overall mortality rate for the operated group (all grades) was 11%. However for the group with good WFNS grading, namely the Grade 1 to 2 groups, there were no deaths. Twenty-four percent of patients developed clinically symptomatic vasospasm. Eighteen percent of patients required ventriculo-peritoneal shunting for hydrocephalus secondary to the subarachnoid haemorrhage. The overall management mortality (operated and non-operated cases) was 14% for proven aneurysmal and angiographically-negative spontaneous subarachnoid haemorrhage. These results are comparable to that of other reputable centers reported in the literature.

  6. Rhegmatogenous retinal detachment and uveitis.

    Science.gov (United States)

    Kerkhoff, Frank T; Lamberts, Querin J; van den Biesen, Pieter R; Rothova, Aniki

    2003-02-01

    To evaluate the frequency, high-risk factors, and visual prognosis of rhegmatogenous retinal detachment (RRD) in patients with uveitis. Retrospective case-control study. We included 1387 consecutive patients with uveitis who consulted our uveitis clinic from January 1990 through December 1997 of whom 43 patients (46 eyes) with RRD were identified. The retinal detachment (RD) controls were 212 consecutive patients with RRD (221 eyes, first occurrence of RD, not associated with uveitis) who were admitted for surgery in the period from April 1999 to April 2000. The uveitis control group consisted of 150 age-matched patients (210 eyes) selected from the entire uveitis series. Retrospective analysis of clinical data. The presence of RRD and eventual risk factors for RRD, such as myopia, retinal lattice degeneration, prior intraocular surgery, anatomic location of uveitis, its specific diagnosis, and clinical manifestations. Furthermore, the surgical and nonsurgical outcomes of RRD, as well as the results of various treatment regimens, were analyzed. RRD was identified in 3.1% of the patients with uveitis. RRD was most frequently associated with panuveitis (6.6%). RRD was associated more frequently with infectious (7.6%) than noninfectious uveitis (2.1%). At the onset of RRD, uveitis was active in most (46%) affected eyes. Proliferative vitreoretinopathy was present in 30% of the uveitic RRD eyes at presentation in contrast to 12% of the RRD control eyes. In uveitic RRD, the retina was reattached in 59% of eyes with a single operation; the final anatomic reattachment rate was 88%. Finally, a visual acuity of less than 20/200 was present in 71% of the uveitic RRD eyes, 10% of which had no light perception. We discovered a high prevalence of RRD in patients with active panuveitis and infectious uveitis and document that uveitis in itself is a risk factor for the development of RRD. The visual prognosis of RRD in uveitis was poor because of the uveitis itself and the

  7. [To cognize retinitis pigmentosa with scientific view].

    Science.gov (United States)

    Li, Gen-lin

    2009-03-01

    Retinitis pigmentosa (RP) is the most common inherited eye disease that usually leads into blind, and is high simplex and clinical heterogeneity. Recent years, some new hereditary forms have been found, such as digenic RP, mitochondrial RP, incomplete dominant inheritance RP. The phenotype of RP is multiplicity. Incompatible phenomenon between genotype and phenotypes was shown in some genes such as peripherin/RDS, RHO, RP2 and RP3. The complicated phenotype was shown in the rare RP forms, such as centricity RP, stemma RP, retinitis pigmentosa sine pigmento, and retinal degeneration slow. Retinal transplantation, retinal implantation, drug and neurotrophic factor therapy, and gene therapy have been well studied worldwide and presented some hopeful efficacy. Ophthalmologists and practitioners should cognize the new advance and new knowledge on RP therapy with a scientific view for better serving the RP patients.

  8. [Indications for Retinal Laser Therapy Revisited].

    Science.gov (United States)

    Enders, P; Schaub, F; Fauser, S

    2017-02-10

    Background Laser therapy is an important treatment option in retinal diseases, especially in cases of vascular involvement. Most approaches are based on coagulation of retinal structures. As there is increasing use of agents targetting vascular endothelial growth factor in the treatment of macular diseases, indications for the use of laser treatment need to be reviewed carefully, especially with respect to their significance in first line therapy. This article explains recent strategies and treatment protocols. Materials and Methods Review of current literature in PubMed as well as synopsis of relevant guidelines. Results and Conclusion Retinal laser therapy is still widely used within retinal opthalmology and covers a large spectrum of indications. Despite the success of medical approaches, retinal laser therapy remains an indispensable treatment option for proliferative diabetic retinopathy, central or peripheral vein occlusion and less frequent pathologies, such as retinopathy of prematurity or Coats's disease. Georg Thieme Verlag KG Stuttgart · New York.

  9. Variable retinal presentations in nanophthalmos

    International Nuclear Information System (INIS)

    Khan, A.; Zafar, S.N.

    2009-01-01

    Nanophthalmos is an uncommon developmental ocular disorder characterized by a small eye with short axial length, high hyperopia and high lens/eye volume ratio due to arrested development of the globe in all directions. Different types of fundus changes can rarely occur with nanophthalmos. We describe five cases of nanophthalmos, each of them presenting with a different fundus appearance. Our case series highlights variability of pigmentary changes from retinal flecks to bone spicules and bull's eye maculopathy, which are rare in the combinations described here. (author)

  10. Regenerative Therapy for Retinal Disorders

    Directory of Open Access Journals (Sweden)

    Narsis Daftarian

    2010-01-01

    Full Text Available Major advances in various disciplines of basic sciences including embryology, molecular and cell biology, genetics, and nanotechnology, as well as stem cell biology have opened new horizons for regenerative therapy. The unique characteristics of stem cells prompt a sound understanding for their use in modern regenerative therapies. This review article discusses stem cells, developmental stages of the eye field, eye field transcriptional factors, and endogenous and exogenous sources of stem cells. Recent studies and challenges in the application of stem cells for retinal pigment epithelial degeneration models will be summarized followed by obstacles facing regenerative therapy.

  11. Heritability of Retinal Vascular Fractals

    DEFF Research Database (Denmark)

    Vergmann, Anna Stage; Broe, Rebecca; Kessel, Line

    2017-01-01

    , the retinal vascular fractal dimension was measured using the box-counting method and compared within monozygotic and dizygotic twin pairs using Pearson correlation coefficients. Falconer's formula and quantitative genetic models were used to determine the genetic component of variation. Results: The mean...... fractal dimension did not differ statistically significantly between monozygotic and dizygotic twin pairs (1.505 vs. 1.495, P = 0.06), supporting that the study population was suitable for quantitative analysis of heritability. The intrapair correlation was markedly higher (0.505, P = 0...

  12. Retinal peripheral changes after LASIK

    OpenAIRE

    Nassaralla Junior,João Jorge; Santos,Regina Cândido Ribeiro dos; Nassaralla,Belquiz Amaral

    2008-01-01

    PURPOSE: To better define the effect of laser in situ keratomileusis (LASIK) on myopic eyes and the risk and incidence of retinal complications after surgery. METHODS: In a prospective study, 200 eyes of 100 patients, 49 male and 51 female, with a mean age of 29.7 years, had a complete posterior pole examination before and at 1 week, 1, 3 and 12 months after bilateral simultaneous LASIK for the correction of myopia. Mean spherical equivalent was 7.75D (range 1.00 to -17.25D). Before LASIK, pr...

  13. Early cryoprecipitate for major haemorrhage in trauma: a randomised controlled feasibility trial.

    Science.gov (United States)

    Curry, N; Rourke, C; Davenport, R; Beer, S; Pankhurst, L; Deary, A; Thomas, H; Llewelyn, C; Green, L; Doughty, H; Nordmann, G; Brohi, K; Stanworth, S

    2015-07-01

    Low fibrinogen (Fg) concentrations in trauma haemorrhage are associated with poorer outcomes. Cryoprecipitate is the standard source for Fg administration in the UK and USA and is often given in the later stages of transfusion therapy. It is not known whether early cryoprecipitate therapy improves clinical outcomes. The primary aim of this feasibility study was to determine whether it was possible to administer cryoprecipitate, within 90 min of admission to hospital. Secondary aims were to evaluate laboratory measures of Fg and clinical outcomes including thrombotic events, organ failure, length of hospital stay and mortality. This was an unblinded RCT, conducted at two civilian UK major trauma centres of adult trauma patients (age ≥16 yrs), with active bleeding and requiring activation of the major haemorrhage protocol. Participants were randomised to standard major haemorrhage therapy (STANDARD) (n=22), or to standard haemorrhage therapy plus two early pools of cryoprecipitate (CRYO) (n=21). 85% (95% CI: 69-100%) CRYO participants received cryoprecipitate within 90 min, median time 60 min (IQR: 57-76) compared with 108 min (67-147), CRYO and STANDARD arms respectively (P=0.002). Fg concentrations were higher in the CRYO arm and were maintained above 1.8 g litre(-1) at all time-points during active haemorrhage. All-cause mortality at 28 days was not significantly different (P=0.14). Early Fg supplementation using cryoprecipitate is feasible in trauma patients. This study supports the need for a definitive RCT to determine the effect of early Fg supplementation on mortality and other clinical outcomes. ISRCTN55509212. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Soetomo score: score model in early identification of acute haemorrhagic stroke

    Directory of Open Access Journals (Sweden)

    Moh Hasan Machfoed

    2016-06-01

    Full Text Available Aim of the study: On financial or facility constraints of brain imaging, score model is used to predict the occurrence of acute haemorrhagic stroke. Accordingly, this study attempts to develop a new score model, called Soetomo score. Material and methods: The researchers performed a cross-sectional study of 176 acute stroke patients with onset of ≤24 hours who visited emergency unit of Dr. Soetomo Hospital from July 14th to December 14th, 2014. The diagnosis of haemorrhagic stroke was confirmed by head computed tomography scan. There were seven predictors of haemorrhagic stroke which were analysed by using bivariate and multivariate analyses. Furthermore, a multiple discriminant analysis resulted in an equation of Soetomo score model. The receiver operating characteristic procedure resulted in the values of area under curve and intersection point identifying haemorrhagic stroke. Afterward, the diagnostic test value was determined. Results: The equation of Soetomo score model was (3 × loss of consciousness + (3.5 × headache + (4 × vomiting − 4.5. Area under curve value of this score was 88.5% (95% confidence interval = 83.3–93.7%. In the Soetomo score model value of ≥−0.75, the score reached the sensitivity of 82.9%, specificity of 83%, positive predictive value of 78.8%, negative predictive value of 86.5%, positive likelihood ratio of 4.88, negative likelihood ratio of 0.21, false negative of 17.1%, false positive of 17%, and accuracy of 83%. Conclusions: The Soetomo score model value of ≥−0.75 can identify acute haemorrhagic stroke properly on the financial or facility constrains of brain imaging.

  15. Immediate post-partum haemorrhage: Epidemiological aspects and maternal prognosis at South N’djamena District Hospital (Chad

    Directory of Open Access Journals (Sweden)

    Gabkika Bray Madoue

    2015-05-01

    Full Text Available Background: Post-partum haemorrhage defined as blood loss after delivery over 500mls, affects all countries and is the commonest cause of maternal mortality. It is a frequent obstetric emergency in developing countries. Objective: To identify the causes of post-partum haemorrhage and identify adequate management of immediate post-partum haemorrhage and thus reduce maternal mortality. Patients and methods: This was a prospective and descriptive study of one year from 1st January 2014 to 31stDecember 2014 conducted at South N’Djamena district hospital. Before including a patient in our survey her consent was obtained after explaining to her the need for the survey. All consenting patients with post-partum haemorrhage were included. Data were analyzed using SPSS17.0. Results: We recorded 100 cases of post-partum haemorrhage among 6815 deliveries giving an incidence of 1.47%. The average age of the women was 25.0 years. The majority of deliveries (90% were vaginal. The main cause of immediate post-partum haemorrhage was a third stage of labour bleeding (66% followed by genital lesions (32%. The management was medical (uterotonic drug, fluid replacement and blood transfusion, obstetric (manual removal of placenta or clot, and surgical (suture of lesions, vascular ligature and hysterectomy. There were two maternal deaths (2%. Conclusion: Post-partum haemorrhage is often fatal in our region. Preventive measures and efficient management can help to improve maternal prognosis.

