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  1. [Crimean-Congo hemorrhagic fever].

    Science.gov (United States)

    Saijo, Masayuki; Moriikawa, Shigeru; Kurane, Ichiro

    2004-12-01

    Crimean-Congo hemorrhagic fever (CCHF) is an acute infectious disease caused by CCHF virus (CCHFV), a member of the family Bunyaviridae, genus Nairovirus. The case fatality rate of CCHF ranges from 10-40%. Because CCHF is not present in Japan, many Japanese virologists and clinicians are not very familiar with this disease. However, there remains the possibility of an introduction of CCHFV or other hemorrhagic fever viruses into Japan from surrounding endemic areas. Development of diagnostic laboratory capacity for viral hemorrhagic fevers is necessary even in countries without these diseases. At the National Institute of Infectious Diseases, Tokyo, Japan, laboratory-based systems such as recombinant protein-based antibody detection, antigen-capture and pathological examination have been developed. In this review article, epidemiologic and clinical data on CCHF in the Xinjiang Uygur Autonomous Region, compiled through field investigations and diagnostic testing utilizing the aforementioned laboratory systems, are presented. CCHFV infections are closely associated with the environmental conditions, life styles, religion, occupation, and human economic activities. Based on these data, preventive measures for CCHFV infections are also discussed.

  2. Crimean-Congo Hemorrhagic Fever

    Directory of Open Access Journals (Sweden)

    Emadi Koochak H

    2003-10-01

    Full Text Available Crimean-Congo hemorrhagic fever (CCHF was first described in the Crimea in 1944 and then in 1956 in congo. CCHF is a viral hemorrhagic fever of the Nairovirus group that belongs to Bunyaviridae family virus. It is transmitted to human by tick bite. The most efficient and common tick that is the vectors of CCHF is a member of the Hyalomma genus which infected many mammals such as livestock, this tick is the main reservoire of virus in nature. Humans also become infected with CCHF virus by direct contact with blood or other infected tissues from livestock or human patients (nosocomial infection. Disease has been found in saharic Africa, Eastern Europe, Pakistan, India and Middle East (specially Iran and Iraq. This disease recently spread in Iran so in 1999 to 2001 at least 222 suspected case(81 definite case reported that led to the death of 15 of 81 cases. It is estimated that 30 percent of the country's cattle are contaminated with this virus."nIn humans, after a short incubation period it appears suddenly with fever, chills, myalgia and GI symptoms followed by severe bleeding and DIC that led to death .If the patient improved, has a long {2-4 weeks convalescence period. Disease diagnosed by clinical manifestations, serologic tests, viral culture and PCR and its specific treatment is oral ribavirin for 10 days, for prevention of disease personal protective measures from tick bite, spraying poison of mews to reduce of ticks crowd, isolation of patients and dis-infection of contaminated personal equipments that who suffering from CCHF is recommended.

  3. Crimean-Congo Hemorrhagic Fever, Sudan, 2008

    Centers for Disease Control (CDC) Podcasts

    This podcast describes the emergence of the first human cases of Crimean-Congo Hemorrhagic Fever in Sudan in 2008. CDC epidemiologist Dr. Stuart Nichol discusses how the disease was found in Sudan and how it spread in a hospital there.

  4. Crimean-Congo Hemorrhagic Fever, Sudan, 2008

    Centers for Disease Control (CDC) Podcasts

    2010-04-15

    This podcast describes the emergence of the first human cases of Crimean-Congo Hemorrhagic Fever in Sudan in 2008. CDC epidemiologist Dr. Stuart Nichol discusses how the disease was found in Sudan and how it spread in a hospital there.  Created: 4/15/2010 by National Center for Emerging and Zoonotic Infections (proposed).   Date Released: 4/15/2010.

  5. Congo crimean hemorrhagic fever in balochistan

    International Nuclear Information System (INIS)

    Durrani, A.B.; Shaikh, M.; Khan, Z.

    2007-01-01

    To observe the pattern and mortality of Congo-Crimean Hemorrhagic Fever (CCHF) in Balochistan. Two hundred and twenty-six febrile patients with bleeding of sudden onset, with initial signs and symptoms including headache, high fever, back pain, joint pain, stomach pain, vomiting, red eyes, flushed face, red throat and petechiae on the palate of both sexes were screened for CCHF over a period of 10 years. Clinical criteria for initial diagnosis directed the subsequent diagnostic work-up. The ages of these patients ranged from 7 years to 74 years. Sixty-three percent of these patients were positive for CCHF. Males were 68% of the total patients. Over the years, CCHF showed a gradual increase ranging from 43% to 80%. Total mortality was 15%, all being secondary cases. Death was not observed in primary CCHF cases. In this study, suspicion of viral hemorrhagic fever was raised in 62% cases at the time of admission and the patients were immediately isolated, noninvasive procedures were instigated and barrier nursing was implemented. None of the family and hospital staff members who had close contact with the patient became ill, while those who were not suspected initially (38%) infected the health care workers and the family members. Although CCHF is rare, this study stresses the need for proper health facilities in Pakistan and to include VHF (viral hemorrhagic fevers) in the differential diagnosis of unexplained fever with hemorrhagic tendencies of sudden onset. (author)

  6. [Emerging diseases. Crimean-Congo hemorrhagic fever].

    Science.gov (United States)

    Kuljić-Kapulica, Nada

    2004-01-01

    Recognized for many years in central Asia and Eastern Europe, Crimean-Congo hemorrhagic fever (CCHF) is a severe zoonotic disease which affects people coming into contact with livestock or ticks. The range of the CCHF virus is now known to extend form central Asia to India, Pakistan, Afghanistan, Iran, Iraq, the Middle East, Eastern Europe, and to most of Saharan and sub-Saharan Africa. CCHF virus is a member of the Bunyavirus family, and is classified as a Nairovirus. After an incubation period of approximately 3 to 6 days the abrupt onset of acute febrile illness occurs. The first symptoms are similar to severe influenza and include fever, headache, severe back and abdominal pain. The hemorrhagic fever manifestations occur after several days of illnesses and include petechial rash, ecchymoses, hematemmesis, and melenna. Cases typically present with some form of hepatitis. The mortality rate is 10-50% in different outbreaks with deaths typically occurring during the second week of illness. The genus Hyalomma of ixodid ticks is the most important vector of the CCHF virus. Vertebrates including birds and small animals provide excellent amplifier hosts of both the virus and the tick. The virus can be transmitted to humans by direct contact with infected animals and from person to person. Early diagnosis is possible in special laboratories using antigen detection by imunofluorescence or ELISA tests or molecular methods as PCR and antibody detection. Tick control measures need to be emphasized and utilized to prevent CCHF. This includes spraying camp sites, clothing and danger areas with acaricides or repellent. Strict isolation of patients with CCHF and a focus on barrier nursing would help to prevent nosocomial spread. Presently the vaccine is a dangerous mouse brain-derived version. Future development of a vaccine would help to prevent human infection.

  7. Crimean-Congo Hemorrhagic Fever Virus in Bulgaria and Turkey

    Czech Academy of Sciences Publication Activity Database

    Mertens, M.; Schuster, I.; Sas, M. A.; Vatansever, Z.; Hubálek, Zdeněk; Güven, E.; Deniz, A.; Georgiev, G.; Peshev, R.; Groschup, M. H.

    2016-01-01

    Roč. 16, č. 9 (2016), s. 619-623 ISSN 1530-3667 EU Projects: European Commission(XE) 261504 - EDENEXT Institutional support: RVO:68081766 Keywords : Crimean-Congo hemorrhagic fever virus: CCHFV * domestic animals * ELISA * epidemiology Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 2.045, year: 2016

  8. Evaluation of patients with Crimean-Congo hemorrhagic fever in ...

    African Journals Online (AJOL)

    Background: Crimean-Congo hemorrhagic fever (CCHF), which is associated with a high mortality rate in the Black Sea region of Turkey, has received increasing attention. Objective: In this study, the epidemiological features, clinical and laboratory findings, treatments, and outcomes of patients diagnosed with CCHF ...

  9. Crimean-Congo Hemorrhagic Fever, Kazakhstan, 2009–2010

    Science.gov (United States)

    Knust, Barbara; Medetov, Zhumagul B.; Kyraubayev, Kakimzhan B.; Bumburidi, Yekaterina; Erickson, Bobbie Rae; MacNeil, Adam; Bayserkin, Baurzhan S.; Ospanov, Kenes S.

    2012-01-01

    We evaluated Crimean-Congo hemorrhagic fever (CCHF) surveillance data from southern Kazakhstan during 2009–2010 and found both spatial and temporal association between reported tick bites and CCHF cases. Public health measures should center on preventing tick bites, increasing awareness of CCHF signs and symptoms, and adopting hospital infection control practices. PMID:22469505

  10. Crimean-Congo hemorrhagic fever in Iran and neighboring countries

    DEFF Research Database (Denmark)

    Chinikar, S; Ghiasi, Seyed Mojtaba; Hewson, R

    2010-01-01

    Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease that is asymptomatic in infected livestock, but a serious threat to humans. Human infections begin with nonspecific febrile symptoms, but progress to a serious hemorrhagic syndrome with a case fatality rate of 2-50%. Although the ...... in Iran and neighboring countries and provide evidence of over 5000 confirmed cases of CCHF in a single period/season....

  11. Possible sexual transmission of Crimean-Congo hemorrhagic fever

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    Natalia Yurievna Pshenichnaya

    2016-04-01

    Full Text Available Three cases of family transmission of laboratory-confirmed Crimean-Congo hemorrhagic fever (CCHF among spouses are reported. These spouses had sexual contact at the end of the incubation period or during the early stage of the mild form of CCHF, without any hemorrhagic symptoms in the first infected spouse. This report demonstrates that sexual contact may represent a real risk of CCHF transmission, even if the patient only experiences mild symptoms.

  12. Molecular Insights into Crimean-Congo Hemorrhagic Fever Virus

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    Marko Zivcec

    2016-04-01

    Full Text Available Crimean-Congo hemorrhagic fever virus (CCHFV is a tick-borne pathogen that causes high morbidity and mortality. Efficacy of vaccines and antivirals to treat human CCHFV infections remains limited and controversial. Research into pathology and underlying molecular mechanisms of CCHFV and other nairoviruses is limited. Significant progress has been made in our understanding of CCHFV replication and pathogenesis in the past decade. Here we review the most recent molecular advances in CCHFV-related research, and provide perspectives on future research.

  13. Second International Conference on Crimean-Congo Hemorrhagic Fever.

    Science.gov (United States)

    Spengler, Jessica R; Bente, Dennis A; Bray, Mike; Burt, Felicity; Hewson, Roger; Korukluoglu, Gülay; Mirazimi, Ali; Weber, Friedemann; Papa, Anna

    2018-02-01

    The Second International Conference on Crimean-Congo Hemorrhagic Fever (CCHF) was held in Thessaloniki, Greece, from September 10-13, 2017, and brought together international public health professionals, clinicians, ecologists, and basic laboratory researchers. Nearly 100 participants, representing 24 countries and the World Health Organization (WHO), were in attendance. Meeting sessions covered the epidemiology of CCHF in humans; ticks and virus-tick interactions; wild and domestic animal hosts; molecular virology; taxonomic classification; pathogenesis and animal models; clinical aspects and diagnosis; clinical management and clinical trials; and disease prevention in humans. The concluding session focused on recent WHO recommendations for public health measures and future research. This report summarizes lectures by the invited speakers and highlights advances in the field. Copyright © 2017. Published by Elsevier B.V.

  14. Crimean-Congo Hemorrhagic Fever: Tick-Host-Virus Interactions

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    Anna Papa

    2017-05-01

    Full Text Available Crimean-Congo hemorrhagic fever virus (CCHFV is transmitted to humans by bite of infected ticks or by direct contact with blood or tissues of viremic patients or animals. It causes to humans a severe disease with fatality up to 30%. The current knowledge about the vector-host-CCHFV interactions is very limited due to the high-level containment required for CCHFV studies. Among ticks, Hyalomma spp. are considered the most competent virus vectors. CCHFV evades the tick immune response, and following its replication in the lining of the tick's midgut, it is disseminated by the hemolymph in the salivary glands and reproductive organs. The introduction of salivary gland secretions into the host cells is the major route via which CCHFV enters the host. Following an initial amplification at the site of inoculation, the virus is spread to the target organs. Apoptosis is induced via both intrinsic and extrinsic pathways. Genetic factors and immune status of the host may affect the release of cytokines which play a major role in disease progression and outcome. It is expected that the use of new technology of metabolomics, transcriptomics and proteomics will lead to improved understanding of CCHFV-host interactions and identify potential targets for blocking the CCHFV transmission.

  15. Brucellosis in Patients with Crimean-Congo Hemorrhagic Fever

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    Fazilet Duygu

    2017-12-01

    Full Text Available Background: Crimean-Congo hemorrhagic fever (CCHF is a fatal zoonotic viral disease caused by infection with a tick-borne virus of the genus Nairovirus. In this study, we investigated the incidence of brucellosis in patients diag­nosed with CCHF.Methods: Overall, 169 patients hospitalized with an initial diagnosis of CCHF were included in 2011 in To­kat/ Turkey. Immunoglobulin M (IgM antibodies and/or PCR results were used in the laboratory diagnosis of CCHF, while plate and standard tube agglutination (STA tests were used to diagnose brucellosis.Results: Overall, 120 patients (79% with positive PCR tests were diagnosed with CCHF. Five (4.16% were also diag­nosed with brucellosis based on the positive plate and STA test results. Four patients (2.36% had negative CCHF PCR and positive STA test results.Conclusion: Brucellosis and CCHF can mimic each other and that all patients with CCHF or brucellosis should be screened for both conditions.

  16. Vectors of Crimean Congo Hemorrhagic Fever Virus in Iran

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    Zakkyeh Telmadarraiy

    2015-10-01

    Full Text Available Background: Ticks are important vectors and reservoirs of Crimean Congo Hemorrhagic Fever (CCHF virus. Human beings may be infected whenever the normal life cycle of the infected ticks on non- human vertebrate hosts is interrupted by the undesirable presence of humans in the cycle. A total of 26 species of Argasid and Ixodid ticks have been recorded in Iran; including nine Hyalomma, two Rhipicephalus, two Dermacentor, five Haemaphysalis, two Boophilus, one Ixodes and two Argas as well as three Ornithodoros species as blood sucking ectoparasites of livestock and poultries. The present paper reviews tick vectors of CCHF virus in Iran, focusing on the role of ticks in different provinces of Iran using reverse transcription polymerase chain reaction (RT-PCR assay.Methods: During ten years study, 1054 tick specimens; including two species of Argasidae and 17 species of Ixodidae were examined for their infection to CCHF virus genome. The output of all studies as well as related publications were discussed in the current paper.Results: The results show that Rhipicephalus sanguineus, Hyalomma marginatum, H. anatolicum, H. asiaticum and H. dromedarii were known as the most frequent species which were positive for CCHF virus.Conclusion: The status of ticks which were positive for CCHF virus revealed that unlike the most common idea that Hyalomma species are the most important vectors of CCHF virus, other ticks including Rhipicephalus,Haemaphysalis and Dermacentor can be reservoir of this virus; thus, considering geographical distribution, type of host and environmental conditions, different tick control measurements should be carried out in areas with high incidence of CCHF disease.

  17. Vectors of Crimean Congo Hemorrhagic Fever Virus in Iran

    Science.gov (United States)

    Telmadarraiy, Zakkyeh; Chinikar, Sadegh; Vatandoost, Hassan; Faghihi, Faezeh; Hosseini-Chegeni, Asadollah

    2015-01-01

    Background: Ticks are important vectors and reservoirs of Crimean Congo Hemorrhagic Fever (CCHF) virus. Human beings may be infected whenever the normal life cycle of the infected ticks on non-human vertebrate hosts is interrupted by the undesirable presence of humans in the cycle. A total of 26 species of Argasid and Ixodid ticks have been recorded in Iran; including nine Hyalomma, two Rhipicephalus, two Dermacentor, five Haemaphysalis, two Boophilus, one Ixodes and two Argas as well as three Ornithodoros species as blood sucking ectoparasites of livestock and poultries. The present paper reviews tick vectors of CCHF virus in Iran, focusing on the role of ticks in different provinces of Iran using reverse transcription polymerase chain reaction (RT-PCR) assay. Methods: During ten years study, 1054 tick specimens; including two species of Argasidae and 17 species of Ixodidae were examined for their infection to CCHF virus genome. The output of all studies as well as related publications were discussed in the current paper. Results: The results show that Rhipicephalus sanguineus, Hyalomma marginatum, H. anatolicum, H. asiaticum and H. dromedarii were known as the most frequent species which were positive for CCHF virus. Conclusion: The status of ticks which were positive for CCHF virus revealed that unlike the most common idea that Hyalomma species are the most important vectors of CCHF virus, other ticks including Rhipicephalus, Haemaphysalis and Dermacentor can be reservoir of this virus; thus, considering geographical distribution, type of host and environmental conditions, different tick control measurements should be carried out in areas with high incidence of CCHF disease. PMID:26623426

  18. A case report of crimean congo hemorrhagic Fever in ostriches in iran

    DEFF Research Database (Denmark)

    Mostafavi, Ehsan; Chinikar, Sadegh; Moradi, Maryam

    2013-01-01

    Crimean Congo hemorrhagic fever (CCHF) is a viral zoonosis, which is usually transmitted via tick bites or close contact with infected blood or tissue. This disease can cause a case fatality rate of up to 25%-30% in humans. CCHF Infection in birds is less documented. An ostrich can reproduce...

  19. Crimean Congo Hemorrhagic Fever Virus and Alkhurma (Alkhumra) Virus in Ticks in Djibouti.

    Science.gov (United States)

    Horton, Katherine C; Fahmy, Nermeen T; Watany, Noha; Zayed, Alia; Mohamed, Abro; Ahmed, Ammar Abdo; Rollin, Pierre E; Dueger, Erica L

    2016-10-01

    Crimean Congo hemorrhagic fever virus and Alkhumra virus, not previously reported in Djibouti, were detected among 141 (infection rate = 15.7 per 100, 95% CI: 13.4-18.1) tick pools from 81 (37%) cattle and 2 (infection rate = 0.2 per 100, 95% CI: 0.0-0.7) tick pools from 2 (1%) cattle, respectively, collected at an abattoir in 2010 and 2011.

  20. A crimean - congo hemorrhagic fever outbreak in northern balochistan

    International Nuclear Information System (INIS)

    Nadeem, M.; Ali, N.

    2007-01-01

    To describe the clinical characteristics, epidemiology, predictors of fatal outcome (PFO), and management effects of Crimean-Congo haemorrhagic fever (CCHF) patients during an outbreak in Northern Balochistan. Patients presenting with a fever of less than 2 weeks duration and bleeding manifestations were included. Clinical history was recorded and patients were placed on oral ribavirin, and hematological support. Diagnosis was established by PCR for CCHF or detection of CCHF specific IgM and IgG. Eighty-four patients were received, 34 (40.5%) were suspected of suffering from classical CCHF. All 34 (100%) patients presented with a history of fever and bleeding (epistaxis, gum bleeding, melena or haematuria). Mean platelet count was 30 x 109/L and mean ALT (alanine transferase) was 288 U/L. Among fatal cases, the mean platelet count was 18.4 x 10 9/L and ALT was 781 units/L. PCR for CCHF viral RNA performed on 10 patients was positive in 3 (30%) patients. CCHF specific IgM and IgG was positive in 17.6% (6/34). Four patients were brought in moribund condition and expired before treatment could be started, 4 patients expired during treatment and 76.5% (26/34) were cured. The overall mortality was 23.5% (8/34). Main predictors of fatal outcome were ALT z 150 units/L, activated partial thromboplastin time(aPT) z 60 seconds, prothrombin time (PT) z 34 seconds, aspartate transferase (AST) z 200 units/L, platelets o 20 x 109/L, and fibrinogen o 110 mg/dL. In this series of CCHF occurring in Northern parts of Balochistan, gastrointestinal tract bleeding was the worst prognostic factor associated with fatal outcome. Providing education to healthcare workers and at risk populations, hematological support, antiviral drugs, and barrier nursing may help reduce mortality. (author)

  1. Hepatitis in Patients with CrimeanCongo Hemorrhagic Fever

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    Batool Sharifi-Mood

    2014-04-01

    Full Text Available Background: Crimean–Congo hemorrhagic fever (CCHF is a viral disease and causing approximately 30% fatality rate. Recent studies have been reported that hepatitis in CCHF patients is with high mortality. The aim of this study was to determine the prevalence of hepatitis in the CCHF cases and also detect the mortality rate among patients with hepatitis. Materials and Methods: The present study was conducted in patients with CCHF who were hospitalized in Boo-Ali hospital in Zahedan between Oct 2009 to Feb 2012. Liver function tests including aminotransferase enzymes and prothrombin time and mortality rate were evaluated. Results: Among 53 patients with CCHF, hepatitis was seen in 19 patients (45%. Nine patients died (21%. All dead patients had a serum aminotransaminase level ≥10 times the upper normal limit. Conclusion: Our study showed that hepatitis is prevalent in CCHF patients and a serum aminotransaminase level ≥5 times the upper normal limit (UNL is a risk factor for severe disease and high mortality.

  2. Isolation and whole-genome sequencing of a Crimean-Congo hemorrhagic fever virus strain, Greece.

    Science.gov (United States)

    Papa, Anna; Papadopoulou, Elpida; Tsioka, Katerina; Kontana, Anastasia; Pappa, Styliani; Melidou, Ageliki; Giadinis, Nektarios D

    2018-03-01

    Crimean-Congo hemorrhagic fever virus (CCHFV) was isolated from a pool of two adult Rhipicephalus bursa ticks removed from a goat in 2015 in Greece. The strain clusters into lineage Europe 2 representing the second available whole-genome sequenced isolate of this lineage. CCHFV IgG antibodies were detected in 8 of 19 goats of the farm. Currently CCHFV is not associated with disease in mammals other than humans. Studies in animal models are needed to investigate the pathogenicity level of lineage Europe 2 and compare it with that of other lineages. Copyright © 2018 Elsevier GmbH. All rights reserved.

  3. Report of the first case of Crimean Congo hemorrhagic fever in Qazvin Province (2016

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    AR. Nikoonejad

    2016-12-01

    Full Text Available Crimean Congo hemorrhagic fever is a potentially fatal disease that is reported from Asia, Africa and Europe. In May, 2016 a 42 year-old female is admitted to Buali-Sina hospital with epistaxis and within a few hours got loss of consciousness and shock. The patient was put on supportive care and oral Ribavirin. From the sixth admission day, the general condition of the patient improved and on the eleventh day she was discharged without an important sequela. Consequently, it is necessary to consider this disease in the differential diagnosis of all patients presented with fever and acute bleeding diathesis.

  4. EPIDEMIOLOGY, CLINICAL AND LABORATORY FEATURES OF CRIMEAN-CONGO HEMORRHAGIC FEVER IN GEORGIA.

    Science.gov (United States)

    Vashakidze, E; Mikadze, I

    2015-10-01

    Crimean-Congo hemorrhagic fever virus transmitted to humans by Hyalomma ticks or by direct contact with the blood of infected humans or domestic animals. The most common clinical signs of CCHF are fever, nausea, headache, diarrhea, myalgia, petechial rash, and bleeding. CCHF is a severe disease in humans with a fatality rate up to 15-85%. This study was undertaken to determine the predictors of fatality among patients with CCHF based on epidemiological, clinical, and laboratory findings. 34 patients were enrolled in the study, aged 4 to 77; 17 - male and 17 female. 3 of them were fatal cases. All of them were from Shua Kartli: Khashuri, Gori and Kaspi districts, involved in farming/handling livestock and the history of tick bite was present in most of patients. Evaluation of the epidemiological characteristics of this cases showed that the female to male ratio was nearly similar. The disease is common in the rural areas of the region, mostly in the actively working age group and almost all patients were farmers. The results of our study show that the most cardinal clinical and laboratory features of Crimean-Congo hemorrhagic fever are - acute beginning of disease, high fever, intoxication and hemorrhagic symptoms, thrombocytopenia, high level of aminotransferases and creatine. Predictors of fatality are: an altered mental status, in early stage of disease dramatic decreased thrombocytes count and significantly high level of aspartate aminotransferase, also longer the mean prothrombin time and INR.

  5. Meeting report: First International Conference on Crimean-Congo hemorrhagic fever.

    Science.gov (United States)

    Papa, Anna; Weber, Friedemann; Hewson, Roger; Weidmann, Manfred; Koksal, Iftihar; Korukluoglu, Gulay; Mirazimi, Ali

    2015-08-01

    Crimean-Congo hemorrhagic fever (CCHF) is the most widespread tick-borne disease of humans, occurring from western China to the Balkans in Eurasia and south throughout the length of Africa. Its incidence has increased over the past decade, particularly in Turkey and Iran, and the disease has also emerged in India. Research has been hindered by limited laboratory capacity in many regions where the disease is prevalent, indicating the need for collaboration between investigators in endemic countries and those with greater scientific resources. In an effort to increase such collaboration, the First International Conference on Crimean-Congo hemorrhagic fever was held in Thessaloniki, Greece, from February 13 to 14, 2015. This meeting followed the conclusion of an EU-supported Collaborative Project under the Health Cooperation Work Programme of the 7th Framework Programme (Grant agreement No. 260427). It is expected to be the first in a series of meetings that will bring together researchers from around the world to exchange knowledge and experience on various aspects of CCHF. This report summarizes major presentations by the invited speakers at the First International Conference on CCHF. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Seroepidemiological Studies of Crimean-Congo Hemorrhagic Fever Virus in Domestic and Wild Animals.

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    Jessica R Spengler

    2016-01-01

    Full Text Available Crimean-Congo hemorrhagic fever (CCHF is a widely distributed, tick-borne viral disease. Humans are the only species known to develop illness after CCHF virus (CCHFV infection, characterized by a nonspecific febrile illness that can progress to severe, often fatal, hemorrhagic disease. A variety of animals may serve as asymptomatic reservoirs of CCHFV in an endemic cycle of transmission. Seroepidemiological studies have been instrumental in elucidating CCHFV reservoirs and in determining endemic foci of viral transmission. Herein, we review over 50 years of CCHFV seroepidemiological studies in domestic and wild animals. This review highlights the role of livestock in the maintenance and transmission of CCHFV, and provides a detailed summary of seroepidemiological studies of wild animal species, reflecting their relative roles in CCHFV ecology.

  7. Reported 5 cases of Crimean-Congo hemorrhagic fever in Fars province in 2011

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    Fatemeh Rezaei

    2012-09-01

    Full Text Available Crimean-Congo Hemorrhagic Fever (CCHF is a viral hemorrhagic disease and a zoonosis disease that has been developed in people who deal with animals such as cattle and butchers. The diagnosis of CCHF is performed by detection of human antibodies (IgG and IgM against CCHF virus. Five Patients with CCHF occurred in Fath Abad’s village (in Fars province in the summer of 2011. All patients were men and aged 25-46 years old. Three patients were farmer and two other ones were butchers. The samples were sent to the National Reference Laboratory for Arboviruses and Viral Haemorrhagic Fevers (Pasteur Institute of Iran in Tehran. The result of laboratory test for all patients was positive. None of the patients had died. Since the CCHF is rare, present study was aimed to assess the causes of the disease’s epidemic and clinical and laboratory symptoms stones.

  8. First international external quality assessment of molecular detection of Crimean-Congo hemorrhagic fever virus.

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    Camille Escadafal

    Full Text Available Crimean-Congo hemorrhagic fever (CCHF is a zoonosis caused by a Nairovirus of the family Bunyaviridae. Infection is transmitted to humans mostly by Hyalomma ticks and also by direct contact with the blood or tissues of infected humans or viremic livestock. Clinical features usually include a rapid progression characterized by hemorrhage, myalgia and fever, with a lethality rate up to 30%. CCHF is one of the most widely distributed viral hemorrhagic fevers and has been reported in Africa, the Middle East and Asia, as well as parts of Europe. There is no approved vaccine or specific treatment against CCHF virus (CCHFV infections. In this context, an accurate diagnosis as well as a reliable surveillance of CCHFV infections is essential. Diagnostic techniques include virus culture, serology and molecular methods, which are now increasingly used. The European Network for the Diagnostics of "Imported" Viral Diseases organized the first international external quality assessment of CCHVF molecular diagnostics in 2011 to assess the efficiency and accurateness of CCHFV molecular methods applied by expert laboratories. A proficiency test panel of 15 samples was distributed to the participants including 10 different CCHFV preparations generated from infected cell cultures, a preparation of plasmid cloned with the nucleoprotein of CCHFV, two CCHFV RNA preparations and two negative controls. Forty-four laboratories worldwide participated in the EQA study and 53 data sets were received. Twenty data sets (38% met all criteria with optimal performance, 10 (19% with acceptable performance, while 23 (43% reported results showing a need for improvement. Differences in performance depended on the method used, the type of strain tested, the concentration of the sample tested and the laboratory performing the test. These results indicate that there is still a need for improving testing conditions and standardizing protocols for the molecular detection of Crimean-Congo

  9. Clinical manifestation and pathophysiology of Crimean-Congo hemorrhagic fever on human

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    Siavash Hamzehpour

    2017-10-01

    Full Text Available The Crimean-Congo hemorrhagic fever is a febrile and acute viral disease, and it is sporadic and epidemic in human societies, although it is special for animals (1. The disease was first identified in the Crimean Peninsula in the years 1945-1944 and was called the Crimean Hemorrhagic Fever. In 1956, the epidemic of the disease in the Congo also occurred, and due to the similarity of the disease agent, the combination of names of these two regions was used for naming the disease (2. The cause of this disease is a single-stranded viraemia virus from the genus Neurovirus and the Bunyaviridae family (3. One of the ways to transmit the disease is tick bites, and the hyaloma ticks are the most important constituent of the Crimean-Congo fever vein and the reservoir. In addition to transmitting the disease to vertebrates, due to a vertical and horizontal transmission, they transmit it to the next generation (4. Also, human contact with meat, blood and contaminated secretions of livestock in a livestock eradication period causes the transmission of the disease (5. Human to human transmission, which is more often seen as a hospital infection, is also a means of transmitting the disease (6. The incubation period after a tick bite is 1 to 3 days and a maximum of 9 days, and is slightly longer after contact with contaminated blood or tissue about 5-6 days, and finally 14 days (7. In the early stages of the disease, symptoms are sudden which include severe headaches, fever, chills, muscle pain, especially the back and leg muscles, neck stiffness, dizziness, reddening of the eyes, fear of light, nausea, vomiting and diarrhea. Then, a severe generalized muscle pain appears, mostly at the back and hamstring, and the patient complains of back pain and epigastric pain (8. In the examination of patients, facial flushing and chest thigtness, hyperemia of throat mucusand petechialsare common symptoms which draw attention. Hemorrhagic phenomena include melena

  10. Plasma oxidative stress and total thiol levels in Crimean-Congo hemorrhagic fever.

    Science.gov (United States)

    Karadag-Oncel, Eda; Erel, Ozcan; Ozsurekci, Yasemin; Caglayik, Dilek Yagci; Kaya, Ali; Gozel, Mustafa Gokhan; Icagasioglu, Fusun Dilara; Engin, Aynur; Korukluoglu, Gulay; Uyar, Yavuz; Elaldi, Nazif; Ceyhan, Mehmet

    2014-01-01

    In this study, we investigated the pro- and antioxidant status of patients with a pathogenesis of Crimean-Congo hemorrhagic fever (CCHF) in terms of their role in its pathogenesis. During the study period, 34 children and 41 adults were diagnosed with CCHF. The control group consisted of healthy age- and gender-matched children and adults. Serum levels of the total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), and plasma total thiol (TTL) were evaluated and compared between groups. The difference in mean TAC values between CCHF patients and healthy controls was not statistically significant (P > 0.05). Mean TOS, OSI, and TTL values were significantly lower in CCHF patients than in healthy controls (P 0.05). Our results suggest that TTL may play a more important role in CCHF pathogenesis than the other parameters investigated. The mean TOS and OSI values were higher in the control group than in CCHF patients.