  16. Cell Therapy Applications for Retinal Vascular Diseases: Diabetic Retinopathy and Retinal Vein Occlusion.

    Science.gov (United States)

    Park, Susanna S

    2016-04-01

    Retinal vascular conditions, such as diabetic retinopathy and retinal vein occlusion, remain leading causes of vision loss. No therapy exists to restore vision loss resulting from retinal ischemia and associated retinal degeneration. Tissue regeneration is possible with cell therapy. The goal would be to restore or replace the damaged retinal vasculature and the retinal neurons that are damaged and/or degenerating from the hypoxic insult. Currently, various adult cell therapies have been explored as potential treatment. They include mesenchymal stem cells, vascular precursor cells (i.e., CD34+ cells, hematopoietic cells or endothelial progenitor cells), and adipose stromal cells. Preclinical studies show that all these cells have a paracrine trophic effect on damaged ischemic tissue, leading to tissue preservation. Endothelial progenitor cells and adipose stromal cells integrate into the damaged retinal vascular wall in preclinical models of diabetic retinopathy and ischemia-reperfusion injury. Mesenchymal stem cells do not integrate as readily but appear to have a primary paracrine trophic effect. Early phase clinical trials have been initiated and ongoing using mesenchymal stem cells or autologous bone marrow CD34+ cells injected intravitreally as potential therapy for diabetic retinopathy or retinal vein occlusion. Adipose stromal cells or pluripotent stem cells differentiated into endothelial colony-forming cells have been explored in preclinical studies and show promise as possible therapies for retinal vascular disorders. The relative safety or efficacy of these various cell therapies for treating retinal vascular disorders have yet to be determined.

  17. Advancing beyond the system: telemedicine nurses' clinical reasoning using a computerised decision support system for patients with COPD - an ethnographic study.

    Science.gov (United States)

    Barken, Tina Lien; Thygesen, Elin; Söderhamn, Ulrika

    2017-12-28

    Telemedicine is changing traditional nursing care, and entails nurses performing advanced and complex care within a new clinical environment, and monitoring patients at a distance. Telemedicine practice requires complex disease management, advocating that the nurses' reasoning and decision-making processes are supported. Computerised decision support systems are being used increasingly to assist reasoning and decision-making in different situations. However, little research has focused on the clinical reasoning of nurses using a computerised decision support system in a telemedicine setting. Therefore, the objective of the study is to explore the process of telemedicine nurses' clinical reasoning when using a computerised decision support system for the management of patients with chronic obstructive pulmonary disease. The factors influencing the reasoning and decision-making processes were investigated. In this ethnographic study, a combination of data collection methods, including participatory observations, the think-aloud technique, and a focus group interview was employed. Collected data were analysed using qualitative content analysis. When telemedicine nurses used a computerised decision support system for the management of patients with complex, unstable chronic obstructive pulmonary disease, two categories emerged: "the process of telemedicine nurses' reasoning to assess health change" and "the influence of the telemedicine setting on nurses' reasoning and decision-making processes". An overall theme, termed "advancing beyond the system", represented the connection between the reasoning processes and the telemedicine work and setting, where being familiar with the patient functioned as a foundation for the nurses' clinical reasoning process. In the telemedicine setting, when supported by a computerised decision support system, nurses' reasoning was enabled by the continuous flow of digital clinical data, regular video-mediated contact and shared decision

  18. Bilateral acute retinal necrosis after herpetic meningitis

    Directory of Open Access Journals (Sweden)

    Katsura T

    2012-04-01

    Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

  19. Retinitis pigmentosa, pigmentary retinopathies, and neurologic diseases.

    Science.gov (United States)

    Bhatti, M Tariq

    2006-09-01

    Retinitis pigmentosa (RP) refers to a group of inherited retinal diseases with phenotypic and genetic heterogeneity. The pathophysiologic basis of the progressive visual loss in patients with RP is not completely understood but is felt to be due to a primary retinal photoreceptor cell degenerative process mainly affecting the rods of the peripheral retina. In most cases RP is seen in isolation (nonsyndromic), but in some other cases it may be a part of a genetic, metabolic, or neurologic syndrome or disorder. Nyctalopia, or night blindness, is the most common symptom of RP. The classic fundus appearance of RP includes retinal pigment epithelial cell changes resulting in retinal hypo- or hyperpigmentation ("salt-and-pepper"), retinal granularity, and bone spicule formation. The retinal vessels are often narrowed or attenuated and there is a waxy pallor appearance of the optic nerve head. Electroretinography will demonstrate rod and cone photoreceptor cell dysfunction and is a helpful test in the diagnosis and monitoring of patients with RP. A detailed history with pedigree analysis, a complete ocular examination, and the appropriate paraclinical testing should be performed in patients complaining of visual difficulties at night or in dim light. This review discusses the clinical manifestations of RP as well as describing the various systemic diseases, with a special emphasis on neurologic diseases, associated with a pigmentary retinopathy.

  20. Genomic analysis of mouse retinal development.

    Directory of Open Access Journals (Sweden)

    Seth Blackshaw

    2004-09-01

    Full Text Available The vertebrate retina is comprised of seven major cell types that are generated in overlapping but well-defined intervals. To identify genes that might regulate retinal development, gene expression in the developing retina was profiled at multiple time points using serial analysis of gene expression (SAGE. The expression patterns of 1,051 genes that showed developmentally dynamic expression by SAGE were investigated using in situ hybridization. A molecular atlas of gene expression in the developing and mature retina was thereby constructed, along with a taxonomic classification of developmental gene expression patterns. Genes were identified that label both temporal and spatial subsets of mitotic progenitor cells. For each developing and mature major retinal cell type, genes selectively expressed in that cell type were identified. The gene expression profiles of retinal Müller glia and mitotic progenitor cells were found to be highly similar, suggesting that Müller glia might serve to produce multiple retinal cell types under the right conditions. In addition, multiple transcripts that were evolutionarily conserved that did not appear to encode open reading frames of more than 100 amino acids in length ("noncoding RNAs" were found to be dynamically and specifically expressed in developing and mature retinal cell types. Finally, many photoreceptor-enriched genes that mapped to chromosomal intervals containing retinal disease genes were identified. These data serve as a starting point for functional investigations of the roles of these genes in retinal development and physiology.

  1. Optical Coherence Tomography Angiography in Retinal Diseases.

    Science.gov (United States)

    Chalam, K V; Sambhav, Kumar

    2016-01-01

    Optical coherence tomography angiography (OCTA) is a new, non-invasive imaging system that generates volumetric data of retinal and choroidal layers. It has the ability to show both structural and blood flow information. Split-spectrum amplitude-decorrelation angiography (SSADA) algorithm (a vital component of OCTA software) helps to decrease the signal to noise ratio of flow detection thus enhancing visualization of retinal vasculature using motion contrast. Published studies describe potential efficacy for OCTA in the evaluation of common ophthalmologic diseases such as diabetic retinopathy, age related macular degeneration (AMD), retinal vascular occlusions and sickle cell disease. OCTA provides a detailed view of the retinal vasculature, which allows accurate delineation of microvascular abnormalities in diabetic eyes and vascular occlusions. It helps quantify vascular compromise depending upon the severity of diabetic retinopathy. OCTA can also elucidate the presence of choroidal neovascularization (CNV) in wet AMD. In this paper, we review the knowledge, available in English language publications regarding OCTA, and compare it with the conventional angiographic standard, fluorescein angiography (FA). Finally, we summarize its potential applications to retinal vascular diseases. Its current limitations include a relatively small field of view, inability to show leakage, and tendency for image artifacts. Further larger studies will define OCTA's utility in clinical settings and establish if the technology may offer a non-invasive option of visualizing the retinal vasculature, enabling us to decrease morbidity through early detection and intervention in retinal diseases.

  2. Silver nano - a trove for retinal therapies.

    Science.gov (United States)

    Kalishwaralal, Kalimuthu; Barathmanikanth, Selvaraj; Pandian, Sureshbabu Ram Kumar; Deepak, Venkatraman; Gurunathan, Sangiliyandi

    2010-07-14

    Pathological retinal angiogenesis (neovascularization) is one of the most feared complications among retinal diseases, leading to visual impairment and irreversible blindness. Recent findings made by us on therapeutic applications of biologically synthesized silver nanoparticles (AgNPs) against VEGF induced retinal endothelial cells, elucidates the effectual inhibitory activities of AgNPs over the downstream signaling pathways (Src and AKT/PI3K) leading to retinal angiogenesis. The current review focuses on the imperative role of VEGF induced angiogenesis in the development of retinal neovascularization and despite the fact that several VEGF targeting ocular drugs are available; the review examines the need for a cost economic alternative, thereby suggesting the role of AgNPs as an emerging economic ocular drug for retinal therapies. The current technologies available for the development of targeted and controlled release of drugs is being discussed and a model has been proposed for the amenable targeting mechanism, by which Poly gamma glutamic acid (PGA) capsulated AgNPs conjugated to cyclic RGD peptides carry out a sustained controlled release specifically targeting the neovascularization cells and induce apoptosis unaffecting the normal retinal cells. These constructs consequently affirm the futuristic application of silver nanoparticles as a boon to ocular therapies. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  3. Paediatric retinal detachment: aetiology, characteristics and outcomes

    Directory of Open Access Journals (Sweden)

    Elizabeth McElnea

    2018-02-01

    Full Text Available AIM: To provide contemporary data on the aetiology, clinical features and outcomes of paediatric retinal detachment. METHODS: A retrospective review of all those under 16y who underwent surgical repair for retinal detachment at a single centre between the years 2008 and 2015 inclusive was performed. In each case the cause of retinal detachment, the type of detachment, the presence or absence of macular involvement, the number and form of reparative surgeries undertaken, and the surgical outcome achieved was recorded. RESULTS: Twenty-eight eyes of 24 patients, 15 (62.5% of whom were male and 9 (37.5% of whom were female, their mean age being 11.6y and range 2-16y developed retinal detachment over the eight year period studied. Trauma featured in the development of retinal detachment in 14 (50.0% cases. Retinal detachment was associated with other ocular and/or systemic conditions in 11 (39.3% cases. A mean of 3.0 procedures with a range of 1-9 procedures per patient were undertaken in the management of retinal detachment. Complex vitrectomy combined with scleral buckling or complex vitrectomy alone were those most frequently performed. Mean postoperative visual acuity was 1.2 logMAR with range 0.0-3.0 logMAR. In 22 of 26 (84.6% cases which underwent surgical repair the retina was attached at last follow-up. CONCLUSION: Aggressive management of paediatric retinal detachment including re-operation increases the likelihood of anatomical success. In cases where the retinal detachment can be repaired by an external approach alone there is a more favourable visual outcome.

  4. Paediatric retinal detachment: aetiology, characteristics and outcomes.

    Science.gov (United States)

    McElnea, Elizabeth; Stephenson, Kirk; Gilmore, Sarah; O'Keefe, Michael; Keegan, David

    2018-01-01

    To provide contemporary data on the aetiology, clinical features and outcomes of paediatric retinal detachment. A retrospective review of all those under 16y who underwent surgical repair for retinal detachment at a single centre between the years 2008 and 2015 inclusive was performed. In each case the cause of retinal detachment, the type of detachment, the presence or absence of macular involvement, the number and form of reparative surgeries undertaken, and the surgical outcome achieved was recorded. Twenty-eight eyes of 24 patients, 15 (62.5%) of whom were male and 9 (37.5%) of whom were female, their mean age being 11.6y and range 2-16y developed retinal detachment over the eight year period studied. Trauma featured in the development of retinal detachment in 14 (50.0%) cases. Retinal detachment was associated with other ocular and/or systemic conditions in 11 (39.3%) cases. A mean of 3.0 procedures with a range of 1-9 procedures per patient were undertaken in the management of retinal detachment. Complex vitrectomy combined with scleral buckling or complex vitrectomy alone were those most frequently performed. Mean postoperative visual acuity was 1.2 logMAR with range 0.0-3.0 logMAR. In 22 of 26 (84.6%) cases which underwent surgical repair the retina was attached at last follow-up. Aggressive management of paediatric retinal detachment including re-operation increases the likelihood of anatomical success. In cases where the retinal detachment can be repaired by an external approach alone there is a more favourable visual outcome.

  5. A clinical approach to the diagnosis of retinal vasculitis.

    Science.gov (United States)

    El-Asrar, Ahmed M Abu; Herbort, Carl P; Tabbara, Khalid F

    2010-04-01

    Retinal vasculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and is confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings.

  6. An Unusual Case of Extensive Lattice Degeneration and Retinal Detachment

    OpenAIRE

    Mathew, David J.; Sarma, Saurabh Kumar; Basaiawmoit, Jennifer V.

    2016-01-01

    Lattice degeneration of the retina is not infrequently encountered on a dilated retinal examination and many of them do not need any intervention. We report a case of atypical lattice degeneration variant with peripheral retinal detachment. An asymptomatic 35-year-old lady with minimal refractive error was found to have extensive lattice degeneration, peripheral retinal detachment and fibrotic changes peripherally with elevation of retinal vessels on dilated retinal examination. There were al...

  7. Smart image processing system for retinal prosthesis.

    Science.gov (United States)

    Weiland, James D; Parikh, Neha; Pradeep, Vivek; Medioni, Gerard

    2012-01-01

    Retinal prostheses for the blind have demonstrated the ability to provide the sensation of light in otherwise blind individuals. However, visual task performance in these patients remains poor relative to someone with normal vision. Computer vision algorithms for navigation and object detection were evaluated for their ability to improve task performance. Blind subjects navigating a mobility course had fewer collisions when using a wearable camera system that guided them on a safe path. Subjects using a retinal prosthesis simulator could locate objects more quickly when an object detection algorithm assisted them. Computer vision algorithms can assist retinal prosthesis patients and low-vision patients in general.

  8. Photostress Testing Device for Diagnosing Retinal Disease

    Directory of Open Access Journals (Sweden)

    Elizabeth Swan

    2014-08-01

    Full Text Available Retinal diseases such as Age-Related Macular Degeneration (ARMD affect nearly one in three elderly patients. ARMD damages the central vision photoreceptors in the fovea. The Photostress Test is a simple technique for testing for the early effects of ARMD. Here, the illumination sources in a novel self-administered Photostress Testing device were modeled for safety and distribution in illumination software. After satisfying the design constraints in the model, a prototype of the illumination system was fabricated and tested to confirm the modeling results. The resultant prototype can be used to aid in the diagnosis of retinal disease and is well within retinal safety levels.

  9. Automation of CT-based haemorrhagic stroke assessment for improved clinical outcomes: study protocol and design.

    Science.gov (United States)

    Chinda, Betty; Medvedev, George; Siu, William; Ester, Martin; Arab, Ali; Gu, Tao; Moreno, Sylvain; D'Arcy, Ryan C N; Song, Xiaowei

    2018-04-19

    Haemorrhagic stroke is of significant healthcare concern due to its association with high mortality and lasting impact on the survivors' quality of life. Treatment decisions and clinical outcomes depend strongly on the size, spread and location of the haematoma. Non-contrast CT (NCCT) is the primary neuroimaging modality for haematoma assessment in haemorrhagic stroke diagnosis. Current procedures do not allow convenient NCCT-based haemorrhage volume calculation in clinical settings, while research-based approaches are yet to be tested for clinical utility; there is a demonstrated need for developing effective solutions. The project under review investigates the development of an automatic NCCT-based haematoma computation tool in support of accurate quantification of haematoma volumes. Several existing research methods for haematoma volume estimation are studied. Selected methods are tested using NCCT images of patients diagnosed with acute haemorrhagic stroke. For inter-rater and intrarater reliability evaluation, different raters will analyse haemorrhage volumes independently. The efficiency with respect to time of haematoma volume assessments will be examined to compare with the results from routine clinical evaluations and planimetry assessment that are known to be more accurate. The project will target the development of an enhanced solution by adapting existing methods and integrating machine learning algorithms. NCCT-based information of brain haemorrhage (eg, size, volume, location) and other relevant information (eg, age, sex, risk factor, comorbidities) will be used in relation to clinical outcomes with future project development. Validity and reliability of the solution will be examined for potential clinical utility. The project including procedures for deidentification of NCCT data has been ethically approved. The study involves secondary use of existing data and does not require new consent of participation. The team consists of clinical neuroimaging

  10. Influencing the practice and outcome in acute upper gastrointestinal haemorrhage. Steering Committee of the National Audit of Acute Upper Gastrointestinal Haemorrhage.

    Science.gov (United States)

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

    1997-11-01

    To assess changes in practice and outcome in acute upper gastrointestinal haemorrhage following the feedback of data, the reemphasis of national guidelines, and specific recommendations following an initial survey. A prospective, multicentre, audit cycle. Forty five hospitals from three health regions participated in two phases of the audit cycle. Phase I: 2332 patients with acute upper gastrointestinal haemorrhage; phase II: 1625 patients with upper gastrointestinal haemorrhage. Patients were evaluated with respect to management (with reference to the recommendations in the national guidelines), mortality, and length of hospital stay. Following the distribution of data from the first phase of the National Audit and the formulation of specific recommendations for improving practice, the proportion of hospitals with local guidelines or protocols for the management of upper gastrointestinal haemorrhage rose from 71% (32/45) to 91% (41/45); 12 of the 32 hospitals with guidelines during the first phase revised their guidelines following the initial survey. There was a small but significant increase in the proportion of all patients who underwent endoscopy (from 81% to 86%), the proportion who underwent endoscopy within 24 hours of admission (from 50% to 56%), and the use of central venous pressure monitoring in patients with organ failure requiring blood transfusion or those with profound shock (from 30% to 43%). There was, however, no change in the use of high dependency beds or joint medical/surgical management in high risk cases. There was no significant change in crude or risk standardised mortality (13.4% in the first phase and 14.4% in the second phase). Although many of the participating hospitals have made efforts to improve practice by producing or updating guidelines or protocols, there has been only a small demonstrable change in some areas of practice during the National Audit. The failure to detect any improvement in mortality may reflect this lack of

  11. The Melbourne East Monash General Practice Database (MAGNET: Using data from computerised medical records to create a platform for primary care and health services research

    Directory of Open Access Journals (Sweden)

    Danielle Mazza

    2016-07-01

    Full Text Available The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET research platform was launched in 2013 to provide a unique data source for primary care and health services research in Australia.  MAGNET contains information from the computerised records of 50 participating general practices and includes data from the computerised medical records of more than 1,100,000 patients.  The data extracted is patient-level episodic information and includes a variety of fields related to patient demographics and historical clinical information, along with the characteristics of the participating general practices.  While there are limitations to the data that is currently available, the MAGNET research platform continues to investigate other avenues for improving the breadth and quality of data, with the aim of providing a more comprehensive picture of primary care in Australia

  12. The Melbourne East Monash General Practice Database (MAGNET): Using data from computerised medical records to create a platform for primary care and health services research.

    Science.gov (United States)

    Mazza, Danielle; Pearce, Christopher; Turner, Lyle Robert; De Leon-Santiago, Maria; McLeod, Adam; Ferriggi, Jason; Shearer, Marianne

    2016-07-04

    The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET) research platform was launched in 2013 to provide a unique data source for primary care and health services research in Australia.  MAGNET contains information from the computerised records of 50 participating general practices and includes data from the computerised medical records of more than 1,100,000 patients.  The data extracted is patient-level episodic information and includes a variety of fields related to patient demographics and historical clinical information, along with the characteristics of the participating general practices.  While there are limitations to the data that is currently available, the MAGNET research platform continues to investigate other avenues for improving the breadth and quality of data, with the aim of providing a more comprehensive picture of primary care in Australia.

  13. Treatment of Retinal Separation in HIV-infected Patients with Cytomegalovirus Retinitis

    Directory of Open Access Journals (Sweden)

    A. L. Onischenko

    2017-01-01

    Full Text Available HIV infection — is a socially significant problem for many countries, as the infected die in an average of 10-11 years due to the immunodeficiency virus. Up to 20% of patients with AIDS lose their sight because of cytomegalovirus retinitis (CMV retinitis, which occurs in 70% of HIV-infected people. In some patients with HIV infection blindness occurs because of acute retinal necrosis of CMV etiology. The algorithm of CMV retinitis treatment in HIV-infected patients is described in modern manuals (ganciclovir, valganciclovir, foscarnet and others on the background of antiretroviral therapy, but the tactics of treatment of retinal separation in these patients is not clearly defined. It may be “wait and see”, providing conservative treatment with antiviral drugs, and the active tactics — vitreoretinal surgery. In this article the authors present their personal clinical observations of three HIV-infected patients with CMV retinitis at the age of 8 to 36 years with a detailed analysis of the clinical data and the results of the laboratory tests. In particular, the authors give their own results of intravitreal introduction of ganciclovir in patients with CMV retinitis. Given the poor prognosis for the life of these patients, the authors put a deontological question of justification of active treatment of retinal separation in AIDS patients with CMV retinitis.

  14. Retinal Endovascular Surgery with Tissue Plasminogen Activator Injection for Central Retinal Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Yuta Takata

    2018-06-01

    Full Text Available Purpose: To report 2 cases of central retinal artery occlusion (CRAO who underwent retinal endovascular surgery with injection of tissue plasminogen activator (tPA into the retinal artery and showed a remarkable improvement in visual acuity and retinal circulation. Methods: Standard 25-G vitrectomy was performed under local anesthesia. Simultaneously, tPA (80,000 units/mL solution was injected into the retinal artery of the optic disc for 2–3 min using a microneedle. Changes in visual acuity, fundus photography, optical coherence tomography (OCT, fluorescein angiography, and laser speckle flowgraphy (LSFG results were examined. Results: Both cases could be treated within 12 h after the onset of CRAO. Case 1 was a 47-year-old woman. Her visual acuity improved from counting fingers before operation to 0.08 logMAR 1 month after the surgery. However, thinning of the retina at the macula was observed by OCT. Case 2 was a 70-year-old man. His visual acuity improved from counting fingers to 0.1 logMAR 2 months after the surgery. Both fluorescein angiography and LSFG showed improvement in retinal circulation after the surgery in case 2. Conclusions: Retinal endovascular surgery with injection of tPA into the retinal artery was feasible and may be a way to improve visual acuity and retinal circulation when performed in the acute phase of CRAO.

  15. Achieved serum magnesium concentrations and occurrence of delayed cerebral ischaemia and poor outcome in aneurysmal subarachnoid haemorrhage

    NARCIS (Netherlands)

    Dorhout Mees, Sanne M.; van den Bergh, Walter M.; Algra, Ale; Rinkel, Gabriel J. E.

    2007-01-01

    BACKGROUND: Magnesium therapy probably reduces the frequency of delayed cerebral ischaemia (DCI) in subarachnoid haemorrhage (SAH) but uncertainty remains about the optimal serum magnesium concentration. We assessed the relationship between serum magnesium concentrations achieved with magnesium

  16. Application of computerised penile arterial waveform analysis in the diagnosis of arteriogenic impotence. An initial study in potent and impotent men.

    Science.gov (United States)

    Desai, K M; Gingell, J C; Skidmore, R; Follett, D H

    1987-11-01

    A new method is described for evaluating arteriogenic impotence by means of noninvasive quantification of penile Doppler arterial waveforms using computerised analysis based on the Laplace Transform model. The haemodynamic changes occurring during a papaverine-induced erection in healthy potent volunteers have been recorded by this technique, which has also been shown to be capable of discriminating between a normal and an abnormal penile arterial supply in an initial study of potent and impotent men.

  17. Understanding the acceptability of e-mental health--attitudes and expectations towards computerised self-help treatments for mental health problems.

    Science.gov (United States)

    Musiat, Peter; Goldstone, Philip; Tarrier, Nicholas

    2014-04-11

    E-mental health and m-mental health include the use of technology in the prevention, treatment and aftercare of mental health problems. With the economical pressure on mental health services increasing, e-mental health and m-mental health could bridge treatment gaps, reduce waiting times for patients and deliver interventions at lower costs. However, despite the existence of numerous effective interventions, the transition of computerised interventions into care is slow. The aim of the present study was to investigate the acceptability of e-mental health and m-mental health in the general population. An advisory group of service users identified dimensions that potentially influence an individual's decision to engage with a particular treatment for mental health problems. A large sample (N = 490) recruited through email, flyers and social media was asked to rate the acceptability of different treatment options for mental health problems on these domains. Results were analysed using repeated measures MANOVA. Participants rated the perceived helpfulness of an intervention, the ability to motivate users, intervention credibility, and immediate access without waiting time as most important dimensions with regard to engaging with a treatment for mental health problems. Participants expected face-to-face therapy to meet their needs on most of these dimensions. Computerised treatments and smartphone applications for mental health were reported to not meet participants' expectations on most domains. However, these interventions scored higher than face-to-face treatments on domains associated with the convenience of access. Overall, participants reported a very low likelihood of using computerised treatments for mental health in the future. Individuals in this study expressed negative views about computerised self-help intervention and low likelihood of use in the future. To improve the implementation and uptake, policy makers need to improve the public perception of such

  18. Understanding the acceptability of e-mental health - attitudes and expectations towards computerised self-help treatments for mental health problems

    OpenAIRE

    Musiat, Peter; Goldstone, Philip; Tarrier, Nicholas

    2014-01-01

    Background E-mental health and m-mental health include the use of technology in the prevention, treatment and aftercare of mental health problems. With the economical pressure on mental health services increasing, e-mental health and m-mental health could bridge treatment gaps, reduce waiting times for patients and deliver interventions at lower costs. However, despite the existence of numerous effective interventions, the transition of computerised interventions into care is slow. The aim of...