  11. Spatial cluster analysis of human cases of Crimean Congo hemorrhagic fever reported in Pakistan.

    Science.gov (United States)

    Abbas, Tariq; Younus, Muhammad; Muhammad, Sayyad Aun

    2015-01-01

    Crimean Congo hemorrhagic fever (CCHF) is a tick-borne viral zoonotic disease that has been reported in almost all geographic regions in Pakistan. The aim of this study was to identify spatial clusters of human cases of CCHF reported in country. Kulldorff's spatial scan statisitc, Anselin's Local Moran's I and Getis Ord Gi* tests were applied on data (i.e. number of laboratory confirmed cases reported from each district during year 2013). The analyses revealed a large multi-district cluster of high CCHF incidence in the uplands of Balochistan province near it border with Afghanistan. The cluster comprised the following districts: Qilla Abdullah; Qilla Saifullah; Loralai, Quetta, Sibi, Chagai, and Mastung. Another cluster was detected in Punjab and included Rawalpindi district and a part of Islamabad. We provide empirical evidence of spatial clustering of human CCHF cases in the country. The districts in the clusters should be given priority in surveillance, control programs, and further research.

  12. Genomic Characterization of Crimean-Congo Hemorrhagic Fever Virus in Hyalomma Tick from Spain, 2014.

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    Cajimat, Maria N B; Rodriguez, Sergio E; Schuster, Isolde U E; Swetnam, Daniele M; Ksiazek, Thomas G; Habela, Miguel A; Negredo, Ana Isabel; Estrada-Peña, Agustín; Barrett, Alan D T; Bente, Dennis A

    2017-10-01

    Crimean-Congo hemorrhagic fever (CCHF) is a severe tick-borne disease caused by CCHF virus (CCHFV). Ticks in the genus Hyalomma are the main vectors and reservoirs of CCHFV. In Spain, CCHFV was first detected in Hyalomma ticks from Cáceres in 2010. Subsequently, two autochthonous CCHF cases were reported in August 2016. In this study, we describe the characterization of the CCHFV genome directly from Hyalomma lusitanicum collected in Cáceres in 2014. Phylogenetic analyses reveal a close relationship with clade III strains from West Africa, with an estimated divergence time of 50 years. The results of this work suggest that CCHFV has been circulating in Spain for some time, and most likely originated from West Africa.

  13. Public Knowledge and Attitude toward Crimean Congo Hemorrhagic Fever in Tokat Turkey

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    R Yilmaz

    2009-12-01

    Full Text Available "nBackground: The World health Organization (WHO declares Crimean Congo hemorrhagic fe­ver (CCHF endemic in Turkey. Despite the magnitude of problem, no documented evi­dence exists in Turkey, which reveals the aware­ness and practices of the country's adult popula­tion regarding CCHF, its spread, symptoms, treatment, and preven­tion. This study was conducted to assess the level of knowledge, attitudes, and practices regarding CCHF in people visit­ing terti­ary care hospital in Tokat, Turkey."nMethods: This questionnaire based cross-sectional survey was conducted among patients' rela­tives or guardians who ad­mitted pediatric outpatient clinics during May-July 2008. The question­naire was composed of 25 questions."nResults: A total of 1034 respondents participated in the survey. Sufficient knowledge about CCHF was not found in 28.9% of the sample. Literate individuals were relatively better informed about CCHF as compared to the illiterate peo­ple. Television and radio were con­sidered as the most important and useful source of information on the disease."nConclusion: We have found insufficient knowledge on CCHF in our population. It is thought to have no chance of suc­cess against a fatal disease such as CCHF, which has serious consequences, without the contribution of commu­nity. It is clear that there are important tasks for health, agri­culture, and media sectors to improve public knowledge and awareness about CCHF. "n Keywords: Crimean Congo hemorrhagic fever, Public knowledge, Survey, Turkey

  14. Crimean Congo hemorrhagic fever among the one-humped camel (Camelus dromedaries) in Central Sudan.

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    Suliman, Hajer M; Adam, Ibrahim A; Saeed, Shamseldin I; Abdelaziz, Sanaa A; Haroun, Eltahir M; Aradaib, Imadeldin E

    2017-08-03

    Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral zoonotic disease caused by Crimean-Congo hemorrhagic fever virus (CCHFV), a member of the genus Nairovirus in the family Bunyaviridae. CCHF is typically asymptomatic in animals but can be highly fatal in humans approaching case fatality rate of approximately 30%. In the present investigation, a cross sectional study was conducted to determine the prevalence of CCHF and to identify the potential risk factors associated with CCHFV seropositivity among the one-humped camel (Camelus dromedaries) in Central Sudan. A total of 361 camels selected randomly from six localities were employed in the study. Sera sampled were tested for the presence of CCHFV-specific immunoglobulin G (IgG) antibodies using enzyme-linked immunosorbent assay (ELISA). CCHFV seropositivity was recorded in 77 out of 361 animals accounting for a prevalence rate of 21.3%. Age (OR = 3.6, CI = 1.72-7.79, p-value = 0.026); locality (OR = 5.85, CI = 1.81-18.83, p- value = 0.003), tick number (OR = 4.6, CI = 1.37-9.81, P-value 0.04); tick control (OR = 2.2, CI, 1.11-4.35, P-value = 0.023) and breed (OR = 6.60, CI = 2.38-18.36, P-value = 0.001) were recorded as potential risk factors for contracting CCHF. The prevalence of CCHF is significantly high among camels in Khartoum State, Sudan. Age, breed, locality and tick control are considered as potential risk factors for contracting CCHF. This study would be expected to reduce the impact on the livelihood of pastoral communities and ultimately avoid disease spread in human.

  15. Clinical symptoms and laboratory findings supporting early diagnosis of Crimean-Congo hemorrhagic fever in Iran.

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    Mostafavi, Ehsan; Pourhossein, Behzad; Chinikar, Sadegh

    2014-07-01

    Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic disease, which is usually transmitted to humans by tick bites or contact with blood or other infected tissues of livestock. Patients suffering from CCHF demonstrate an extensive spectrum of clinical symptoms. As it can take considerable time from suspecting the disease in hospital until reaching a definitive diagnosis in the laboratory, understanding the clinical symptoms and laboratory findings of CCHF patients is of paramount importance for clinicians. The data were collected from patients who were referred to the Laboratory of Arboviruses and Viral Hemorrhagic Fevers at the Pasteur institute of Iran with a primary diagnosis of CCHF between 1999 and 2012 and were assessed by molecular and serologic tests. Referred patients were divided into two groups: patients with a CCHF positive result and patients with a CCHF negative result. The laboratory and clinical findings of these two groups were then compared. Two-thousand five hundred thirty-six probable cases of CCHF were referred to the laboratory, of which 871 cases (34.3%) were confirmed to be CCHF. Contact with infected humans and animals increased the CCHF infection risk (P important role in patient survival and the application of the findings of this study can prove helpful as a key for early diagnosis. © 2014 Wiley Periodicals, Inc.

  16. Crimean-Congo Hemorrhagic Fever Virus Nucleocapsid Protein Augments mRNA Translation.

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    Jeeva, Subbiah; Cheng, Erdong; Ganaie, Safder S; Mir, Mohammad A

    2017-08-01

    Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne Nairovirus of the Bunyaviridae family, causing severe illness with high mortality rates in humans. Here, we demonstrate that CCHFV nucleocapsid protein (CCHFV-NP) augments mRNA translation. CCHFV-NP binds to the viral mRNA 5' untranslated region (UTR) with high affinity. It facilitates the translation of reporter mRNA both in vivo and in vitro with the assistance of the viral mRNA 5' UTR. CCHFV-NP equally favors the translation of both capped and uncapped mRNAs, demonstrating the independence of this translation strategy on the 5' cap. Unlike the canonical host translation machinery, inhibition of eIF4F complex, an amalgam of three initiation factors, eIF4A, eIF4G, and eIF4E, by the chemical inhibitor 4E1RCat did not impact the CCHFV-NP-mediated translation mechanism. However, the proteolytic degradation of eIF4G alone by the human rhinovirus 2A protease abrogated this translation strategy. Our results demonstrate that eIF4F complex formation is not required but eIF4G plays a critical role in this translation mechanism. Our results suggest that CCHFV has adopted a unique translation mechanism to facilitate the translation of viral mRNAs in the host cell cytoplasm where cellular transcripts are competing for the same translation apparatus. IMPORTANCE Crimean-Congo hemorrhagic fever, a highly contagious viral disease endemic to more than 30 countries, has limited treatment options. Our results demonstrate that NP favors the translation of a reporter mRNA harboring the viral mRNA 5' UTR. It is highly likely that CCHFV uses an NP-mediated translation strategy for the rapid synthesis of viral proteins during the course of infection. Shutdown of this translation mechanism might selectively impact viral protein synthesis, suggesting that an NP-mediated translation strategy is a target for therapeutic intervention against this viral disease. Copyright © 2017 American Society for Microbiology.

  17. Ribavirin for Crimean-Congo hemorrhagic fever: systematic review and meta-analysis

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    G Gail

    2010-07-01

    Full Text Available Abstract Background Crimean-Congo hemorrhagic fever epidemics often occur in areas where health services are limited, and result in high case fatality rates. Besides intensive care, ribavirin is often recommended. A solid evidence base for the use of this drug will help justify assuring access to the drug in areas where epidemics are common. Methods We carried out a systematic review of observational and experimental studies of people with suspected or confirmed Crimean-Congo hemorrhagic fever that included comparisons between patients given ribavirin and those not. We extracted data on mortality, hospital stay, and adverse events. Risk of bias was assessed using a standard checklist, and data were presented in meta-analytical graphs, stratified by study design, and GRADE tables presented. The risk of bias was summarised using the GRADE method. Results 21 unique studies, including one randomised controlled trial of ribavirin, were included. Quality of the evidence was very low, with a Down and Black median score of 4 (maximum possible 33. Ribavirin treatment was not shown to be superior to no ribavirin treatment for mortality rate in a single RCT (RR: 1.13, 95%CI: 0.29 to 4.32, 136 participants, GRADE=low quality evidence; but ribavirin was associated with reduced mortality by 44% when compared to no ribavirin treatment in the pooled observational studies (RR: 0.56, 95%CI: 0.35 to 0.90, 955 participants; GRADE=very low quality evidence. Adverse events were more common with the ribavirin patients, but no severe adverse events were reported. No difference in length of hospital stay was reported. Conclusions No clear message of benefit is available from the current data on ribavirin as observational data are heavily confounded, and the one trial carried out has limited power. However, ribavirin could potentially have benefits in this condition and these results clearly indicate a pragmatic, randomised controlled trial in the context of good quality

  18. Various clinical conditions can mimic Crimean-Congo hemorrhagic fever in pediatric patients in endemic regions

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    Soner S. Kara

    2016-09-01

    Full Text Available Summary: Crimean-Congo hemorrhagic fever (CCHF is a tick-borne disease with high mortality. Many disorders can mimic CCHF. It is important to recognize the condition and to perform differential diagnosis in endemic countries. Twenty-one children aged 18 years or less with a preliminary diagnosis of CCHF were retrospectively evaluated. Real-time PCR and a confirmatory indirect immunofluorescence assay for negative results were performed. The diagnoses determined that 9 patients had (42.9% CCHF; 7 patients had (33.3% viral upper respiratory tract infections (URTI; 2 patients had (9.5% brucellosis; 1 patients had (4.7% periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA syndrome episode; 1 patient had (4.7% cerebral palsy, diabetes insipidus, acute gastroenteritis, and hypernatremic dehydration; and 1 patient had (4.7% cellulitis after a tick bite. The mean age of patients with CCHF was greater than that of the other patients (116.1 ± 53.6 vs. 94.1 ± 52.1 months, p = 0.02. Seventeen (81% of the children included had a history of tick bites, 2 (9.5% had a history of contact with a patient with CCHF, and 2 (9.5% had no exposure, but were living in an endemic region. Three patients had an underlying disorder: cerebral palsy and diabetes insipidus, epilepsy, or PFAPA. All of the children experienced fever. Other frequent symptoms were malaise, diarrhea, vomiting, and abdominal pain, but none of these differed statistically between the patient groups. CCHF patients had a longer mean duration of symptoms (10.56 ± 1.42 vs. 6.75 ± 3.62 days, p = 0.008 and a longer mean length of hospitalization (8.00 ± 2.08 vs. 3.58 ± 1.56 days, p < 0.001 than the other patients. At laboratory examination, patients with CCHF had statistically significant lower leukocyte and platelet counts, more prolonged coagulation parameters, and greater AST, ALT, LDH, and CK levels than the other patients. No mortality or complications occurred

  19. Molecular epidemiology of Crimean-Congo hemorrhagic fever virus in Kosovo.

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    Luka Fajs

    Full Text Available Crimean-Congo hemorrhagic fever virus (CCHFV is a zoonotic agent that causes severe, life-threatening disease, with a case fatality rate of 10-50%. It is the most widespread tick-borne virus in the world, with cases reported in Africa, Asia and Eastern Europe. CCHFV is a genetically diverse virus. Its genetic diversity is often correlated to its geographical origin. Genetic variability of CCHFV was determined within few endemic areas, however limited data is available for Kosovo. Furthermore, there is little information about the spatiotemporal genetic changes of CCHFV in endemic areas. Kosovo is an important endemic area for CCHFV. Cases were reported each year and the case-fatality rate is significantly higher compared to nearby regions. In this study, we wanted to examine the genetic variability of CCHFV obtained directly from CCHF-confirmed patients, hospitalized in Kosovo from 1991 to 2013. We sequenced partial S segment CCHFV nucleotide sequences from 89 patients. Our results show that several viral variants are present in Kosovo and that the genetic diversity is high in relation to the studied area. We also show that variants are mostly uniformly distributed throughout Kosovo and that limited evolutionary changes have occurred in 22 years. Our results also suggest the presence of a new distinct lineage within the European CCHF phylogenetic clade. Our study provide the largest number of CCHFV nucleotide sequences from patients in 22 year span in one endemic area.