  19. Heritability of Retinal Vascular Fractals

    DEFF Research Database (Denmark)

    Vergmann, Anna Stage; Broe, Rebecca; Kessel, Line

    2017-01-01

    Purpose: To determine the genetic contribution to the pattern of retinal vascular branching expressed by its fractal dimension. Methods: This was a cross-sectional study of 50 monozygotic and 49 dizygotic, same-sex twin pairs aged 20 to 46 years. In 50°, disc-centered fundus photographs, the reti...... fractal dimension did not differ statistically significantly between monozygotic and dizygotic twin pairs (1.505 vs. 1.495, P = 0.06), supporting that the study population was suitable for quantitative analysis of heritability. The intrapair correlation was markedly higher (0.505, P = 0.......0002) in monozygotic twins than in dizygotic twins (0.108, P = 0.46), corresponding to a heritability h2 for the fractal dimension of 0.79. In quantitative genetic models, dominant genetic effects explained 54% of the variation and 46% was individually environmentally determined. Conclusions: In young adult twins...

  20. Accommodative loss after retinal cryotherapy.

    Science.gov (United States)

    Uno, Tsuyoshi; Okuyama, Michiko; Tanabe, Tatsuro; Kawamura, Ryosuke; Ideta, Hidenao

    2009-01-01

    To investigate the effects of peripheral retinal cryotherapy on accommodative amplitude in patients with retinal lattice degeneration. Prospective, observational case series. We studied 92 eyes in 69 patients (age range, 13 to 79 years) treated with cryotherapy for lattice degeneration between December 2001 and September 2004. Pretreatment and posttreatment accommodative amplitudes were measured. Acute accommodative loss was calculated from the difference between accommodative amplitudes before treatment and one week after treatment. We investigated the time course of accommodative amplitudes, acute accommodative loss in different age groups and in pretreatment accommodative amplitude groups, the influence of cryotherapy numbers on accommodative amplitude, and the influence of cryotherapy sites on accommodative amplitude. No significant difference was noted between pretreatment and posttreatment accommodative amplitudes in the overall subject cohort. Dividing subjects by age revealed significant decreases in accommodative amplitude only among patients in their 10s and 20s at one and three weeks after treatment. Accommodative amplitude was lowest among those in their 10s, followed by that among those in their 20s (P < .01). Accommodative amplitudes recovered to pretreatment level by six weeks. Acute accommodative loss was greatest in those in their 10s compared with other age groups (P < .01). A significant correlation was observed between acute accommodative loss and cryotherapy numbers (P = .03; r = 0.41). The decrease in accommodative amplitude was greatest at one week after treatment and recovered to pretreatment levels after six weeks. Accommodative amplitude showed the greatest decrease after cryotherapy among patients in their 10s and 20s. A decrease in accommodative amplitude was observed with increased numbers of cryotherapy spots administered.

  1. Initial presentation of a giant gastrointestinal stromal tumour of the stomach with recurrent spontaneous intra-peritoneal haemorrhage

    Directory of Open Access Journals (Sweden)

    Margarida Vinagreiro

    2015-01-01

    Discussion and conclusion: GISTs are uncommon and rarely present with spontaneous intra-peritoneal haemorrhage, which may be life threatening. In our understanding, this is the first reported case of the reviewed literature presenting with a chronic hemoperitoneum, due to recurrent brisk episodes of tumour haemorrhage. Tumour rupture and large tumour size are two poor independent prognostic tumour factors for recurrence. Despite this, the patient remains free of disease after surgery and instituted adjuvant imatinib mesylate.

  2. Feasibility and effectiveness of a cognitive remediation programme with original computerised cognitive training and group intervention for schizophrenia: a multicentre randomised trial.

    Science.gov (United States)

    Matsuda, Yasuhiro; Morimoto, Tsubasa; Furukawa, Shunichi; Sato, Sayaka; Hatsuse, Norifumi; Iwata, Kazuhiko; Kimura, Mieko; Kishimoto, Toshifumi; Ikebuchi, Emi

    2018-04-01

    Devising new methods to improve neurocognitive impairment through cognitive remediation is an important research goal. We developed an original computer programme termed the Japanese Cognitive Rehabilitation Programme for Schizophrenia (JCORES) that provides cognitive practice across a broad range of abilities. The current study examined for the first time whether a cognitive remediation programme, including both computerised cognitive training using JCORES and group intervention such as enhancing meta-cognition and teaching strategies, is more effective than treatment as usual for improving neurocognitive and social functioning. Sixty-two outpatients with schizophrenia were randomised to either a cognitive remediation group or a control group. Participants engaged in two computerised cognitive training sessions and one group meeting per week for 12 weeks. The average number of total sessions attended (computerised cognitive practice + group intervention) was 32.3 (89.7%). The cognitive remediation group showed significantly more improvements in verbal memory, composite score of the Brief Assessment of Cognition in Schizophrenia, Japanese version (BACS-J), and general psychopathology on the Positive and Negative Syndrome Scale (PANSS) than the control group. These findings demonstrate that a cognitive remediation programme is feasible in Japan and is a more effective way to improve neurocognitive functioning and psychiatric symptoms.

  3. Rhegmatogenous retinal detachment following intravitreal ocriplasmin

    NARCIS (Netherlands)

    Madi, Haifa A.; Haynes, Richard J.; Depla, Diana; de la Cour, Morten D.; Lesnik-Oberstein, Sarit; Muqit, Mahi M. K.; Patton, Niall; Price, Nick; Steel, David H. W.

    2016-01-01

    To describe the characteristics and outcomes of patients presenting with rhegmatogenous retinal detachment (RRD) after ocriplasmin (OCP) injection. Retrospective, multi-centre, observational case series with case note review. Eight patients with symptomatic vitreomacular traction (six with

  4. [Paediatric retinal detachment and hereditary vitreoretinal disorders].

    Science.gov (United States)

    Meier, P

    2013-09-01

    The number of retinal detachments in children is very low in comparison to the number in adults. One predisposing factor for development of paediatric retinal detachment is suffering from hereditary vitreoretinal degeneration (e.g., Stickler syndrome, Wagner syndrome, Kniest dysplasia, familial exudative vitreoretinopathy, congenital X-linked retinoschisis, Knobloch syndrome, incontinentia pigmenti, Norrie disease). Hereditary vitreoretinopathies are characterised by an abnormal-appearing vitreous gel with associated retinal changes. In most of these eyes further ocular abnormalities can be diagnosed. A group of hereditary disorders is associated with characteristic systemic abnormalities. Allied conditions should be considered in the clinical diagnosis. Vitreoretinopathies are the most common cause of inherited retinal detachment. In most eyes primary vitrectomy is necessary, and disease-specific surgical treatment is discussed. Georg Thieme Verlag KG Stuttgart · New York.

  5. Retinal Detachment: Torn or Detached Retina Diagnosis

    Science.gov (United States)

    ... Feb 20, 2018 Gene Therapy May Be a Game-Changer for People With Inherited Retinal Disease Dec 19, 2017 ... the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

  6. Retinal Detachment: Torn or Detached Retina Treatment

    Science.gov (United States)

    ... Feb 20, 2018 Gene Therapy May Be a Game-Changer for People With Inherited Retinal Disease Dec 19, 2017 ... the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

  7. Retinal Detachment: Torn or Detached Retina Symptoms

    Science.gov (United States)

    ... Feb 20, 2018 Gene Therapy May Be a Game-Changer for People With Inherited Retinal Disease Dec 19, 2017 ... the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

  8. Adaptive optics imaging of inherited retinal diseases.

    Science.gov (United States)

    Georgiou, Michalis; Kalitzeos, Angelos; Patterson, Emily J; Dubra, Alfredo; Carroll, Joseph; Michaelides, Michel

    2017-11-15

    Adaptive optics (AO) ophthalmoscopy allows for non-invasive retinal phenotyping on a microscopic scale, thereby helping to improve our understanding of retinal diseases. An increasing number of natural history studies and ongoing/planned interventional clinical trials exploit AO ophthalmoscopy both for participant selection, stratification and monitoring treatment safety and efficacy. In this review, we briefly discuss the evolution of AO ophthalmoscopy, recent developments and its application to a broad range of inherited retinal diseases, including Stargardt disease, retinitis pigmentosa and achromatopsia. Finally, we describe the impact of this in vivo microscopic imaging on our understanding of disease pathogenesis, clinical trial design and outcome metrics, while recognising the limitation of the small cohorts reported to date. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Regulatory and Economic Considerations of Retinal Drugs.

    Science.gov (United States)

    Shah, Ankoor R; Williams, George A

    2016-01-01

    The advent of anti-VEGF therapy for neovascular age-related macular degeneration and macular edema secondary to retinal vein occlusion and diabetes mellitus has prevented blindness in tens of thousands of people. However, the costs of these drugs are without precedent in ophthalmic drug therapeutics. An analysis of the financial implications of retinal drugs and the impact of the Food and Drug Administration on treatment of retinal disease must include not only an evaluation of the direct costs of the drugs and the costs associated with their administration, but also the cost savings which accrue from their clinical benefit. This chapter will discuss the financial and regulatory issues associated with retinal drugs. © 2016 S. Karger AG, Basel.

  10. Severe acute haemorrhagic liver failure in a neonate with a favourable spontaneous outcome

    International Nuclear Information System (INIS)

    Cavet, Madeleine; Balu, Marie; Garel, Catherine; Ducou le Pointe, Hubert; Mitanchez, Delphine; Alexandre, Marie; Renolleau, Sylvain; Pariente, Daniele

    2008-01-01

    Acute liver failure in neonates is rare and is frequently associated with an unfavourable outcome. There is no curative treatment other than liver transplantation. Screening for viral, metabolic, toxic or vascular disease is essential to assess the prognosis and to guide specific treatment. Hepatic haemorrhage in neonates is often associated with bacterial infection, trauma and coagulopathies. We present a unique case of neonatal acute liver failure and multifocal massive haemorrhagic intrahepatic lesions of traumatic origin, documented by US and MRI. The patient made a spontaneous recovery. Clinical, biological and imaging outcome was excellent despite the apparent severity of the initial features. The only possible aetiology was a difficult caesarean delivery for mild fetal macrosomia. (orig.)

  11. Infrastructure and clinical practice for the detection and management of trauma-associated haemorrhage and coagulopathy

    DEFF Research Database (Denmark)

    Driessen, Annemariek; Schäfer, N; Albrecht, V

    2015-01-01

    of trauma-associated haemorrhage and coagulopathy, we have conducted a web-based survey amongst the delegates to the 15th European Congress of Trauma and Emergency Surgery (ECTES) and the 2nd World Trauma (WT) Congress held in Frankfurt, Germany, 25-27 May 2014. RESULTS: 446/1,540 delegates completed...... frequently used strategies for early detection and monitoring of bleeding trauma patients with coagulopathy. Only 30% of the respondents declared to use extended coagulation assays to better characterise the bleeding and coagulopathy prompted by more individualised treatment concepts. Most trauma centres (69...... intake of anticoagulants including "new oral anticoagulants" and platelet inhibitors as an increasing threat to bleeding trauma patients. CONCLUSIONS: This study confirms differences in infrastructure, logistics and clinical practice for the detection and management of trauma-haemorrhage and trauma...

  12. CT Scan Features of Presumptive Haemorrhagic Stroke in a Dog with Cushing’s Disease

    Directory of Open Access Journals (Sweden)

    A. Liotta

    2014-01-01

    Full Text Available A 9-year-old, intact male, Brie’s shepherd dog, with a 10-day history of depression and tachypnoea developed signs of central neurological dysfunction. 16 Multislice Computed Tomography (CT pre- and postcontrast studies of the brain revealed a single intra-axial homogeneous well-circumscribed hyperattenuating (+/− 62 HU and noncontrast-enhancing area, 5 mm in diameter, in the caudal part of the mesencephalon. This finding was highly suggestive of a haemorrhagic event. A pituitary-dependent hyperadrenocorticism (PDH was identified and is considered likely to be the underlying cause. A repeat CT scan examination, 2 months later, showed almost complete resolution of the brain lesion. The present case describes a solitary 5 mm diameter lesion: the result of intracranial haemorrhage in a dog with presumed PDH.