  20. Consensus report: Preventive measures for Crimean-Congo Hemorrhagic Fever during Eid-al-Adha festival.

    Science.gov (United States)

    Leblebicioglu, Hakan; Sunbul, Mustafa; Memish, Ziad A; Al-Tawfiq, Jaffar A; Bodur, Hurrem; Ozkul, Aykut; Gucukoglu, Ali; Chinikar, Sadegh; Hasan, Zahra

    2015-09-01

    Crimean-Congo hemorrhagic fever (CCHF) is endemic in Eurasian countries such as, Turkey, Pakistan, Afghanistan and Iran. CCHF virus is spread by the Hyalomma tick, which is found mainly on cattle and sheep. Muslim countries, in which these animals are sacrificed during Eid-Al-Adha, are among the countries where CCHF is endemic, and it has been observed that CCHF is associated with practices surrounding the Eid-ad-Adha festival. The dates for Eid-Al-Adha drift 10 days earlier in each year according to Georgian calendar. In previous years Eid-al-Adha occurred in autumn-winter months however in the next 10-15 years it will be take place in the summer months when CCHF is more prevalent. This may lead to a rise in the number of cases due to increased dissemination of CCHF virus with uncontrolled animal movements in and between countries. This consensus report focuses on the variable practices regarding animal handling in different regions and possible preventative measures to reduce the incidence of CCHF. Environmental hygiene and personal protection are essential parts of prevention. There is a need for international collaborative preparedness and response plans for prevention and management of CCHF during Eid-Al-Adha in countries where the disease is prevalent. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Evaluation of knowledge about protection against Crimean-Congo hemorrhagic fever.

    Science.gov (United States)

    Gungormus, Z; Kiyak, E

    2011-05-01

    This study was conducted in order to evaluate individuals' knowledge about protection against Crimean Congo hemorrhagic fever (CCHF). This descriptive study was carried out among 478 persons, to whom a Family Health Center located within boundaries of Erzurum Metropolitan Municipality, provides health service. A questionnaire form developed by the researchers was used for collecting data. Seventy-one point eight percent of individuals who participated in the study stated they had knowledge about CCHF, 25.9% stated that region was risky in terms of being bitten by ticks, 61.3% stated they could recognize ticks and 56.1% stated that not all tick bites cause the disease. Seventy-seven point eight percent stated CCHF is a virulent disease, 33.1% stated it can be transmitted from human to human and 30.3% stated it can be transmitted from animals to humans. In terms of protection from tick bites, 45, 15.3 and 11.3% of individuals stated wearing clothes to cover the whole body, carefully inspecting the body, and not touching ticks with bare hands, respectively, were good methods. Ninety-two point one percent stated it is necessary to go to a healthcare organization immediately in case of tick bite, whereas 18% of individuals stated it is necessary to remove the tick with tweezers or forceps. The results of this study show most individuals are not well informed about methods for protecting against CCHF, for removing ticks and what precautions to take to protect against tick bites.

  2. Molecular detection of Crimean-Congo hemorrhagic fever virus in ticks, Greece, 2012-2014.

    Science.gov (United States)

    Papa, Anna; Kontana, Anastasia; Tsioka, Katerina; Chaligiannis, Ilias; Sotiraki, Smaragda

    2017-11-01

    Crimean-Congo hemorrhagic fever virus (CCHFV) is transmitted to humans mainly through the bite of infected ticks. In Greece, only one clinical case has been observed, in 2008, but the seroprevalence in humans is relatively high (4.2%). To have a first insight into the circulation of CCHFV in Greece, 2000 ticks collected from livestock during 2012-2014 were tested. CCHFV was detected in 36 of the 1290 (2.8%) tick pools (1-5 ticks per pool). Two genetic lineages were identified: Europe 1 and Europe 2. Most Europe 1 sequences were obtained from Rhipicephalus sanguineus sensu lato ticks, while most Europe 2 sequences were recovered from Rhipicephalus bursa ticks. The number of collected Hyalomma marginatum ticks (the principal vector of CCHFV) was low (0.5% of ticks) and all were CCHFV negative. Since it is not known how efficient ticks of the Rhipicephalus genus are as vectors of the virus, laboratory studies will be required to explore the role of Rhipicephalus spp. ticks in CCHFV maintenance and transmission.

  3. Crimean-Congo hemorrhagic fever: Risk factors and control measures for the infection abatement

    Science.gov (United States)

    ASLAM, SAADIA; LATIF, MUHAMMAD SHAHZAD; DAUD, MUHAMMAD; RAHMAN, ZIA UR; TABASSUM, BUSHRA; RIAZ, MUHAMMAD SOHAIL; KHAN, ANWAR; TARIQ, MUHAMMAD; HUSNAIN, TAYYAB

    2016-01-01

    Crimean-Congo hemorrhagic fever (CCHF) is a vector-borne viral disease, widely distributed in different regions of the world. The fever is caused by the CCHF virus (CCHFV), which belongs to the Nairovirus genus and Bunyaviridae family. The virus is clustered in seven genotypes, which are Africa-1, Africa-2, Africa-3, Europe-1, Europe-2, Asia-1 and Asia-2. The virus is highly pathogenic in nature, easily transmissible and has a high case fatality rate of 10–40%. The reservoir and vector of CCHFV are the ticks of the Hyalomma genus. Therefore, the circulation of this virus depends upon the distribution of the ticks. The virus can be transmitted from tick to animal, animal to human and human to human. The major symptoms include headache, high fever, abdominal pain, myalgia, hypotension and flushed face. As the disease progresses, severe symptoms start appearing, which include petechiae, ecchymosis, epistaxis, bleeding gums and emesis. Enzyme-linked immunosorbent assay, quantitative polymerase chain reaction, antigen detection, serum neutralization and isolation of the virus by cell culture are the diagnostic techniques used for this viral infection. There is no specific antiviral therapy available thus far. However, ribavirin has been approved by the World Health Organization for the treatment of CCHFV infection. Awareness campaigns regarding the risk factors and control measures can aid in reducing the spread of this disease to a greater extent, particularly in developing countries. PMID:26870327

  4. Hard ticks (Ixodidae and Crimean-Congo hemorrhagic fever virus in south west of Iran.

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    Narges Sharifinia

    2015-03-01

    Full Text Available Ticks are vectors of some important arthropod-borne diseases in both fields of veterinary and medicine, such as Lyme, tularemia, Rocky Mountain spotted fever, and some types of encephalitis as well as Crimean Congo hemorrhagic fever (CCHF. Iran is known as one of the main foci of CCHF in west of Asia. This study was conducted in DarrehShahr County because of the development of animal husbandry in this area to detect the fauna and viral infection of the hard ticks of livestock. A cross-sectional survey was conducted during 2011-2012 with random sampling in four villages. A sample of ticks was subjected to RT-PCR method for detection of viral infection. During the study period, 592 Ixodidae ticks were collected and identified as seven species of Hyalomma asiaticum, Hy. marginatum, Hy. anatolicum, Hy. dromedarii, Hy. detritum, Rhipicephalus bursa and Rh. sanguineus. More than 20% of these ticks were examined to detect the genome of CCHF virus while 6.6% were positive. All species of Hyalomma were found to be positive. A high rate of livestock was found to be infected with hard ticks, which can act as the vectors of the CCHF disease. Regarding infection of all five Hyalomma species captured in this area, this genus should be considered as the main vector of CCHF. Planning control program can be performed based on the obtained data on seasonal activity of Ixodidae to prevent animal infestation as well as to reduce the risk of CCHF transmission.

  5. A case of Crimean-Congo hemorrhagic fever complicated with acute pancreatitis.

    Science.gov (United States)

    Bastug, Aliye; Kayaaslan, Bircan; But, Ayse; Aslaner, Halide; Sertcelik, Ahmet; Akinci, Esragul; Onguru, Pinar; Yetkin, Meltem Arzu; Bodur, Hurrem

    2014-11-01

    Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease characterized by nonspecific symptoms like fever, myalgia, severe headache, nausea, vomiting, diarrhea, and abdominal pain. It can result in various complications during the course of the disease due to the diffuse endothelial injury involved in the pathogenesis of CCHF. Here we present a patient with CCHF complicated by acute pancreatitis, including pleural and intra-abdominal effusions. A 70-year-old patient was referred to our hospital from an endemic area with the suspicion of CCHF. The physical examination of the patient revealed high fever (38°C), somnolence, and petechial eruption. The diagnosis of case was confirmed with positive reverse transcriptase polymerase chain reaction (RT-PCR). The viral load of the patient was 4×10(9) copies/mL. On the fifth day of admission, upper abdominal pain, scleral ichter, and abdominal distention developed. The patient had abdominal tenderness with guarding. The laboratory tests revealed an amylase level of 1740 U/L (28-100), lipase level of 583 U/L (13-60), and total bilirubin level of 3.75 mg/dL (<0.3). The diagnosis of acute pancreatitis was confirmed with radiological findings. Until now, atypical presentations of CCHF have been reported in some case reports, but not acute pancreatitis. To the best of our knowledge, this is the first case of acute pancreatitis in the literature seen in the course of CCHF.

  6. Epidemiological survey of Crimean Congo hemorrhagic fever virus in cattle in East Darfur State, Sudan.

    Science.gov (United States)

    Ibrahim, Alaa M; Adam, Ibrahim A; Osman, Badreldin T; Aradaib, Imadeldin E

    2015-06-01

    Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease caused by CCHF virus (CCHFV) of the genus Nairovirus in the family Bunyaviridae. CCHFV causes subclinical infection in domestic livestock and an often fatal hemorrhagic illness in humans, with approximately 30% mortality rates. In the present study, a cross-sectional serosurvey was conducted in a total of 282 randomly selected cattle from five localities in East Darfur State, Sudan. The exposure status to CCHF was determined using enzyme-linked immunosorbent assay (ELISA) for detection of CCHFV-specific IgG antibodies in cattle serum samples. The CCHFV-specific IgG antibodies were detected in 54 out of 282 animals, accounting for a 19.14% prevalence rate. Older cattle (>2 years of age) were approximately five times more likely to be infected with the virus (OR=4.90, CI=1.28-18.98, p-value=0.02). Heavily tick-infested cattle (ticks all over the body) were at 11 times higher at risk compared to tick-free animals (OR=11.11, CI=2.86-43.25, p-value=0.01). Grazing system is another factor affecting CCHF, where cattle grazing on open system were 27 times more at risk compared to other grazing systems (OR=27.22, CI=7.46-99.24, p-value=0.001). There was an association between localities and CCHF cattle (OR=0.24, CI=0.07-0.83, p-value=0.02). This study confirms the exposure of cattle to CCHF in East Darfur and identifies potential risk factors associated with the disease. Further epidemiological studies and improved surveillance are urgently needed to prevent a possible outbreak of CCHF among humans in the Darfur region of Sudan. Copyright © 2015 Elsevier GmbH. All rights reserved.

  7. [Two Crimean-Congo hemorrhagic fever cases without history of tick contact from Ankara region].

    Science.gov (United States)

    Kaya Kiliç, Esra; Yilmaz, Umut; Cesur, Salih; Koçak Tufan, Zeliha; Kurtoğlu, Yasemin; Bulut, Cemal; Kinikli, Sami; Irmak, Hasan; Demiröz, Ali Pekcan

    2009-10-01

    Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease presenting with flu-like symptoms, fever, hemorrhage and petechia. The virus (CCHFV) is a member of the Nairovirus genera of Bunyaviridae family and can be transmitted to humans by Hyalomma tick-bite, by exposure to infected blood and fomites of patient with CCHF or contact with animal tissue in viremic phase. In this study we present two cases with CCHF but without history of tick bite or exposure to infected fomites, even not coming from endemic areas. The first case was a 67 years old male patient presented with fever, fatique and shortness of breath. Physical examination revealed rales in right lower segments of lung. Laboratory findings showed elevation of liver enzymes with thrombocytopenia and prolonged prothrombin time. Serological markers for viral hepatitis, cytomegalovirus (CMV) and Epstein-Barr virus (EBV) were negative. The patient was found to be IgM and RNA positive for CCHFV by ELISA and polymerase chain reaction (PCR) methods, respectively. His history indicated a contact with livestock. The second patient was a 60 years old male dealing with husbandry. He had fever, fatique and myalgia. Physical examination revealed petechial rash on legs. Laboratory findings showed elevated liver enzymes, prolonged phrothrombin time and thrombocytopenia. Viral hepatitis markers, CMV-IgM and EBV-IgM were found negative. He was also found to be IgM and RNA positive for CCHFV in the reference laboratory. In conclusion, CCHF should be considered in the differential diagnosis of patients who contact with livestock and present with fever, fatigue, rash, elevated liver enzymes, thrombocytopenia and prolonged prothrombin time eventhough they do not reside in endemic areas for CCHF.

  8. Novel Molecular Beacon Probe-Based Real-Time RT-PCR Assay for Diagnosis of Crimean-Congo Hemorrhagic Fever Encountered in India

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    Aman Kamboj

    2014-01-01

    Full Text Available Crimean-Congo hemorrhagic fever (CCHF is an emerging zoonotic disease in India and requires immediate detection of infection both for preventing further transmission and for controlling the infection. The present study describes development, optimization, and evaluation of a novel molecular beacon-based real-time RT-PCR assay for rapid, sensitive, and specific diagnosis of Crimean-Congo hemorrhagic fever virus (CCHFV. The developed assay was found to be a better alternative to the reported TaqMan assay for routine diagnosis of CCHF.

  9. Molecular epidemiology of Crimean- Congo hemorrhagic fever virus genome isolated from ticks of Hamadan province of Iran

    DEFF Research Database (Denmark)

    Tahmasebi, F; Ghiasi, Seyed Mojtaba; Mostafavi, E

    2010-01-01

    BACKGROUND & OBJECTIVES: Crimean-Congo hemorrhagic fever (CCHF) virus is a tick-borne member of the genus Nairovirus, family Bunyaviridae. CCHFV has been isolated from at least 31 different tick species. The virus is transmitted through the bite of an infected tick, or by direct contact with CCHFV...... to each other. Even though they clustered in the same group with the strain circulating in Iran, they had a closer relationship to the Matin strain. INTERPRETATION & CONCLUSION: Vector control programs should be applied for reducing population density of potential tick vectors in this province. Further...

  10. Public Knowledge and Attitude toward Crimean Congo Hemorrhagic Fever in Tokat Turkey

    Directory of Open Access Journals (Sweden)

    R Yilmaz

    2009-12-01

    Full Text Available Background: The World health Organization (WHO declares Crimean Congo hemorrhagic fe­ver (CCHF endemic in Turkey. Despite the magnitude of problem, no documented evi­dence exists in Turkey, which reveals the aware­ness and practices of the country's adult popula­tion regarding CCHF, its spread, symptoms, treatment, and preven­tion. This study was conducted to assess the level of knowledge, attitudes, and practices regarding CCHF in people visit­ing terti­ary care hospital in Tokat, Turkey.Methods: This questionnaire based cross-sectional survey was conducted among patients' rela­tives or guardians who ad­mitted pediatric outpatient clinics during May-July 2008. The question­naire was composed of 25 questions.Results: A total of 1034 respondents participated in the survey. Sufficient knowledge about CCHF was not found in 28.9% of the sample. Literate individuals were relatively better informed about CCHF as compared to the illiterate peo­ple. Television and radio were con­sidered as the most important and useful source of information on the disease.Conclusion: We have found insufficient knowledge on CCHF in our population. It is thought to have no chance of suc­cess against a fatal disease such as CCHF, which has serious consequences, without the contribution of commu­nity. It is clear that there are important tasks for health, agri­culture, and media sectors to improve public knowledge and awareness about CCHF.

  11. Genetic Diversity of Crimean Congo Hemorrhagic Fever Virus Strains from Iran

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    Sadegh Chinikar

    2016-01-01

    Full Text Available Background: Crimean Congo hemorrhagic fever virus (CCHFV is a member of the Bunyaviridae family and Nairovirus genus. It has a negative-sense, single stranded RNA genome approximately 19.2 kb, containing the Small, Medium, and Large segments. CCHFVs are relatively divergent in their genome sequence and grouped in seven distinct clades based on S-segment sequence analysis and six clades based on M-segment sequences. Our aim was to obtain new insights into the molecular epidemiology of CCHFV in Iran.Methods: We analyzed partial and complete nucleotide sequences of the S and M segments derived from 50 Iranian patients. The extracted RNA was amplified using one-step RT-PCR and then sequenced. The sequences were ana­lyzed using Mega5 software.Results: Phylogenetic analysis of partial S segment sequences demonstrated that clade IV-(Asia 1, clade IV-(Asia 2 and clade V-(Europe accounted for 80 %, 4 % and 14 % of the circulating genomic variants of CCHFV in Iran respectively. However, one of the Iranian strains (Iran-Kerman/22 was associated with none of other sequences and formed a new clade (VII. The phylogenetic analysis of complete S-segment nucleotide sequences from selected Ira­nian CCHFV strains complemented with representative strains from GenBank revealed similar topology as partial sequences with eight major clusters. A partial M segment phylogeny positioned the Iranian strains in either associa­tion with clade III (Asia-Africa or clade V (Europe.Conclusion: The phylogenetic analysis revealed subtle links between distant geographic locations, which we pro­pose might originate either from international livestock trade or from long-distance carriage of CCHFV by infected ticks via bird migration.

  12. Crimean-Congo hemorrhagic fever virus in ticks collected from livestock in Albania.

    Science.gov (United States)

    Papa, Anna; Velo, Enkeleda; Kadiaj, Perparim; Tsioka, Katerina; Kontana, Anastasia; Kota, Majlinda; Bino, Silvia

    2017-10-01

    Albania is a Balkan country endemic for Crimean-Congo hemorrhagic fever (CCHF). It was shown previously that CCHF virus (CCHFV) sequences from Albanian patients cluster into Europe 1 clade. Aim of the present study was to test for CCHFV ticks collected in several regions of Albania, and to determine the genetic lineage(s) of the CCHFV strains in relation with their geographic distribution. A total of 726 ticks (366 Hyalomma marginatum, 349 Rhipicephalus bursa and 11 Rhipicephalus sanguineus) collected from livestock during 2007-2014 were included in the study. Thirty of 215 (13.9%) tick pools were positive for CCHFV. Lineage Europe 1 was detected in H. marginatum ticks collected in the endemic region of Albania, while lineage Europe 2 was detected mainly in R. bursa ticks in various regions of the country. Both genetic lineages were detected in the CCHF endemic area (northeastern Albania), while only Europe 2 lineage was detected in the south of the country. A higher genetic diversity was seen among Europe 2 than Europe 1 Albanian sequences (mean distance 3.7% versus 1%), suggesting a longer evolution of AP92-like strains (Europe 2) in their tick hosts. The present study shows that besides CCHFV lineage Europe 1, lineage Europe 2 is also present in Albania. Combined with results from recent studies, it is concluded that lineage Europe 2 is widely spread in the Balkans and Turkey, and is associated mainly with R. bursa ticks (at least in this region). Its pathogenicity and impact to the public health remain to be elucidated. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Emergence of viral hemorrhagic fevers: Is recent outbreak of crimean congo hemorrhagic fever in India an indication?

    Directory of Open Access Journals (Sweden)

    C Lahariya

    2012-01-01

    Full Text Available The emerging and re-emerging diseases are posing a great health risk for the last few years. One such category of diseases is viral haemorrhagic fevers (VHFs, which have emerged in the new territories, worldwide. Crimean Congo Hemorrhagic Fever (CCHF cases, for the first time in India, were reported from Gujarat, in January 2011. The emergence of diseases not reported earlier, pose great economic and social challenge, burden health system, and create panic reaction. Nonetheless, with recent experience in control of epidemic diseases, and advances in basic scientific knowledge; the public health community is better prepared for these unexpected events. This review provides information to physicians on CCHF for managing outbreak, and identifies public health measures to prevent emergence and re-emergence of VHFs (including CCHF in future. The authors suggest that though, there are a few challenging and unanswered questions, the public health preparedness still remains the key to control emerging and re-emerging diseases. The countries where virus activities have been reported need to be prepared accordingly.

  14. Molecular (ticks) and serological (humans) study of Crimean-Congo hemorrhagic fever virus in the Iberian Peninsula, 2013-2015.

    Science.gov (United States)

    Palomar, Ana M; Portillo, Aránzazu; Santibáñez, Sonia; García-Álvarez, Lara; Muñoz-Sanz, Agustín; Márquez, Francisco J; Romero, Lourdes; Eiros, José M; Oteo, José A

    Crimean-Congo hemorrhagic fever (CCHF) is a viral disease, mainly transmitted through tick bite, of great importance in Public Health. In Spain, Crimean-Congo hemorrhagic fever virus (CCHFV) was detected for the first time in 2010 in Hyalomma lusitanicum ticks collected from deer in Cáceres. The aim of this study was to investigate the presence of CCHFV in ticks from Cáceres, and from other Spanish areas, and to evaluate the presence of antibodies against the virus in individuals exposed to tick bites. A total of 2053 ticks (1333 Hyalomma marginatum, 680 H. lusitanicum and 40 Rhipicephalus bursa) were analyzed using molecular biology techniques (PCR) for CCHFV detection. The determination of specific IgG antibodies against CCHFV in 228 serum samples from humans with regular contact with ticks (at risk of acquiring the infection) was performed by indirect immunofluorescence assay. The CCHFV was not amplified in ticks, nor were antibodies against the virus found in the serum samples analyzed. The absence of the CCHFV in the ticks studied and the lack of antibodies against the virus in individuals exposed to tick bites would seem to suggest a low risk of acquisition of human infection by CCHFV in Spain. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  15. Molecular Assay on Crimean Congo Hemorrhagic Fever Virus in Ticks (Ixodidae) Collected from Kermanshah Province, Western Iran

    Science.gov (United States)

    Mohammadian, Maria; Chinikar, Sadegh; Telmadarraiy, Zakkyeh; Vatandoost, Hassan; Oshaghi, Mohammad Ali; Hanafi-Bojd, Ahmad Ali; Sedaghat, Mohammad Mehdi; Noroozi, Mehdi; Faghihi, Faezeh; Jalali, Tahmineh; Khakifirouz, Sahar; Shahhosseini, Nariman; Farhadpour, Firoozeh

    2016-01-01

    Background: Crimean-Congo Hemorrhagic Fever (CCHF) is a feverous and hemorrhagic disease endemic in some parts of Iran and caused by an arbovirus related to Bunyaviridae family and Nairovirusgenus. The main virus reservoir in the nature is ticks, however small vertebrates and a wide range of domestic and wild animals are regarded as reservoir hosts. This study was conducted to determine the infection rate of CCHF virus in hard ticks of Sarpole-Zahab County, Kermanshah province, west of Iran. Methods: From total number of 851 collected ticks from 8 villages, 131 ticks were selected randomlyand investigated for detection of CCHF virus using RT-PCR. Results: The virus was found in 3.8% of the tested ticks. Hyalommaanatolicum, H. asiaticum and Rhipicephalus sanguineus species were found to have viral infection, with the highest infection rate (11.11%) in Rh. sanguineus. Conclusion: These findings provide epidemiological evidence for planning control strategies of the disease in the study area. PMID:27308296

  16. Biosafety standards for working with Crimean-Congo hemorrhagic fever virus.

    Science.gov (United States)

    Weidmann, Manfred; Avsic-Zupanc, Tatjana; Bino, Silvia; Bouloy, Michelle; Burt, Felicity; Chinikar, Sadegh; Christova, Iva; Dedushaj, Isuf; El-Sanousi, Ahmed; Elaldi, Nazif; Hewson, Roger; Hufert, Frank T; Humolli, Isme; Jansen van Vuren, Petrus; Koçak Tufan, Zeliha; Korukluoglu, Gülay; Lyssen, Pieter; Mirazimi, Ali; Neyts, Johan; Niedrig, Matthias; Ozkul, Aykut; Papa, Anna; Paweska, Janusz; Sall, Amadou A; Schmaljohn, Connie S; Swanepoel, Robert; Uyar, Yavuz; Weber, Friedemann; Zeller, Herve

    2016-11-01

    In countries from which Crimean-Congo haemorrhagic fever (CCHF) is absent, the causative virus, CCHF virus (CCHFV), is classified as a hazard group 4 agent and handled in containment level (CL)-4. In contrast, most endemic countries out of necessity have had to perform diagnostic tests under biosafety level (BSL)-2 or -3 conditions. In particular, Turkey and several of the Balkan countries have safely processed more than 100 000 samples over many years in BSL-2 laboratories. It is therefore advocated that biosafety requirements for CCHF diagnostic procedures should be revised, to allow the tests required to be performed under enhanced BSL-2 conditions with appropriate biosafety laboratory equipment and personal protective equipment used according to standardized protocols in the countries affected. Downgrading of CCHFV research work from CL-4, BSL-4 to CL-3, BSL-3 should also be considered.

  17. Crimean-Congo Hemorrhagic Fever Virus Suppresses Innate Immune Responses via a Ubiquitin and ISG15 Specific Protease

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    Florine E.M. Scholte

    2017-09-01

    Full Text Available Antiviral responses are regulated by conjugation of ubiquitin (Ub and interferon-stimulated gene 15 (ISG15 to proteins. Certain classes of viruses encode Ub- or ISG15-specific proteases belonging to the ovarian tumor (OTU superfamily. Their activity is thought to suppress cellular immune responses, but studies demonstrating the function of viral OTU proteases during infection are lacking. Crimean-Congo hemorrhagic fever virus (CCHFV, family Nairoviridae is a highly pathogenic human virus that encodes an OTU with both deubiquitinase and deISGylase activity as part of the viral RNA polymerase. We investigated CCHFV OTU function by inactivating protease catalytic activity or by selectively disrupting its deubiquitinase and deISGylase activity using reverse genetics. CCHFV OTU inactivation blocked viral replication independently of its RNA polymerase activity, while deubiquitinase activity proved critical for suppressing the interferon responses. Our findings provide insights into viral OTU functions and support the development of therapeutics and vaccines.

  18. Mice orally immunized with a transgenic plant expressing the glycoprotein of Crimean-Congo hemorrhagic fever virus

    DEFF Research Database (Denmark)

    Ghiasi, Seyed Mojtaba; Salmanian, A H; Chinikar, S

    2011-01-01

    in their serum and feces, respectively. The mice in the fed/boosted group showed a significant rise in specific IgG antibodies after a single boost. Our results imply that oral immunization of animals with edible materials from transgenic plants is feasible, and further assessments are under way. In addition......While Crimean-Congo hemorrhagic fever (CCHF) has a high mortality rate in humans, the associated virus (CCHFV) does not induce clinical symptoms in animals, but animals play an important role in disease transmission to humans. Our aim in this study was to examine the immunogenicity of the CCHFV...... glycoprotein when expressed in the root and leaf of transgenic plants via hairy roots and stable transformation of tobacco plants, respectively. After confirmatory analyses of transgenic plant lines and quantification of the expressed glycoprotein, mice were either fed with the transgenic leaves or roots, fed...

  19. [A case of brucellosis and Crimean-Congo hemorrhagic fever coinfection in an endemic area].

    Science.gov (United States)

    Karakeçili, Faruk; Çıkman, Aytekin; Akın, Hicran; Gülhan, Barış; Özçiçek, Adalet

    2016-04-01

    Brucellosis, a zoonotic disease which is especially seen in developing countries is still an important public health problem worldwide. Crimean-Congo hemorrhagic fever (CCHF) is another zoonotic disease that transmits to humans by infected tick bites as well as exposure to blood or tissue from infected animals. Both of the diseases are common among persons who live in rural areas and deal with animal husbandry. Since brucellosis usually presents with non-specific clinical symptoms and may easily be confused with many other diseases, the diagnosis of those infections could be delayed or misdiagnosed. In this report, a case of coinfection of brucellosis and CCHF has been presented to emphasize the possibility of association of these infections. A 70-year-old female patient with a history of dealing with animal husbandry in a rural area admitted to our hospital with the complaints of fever, malaise, generalized body and joint pains, and headache. Her complaints had progressed within the past two days. She also reported nausea, vomiting, abdominal pain and bloody diarrhea. She denied any history of tick bites. Her physical examination was significant for the presence of 38.8°C fever, increased bowel sounds and splenomegaly. Laboratory analysis revealed leukopenia, thrombocytopenia and high levels of liver enzymes. The patient was admitted to our service with the prediagnosis of CCHF. Serum sample was sent to the Department of Microbiology Reference Laboratory at Public Health Agency of Turkey for CCHF testing. During patient's hospitalization in service, more detailed history was confronted and it was learned that she had fatigue, loss of appetite, sweating, joint pain, and intermittent fever complaints were continuing within a month and received various antibiotic treatments. The tests for brucellosis were conducted and positive results for Brucella Rose Bengal test, tube agglutination (1/160 titers) and immune capture test with Coombs (1/320 titers) were determined

  20. Awareness among butchers regarding crimean congo hemorrhagic fever in rawalpindi cantt

    International Nuclear Information System (INIS)

    Khaleeq, T.A.; Rahman, M.U.; Tariq, N.A.; Mashhadi, S.F.; Jamil, R.