  13. Efficacy of intra-arterial nimodipine in the treatment of cerebral vasospasm complicating subarachnoid haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Hui, C. [Department of Diagnostic Imaging, Monash Medical Centre, Clayton, Vic. (Australia)]. E-mail: cathryn.hui@southernhealth.org.au; Lau, K.P. [Department of Diagnostic Imaging, Monash Medical Centre, Clayton, Vic. (Australia)

    2005-09-01

    AIM: To examine the efficacy and safety of nimodipine as an alternative to papaverine for the treatment of cerebral vasospasm following subarachnoid haemorrhage. METHODS: We retrospectively reviewed the procedure reports, anaesthetic records, clinical charts and CT and angiographic images of 9 patients who had received intra-arterial nimodipine; 1 of these patients received both nimodipine and papaverine. The difference in arterial luminal diameter before and after treatment was calculated as a percentage change. RESULTS: The average dose of nimodipine administered per vessel was 3.3 mg. The mean increase in arterial diameter was 66.6% in the vasospastic segment. There was no significant change in blood pressure of any of the subjects during endovascular treatment of vasospasm. CONCLUSION: Intra-arterial nimodipine is effective in improving angiographic vasospasm complicating subarachnoid haemorrhage. Further studies aimed at examining the clinical benefits of nimodipine are warranted, particularly in view of the low risk of adverse side effects of nimopidine when compared with papaverine.

  14. Bilateral adrenal haemorrhage associated with heparin-induced thrombocytopaenia during treatment of Fournier gangrene.

    Science.gov (United States)

    Tattersall, Timothy Lee; Thangasamy, Isaac A; Reynolds, Jamie

    2014-10-14

    We present a case of bilateral adrenal haemorrhage (BAH) associated with heparin-induced thrombocytopaenia (HIT) in a 61-year-old man admitted to hospital for the treatment of Fournier's gangrene. He presented to hospital with scrotal swelling and fever, and developed spreading erythaema and a gangrenous scrotum. His scrotum was surgically debrided and intravenous broad-spectrum antibiotics were administered. Unfractionated heparin was given postoperatively for venous thromboembolism prophylaxis. The patient deteriorated clinically 8-11 days postoperatively with delirium, chest pain and severe hypertension followed by hypotension and thrombocytopaenia. Abdominal CT scan revealed bilateral adrenal haemorrhage. Antibodies to the heparin-platelet factor 4 complex were present. HIT-associated BAH was diagnosed and heparin was discontinued. Intravenous bivalirudin and hydrocortisone were started, with rapid improvement in clinical status. BAH is a rare complication of HIT and should be considered in the postoperative patient with unexplained clinical deterioration. 2014 BMJ Publishing Group Ltd.

  15. Bilateral large subconjunctival haemorrhages unmasking immune thrombocytopenic purpura during retinopathy of prematurity screening.

    Science.gov (United States)

    Chandra, Parijat; Kumawat, Devesh; Kumar, Vinod; Tewari, Ruchir

    2017-10-04

    Although thrombocytopenia is known to be associated with pathogenesis of retinopathy of prematurity (ROP), immune thrombocytopenic purpura (ITP) is rare in infancy and not reported to occur with ROP. A preterm infant with aggressive posterior ROP developed bilateral massive subconjunctival haemorrhage after scleral indentation during screening. On evaluation, the infant was found to have severe ITP. Following intravenous transfusion of platelets and immunoglobulin, platelet counts improved and subconjunctival haemorrhage resolved over time. This case highlights the unusual presentation of ITP and also discusses the association of thrombocytopenia with ROP. Ophthalmologists should get prompt haematological work-up of such occurrences. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Severe acute haemorrhagic liver failure in a neonate with a favourable spontaneous outcome

    Energy Technology Data Exchange (ETDEWEB)

    Cavet, Madeleine; Balu, Marie; Garel, Catherine; Ducou le Pointe, Hubert [Universite Pierre et Marie Curie Paris VI, Service de Radiologie, Hopital d' enfants Armand-Trousseau, Paris (France); Mitanchez, Delphine; Alexandre, Marie [Universite Pierre et Marie Curie Paris VI, Service de Neonatologie, Hopital d' enfants Armand-Trousseau, Paris (France); Renolleau, Sylvain [Universite Pierre et Marie Curie Paris VI, Service de Reanimation, Hopital d' enfants Armand-Trousseau, Paris (France); Pariente, Daniele [Hopital de Bicetre, Service de Radiologie Pediatrique, Paris (France)

    2008-10-15

    Acute liver failure in neonates is rare and is frequently associated with an unfavourable outcome. There is no curative treatment other than liver transplantation. Screening for viral, metabolic, toxic or vascular disease is essential to assess the prognosis and to guide specific treatment. Hepatic haemorrhage in neonates is often associated with bacterial infection, trauma and coagulopathies. We present a unique case of neonatal acute liver failure and multifocal massive haemorrhagic intrahepatic lesions of traumatic origin, documented by US and MRI. The patient made a spontaneous recovery. Clinical, biological and imaging outcome was excellent despite the apparent severity of the initial features. The only possible aetiology was a difficult caesarean delivery for mild fetal macrosomia. (orig.)

  17. Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement.

    Science.gov (United States)

    Dupont, Corinne; Occelli, Pauline; Deneux-Tharaux, Catherine; Touzet, Sandrine; Duclos, Antoine; Bouvier-Colle, Marie-Hélène; Rudigoz, René-Charles; Huissoud, Cyril

    2014-07-01

    Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement To use statistical process control charts to describe trends in the prevalence of severe postpartum haemorrhage after vaginal delivery. This assessment was performed 7 years after we initiated a continuous quality improvement programme that began with regular criteria-based audits Observational descriptive study, in a French maternity unit in the Rhône-Alpes region. Quarterly clinical audit meetings to analyse all cases of severe postpartum haemorrhage after vaginal delivery and provide feedback on quality of care with statistical process control tools. The primary outcomes were the prevalence of severe PPH after vaginal delivery and its quarterly monitoring with a control chart. The secondary outcomes included the global quality of care for women with severe postpartum haemorrhage, including the performance rate of each recommended procedure. Differences in these variables between 2005 and 2012 were tested. From 2005 to 2012, the prevalence of severe postpartum haemorrhage declined significantly, from 1.2% to 0.6% of vaginal deliveries (pcontrol limits, that is, been out of statistical control. The proportion of cases that were managed consistently with the guidelines increased for all of their main components. Implementation of continuous quality improvement efforts began seven years ago and used, among other tools, statistical process control charts. During this period, the prevalence of severe postpartum haemorrhage after vaginal delivery has been reduced by 50%. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Optic Disc Pit with Sectorial Retinitis Pigmentosa

    OpenAIRE

    Balikoglu-Yilmaz, Melike; Taskapili, Muhittin; Yilmaz, Tolga; Teke, Mehmet Yasin

    2013-01-01

    Sectorial retinitis pigmentosa (RP) and optic disc pit (ODP) are rare clinical conditions. We present a 40-year-old woman with a history of mild night blindness and decreased vision in the right eye for about 5 years. Fundus examination revealed retinal pigmentary changes in the superior and inferotemporal sectors covering the macula and reduced arterial calibre and ODP at the temporal edge of the optic disc. In addition, fundus autofluorescence, spectral-domain optical coherence tomography, ...

  19. Retinal function in deaf-blind syndromes

    OpenAIRE

    Malm, Eva

    2011-01-01

    A variety of disorders can cause retinal degeneration and hearing impairment, and it is of great value to have an early diagnosis since there is a large variation in phenotype and prognosis both within and between the different disorders. The general aim of this thesis was to characterize the retinal function, to describe the phenotype, and – where appropriate – to relate the phenotype to genotype in patients with combined visual and hearing impairment. Alström syndrome is a rare auto...

  20. Branch retinal artery occlusion in Susac's syndrome

    Directory of Open Access Journals (Sweden)

    Ricardo Evangelista Marrocos de Aragão

    2015-02-01

    Full Text Available Susac's syndrome is a rare disease attribuited to a microangiopathy involving the arterioles of the cochlea, retina and brain. Encefalopathy, hearing loss, and visual deficits are the hallmarks of the disease. Visual loss is due to multiple, recurrent branch arterial retinal occlusions. We report a case of a 20-year-old women with Susac syndrome presented with peripheral vestibular syndrome, hearing loss, ataxia, vertigo, and vision loss due occlusion of the retinal branch artery.

  1. Current surgery of retinal detachment recurrence. Review

    Directory of Open Access Journals (Sweden)

    V. D. Zakharov

    2012-01-01

    Full Text Available this review presents a detailed analysis and an experience of surgical treatment of retinal detachment recurrence associated with light silicone oil tamponade of vitreous cavity. Approaches and variants of treatment were described in the historical aspect and till now. there are considered general and particular issues in case of retinal detachment recurrence appearance, expediency and volume of intraoperative manipulations, time of operation and choice of temporary substitute of vitreous body for a purpose of postoperative tamponade of vitreous cavity.

  2. CCR7 signaling pathway and retinal neovascularization

    Directory of Open Access Journals (Sweden)

    Lin-Hui Yuan

    2015-11-01

    Full Text Available Retinal neovascularization diseases are the major causes of blindness. C-C chemokine receptor type 7(CCR7can promote the expression of vascular endothelial growth factor(VEGFthrough the extracellular signal regulated kinase(ERKpathway, leading to vascular leakage, proliferation of vascular endothelial cell, neovascularization and etc. The detection of CCR7 can guide the diagnosis and treatments of retinal neovascularization diseases.

  3. Safety of iPhone retinal photography.

    Science.gov (United States)

    Hong, Sheng Chiong; Wynn-Williams, Giles; Wilson, Graham

    2017-04-01

    With the advancement in mobile technology, smartphone retinal photography is becoming a popular practice. However, there is limited information about the safety of the latest smartphones used for retinal photography. This study aims to determine the photobiological risk of iPhone 6 and iPhone 6 plus when used in conjunction with a 20Diopter condensing lens for retinal photography. iPhone 6 and iPhone 6 plus (Apple, Cupertino, CA) were used in this study. The geometrical setup of the study was similar to the indirect ophthalmoscopy technique. The phone was set up at one end of the bench with its flash turned on at maximal brightness; a 20 Dioptre lens was placed 15 cm away from the phone. The light that passes through the lens was measured with a spectroradiometer and an illuminance probe at the other end to determine the spectral profile, spatial irradiance, radiant power emitted by the phone's flash. Trigonometric and lens formula were applied to determine the field of view and retinal surface in order to determine the weighted retinal irradiance and weighted retinal radiant exposure. Taking ocular transmission and the distribution of the beam's spatial irradiance into account, the weighted retinal irradiance is 1.40 mW/cm 2 and the weighted retinal radiant exposure is 56.25 mJ/cm 2 . The peak weighted foveal irradiance is 1.61 mW/cm 2 . Our study concluded that the photobiological risk posed by iPhone 6 indirect ophthalmoscopy was at least 1 order of magnitude below the safety limits set by the ISO15004-2.2.

  4. Effectiveness of Per Rectal Misoprostol Versus Intramuscular Oxytocin for Prevention of Primary Postpartum Haemorrhage.

    Science.gov (United States)

    Asmat, Raheela; Ashraf, Tasneem; Asmat, Fazila; Asmat, Shakila; Asmat, Nagina

    2017-01-01

    To compare the effectiveness of per rectal misoprostol over oxytocin in primary postpartum haemorrhage (PPH). Randomised controlled trial study. Gynaecology and Obstetrics Department, Unit IV, Bolan Medical Complex Hospital, Quetta, from September 2013 to February 2014. Emergency obstetric patients receiving per rectal misoprostol (800 µgm) were named as group 'A' and those receiving 10 units oxytocin intramuscularly were labelled as group 'B'. The patients were followed within 24 hours of spontaneous vaginal deliveries. Pads soaked were used to assess the amount of blood loss. A total of 1,678 patients were included in the study. The mean age of patients in group-A was 29.11 years while the mean age of patients in group-B was 29.16 years. One hundred and twenty-three (14.66%) patients in group-A and 120 (14.31%) patients in group-B had PPH. Among the total 1,678 patients, 243 (14.49%) had postpartum haemorrhage among whom 24 (9.88%) had major haemorrhage with a blood loss ≥1000 mL. Among the sub-group (839 patients) administered misoprostol had 123 (14.66%) patients with blood loss greater than 500 mL and the rest 716 patients (85.34%) had blood loss less than 500 mL. The sub-group administered oxytocin have 120 (14.31%) out of 839 patients with postpartum haemorrhage while 719 (85.69%) had blood loss less than 500 mL. Active management of 3rd stage of labour with per rectal misoprostol administration was as effective as intramuscular oxytocin. Both were equally effective to reduce PPH and the subsequent need for surgical interventions.