    2016-01-01

    To study the awareness of butchers regarding Crimean-Congo Haemorrhagic fever (CCHF) in relation to their education level. Study Design: Cross sectional survey. Place and Duration of Study: Conducted from January to March 2015 in Qasaiee Chowk and Tench Bhatta markets of ward 5 of Rawalpindi cantt. Material and Methods: Sample size was calculated using G-Power sample size calculator at 95 percent confidence level with an effect size of 0.38. Ward 5 of Rawalpindi cantt was chosen through lottery method and all available professional butchers in the markets were interviewed with informed consent. A pre-tested 14 items closed ended questionnaire was used and interview was conducted by a well briefed team of medical students. Data was analyzed using SPSS version 20.0. Results: Results showed that only 14 (9.33 percent) butchers knew the name of CCHF. Out of these 10 (71.4 percent) had some form of formal education. All 14 of these had heard about CCHF from television proving it to be an important medium of information. However none of the 150 respondents took any preventive measure against CCHF. Conclusion: Our study concluded that the level of awareness regarding CCHF in butchers is very low and no preventive measures are taken by them. Also the level of education has a significant effect on the awareness. (author)

  1. Molecular Assay on Crimean Congo Hemorrhagic Fever Virus in Ticks (Ixodidae Collected from Kermanshah Province, Western Iran

    Directory of Open Access Journals (Sweden)

    Maria Mohammadian

    2016-01-01

    Full Text Available Background: Crimean-Congo Hemorrhagic Fever (CCHF is a feverous and hemorrhagic disease endemic in some parts of Iran and caused by an arbovirus related to Bunyaviridae family and Nairovirusgenus. The main virus reser­voir in the nature is ticks, however small vertebrates and a wide range of domestic and wild animals are regarded as reservoir hosts. This study was conducted to determine the infection rate of CCHF virus in hard ticks of Sarpole-Zahab County, Kermanshah province, west of Iran.Methods: From total number of 851 collected ticks from 8 villages, 131 ticks were selected randomlyand investi­gated for detection of CCHF virus using RT-PCR.Results: The virus was found in 3.8% of the tested ticks. Hyalommaanatolicum, H.asiaticum and Rhipicephalus sanguineus species were found to have viral infection, with the highest infection rate (11.11% in Rh. sanguineus.Conclusion: These findings provide epidemiological evidence for planning control strategies of the disease in the study area.

  2. Protective role of host aquaporin 6 against Hazara virus, a model for Crimean-Congo hemorrhagic fever virus infection.

    Science.gov (United States)

    Molinas, Andrea; Mirazimi, Ali; Holm, Angelika; Loitto, Vesa M; Magnusson, Karl-Eric; Vikström, Elena

    2016-04-01

    Crimean-Congo hemorrhagic fever virus (CCHFV) is an arthropod-borne pathogen that causes infectious disease with severe hemorrhagic manifestations in vascular system in humans. The proper function of the cells in the vascular system is critically regulated by aquaporins (AQP), water channels that facilitate fluxes of water and small solutes across membranes. With Hazara virus as a model for CCHFV, we investigated the effects of viruses on AQP6 and the impact of AQP6 on virus infectivity in host cells, using transiently expressed GFP-AQP6 cells, immunofluorescent assay for virus detection, epifluorescent imaging of living cells and confocal microscopy. In GFP-AQP6 expressing cells, Hazara virus reduced both the cellular and perinuclear AQP6 distribution and changed the cell area. Infection of human cell with CCHFV strain IbAR 10200 downregulated AQP6 expression at mRNA level. Interestingly, the overexpression of AQP6 in host cells decreased the infectivity of Hazara virus, speaking for a protective role of AQP6. We suggest the possibility for AQP6 being a novel player in the virus-host interactions, which may lead to less severe outcomes of an infection. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Crimean-Congo hemorrhagic fever in pregnancy: A systematic review and case series from Russia, Kazakhstan and Turkey.

    Science.gov (United States)

    Pshenichnaya, Natalia Yurievna; Leblebicioglu, Hakan; Bozkurt, Ilkay; Sannikova, Irina Viktorovna; Abuova, Gulzhan Narkenovna; Zhuravlev, Andrey Sergeevich; Barut, Sener; Shermetova, Mutabar Bekovna; Fletcher, Tom E

    2017-05-01

    Crimean-Congo hemorrhagic fever (CCHF) is acute viral infection and a major emerging infectious diseases threat, affecting a large geographical area. There is no proven antiviral therapy and it has a case fatality rate of 4-30%. The natural history of disease and outcomes of CCHF in pregnant women is poorly understood. To systematically review the characteristics of CCHF in pregnancy, and report a case series of 8 CCHF cases in pregnant women from Russia, Kazakhstan and Turkey. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement protocol. PubMed, SCOPUS, Science Citation Index (SCI) were searched for reports published between January 1960 and June 2016. Two independent reviewers selected and reviewed studies and extracted data. Thirty-four cases of CCHF in pregnancy were identified, and combined with the case series data, 42 cases were analyzed. The majority of cases originated in Turkey (14), Iran (10) and Russia (6). There was a maternal mortality of 14/41(34%) and fetal/neonatal mortality of in 24/41 cases (58.5%). Hemorrhage was associated with maternal (p=0.009) and fetal/neonatal death (p<0.0001). There was nosocomial transmission to 38 cases from 6/37 index pregnant cases. Cases of CCHF in pregnancy are rare, but associated with high rates of maternal and fetal mortality, and nosocomial transmission. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Crimean-Congo Hemorrhagic Fever Virus and Borrelia burgdorferi sensu lato in Ticks from Kosovo and Albania.

    Science.gov (United States)

    Sherifi, Kurtesh; Rexhepi, Agim; Berxholi, Kristaq; Mehmedi, Blerta; Gecaj, Rreze M; Hoxha, Zamira; Joachim, Anja; Duscher, Georg G

    2018-01-01

    Tick-borne diseases pose a serious threat to human health in South-Eastern Europe, including Kosovo. While Crimean-Congo hemorrhagic fever (CCHF) is a well-known emerging infection in this area, there are no accurate data on Lyme borreliosis and tick-borne encephalitis (TBE). Therefore, we sampled and tested 795 ticks. Ixodes ricinus ( n  = 218), Dermacentor marginatus ( n  = 98), and Haemaphysalis spp. ( n  = 24) were collected from the environment by flagging (all from Kosovo), while Hyalomma marginatum ( n  = 199 from Kosovo, all from Kosovo) and Rhipicephalus bursa ( n  = 130, 126 from Albania) could be collected only by removal from animal pasture and domestic ruminants. Ticks were collected in the years 2014/2015 and tested for viral RNA of CCHF and TBE viruses, as well as for DNA of Borrelia burgdorferi sensu lato by real-time PCR. In Kosovo, nine ticks were positive for RNA of Crimean-Congo hemorrhagic fever virus and seven for DNA of B. burgdorferi s. l. None of the ticks tested positive for TBEV. CCHF virus was detected in one H. marginatum male specimen collected while feeding on grazing cattle from the Prizren region and in eight R. bursa specimens (five females and three males collected while feeding on grazing sheep and cattle) from the Prishtina region (Kosovo). B. burgdorferi s. l. was detected in seven questing ticks (four male and one female D. marginatus , two I. ricinus one female and one male) from the Mitrovica region (Kosovo). Our study confirmed that CCHF virus is circulating in Kosovo mainly in H. marginatum and R. bursa in the central areas of the country. B. burgdorferi s. l. was found in its major European host tick, I. ricinus , but also in D. marginatus , in the north of the Kosovo. In order to prevent the spread of these diseases and better control of the tick-borne infections, an improved vector surveillance and testing of ticks for the presence of pathogens needs to be established.

  5. Inherent dynamics within the Crimean-Congo Hemorrhagic fever virus protease are localized to the same region as substrate interactions

    Energy Technology Data Exchange (ETDEWEB)

    Eisenmesser, Elan Z.; Capodagli, Glenn; Armstrong, Geoffrey S.; Holliday, Michael; Isern, Nancy G.; Zhang, Fengli; Pegan, Scott D.

    2015-05-01

    Crimean-Congo Hemorrhagic fever virus (CCHFV) is one of several lethal viruses that encodes for a viral ovarian tumor domain (vOTU), which serves to cleave and remove multiple proteins involved in cellular signaling such as ubiquitin (Ub) and interferon stimulated gene produce 15 (ISG15). Such manipulation of the host cell machinery serves to downregulate the host response and, therefore, complete characterization of these proteases is important. While several structures of the CCHFV vOTU protease have been solved, both free and bound to Ub and ISG15, few structural differences have been found and little insight has been gained as to the dynamic plasticity of this protease. Therefore, we have used NMR relaxation experiments to probe the dynamics of CCHV vOTU, both alone and in complex with Ub, thereby discovering a highly dynamic protease that exhibits conformational exchange within the same regions found to engage its Ub substrate. These experiments reveal a structural plasticity around the N-terminal regions of CCHV vOTU, which are unique to vOTUs, and provide a rationale for engaging multiple substrates with the same binding site.

  6. Combination of RT-PCR and proteomics for the identification of Crimean-Congo hemorrhagic fever virus in ticks

    Directory of Open Access Journals (Sweden)

    Isabel G. Fernández de Mera

    2017-07-01

    Full Text Available Crimean-Congo hemorrhagic fever (CCHF is an emerging tick-borne zoonotic disease caused by the CCHF virus (CCHFV. In this study, an experimental approach combining RT-PCR and proteomics was used for the identification and characterization of CCHFV in 106 ticks from 7 species that were collected from small ruminants in Greece. The methodological approach included an initial screening for CCHFV by RT-PCR followed by proteomics analysis of positive and control negative tick samples. This novel approach allowed the identification of CCHFV-positive ticks and provided additional information to corroborate the RT-PCR findings using a different approach. Two ticks, Dermacentor marginatus and Haemaphysalis parva collected from a goat and a sheep, respectively were positive for CCHFV. The sequences for CCHFV RNA segments S and L were characterized by RT-PCR and proteomics analysis of tick samples, respectively. These results showed the possibility of combining analyses at the RNA and protein levels using RT-PCR and proteomics for the characterization of CCHFV in ticks. The results supported that the CCHFV identified in ticks are genetic variants of the AP92 strain. Although the AP92-like strains probably do not represent a high risk of CCHF to the population, the circulation of genetically diverse CCHFV strains could potentially result in the appearance of novel viral genotypes with increased pathogenicity and fitness.

  7. Increased Levels of VEGF-A and HIF-1α in Turkish Children with Crimean-Congo Hemorrhagic Fever

    Directory of Open Access Journals (Sweden)

    Murat Sefikogullari

    2017-04-01

    Full Text Available Background: Crimean-Congo Hemorrhagic Fever (CCHF is a disease characterized by serious course, including acute viral fever, ecchymosis, thrombocytopenia, liver dysfunction and high rate of mortality. Hypoxia Inducible Factor-1α (HIF-1α and Vascular Endothelial Growth Factor-A (VEGF-A play an important role both in the inflamma­tory process and plasma leakage. The aim of this study was to define HIF-1α and VEGF-A serum levels obtained from CCHF patients and control group and to investigate whether these factors were correlated with the pathogenesis of this disease.Methods: Thirty cases younger than 17 yr confirmed by RT-PCR and/or ELISA for CCHF were included in this study. Thirty age and sex matched healthy peoples were enrolled as controls. Blood samples collected from the pa­tient and control groups. Serum levels of HIF-1α and VEGF-A were measured with ELISA.Results: Levels of HIF-1α and VEGF-A were statistically significantly increased in CCHF patients compared to the control group (P< 0.05.  A significant positive correlation was found between the levels of HIF-1α and VEGF-A in the patient group (P< 0.01. The levels of ALT, AST, CK, aPTT, WBC and Thrombocyte count were significantly higher in the patients than in the control group (P< 0.001. A positive correlation was found among the levels of AST and CK from biochemical parame­ters and VEGF and HIF-1α in the patient group (P< 0.05Conclusion: HIF-1α and VEGF-A might play an important role in CCHF pathogenesis.

  8. Crimean-Congo hemorrhagic fever virus clades V and VI (Europe 1 and 2 in ticks in Kosovo, 2012.

    Directory of Open Access Journals (Sweden)

    Kurtesh Sherifi

    2014-09-01

    Full Text Available Despite being a small country, Kosovo represents one of the few foci of Crimean-Congo hemorrhagic fever (CCHF in Europe. The distribution of Kosovar tick vectors and the evolution of CCHF virus in ticks are both as yet unknown. A better description of the extent and the genetic diversity of CCHFV in ticks from endemic settings is essential, in order to be controlled. We investigated the 2012 distribution of Kosovar ticks alongside the prevalence and the phylogeography of tick-derived CCHFV. Hyalomma marginatum dominated in the endemic municipalities with 90.2% versus 24.3% in the non-endemic regions. Of 1,102 tested ticks, 40 (3.6% were CCHFV-positive, belonging to H. marginatum (29, Rhipicephalus bursa (10, and Ixodes ricinus (1. The virus strains clustered with clade V and VI related sequences. They fell into two lineages: Kosovo I and II. Kosovo I comprised strains recovered exclusively from R. bursa ticks and was closely related to AP92 prototype strain. Kosovo II clustered into Kosovo IIa, including human-derived strains, and IIb including only strains detected in H. marginatum and I. ricinus. Our phylogeographic reconstruction suggests two temporally distinct CCHFV introductions: the most probable location of the most recent common ancestor of Kosovo I lineage was in Greece (63 years ago and that of lineages IIa-b in Turkey (35 years ago. After each CCHFV introduction into Kosovo, subsequent lineage expansions suggest periods of in situ evolution. The study provides the first insight into the genetic variability and the origin of CCHFV in ticks from Kosovo. Our findings indicate the spreading of CCHFV to non-endemic areas, which underlines the importance of further studies in order to monitor and predict future CCHF outbreaks in Kosovo. The AP92-like strains appear to be more widespread than previously thought and may provide a promising target for experimental studies due to their assumed low pathogenicity.

  9. The Non-structural Protein of Crimean-Congo Hemorrhagic Fever Virus Disrupts the Mitochondrial Membrane Potential and Induces Apoptosis*

    Science.gov (United States)

    Barnwal, Bhaskar; Karlberg, Helen; Mirazimi, Ali; Tan, Yee-Joo

    2016-01-01

    Viruses have developed distinct strategies to overcome the host defense system. Regulation of apoptosis in response to viral infection is important for virus survival and dissemination. Like other viruses, Crimean-Congo hemorrhagic fever virus (CCHFV) is known to regulate apoptosis. This study, for the first time, suggests that the non-structural protein NSs of CCHFV, a member of the genus Nairovirus, induces apoptosis. In this report, we demonstrated the expression of CCHFV NSs, which contains 150 amino acid residues, in CCHFV-infected cells. CCHFV NSs undergoes active degradation during infection. We further demonstrated that ectopic expression of CCHFV NSs induces apoptosis, as reflected by caspase-3/7 activity and cleaved poly(ADP-ribose) polymerase, in different cell lines that support CCHFV replication. Using specific inhibitors, we showed that CCHFV NSs induces apoptosis via both intrinsic and extrinsic pathways. The minimal active region of the CCHFV NSs protein was determined to be 93–140 amino acid residues. Using alanine scanning, we demonstrated that Leu-127 and Leu-135 are the key residues for NSs-induced apoptosis. Interestingly, CCHFV NSs co-localizes in mitochondria and also disrupts the mitochondrial membrane potential. We also demonstrated that Leu-127 and Leu-135 are important residues for disruption of the mitochondrial membrane potential by NSs. Therefore, these results indicate that the C terminus of CCHFV NSs triggers mitochondrial membrane permeabilization, leading to activation of caspases, which, ultimately, leads to apoptosis. Given that multiple factors contribute to apoptosis during CCHFV infection, further studies are needed to define the involvement of CCHFV NSs in regulating apoptosis in infected cells. PMID:26574543

  10. Host preferences support the prominent role of Hyalomma ticks in the ecology of Crimean-Congo hemorrhagic fever.

    Directory of Open Access Journals (Sweden)

    Jessica R Spengler

    2018-02-01

    Full Text Available Crimean-Congo hemorrhagic fever virus (CCHFV is a tick-borne zoonotic agent that is maintained in nature in an enzootic vertebrate-tick-vertebrate cycle. Hyalomma genus ticks have been implicated as the main CCHFV vector and are key in maintaining silent endemic foci. However, what contributes to their central role in CCHFV ecology is unclear. To assess the significance of host preferences of ticks in CCHFV ecology, we performed comparative analyses of hosts exploited by 133 species of ticks; these species represent 5 genera with reported geographical distribution over the range of CCHFV. We found that the composition of vertebrate hosts on which Hyalomma spp. feed is different than for other tick genera. Immatures of the genus Hyalomma feed preferentially on species of the orders Rodentia, Lagomorpha, and the class Aves, while adults concentrate mainly on the family Bovidae. With the exception of Aves, these hosts include the majority of the vertebrates consistently reported to be viremic upon CCHFV infection. While other tick genera also feed on these hosts, Hyalomma spp. almost completely concentrate their populations on them. Hyalomma spp. feed on less phylogenetically diverse hosts than any other tick genus, implying that this network of hosts has a low resilience. Indeed, removing the most prominent hosts quickly collapsed the network of parasitic interactions. These results support the intermittent activity of CCHFV foci: likely, populations of infected Hyalomma spp. ticks exceed the threshold of contact with humans only when these critical hosts reach adequate population density, accounting for the sporadic occurence of clinical tick-transmitted cases. Our data describe the association of vertebrate host preferences with the role of Hyalomma spp. ticks in maintaining endemic CCHFV foci, and highlight the importance of host-tick dynamics in pathogen ecology.