  5. Neurosarcoidosis-related intracranial haemorrhage: three new cases and a systematic review of the literature.

    LENUS (Irish Health Repository)

    O'Dwyer, J P

    2012-06-09

    BACKGROUND AND PURPOSE: Intracranial haemorrhage in neurosarcoidosis (NS-ICH) is rare, poorly understood and the diagnosis of NS may not be immediately apparent. METHODS: The clinical features of three new NS-ICH cases are described including new neuropathological findings and collated with cases from a systematic literature review. RESULTS: Cases: (i) A 41-year-old man with headaches, hypoandrogenism and encephalopathy developed a cerebellar haemorrhage. He had neuropathological confirmation of NS with biopsy-proven angiocentric granulomata and venous disruption. He responded to immunosuppressive therapy. (ii) A 41-year-old man with no history of hypertension was found unconscious. A subsequently fatal pontine haemorrhage was diagnosed. Liver biopsy revealed sarcoid granulomas. (iii) A 36-year-old man with raised intracranial pressure headaches presented with a seizure and a frontal haemorrhage. Hilar lymph node biopsy confirmed sarcoidosis, and he was treated successfully. Systematic Review: Twelve other published cases were identified and collated with our cases. Average age was 36 years and M:F = 2.3:1; 46% presented with neurological symptoms and 31% had CNS-isolated disease. Immediate symptoms of ICH were acute\\/worsening headache or seizures (60%). ICH was supratentorial (62%), infratentorial (31%) or subarachnoid (7%). 40% had definite NS, 53% probable NS and 7% possible NS (Zajicek criteria). Antigranulomatous\\/immunosuppressive therapy regimens varied and 31% died. CONCLUSIONS: This series expands our knowledge of the pathology of NS-ICH, which may be of arterial or venous origin. One-third have isolated NS. Clinicians should consider NS in young-onset ICH because early aggressive antigranulomatous therapy may improve outcome.

  6. Neonatal cerebral oxygenation is not linked to foetal vasculitis and predicts intraventricular haemorrhage in preterm infants

    DEFF Research Database (Denmark)

    Sørensen, Line Carøe; Maroun, Lisa Leth; Borch, K.

    2008-01-01

    AIM: The aim of the study was to compare the cerebral tissue oxygenation index (c-TOI) measured by near infrared spectroscopy (NIRS) in infants with and without foetal vasculitis. METHODS: Twenty-four infants with placental signs of a foetal inflammatory response (FIR), foetal vasculitis, were.......002). CONCLUSION: Cerebral oxygenation was not affected in the first day of life in preterm infants born with foetal vasculitis, while cerebral oxygenation in infants that later developed intraventricular haemorrhage was impaired Udgivelsesdato: 2008/11...

  7. Neonatal cerebral oxygenation is not linked to foetal vasculitis and predicts intraventricular haemorrhage in preterm infants

    DEFF Research Database (Denmark)

    Sorensen, Line C; Maroun, Lisa L; Borch, Klaus

    2008-01-01

    Aim: The aim of the study was to compare the cerebral tissue oxygenation index (c-TOI) measured by near infrared spectroscopy (NIRS) in infants with and without foetal vasculitis. Methods: Twenty-four infants with placental signs of a foetal inflammatory response (FIR), foetal vasculitis, were.......002). Conclusion: Cerebral oxygenation was not affected in the first day of life in preterm infants born with foetal vasculitis, while cerebral oxygenation in infants that later developed intraventricular haemorrhage was impaired....

  8. Gastrointestinal haemorrhage due to lymphangiectasia caused by protein-losing enteropathy in the Fontan circulation.

    Science.gov (United States)

    Gras, Pauline; Gottrand, Frédéric; Godart, François

    2017-10-01

    We report the case of a 14-year-old boy with severe protein-losing enteropathy after Fontan surgery that led to lymphangiectasia, which caused gastrointestinal haemorrhage and required invasive treatment to stop the bleeding. Through this case and a review of the literature on protein-losing enteropathy after Fontan surgery, we highlight a rare and serious presentation of the disease and the difficulties of diagnosis and management.

  9. Emergence of a new lagovirus related to rabbit haemorrhagic disease virus

    OpenAIRE

    Le Gall-Recule, Ghislaine; Lavazza, Antonio; Marchandeau, Stephane; Bertagnoli, Stéphane; Zwingelstein, Francoise; Cavadini, Patrizia; Martinelli, Nicola; Lombardi, Guerino; Guérin, Jean-Luc; Lemaitre, Evelyne; Decors, Anouk; Boucher, Samuel; Le Normand, Bernadette; Capucci, Lorenzo

    2013-01-01

    Since summer 2010, numerous cases of Rabbit Haemorrhagic Disease (RHD) have been reported in north-western France both in rabbitries, affecting RHD-vaccinated rabbits, and in wild populations. We demonstrate that the aetiological agent was a lagovirus phylogenetically distinct from other lagoviruses and which presents a unique antigenic profile. Experimental results show that the disease differs from RHD in terms of disease duration, mortality rates, higher occurrence of subacute/chronic form...

  10. Crimean-Congo Haemorrhagic Fever in Kosova : a fatal case report

    Directory of Open Access Journals (Sweden)

    Raka Lul

    2006-10-01

    Full Text Available Abstract Crimean-Congo haemorrhagic fever (CCHF is an often fatal viral infection described in about 30 countries around the world. The authors report a fatal case of Crimean-Congo hemorrhagic fever (CCHF observed in a patient from Kosova. The diagnosis of CCHF was confirmed by reverse transcription-PCR. Late diagnosis decreased the efficacy of treatment and patient died due to severe complications of infection.

  11. Biochemical and functional characterization of Bothropoidin: the first haemorrhagic metalloproteinase from Bothrops pauloensis snake venom.

    Science.gov (United States)

    Gomes, Mário Sérgio R; Naves de Souza, Dayane L; Guimarães, Denise O; Lopes, Daiana S; Mamede, Carla C N; Gimenes, Sarah Natalie C; Achê, David C; Rodrigues, Renata S; Yoneyama, Kelly A G; Borges, Márcia H; de Oliveira, Fábio; Rodrigues, Veridiana M

    2015-03-01

    We present the biochemical and functional characterization of Bothropoidin, the first haemorrhagic metalloproteinase isolated from Bothrops pauloensis snake venom. This protein was purified after three chromatographic steps on cation exchange CM-Sepharose fast flow, size-exclusion column Sephacryl S-300 and anion exchange Capto Q. Bothropoidin was homogeneous by SDS-PAGE under reducing and non-reducing conditions, and comprised a single chain of 49,558 Da according to MALDI TOF analysis. The protein presented an isoelectric point of 3.76, and the sequence of six fragments obtained by MS (MALDI TOF\\TOF) showed a significant score when compared with other PIII Snake venom metalloproteinases (SVMPs). Bothropoidin showed proteolytic activity on azocasein, Aα-chain of fibrinogen, fibrin, collagen and fibronectin. The enzyme was stable at pH 6-9 and at lower temperatures when assayed on azocasein. Moreover, its activity was inhibited by EDTA, 1.10-phenanthroline and β-mercaptoethanol. Bothropoidin induced haemorrhage [minimum haemorrhagic dose (MHD) = 0.75 µg], inhibited platelet aggregation induced by collagen and ADP, and interfered with viability and cell adhesion when incubated with endothelial cells in a dose and time-dependent manner. Our results showed that Bothropoidin is a haemorrhagic metalloproteinase that can play an important role in the toxicity of B. pauloensis envenomation and might be used as a tool for studying the effects of SVMPs on haemostatic disorders and tumour metastasis. © The Authors 2014. Published by Oxford University Press on behalf of the Japanese Biochemical Society. All rights reserved.

  12. Molecular epidemiology of Rabbit Haemorrhagic Disease Virus (RHDV) in Australia: when one became many

    OpenAIRE

    Kovaliski, John; Sinclair, Ron; Mutze, Greg; Peacock, David; Strive, Tanja; Abrantes, Joana; Esteves, Pedro J.; Holmes, Edward C.

    2013-01-01

    Rabbit Haemorrhagic Disease Virus (RHDV) was introduced into Australia in 1995 as a biological control agent against the wild European rabbit (Oryctolagus cuniculus). We evaluated its evolution over a 16 year period (1995–2011) by examining 50 isolates collected throughout Australia, as well as the original inoculum strains. Phylogenetic analysis of capsid protein VP60 sequences of the Australian isolates, compared to those sampled globally, revealed that they form a monophyletic group with t...

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  14. Superior cerebellar aneurysm causing subarachnoid haemorrhage in a 17-year-old with alagille syndrome.

    LENUS (Irish Health Repository)

    O'Connell, David

    2012-04-01

    Alagille syndrome is a rare autosomal dominant condition characterised by mutation in Jagged1 gene. Intracranial aneurysms may be seen in this condition and may present as subarachnoid hemorrhage. We describe the first case of superior cerebellar aneurysm rupture causing WFNS grade 1 subarachnoid haemorrhage in a 17-year-old girl. The clinical condition and management of this rare occurrence is discussed with a review of literature.

  15. Clinical symptoms according to genotype amongst patients with hereditary haemorrhagic telangiectasia

    DEFF Research Database (Denmark)

    Kjeldsen, A D; Møller, T R; Brusgaard, K

    2005-01-01

    BACKGROUND: Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited disease, characterized by a wide variety of clinical manifestations, including epistaxis, gastrointestinal (GI) bleeding, pulmonary arteriovenous malformations (PAVMs) and neurological symptoms. HHT is a genetically...... patients had experienced more severe GI bleeding than HHT2 patients. There was no significant difference in severity of epistaxis or age at debut. Finally the mortality over a 90-month observation period was not significantly increased....

  16. Post-surgery lung torsion and haemorrhagic infarction - a case report

    International Nuclear Information System (INIS)

    Noemayr, A.; Schmitt, R.; Wichert, C.; Bautz, W.; Rupprecht, H.

    1998-01-01

    Lung or lobe torsion may occur after thoracic surgery, chest trauma, pneumothorax, pneumonia, or even spontaneously. Lung infarction is a possible complication. The characteristic radiological signs on plain radiographs are opacification and/or displacement of lobes and hilus structures. CT-signs of haemorrhagic infarction are opacification and multiple punctate gas accumulations. The bronchus could be interrupted at the level of the torsion (''bronchus cutoff''). (orig.) [de

  17. Neurologic Manifestation as Initial Presentation in a Case of Hereditary Haemorrhagic Telangiectasia

    Directory of Open Access Journals (Sweden)

    Yeow Kwan Teo

    2010-01-01

    Full Text Available Hereditary Haemorrhagic Telangiectasia (HHT, or Osler-Weber-Rendu syndrome is an uncommon autosomal dominant multi-organ condition of vascular dysplasias. We describe a 19 year old Indian female who presented with cerebral abscess secondary to paradoxical emboli from pulmonary arteriovenous malformations (PAVMs associated with HHT. Cerebral, pulmonary, hepatic and gastrointestinal involvement can be life-threatening and it is important to have lifelong follow-ups on these patients.

  18. Patient Dashboard: the use of a colour-coded computerised clinical reminder in Whanganui regional general practices.

    Science.gov (United States)

    McMenamin, John; Nicholson, Rick; Leech, Ken

    2011-12-01

    Clinical reminders have been shown to help general practice achieve an increase in some preventive care items, especially if they identify a patient's eligibility for the target item, prompt clinicians at the right time, provide a fast link to management tools and facilitate clinical recording. WRPHO has introduced the Patient Dashboard clinical reminder and monitored its impact on health targets. This paper reports the impact of a computerised colour-coded clinical reminder on achieving agreed health targets in Whanganui regional practices. Patient Dashboard was developed from previous versions in Auckland and Northland and provided to Whanganui regional practices with Primary Health Organisation (PHO) support. The Dashboard was linked with existing and new clinical management tools which automatically updated clinical records. Data from practices was pooled by Whanganui Regional Primary Health Organisation and target achievement rates reported over 15 months. Over the initial 15 months of Patient Dashboard use, recording of smoking status increased from 74% to 82% and of alcohol use from 15% to 47%. Screening for diabetes increased from 62% to 74%, cardiovascular risk assessment from 20% to 43%, cervical screening from 71% to 79%, and breast screening from 60% to 80%. Patient Dashboard was associated with increased performance indicators both for those targets which were part of a PHO programme and for targets without additional support.

  19. SCAN- a maintenance-free flowrate meter with direct digital read-out for computerised control applications in radiochemical plants

    Energy Technology Data Exchange (ETDEWEB)

    Shah, B V; Siddiqui, I A; Theyyunni, T K [Process Engineering and Systems Division, Bhabha Atomic Research Centre, Mumbai (India)

    1994-06-01

    In radiochemical plants, the choice of flowrate sensor is subject to stringent requirements of fail-safe design and freedom from maintenance. The SCAN remote digital direct indicating flowrate meter described in this paper was developed to meet the requirements of flowrate and transmitting it to the control room, and to a computerised control system. SCAN is designed on the principle that flowrate through an orifice is a function of the head of liquid acting upon it. SCAN consists of a small chamber which receives the flow, and discharges it through an orifice located in bottom. The level of liquid in the pot represents the flowrate of the input stream. SCAN has been developed into an accurate, rugged and practical device by refinements in the design of internals, and by introducing a special end-section which makes the calibration insensitive to location. An important feature of SCAN is that it is passive, maintenance free, fail-safe device and contains no moving parts. There is no liquid hold up in the SCAN when idle, which is a desirable feature for the radiochemical plant environment. (author). 3 figs., 2 tabs.

  20. Development of state computerised accounting system for nuclear material in the Slovak Republic and the Czech Republic towards 2000

    International Nuclear Information System (INIS)

    Bezak, S.; Bencova, A.; Cisar, V.; Zajicova, M.; Bilek, J.; Olsansky, J.

    1999-01-01

    The presentation describes the evaluation of computerised system for processing of safeguards data and reporting to the IAEA in the Slovak Republic and in the Czech Republic in accordance with their Safeguards Agreements. The attention is given to the first code for processing of accounting data, established and operated in the Nuclear Research Institute in Rez in 1980. Further it is concentrated on the code ZARUKY, developed as a tool for control of and accounting for nuclear material at the State level in 1992, created on the database system CLIPPER-5 in operational system MS-DOS and operated until now. The general intention is to show and clarify main problems connected with the year 2000 and to share this experience with other colleagues. Possible ways for solution of these problems are listed and necessary regulatory role of the SSACs is presented. Also the main requirements for new code, which should communicate with the database of operators and reflect all limitations specified in their permissions, which should be a system with fully satisfactory safety, strictly defined confidentiality and should allow the access of several users in parallel is described. As a new component of this afford the requirements for reporting in accordance with the Protocol Additional to the Safeguard Agreement is mentioned. It is presented that the code in WINDOWS operation system on a database system ORACLE accepting also new date format 'YYYYMMDD' would meet all of these requirements. (author)

  1. Applying modern psychometric techniques to melodic discrimination testing: Item response theory, computerised adaptive testing, and automatic item generation.

    Science.gov (United States)

    Harrison, Peter M C; Collins, Tom; Müllensiefen, Daniel

    2017-06-15

    Modern psychometric theory provides many useful tools for ability testing, such as item response theory, computerised adaptive testing, and automatic item generation. However, these techniques have yet to be integrated into mainstream psychological practice. This is unfortunate, because modern psychometric techniques can bring many benefits, including sophisticated reliability measures, improved construct validity, avoidance of exposure effects, and improved efficiency. In the present research we therefore use these techniques to develop a new test of a well-studied psychological capacity: melodic discrimination, the ability to detect differences between melodies. We calibrate and validate this test in a series of studies. Studies 1 and 2 respectively calibrate and validate an initial test version, while Studies 3 and 4 calibrate and validate an updated test version incorporating additional easy items. The results support the new test's viability, with evidence for strong reliability and construct validity. We discuss how these modern psychometric techniques may also be profitably applied to other areas of music psychology and psychological science in general.

  2. The use of computerised tomography guided percutaneous fine needle aspiration in the evaluation of solitary pulmonary nodules.

    LENUS (Irish Health Repository)

    Khan, K A

    2012-02-01

    The evaluation of a solitary pulmonary nodule (SPN) has changed over the years with increased access to percutaneous computerised tomography (CT) guided fine needle aspiration (FNA), where bronchoscopy is unhelpful. The aim of our study was to evaluate the sample adequacy, diagnostic and complication rate of CT-FNA of a SPN at our academic teaching hospital over an 18 month period. CT-FNA was performed by a radiologist, with a cytopathologist in attendance to confirm the adequacy of the sample obtained. The size of the nodule, sample material and adequacy, diagnosis and complications were recorded. A total of 101 patients were included, 54 male and the mean age was 68 +\\/- 11 years. The mean size of the SPN was 2.3 cm (range 1-11 cm). 56 (56%) patients had a right SPN, 45 (45%) had a left SPN. CT-FNA was diagnostic in 80 (80%) patients and non-diagnostic in 21 (20%) patients. The sample was insufficient for immunocytochemistry, although the morphological appearance was diagnostic in 20 (25%) of the 80 patients. Pneumothorax occurred in 26\\/101 (26%) patients post CT-FNA, of these 7 (27%) required chest drain insertion, while 19 (73%) were managed conservatively. CT FNA is a useful tool for the diagnosis of a SPN, with our diagnostic accuracy comparable to that reported in the literature. However, CT-FNA may not provide adequate sample volume to perform ancillary testing and has a moderate complication rate.

  3. Integrating the Radiology Information System with Computerised Provider Order Entry: The Impact on Repeat Medical Imaging Investigations.

    Science.gov (United States)

    Vecellio, Elia; Georgiou, Andrew

    2016-01-01

    Repeat and redundant procedures in medical imaging are associated with increases in resource utilisation and labour costs. Unnecessary medical imaging in some modalities, such as X-Ray (XR) and Computed Tomography (CT) is an important safety issue because it exposes patients to ionising radiation which can be carcinogenic and is associated with higher rates of cancer. The aim of this study was to assess the impact of implementing an integrated Computerised Provider Order Entry (CPOE)/Radiology Information System (RIS)/Picture Archiving and Communications System (PACS) system on the number of XR and CT imaging procedures (including repeat imaging requests) for inpatients at a large metropolitan hospital. The study found that patients had an average 0.47 fewer XR procedures and 0.07 fewer CT procedures after the implementation of the integrated system. Part of this reduction was driven by a lower rate of repeat procedures: the average inpatient had 0.13 fewer repeat XR procedures within 24-hours of the previous identical XR procedure. A similar decrease was not evident for repeat CT procedures. Reduced utilisation of imaging procedures (especially those within very short intervals from the previous identical procedure, which are more likely to be redundant) has implications for the safety of patients and the cost of medical imaging services.

  4. Ergometrine given during caesarean section and incidence of delayed postpartum haemorrhage due to uterine atony.

    Science.gov (United States)

    Lourens, R; Paterson-Brown, S

    2007-11-01

    Delayed postpartum haemorrhage due to uterine atony after caesarean section was occurring in women in our recovery area despite many of them already having an oxytocin infusion running to prevent such a problem. We therefore decided to compare the incidence of such problems for a 2-month period before and after altering our uterotonic policy: in addition to the routine bolus dose of 5 units of oxytocin after delivery of the baby, we added 500 microg of intramuscular ergometrine during abdominal closure. We noticed a reduced number of massive postpartum haemorrhages due to an atonic uterus in the recovery room but an increased incidence of nausea and vomiting. No prophylactic anti-emetic was given during this pilot study. This small study suggests that 50 women would need to be given ergometrine at caesarean section to prevent one delayed massive haemorrhage from uterine atony and four extra women would suffer with vomiting. We feel this is reasonable and now use a prophylactic anti-emetic as well as delaying the ergometrine until closure of the rectus sheath which reduces the incidence of nausea and vomiting.

  5. In vitro contractile effects of agents used in the clinical management of postpartum haemorrhage.

    Science.gov (United States)

    Morrison, John J; Crosby, David A; Crankshaw, Denis J

    2016-10-15

    Uterine atony is a major cause of postpartum haemorrhage and maternal mortality. However, the comparative pharmacology of agents used to treat this condition is poorly understood. This study evaluates, using human pregnant myometrium in vitro, a range of contractile parameters for agents used in the clinical treatment of atonic postpartum haemorrhage. The effects of oxytocin, carbetocin, ergometrine, carboprost, syntometrine and misoprostol were investigated in 146 myometrial strips from 19 donors. The potency and maximal response values were obtained, and compared, using both maximal amplitude and mean contractile force as indices of contraction. Single, EC50 concentrations of the agents were administered and both force and contraction peak parameters were compared during a 15-min exposure. Differences were considered significant when Poxytocin and carbetocin being the most potent. The most important difference between the agents was in their ability to increase the mean contractile force, with oxytocin superior to all agents except syntometrine. In single dose experiments, mean contractile force was the parameter that separated the agents. In this respect, oxytocin was not statistically different from carboprost or syntometrine, but was superior to all other agents. These findings support a clear role for oxytocin as the first line agent for treatment of postpartum haemorrhage and raise doubts about the potential clinical usefulness of misoprostol. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Transfusion of blood and blood component therapy for postpartum haemorrhage at a tertiary referral center

    International Nuclear Information System (INIS)

    Hussain, N.; Shah, T.; Shah, N.; Khan, N.H.

    2011-01-01

    Objective: To determine the practice of transfusion of blood and blood products in cases of postpartum haemorrhage, at a tertiary referral center. Methods: A retrospective study was conducted where medical records were reviewed for women, who either delivered or were admitted in labour suite with diagnosis of postpartum haemorrhage. The study period extended from Jan 2008 to Oct 2009. During a period of 22 months, records were reviewed for transfusion of blood and blood products in above group of women. Data were analyzed for descriptive statistics. Results: During the study period, a total of 4744 patients were admitted in the labour suite. A total of 113 (2.36%) women were diagnosed with Post partum haemorrhage. Uterine atony was the commonest cause of PPH, followed by genital tract trauma. A total of 81(71%) women received transfusion of blood and blood components (1.6%). The mean blood loss was 1088 ml (+- 584ml). Transfusion of blood and blood component therapy was significantly more in women who underwent caesarean section, compared to those women who delivered vaginally. There was one case of acute tubular necrosis due to PPH, and seven maternal deaths. The mean hospital stay was of +- 3 days. Conclusion: In this hospital based study, the prevalence of PPH was 2.36 +- %, and the rate of transfusion of blood and blood products was 1.6%.

  7. Acute variceal haemorrhage in the United Kingdom: patient characteristics, management and outcomes in a nationwide audit.

    Science.gov (United States)

    Jairath, Vipul; Rehal, Sunita; Logan, Richard; Kahan, Brennan; Hearnshaw, Sarah; Stanworth, Simon; Travis, Simon; Murphy, Michael; Palmer, Kelvin; Burroughs, Andrew

    2014-05-01

    Despite advances in treatment, acute variceal haemorrhage remains life-threatening. To describe contemporary characteristics, management and outcomes of patients with cirrhosis and acute variceal haemorrhage and risk factors for rebleeding and mortality. Multi-centre clinical audit conducted in 212 UK hospitals. In 526 cases of acute variceal haemorrhage, 66% underwent endoscopy within 24h with 64% (n=339) receiving endoscopic therapy. Prior to endoscopy, 57% (n=299) received proton pump inhibitors, 44% (n=232) vasopressors and 27% (n=144) antibiotics. 73% (n=386) received red cell transfusion, 35% (n=184) fresh frozen plasma and 14% (n=76) platelets, with widely varying transfusion thresholds. 26% (n=135) experienced further bleeding and 15% (n=80) died by day 30. The Model for End Stage Liver Disease score was the best predictor of mortality (area under the receiver operating curve=0.74, Prisk stratification tools are required to identify patients needing more intensive support. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  8. Contrast-enhanced magnetic resonance imaging for the detection of acute haemorrhagic necrotizing pancreatitis

    International Nuclear Information System (INIS)

    Piironen, A.; Kivisaari, R.; Pitkaeranta, P.; Poutanen, V.P.; Laippala, P.; Laurila, P.; Kivisaari, L.

    1997-01-01

    Eleven piglets with haemorrhagic necrotizing pancreatitis and nine piglets with oedematous pancreatitis were imaged using a multi-breath-hold TurboFLASH (TR 6.5 ms, TE 3 ms, TI 300 ms, flip angle 8 , three slices) pre-excited T1-weighted sequence with an IV bolus injection of gadopentetate dimeglumine (Gd-DTPA, 0.3 mmol/kg) as a contrast agent to show dynamic contrast enhancement of the pancreas by MRI. All piglets were imaged according to the same protocol before inducing the disease. Following the IV Gd-DTPA bolus, time-enhancement curve of the pancreas during haemorrhagic necrotizing pancreatitis was significantly lower than during oedematous pancreatitis. The enhancement curves for the healthy piglets and piglets with oedematous pancreatitis did not differ significantly. Each piglet served as its own control. Because the results of this initial study are similar to those obtained with contrast-enhanced CT, we conclude that our results may encourage further clinical trials, and contrast-enhanced dynamic MRI may be an alternative to the established method of CT for diagnosing acute haemorrhagic necrotizing pancreatitis. (orig.). With 3 figs

  9. Diagnostic efficacy of molecular assays for the viral haemorrhagic septicaemia virus isolates from the Czech Republic

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    Ľubomír Pojezdal

    2017-01-01

    Full Text Available The diagnostic properties of the one-step real-time reverse-transcription polymerase chain reaction assay for viral haemorrhagic septicaemia virus detection were compared to methods currently in use in the Czech Republic, namely, virus isolation using the cell culture and conventional reverse-transcription polymerase chain reaction followed by the nested polymerase chain reaction. The assays were tested on a panel of 25 archived viral haemorrhagic septicaemia isolates and 8 archived infectious haematopoietic necrosis isolates obtained from monitoring and/or outbreaks of the diseases among farmed salmonids in the Czech Republic. The ability to detect the presence of the virus in the tissues of fish was tested on additional 32 field samples collected from the rainbow trout (Oncorhynchus mykiss, brown trout (Salmo trutta and brook trout (Salvelinus fontinalis. The real-time assay showed the highest analytic sensitivity by detecting the presence of viral nucleic acid in samples with 10-7 dilution, whereas the sensitivity of the conventional polymerase chain reaction peaked at 10-5. Diagnostic specificity of both molecular assays was confirmed by absence of cross-reactivity with the infectious haematopoietic necrosis virus isolates. This, along with consistent results in the detection of the virus in the fish tissues, confirms that the one-step real-time reverse-transcription polymerase chain reaction is currently an optimal stand-alone diagnostic method for the detection of the viral haemorrhagic septicaemia virus.