  11. A comparison of clinical diagnosis and serological diagnosis in an epidemic of Crimean-Congo Hemorrhagic Fever

    International Nuclear Information System (INIS)

    Nadeem, M.; Ali, N.; Anwar, M.

    2003-01-01

    Crimean Congo Hemorrhagic Fever (CCHF) is the life-threatening disease caused by Nairovirus of genus Bunya virus caused by tick bite of Hayalomma species or by direct contact of the blood/sera of the patient and animals suffering from this disease. Epidemics have been occurring in Balochistan province of Pakistan and neighboring Afghanistan and Iran from time to time with this mortality. Aim: In the absence of facilities for detection of serological markers of CCHF (IgM Et IgG antibodies and PCR for viral RNA), a study was designed to diagnose and treat cases of CCHF reporting to a specialist unit hospital situated at Quetta, Pakistan. The aim was to compare the clinical features, complications and outcome of both groups of patients: one detecting the disease clinically only and the other depending upon serological tests for the diagnosis. Methods: Thirty-four patients having fever of less than two weeks of duration with features of bleeding from the skin and various orifices were included in this study from June 2001 to September 2001 after hospitalization. Index case and some of the consecutive cases were subjected to detection of serological markers. Rest of the cases were diagnosed on clinical ground and baseline laboratory investigations only. Difference in both the group was noted carefully. All the patients were given Ribavirin and blood products as and when required. Results: Statistically there was no obvious difference in clinical manifestations (fever, body aches, purpuric spots, ecchymosis, epistaxis, gum bleed etc. ) and laboratory findings (blood picture, serum ALT, serum urea and electrolytes, PT, APTT, etc). There was also no difference in mortality of the two groups studied. Conclusion: In an on ongoing outbreak of CCHF, history, clinical findings and supportive baseline, laboratory investigations may be sufficient for early detection and treatment of CCHF cases. However for documentation of start of epidemic, serological markers should be done

  12. Increased serum ferritin levels in patients with Crimean-Congo hemorrhagic fever: can it be a new severity criterion?

    Science.gov (United States)

    Barut, Sener; Dincer, Fatma; Sahin, Idris; Ozyurt, Huseyin; Akkus, Mehmet; Erkorkmaz, Unal

    2010-01-01

    Serum ferritin is one of the markers indicating hemophagocytosis that may have a role in the pathogenesis of Crimean-Congo hemorrhagic fever (CCHF). This study was designed to determine any correlation between serum ferritin and routine diagnostic laboratory markers of CCHF, and to investigate the relationship between serum ferritin levels and disease severity. Sixty-six patients with CCHF admitted to the hospital during the spring and summer months of 2006 and 2007 were included in the study. Serum ferritin levels were measured in sera obtained during the initial days of hospitalization. Data from 53 patients showing decreasing platelet counts over the first three days were used for further analysis and these patients were divided into two groups according to disease severity: group A included severe cases with lowest platelet counts 20x10(9)/l. Forty patients (60.6%) were male (mean age 43+/-17 years). Three patients died, thus the fatality rate was 4.5%. Fifty-one patients (77.3%) had abnormal serum ferritin levels, with levels above 500 ng/ml in 62.1%. There was a significant negative correlation between ferritin levels and concordant platelet counts (p or =1862ng/ml had a sensitivity of 87.5% and a specificity of 83.8% in differentiating severe cases from mild ones. Increased serum ferritin levels may suggest a significant role of hemophagocytosis in the pathogenesis of CCHF and may be a useful marker for diagnosis, disease activity, and prognosis. Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  13. Serological evaluation of Crimean-Congo hemorrhagic fever in humans with high-risk professions living in enzootic regions of Isfahan province of Iran and genetic analysis of circulating strains

    DEFF Research Database (Denmark)

    Chinikar, Sadegh; Ghiasi, Seyed Mojtaba; Naddaf, Saeed

    2012-01-01

    Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease that is asymptomatic in infected livestock, but causes a serious threat to humans with a mortality rate up to 50%. Although the CCHF virus (CCHFV) is often transmitted by ticks, livestock-to-human and human-to-human transmission a...

  14. Seroepidemiology and risk factors of Crimean-Congo Hemorrhagic Fever among butchers and slaughterhouse workers in southeastern Iran

    Directory of Open Access Journals (Sweden)

    Ehsan Mostafavi

    2017-11-01

    Full Text Available Objective: Crimean-Congo Haemorrhagic Fever (CCHF is a viral zoonotic disease. Butchers and slaughterhouse workers are considered to be high risk occupational groups for the disease. Sistan and Baluchistan province is an area in southeastern Iran which is endemic for CCHF, and the most confirmed cases of the disease are reported from this province. The aim of this study was to investigate the seroprevalence of CCHF and risk factors for seropositivity among them in Sistan and Baluchistan province in 2011. Methods: Questionnaire data and blood sample collection were carried out for each participant and the sera samples were sent to the national reference laboratory for ELISA IgG testing. Results: In this study, the seroprevalence of CCHF among 190 butchers and slaughterhouse workers from 11 counties was 16.49%. 79% of participants were aware that they were at risk of zoonosis and 39.7% did not use any personal protective equipment during their work. Of 31 CCHF IgG positive individuals in this study, eleven individuals had a previous record of CCHF infection in 57 months prior to the study. Conclusions: High seroprevalence of CCHF among butchers and slaughterhouse workers and minimal use of personal protective equipment’s during daily work indicates the need for training courses, for these groups to increase their knowledge, attitude and practice with respect to zoonosis. Keywords: Seroepidemiology, Crimean-Congo Haemorrhagic Fever, Butchers, Slaughterhouse Workers, Iran

  15. Structural Analysis of a Viral Ovarian Tumor Domain Protease from the Crimean-Congo Hemorrhagic Fever Virus in Complex with Covalently Bonded Ubiquitin

    Energy Technology Data Exchange (ETDEWEB)

    Capodagli, Glenn C.; McKercher, Marissa A.; Baker, Erica A.; Masters, Emily M.; Brunzelle, Joseph S.; Pegan, Scott D. (Denver); (NWU)

    2014-10-02

    Crimean-Congo hemorrhagic fever (CCHF) virus is a tick-borne, negative-sense, single-stranded RNA [ssRNA(-)] nairovirus that produces fever, prostration, and severe hemorrhages in humans. With fatality rates for CCHF ranging up to 70% based on several factors, CCHF is considered a dangerous emerging disease. Originally identified in the former Soviet Union and the Congo, CCHF has rapidly spread across large sections of Europe, Asia, and Africa. Recent reports have identified a viral homologue of the ovarian tumor protease superfamily (vOTU) within its L protein. This protease has subsequently been implicated in downregulation of the type I interferon immune response through cleavage of posttranslational modifying proteins ubiquitin (Ub) and the Ub-like interferon-simulated gene 15 (ISG15). Additionally, homologues of vOTU have been suggested to perform similar roles in the positive-sense, single-stranded RNA [ssRNA(+)] arteriviruses. By utilizing X-ray crystallographic techniques, the structure of vOTU covalently bound to ubiquitin propylamine, a suicide substrate of the enzyme, was elucidated to 1.7 {angstrom}, revealing unique structural elements that define this new subclass of the OTU superfamily. In addition, kinetic studies were carried out with aminomethylcoumarin (AMC) conjugates of monomeric Ub, ISG15, and NEDD8 (neural precursor cell expressed, developmentally downregulated 8) substrates in order to provide quantitative insights into vOTU's preference for Ub and Ub-like substrates.

  16. Crimean-Congo Haemorrhagic Fever in Kosova : a fatal case report

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    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.

  17. Interim Report on SNP analysis and forensic microarray probe design for South American hemorrhagic fever viruses, tick-borne encephalitis virus, henipaviruses, Old World Arenaviruses, filoviruses, Crimean-Congo hemorrhagic fever viruses, Rift Valley fever

    Energy Technology Data Exchange (ETDEWEB)

    Jaing, C; Gardner, S

    2012-06-05

    The goal of this project is to develop forensic genotyping assays for select agent viruses, enhancing the current capabilities for the viral bioforensics and law enforcement community. We used a multipronged approach combining bioinformatics analysis, PCR-enriched samples, microarrays and TaqMan assays to develop high resolution and cost effective genotyping methods for strain level forensic discrimination of viruses. We have leveraged substantial experience and efficiency gained through year 1 on software development, SNP discovery, TaqMan signature design and phylogenetic signature mapping to scale up the development of forensics signatures in year 2. In this report, we have summarized the whole genome wide SNP analysis and microarray probe design for forensics characterization of South American hemorrhagic fever viruses, tick-borne encephalitis viruses and henipaviruses, Old World Arenaviruses, filoviruses, Crimean-Congo hemorrhagic fever virus, Rift Valley fever virus and Japanese encephalitis virus.

  18. Reverse transcription PCR-based detection of Crimean-Congo hemorrhagic fever virus isolated from ticks of domestic ruminants in Kurdistan province of Iran.

    Science.gov (United States)

    Fakoorziba, Mohammad Reza; Golmohammadi, Parvaneh; Moradzadeh, Rahmatollah; Moemenbellah-Fard, Mohammad Djaefar; Azizi, Kourosh; Davari, Behrooz; Alipour, Hamzeh; Ahmadnia, Sara; Chinikar, Sadegh

    2012-09-01

    Crimean-Congo hemorrhagic fever (CCHF) is a potentially fatal viral vector-borne zoonosis which has a mortality rate of up to 30% without treatment in humans. CCHF virus is transmitted to humans by ticks, predominantly from the Hyalomma genus. Following the report of two confirmed and one suspected death due to CCHF virus in Kurdistan province of Iran in 2007, this study was undertaken to determine the fauna of hard ticks on domestic ruminants (cattle, sheep, and goats) and their possible infection with CCHF virus using reverse transcription PCR technique. This is the first detection of CCHF virus in ticks from the Kurdistan province of Iran. Overall, 414 ixodid ticks were collected from two districts in this province. They represented four genera from which 10 separate species were identified. The Hyalomma genus was the most abundant tick genus (70%). It was the only genus shown to be infected with the CCHF virus using RT-PCR technique. The number of ticks positive for CCHF virus was 5 out of 90 (5.6%) adult ticks. The three remaining genera (Haemaphysalis, Rhipicephalus, and Dermacentor) were all negative following molecular survey. Four of the five virally-infected ticks were from cattle mainly in the Sanandaj district. We concluded that CCHF virus is present in the Hyalomma ticks on domestic ruminants (cattle) in Kurdistan province of Iran.

  19. Co-circulation of Crimean-Congo Hemorrhagic Fever virus strains Asia 1 and 2 between the border of Iran and Pakistan.

    Science.gov (United States)

    Shahhosseini, Nariman; Jafarbekloo, Ahmad; Telmadarraiy, Zakkyeh; Chinikar, Sadegh; Haeri, Ali; Nowotny, Norbert; Groschup, Martin H; Fooks, Anthony R; Faghihi, Faezeh

    2017-11-01

    Crimean-Congo Hemorrhagic Fever (CCHF) is a tick-borne viral disease that is transmitted by numerous species of ticks, which serve both as a reservoir and vector of CCHF virus (CCHFV). Molecular and serological tests were undertaken on hard ticks (Ixodidae spp.) and samples from livestock were collected in 2015 from Chabahar County in Southeast Iran. Using RT-PCR, the ticks were tested for the presence of CCHFV. In addition, seven livestock were serologically tested for the presence of IgG antibodies using an ELISA test. IgG antibodies against CCHFV were detected in one of 7 of the livestock that were tested. In total, 49 ticks including five species: Rhipicephalus sanguineus, Hyalomma anatolicum , Hy. asiaticum, Hy. dromedarii and Hy. marginatum with a prevalence of 46.9%, 32.7%, 4.1%, 4.1% and 2.1% respectively were identified. CCHFV was detected in three ticks among 49 collected ticks. The ticks infected with CCHFV belonged to the genus Hyalomma and Rhipicephalus. Phylogenetic analysis demonstrated that two sequences clustered in clade IV (Asia-1) and one sequence was located within clade IV (Asia-2). Most of the animal and human CCHF cases of the country are reported from Sistan and Baluchistan provinces. Regular monitoring programs in the tick population and livestock are needed in the future.

  20. Co-circulation of Crimean-Congo Hemorrhagic Fever virus strains Asia 1 and 2 between the border of Iran and Pakistan

    Directory of Open Access Journals (Sweden)

    Nariman Shahhosseini

    2017-11-01

    Full Text Available Crimean-Congo Hemorrhagic Fever (CCHF is a tick-borne viral disease that is transmitted by numerous species of ticks, which serve both as a reservoir and vector of CCHF virus (CCHFV. Molecular and serological tests were undertaken on hard ticks (Ixodidae spp. and samples from livestock were collected in 2015 from Chabahar County in Southeast Iran. Using RT-PCR, the ticks were tested for the presence of CCHFV. In addition, seven livestock were serologically tested for the presence of IgG antibodies using an ELISA test. IgG antibodies against CCHFV were detected in one of 7 of the livestock that were tested. In total, 49 ticks including five species: Rhipicephalus sanguineus, Hyalomma anatolicum, Hy. asiaticum, Hy. dromedarii and Hy. marginatum with a prevalence of 46.9%, 32.7%, 4.1%, 4.1% and 2.1% respectively were identified. CCHFV was detected in three ticks among 49 collected ticks. The ticks infected with CCHFV belonged to the genus Hyalomma and Rhipicephalus. Phylogenetic analysis demonstrated that two sequences clustered in clade IV (Asia-1 and one sequence was located within clade IV (Asia-2. Most of the animal and human CCHF cases of the country are reported from Sistan and Baluchistan provinces. Regular monitoring programs in the tick population and livestock are needed in the future. Keywords: Virology

  1. Experimental transmission of Crimean-Congo hemorrhagic fever virus by west African wild ground-feeding birds to Hyalomma marginatum rufipes ticks.