  10. Intracerebral haemorrhage associated with hourly concentration of ambient particulate matter: case-crossover analysis.

    Science.gov (United States)

    Yamazaki, S; Nitta, H; Ono, M; Green, J; Fukuhara, S

    2007-01-01

    To examine the association of hourly time lagged concentration of ambient particulate matter and death due to stroke. Mortality data for five years (January 1990 to December 1994) were obtained from the Ministry of Health, Labour, and Welfare of Japan. Data were used only if the deceased was 65 years old or older at the time of death, if death was attributed to intracerebral haemorrhage or ischaemic stroke, and if the deceased lived in one of 13 major urban areas. Hourly mean concentrations of PM7, NO2, and photochemical oxidants were measured at monitoring stations in the 13 areas. Time stratified case-crossover analysis was used to examine the data for evidence of triggering stroke mortality. The 1-hour mean concentration of PM7 measured about 2 hours before death was associated with the risk of death due to intracerebral haemorrhage from April to September (odds ratio = 2.40, 95% CI 1.48 to 3.89, for exposure to PM7 of more than 200 microg/m3 (threshold)). The higher risk was independent of the 24-hour mean concentration of PM7. PM7 was not associated with death due to ischaemic stroke. Transiently high concentrations of PM7 are associated with death due to intracerebral haemorrhage. Air quality standards or guidelines for particulate matter should be based not only on 24-hour mean concentrations, but also on hourly data.

  11. Intracerebral haemorrhage associated with hourly concentration of ambient particulate matter: case‐crossover analysis

    Science.gov (United States)

    Yamazaki, S; Nitta, H; Ono, M; Green, J; Fukuhara, S

    2007-01-01

    Aims To examine the association of hourly time lagged concentration of ambient particulate matter and death due to stroke. Methods Mortality data for five years (January 1990 to December 1994) were obtained from the Ministry of Health, Labour, and Welfare of Japan. Data were used only if the deceased was 65 years old or older at the time of death, if death was attributed to intracerebral haemorrhage or ischaemic stroke, and if the deceased lived in one of 13 major urban areas. Hourly mean concentrations of PM7, NO2, and photochemical oxidants were measured at monitoring stations in the 13 areas. Time stratified case‐crossover analysis was used to examine the data for evidence of triggering stroke mortality. Results The 1‐hour mean concentration of PM7 measured about 2 hours before death was associated with the risk of death due to intracerebral haemorrhage from April to September (odds ratio = 2.40, 95% CI 1.48 to 3.89, for exposure to PM7 of more than 200 μg/m3 (threshold)). The higher risk was independent of the 24‐hour mean concentration of PM7. PM7 was not associated with death due to ischaemic stroke. Conclusions Transiently high concentrations of PM7 are associated with death due to intracerebral haemorrhage. Air quality standards or guidelines for particulate matter should be based not only on 24‐hour mean concentrations, but also on hourly data. PMID:16847037

  12. Intraventricular haemorrhage in preterm infants--can we improve outcome by addressing coagulation?

    Science.gov (United States)

    Kuperman, Amir A; Brenner, Benjamin; Kenet, Gili

    2015-11-01

    During the last few decades, the survival of preterm infants has increased dramatically. Nevertheless, with the increasing number of very young and extremely low birth weight infants, morbidity is still a major problem. Intraventricular Haemorrhage (IVH) is a major complication of preterm birth, and large haemorrhages or haemorrhages associated with parenchymal brain lesions may yield a high rate of future disability. IVH is a complex, multi-factorial disorder. Prematurity and low birth weight remain as its most important risk factors, affecting vulnerability of the germinal matrix as well as the coagulation system. Approximately 80% of IVHs occur by 72 h after birth, but a considerable proportion of IVH is already visible on the first cranial ultrasound scan within a few hours of birth. The hypothesis that a severe coagulation deficiency in the premature newborn could be a major contributing factor to IVH has been suggested, and small open label interventional studies targeting the premature coagulation system have been conducted with ethamsylate, vitamin K, fresh frozen plasma, recombinant activated factor VII and prothrombin complex concentrate. The outcome of these studies will be reviewed.

  13. Risk factors associated with postpartum haemorrhage at Juba Teaching Hospital, South Sudan, 2011

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    Thomas Tako Akim Ujjiga

    2014-08-01

    Full Text Available Objective: To study risk factors associated with post partum haemorrhage (PPH in Juba Teaching Hospital, South Sudan. Method: An unmatched case control study was conducted in which 44 cases and 88 Controls were involved, from September to December 2011. Data was collected using a structured questionnaire in face to face interviews, and analyzed using Epi-info 3.5.3 statistical programme to determine if there was a correlation. Results: Maternal demographic and obstetric characteristics were found to be associated with the risk of bleeding during Bivariate analysis. However, age was found to confound emergency admission, uterotonic use (Oxytocin and Misoprostol use and delivery type, the latter being modified, in the development of post partum haemorrhage. Conclusion: These results indicate that active management of the third stage of labour (AMTSL and prompt intervention reduced the risk of developing PPH. Understanding the factors that cause PPH will allow us to better strengthen and effect pre delivery and emergency obstetric care which may help us reduce maternal mortality due to post partum haemorrhage.

  14. Henoch-Schönlein purpura with intracerebral haemorrhage in an adult patient: a case report

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    Karamadoukis Lazarus

    2008-06-01

    Full Text Available Abstract Introduction Henoch-Schönlein purpura is a small vessel vasculitis that affects mainly the skin, joints, gastrointestinal tract and kidneys. The central nervous system is also occasionally affected, although the majority of patients experience only mild symptoms such as headaches and behavioural changes. Intracerebral haemorrhage is a rare complication of Henoch-Schönlein purpura that so far has mainly been described in children and young adolescence. Case presentation We describe a 42-year-old man with Henoch-Schönlein purpura who developed an acute intracerebral haemorrhage that coincided with a reactivation of his vasculitis and the development of renal failure following discontinuation of steroids. In this patient, both the Henoch-Schönlein purpura and his neurological symptoms were successfully treated with intravenous cyclophosphamide and methylprednisolone, followed by a short course of oral cyclophosphamide and long-term oral prednisolone. His renal function also recovered sufficiently not to require renal replacement therapy. Conclusion The management of Henoch-Schönlein nephritis remains unclear, especially in the presence of severe complications such as intracerebral haemorrhage. We describe a successful outcome in such a patient.

  15. Home therapy with continuous infusion of factor VIII after minor surgery or serious haemorrhage.

    Science.gov (United States)

    Varon, D; Schulman, S; Bashari, D; Martinowitz, U

    1996-10-01

    Administration of factor VIII (F VIII) concentrates by continuous infusion is now routinely used at several haemophilia centers but almost exclusively for hospitalized patients. We evaluated various aspects of home therapy with continuous infusion of an immunoaffinity purified F VIII concentrate (Monoclate P®, Armour) in patients who would normally have been treated with high doses in bolus injections or with continuous infusion as in-patients. Twenty haemophilia A patients, eight after minor surgery and 12 for serious haemorrhage, received continuous infusion with undiluted F VIII by a minipump for a mean of 0.9 days in the hospital, followed by 3.3 days at home. Infusion bags were exchanged every 2.5 days. No haemorrhagic complications occurred, and five haemorrhages that had been resistant to treatment with bolus injections responded promptly to the continuous infusion. There were no technical problems and patient compliance and acceptance was good. We find this mode of therapy safe, efficacious and convenient for the patients as well as for the staff.

  16. Serial CT and MRI of ischaemic cerebral infarcts: frequency and clinical impact of haemorrhagic transformation

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, T.E.; Brueckmann, H. [Muenchen Univ. (Germany). Abt. fuer Neuroradiologie; Schulte-Altedorneburg, G. [Dept. of Radiology/Neuroradiology, University Medical School of Luebeck (Germany); Droste, D.W. [Dept. of Neurology, University Medical School of Luebeck (Germany)

    2000-04-01

    The frequency, predisposing factors and clinical consequences of haemorrhagic infarcts and damaged blood-brain barrier as shown by contrast enhancement (CE) in ischaemic cerebral infarcts are controversial. We prospectively compared the sensitivity of CT and MRI to haemorrhagic transformation (HT) and CE. We also wished to investigate the clinical significance of HT and factors possibly associated with it. We studied 36 patients with acute ischaemic infarcts in the middle cerebral artery territory during the first 2 weeks after the ictus. After CT and rating of the neurological deficit on admission, serial examinations with clinical neuromonitoring, contrast-enhanced CT and MRI were done on the same day. The occurrence and severity of HT were correlated with CE, stroke mechanism, infarct size, development of neurological deficits and antithrombotic treatment. The frequency of HT detected by MRI was 80 %. CE usually preceded HT or was seen simultaneously. MRI had a higher sensitivity than CT to HT and CE. Severity of HT was positively correlated with infarct size (P < 0.01). HT had no influence on patient's neurological status. Neither the type of antithrombotic treatment nor the stroke mechanism was associated with the severity of HT. No parenchymal haemorrhage occurred. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Alexander Shaw

    2013-01-01

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

  18. Follow-up of Thalidomide treatment in patients with Hereditary Haemorrhagic Telangiectasia.

    Science.gov (United States)

    Hosman, A; Westermann, C J J; Snijder, R; Disch, F; Mummery, C L; Mager, J J

    2015-12-01

    Patients with a hereditary vascular disorder called Rendu-Osler-Weber syndrome (Hereditary Haemorrhagic Telangiectasia, HHT) haemorrhage easily due to weak-walled vessels. Haemorrhage in lungs or brain can be fatal but patients suffer most from chronic and prolonged nosebleeds (epistaxis), the frequency and intensity of which increases with age. Several years ago, it was discovered serendipitously that the drug Thalidomide had beneficial effects on the disease symptoms in several of a small group of HHT patients: epistaxis and the incidence of anaemia were reduced and patients required fewer blood transfusions. In addition, they reported a better quality of life. However, Thalidomide has significant negative side effects, including neuropathy and fatigue. We followed up all HHT patients in the Netherlands who had been taking Thalidomide at the time the original study was completed to find out (i) how many had continued taking Thalidomide and for how long (ii) the nature and severity of any side-effects and (iii) whether side-effects had influenced their decision to continue taking Thalidomide. Only a minority of patients had continued taking the drug despite its beneficial effects on their symptoms and that the side effects were the primary reason to stop. Despite symptom reduction, alternative treatments are still necessary for epistaxis in HHT patients and a large-scale clinical trial is not justified although incidental use in the most severely affected patients can be considered.

  19. Evolution of Outer Retinal Folds Occurring after Vitrectomy for Retinal Detachment Repair

    NARCIS (Netherlands)

    Dell'Omo, Roberto; Tan, H. Stevie; Schlingemann, Reinier O.; Bijl, Heico M.; Lesnik Oberstein, Sarit Y.; Barca, Francesco; Mura, Marco

    2012-01-01

    PURPOSE. To assess the evolution of outer retinal folds (ORFs) occurring after repair of rhegmatogenous retinal detachment (RRD) using spectral domain-optical coherence tomography (sd-OCT) and fundus autofluorescence (FAF), and to discuss their pathogenesis. METHODS. Twenty patients were operated on

  20. Protein kinase C in porcine retinal arteries and neuroretina following retinal ischemia-reperfusion

    DEFF Research Database (Denmark)

    Gesslein, Bodil; Gustafsson, Lotta; Wackenfors, Angelica

    2009-01-01

    Identification of the intracellular signal-transduction pathways activated in retinal ischemia may be important in revealing novel pharmacological targets. To date, most studies have focused on identifying neuroprotective agents. The retinal blood vessels are key organs in circulatory failure, an...