    Science.gov (United States)

    Zeller, H G; Cornet, J P; Camicas, J L

    1994-06-01

    Hyalomma (H.) marginatum rufipes ticks commonly infest birds and are potential vectors of Crimean-Congo hemorrhagic fever (CCHF) virus in west Africa. An experimental model for investigating the role of birds in the CCHF virus transmission cycle was developed. Following CCHF virus inoculation, antibodies were detected by enzyme-linked immunosorbent assay in one red-beaked hornbill and one glossy starling, but not in two laughing doves and six domestic chickens. None of the birds showed a detectable viremia. Hyalomma marginatum rufipes larvae were placed on three red-beaked hornbills and one glossy starling. These birds were then inoculated with CCHF virus (10(1.5) 50% mouse intracerebral lethal doses). Virus transmission to larvae or nymphs was obtained and seroconversions in birds were recorded. Virus was also detected in 90% of the individually tested nymphs, as well as in adults. The virus was then successfully transmitted by adult ticks to rabbits and the engorged females were allowed to oviposit. Progeny larvae were placed on another group of birds and one of three birds showed seroconversion. The cycle of transmission of virus between ticks and aviremic ground-feeding birds represent a potential reservoir and amplification mechanism of CCHF virus in west Africa.

  2. Detection, isolation and confirmation of Crimean-Congo hemorrhagic fever virus in human, ticks and animals in Ahmadabad, India, 2010-2011.

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    Devendra T Mourya

    Full Text Available BACKGROUND: In January 2011, human cases with hemorrhagic manifestations in the hospital staff were reported from a tertiary care hospital in Ahmadabad, India. This paper reports a detailed epidemiological investigation of nosocomial outbreak from the affected area of Ahmadabad, Gujarat, India. PRINCIPAL FINDINGS: Samples from 3 suspected cases, 83 contacts, Hyalomma ticks and livestock were screened for Crimean-Congo hemorrhagic fever (CCHF virus by qRT-PCR of which samples of two medical professionals (case C and E and the husband of the index case (case D were positive for CCHFV. The sensitivity and specificity of indigenous developed IgM ELISA to screen CCHFV specific antibodies in human serum was 75.0% and 97.5% respectively as compared to commercial kit. About 17.0% domestic animals from Kolat, Ahmadabad were positive for IgG antibodies while only two cattle and a goat showed positivity by qRT-PCR. Surprisingly, 43.0% domestic animals (Buffalo, cattle, sheep and goat showed IgG antibodies in the adjoining village Jivanpara but only one of the buffalo was positive for CCHFV. The Hyalomma anatolicum anatolicum ticks were positive in PCR and virus isolation. CCHFV was isolated from the blood sample of case C, E in Vero E-6 cells and Swiss albino mice. In partial nucleocapsid gene phylogeny from CCHFV positive human samples of the years 2010 and 2011, livestock and ticks showed this virus was similar to Tajikistan (strain TAJ/H08966, which belongs in the Asian/middle east genetic lineage IV. CONCLUSIONS: The likely source of CCHFV was identified as virus infected Hyalomma ticks and livestock at the rural village residence of the primary case (case A. In addition, retrospective sample analysis revealed the existence of CCHFV in Gujarat and Rajasthan states before this outbreak. An indigenous developed IgM ELISA kit will be of great use for screening this virus in India.

  3. Influence of laboratory animal hosts on the life cycle of Hyalomma marginatum and implications for an in vivo transmission model for Crimean-Congo hemorrhagic fever virus

    Directory of Open Access Journals (Sweden)

    Aysen eGargili

    2013-08-01

    Full Text Available Crimean-Congo hemorrhagic fever virus (CCHFV is one of the most geographically widespread arboviruses and causes a severe hemorrhagic syndrome in humans. The virus circulates in nature in a vertebrate-tick cycle and ticks of the genus Hyalomma are the main vectors and reservoirs. Although the tick vector plays a central role in the maintenance and transmission of CCHFV in nature, comparatively little is known of CCHFV-tick interactions. This is mostly due to the fact that establishing tick colonies is laborious, and working with CCHFV requires a biosafety level 4 laboratory (BSL4 in many countries. Nonetheless, an in vivo transmission model is essential to understand the epidemiology of the transmission cycle of CCHFV. In addition, important parameters such as vectorial capacity of tick species, levels of infection in the host necessary to infect the tick, and aspects of virus transmission by tick bite including the influence of tick saliva, cannot be investigated any other way. Here, we evaluate the influence of different laboratory animal species as hosts supporting the life cycle of Hyalomma marginatum, a two-host tick. Rabbits were considered the host of choice for the maintenance of the uninfected colonies due to high larval attachment rates, shorter larval-nymphal feeding times, higher nymphal molting rates, high egg hatching rates and higher conversion efficiency index. Furthermore, we describe the successful establishment of an in vivo transmission model CCHFV in a BSL4 biocontainment setting using interferon knockout mice. This will give us a new tool to study the transmission and interaction of CCHFV with its tick vector.

  4. Seasonality in hospital admissions of Crimean-Congo hemorrhagic fever and its dependence on ambient temperature—empirical evidence from Pakistan

    Science.gov (United States)

    Abbas, Tariq; Xu, Zhiwei; Younus, Muhammad; Qayyum, Abdul; Riaz, Muhammad T.

    2017-11-01

    Crimean-Congo hemorrhagic fever (CCHF) has been reported from all provinces of Pakistan. Little is known about the seasonal variations in the disease and its association with weather conditions. In this study, we explored time-series data about monthly number of CCHF admissions (2007-2010) in three public sector hospitals of Quetta—the capital city of Baluchistan province of Pakistan. Cosinor analysis was carried out to investigate seasonality in the data. To assess the effect of average monthly ambient temperature (°C) on disease, a distributed lag nonlinear model (DLNM) was applied. Cosinor model revealed statistically significant seasonality in monthly number of CCHF patients admitted to the study hospitals. The estimated amplitude was 3.24 cases per month with phase in mid-June and low point in mid-December. DLNM confirmed nonlinear and delayed effect of temperature on hospital admissions. At a lag of 2 months, the cumulative relative risk was more than 1 at temperature at 18.37 °C and above. In addition, relative risk was significantly high at 60th (21.98 °C), 70th (24.50 °C), 80th (27.33 °C), and 90th (29.25 °C) percentiles of temperature (relative to median value, 18.37 °C). Inclusion of Eid-al-Adha as a predictor did not improve the fitness of DLNM. Based on our analysis, we concluded significant seasonality in CCHF hospital admissions. Our findings also suggested average monthly ambient temperature (°C) as a significant predictor of CCHF hospitalizations. DLNM presented in this study may be improved with inclusion of other possible time-varying predictors particularly meteorological conditions of this region.

  5. Infection prevention and control practice for Crimean-Congo hemorrhagic fever-A multi-center cross-sectional survey in Eurasia.

    Science.gov (United States)

    Fletcher, Tom E; Gulzhan, Abuova; Ahmeti, Salih; Al-Abri, Seif S; Asik, Zahide; Atilla, Aynur; Beeching, Nick J; Bilek, Heval; Bozkurt, Ilkay; Christova, Iva; Duygu, Fazilet; Esen, Saban; Khanna, Arjun; Kader, Çiğdem; Mardani, Masoud; Mahmood, Faisal; Mamuchishvili, Nana; Pshenichnaya, Natalia; Sunbul, Mustafa; Yalcin, Tuğba Y; Leblebicioglu, Hakan

    2017-01-01

    Crimean Congo Hemorrhagic Fever (CCHF) is a life threatening acute viral infection that presents significant risk of nosocomial transmission to healthcare workers. Evaluation of CCHF infection prevention and control (IP&C) practices in healthcare facilities that routinely manage CCHF cases in Eurasia. A cross-sectional CCHF IP&C survey was designed and distributed to CCHF centers in 10 endemic Eurasian countries in 2016. Twenty-three responses were received from centers in Turkey, Pakistan, Russia, Georgia, Kosovo, Bulgaria, Oman, Iran, India and Kazakhstan. All units had dedicated isolation rooms for CCHF, with cohorting of confirmed cases in 15/23 centers and cohorting of suspect and confirmed cases in 9/23 centers. There was adequate personal protective equipment (PPE) in 22/23 facilities, with 21/23 facilities reporting routine use of PPE for CCHF patients. Adequate staffing levels to provide care reported in 14/23 locations. All centers reported having a high risk CCHFV nosocomial exposure in last five years, with 5 centers reporting more than 5 exposures. Education was provided annually in most centers (13/23), with additional training requested in PPE use (11/23), PPE donning/doffing (12/23), environmental disinfection (12/23) and waste management (14/23). Staff and patient safety must be improved and healthcare associated CCHF exposure and transmission eliminated. Improvements are recommended in isolation capacity in healthcare facilities, use of PPE and maintenance of adequate staffing levels. We recommend further audit of IP&C practice at individual units in endemic areas, as part of national quality assurance programs.

  6. [An assessment of the status of natural foci of Crimean-Congo hemorrhagic fever in the Crimea].

    Science.gov (United States)

    Markeshin, S Ia; Smirnova, S E; Evstaf'ev, I L

    1992-04-01

    The parasitological data and the results of the virological and serological investigations of materials, collected in nature and in the course of study of the immune structure of the population, are indicative of the circulation of CHF virus in the Crimea and the possibility of human infection. Data on spontaneous infection of four species of Ixodes ticks with CHF virus have been confirmed, including the data, obtained for the first time for this region, on the participation of Dermacentor marginatus in this process. The study has revealed, also for the first time, that, together with European brown hares, the natural foci of this infection may be maintained by scilly shrews, common voles and European wood mice. Low activity of the Crimean focus may be the result of active land reclamation, keeping the cattle stalled in most of the stock-breeding farms of the region, as well as a sharp decline in the number of hares at the territories of hunting preserves.

  7. [An evaluation of the status of natural foci of Crimean-Congo hemorrhagic fever in the Crimea].

    Science.gov (United States)

    Markeshin, S Ia; Smirnova, S E; Evstaf'ev, I L

    1991-09-01

    Parasitological data, the results of virological and serological investigations of materials, collected in nature and during the study of the immune structure of the population and indicative of the circulation of CCHF, virus in the Crimea and the possibility of human infection, are presented. The data on the spontaneous CCHF virus infection of 4 tick species belonging to the genus Ixodes have been confirmed, and evidence on the participation of Dermacentor marginatus in this process obtained for the first time in this region. The study has revealed for the first time that, besides European brown hares, scilly shrews, common voles and field mice may contribute to the maintenance of the natural foci of this infection. The low activity of the Crimean focus of CCHF may be the result of the intensive use of land, the widely spread stall-feeding of cattle, as well as a sharp decrease in the number of hares on the territories of hunting preserves.

  8. Genetic characterization of Erve virus, a European Nairovirus distantly related to Crimean-Congo hemorrhagic fever virus

    OpenAIRE

    Dilcher, Meik; Koch, Andrea; Hasib, Lekbira; Dobler, Gerhard; Hufert, Frank T.; Weidmann, Manfred

    2012-01-01

    Erve virus (ERVEV) is a European Nairovirus that is suspected to cause severe headache (thunderclap headache) and intracerebral hemorrhage. The mode of transmission to humans (ticks or mosquitoes) is still unknown. Currently, no standardized testing method for ERVEV exists and only a small partial sequence of the polymerase gene is available. Here, we present the first complete genome sequence of ERVEV S, M, and L segments. Phylogenetic comparison of the amino acid sequence of the L-protein (...

  9. Serological evaluation of Crimean-Congo hemorrhagic fever in humans with high-risk professions living in enzootic regions of Isfahan province of Iran and genetic analysis of circulating strains.

    Science.gov (United States)

    Chinikar, Sadegh; Ghiasi, Seyed M; Naddaf, Saeed; Piazak, Norair; Moradi, Maryam; Razavi, Mohammad R; Afzali, Neda; Haeri, Ali; Mostafavizadeh, Kamyar; Ataei, Behrouz; Khalilifard-Brojeni, Mohammad; Husseini, Sayed M; Bouloy, Michele

    2012-09-01

    Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease that is asymptomatic in infected livestock, but causes a serious threat to humans with a mortality rate up to 50%. Although the CCHF virus (CCHFV) is often transmitted by ticks, livestock-to-human and human-to-human transmission also occurs. In the current study, we focused on CCHF in the province of Isfahan, located in the center of Iran and deemed to be the second most infected province. Human and livestock sera and resident ticks in the livestock are collected from different regions of the province and analyzed with specific IgG ELISA and RT-PCR tests. Overall, 12% and 12.7% of studied human and livestock populations were IgG positive, respectively. The genome of CCHFV was detected in 9% of ticks resident in livestock involved in this survey. The CCHFV isolates from infected ticks were genetically examined. Nucleotide sequence of the S-segment revealed that the different isolates were closely related to each other, with nucleotide sequence identities higher than 98%. Phylogenetic analysis demonstrated that a variant isolate clustered with the Iraq strain. This high proportion of IgG-positive sera and nearly high proportion of infected ticks increases the risk of CCHF outbreaks in the province and probably posits a great danger to other provinces.

  10. 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.

  11. 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.

  12. Two cases of Hantavirus infection in Crimean-Congo Haemorrhagic Fever endemic region

    Directory of Open Access Journals (Sweden)

    Mustafa Sünbül

    2012-09-01

    Full Text Available Crimean-Congo Hemorrhagic Fever (CCHF and Leptospirosis are endemic in our region. Hantavirus infections may beconfused with similar clinical picture zoonotic infections. Two patients with fever, malaise, cough, phlegm, nausea, vomiting,thrombocytopenia, renal failure, elevated transaminases, and a history of mouse contact were hospitalized in ourclinic with a presumptive diagnosis of leptospirosis, pneumonia, CCHF and Hantavirus infections. Empirical antibiotictreatment was initiated and CCHF and leptospirosis was ruled out with laboratory tests. Hantavirus immunoglobulin(Ig-G and Ig-M antibodies were detected positive by immunofluorescent antibody (IFA method in both cases but,Dobrova virus was detected in only one patient with immunoblotting methods. Both patients were discharged aftertreatment. Hantavirus infections may be misdiagnosed as zoonotic infections since they have similar clinical picture. Itshould be considered in the differential diagnosis of patients with a history of contact with mouse. J Microbiol Infect Dis2012; 2(3: 117-120Key words: Hantavirus, hemorrhagic fever, renal syndrome, pulmonary syndrome

  13. Question about the Clinical Characteristics of Crimean Hemorrhagic Fever

    Directory of Open Access Journals (Sweden)

    A.I. Bogdanova

    2016-11-01

    Full Text Available Background. The research was organized in order to analyze features of the main clinical symptoms in patients with Crimean hemorrhagic fever (CHF. Materials and methods. In furtherance of this goal 37 patients with the diagnosis of moderate CHF were exa­mined; they were treated at BPHF Nichoga Regional Clinical Hospital of Infectious Diseases during 2005–2016. Results. The main complaints were general weakness (100 %, diffuse headache (91 %, loss of appetite (76 %, arthralgias (80 %, giddiness (32 %, nausea (52 %, vomiting (46 %, myalgia (65 % and arthralgia (78 %. Hemorrhagic syndrome manifested with petechial rash (79 %, post-injection (32.2 % and traumatic (7.5 % hematomas, blee­ding gums (52.3 %. Among cavity bleedings the examined patients had nasal (14.3 %, gastrointestinal (15.7 %, and microhematuria (18.3 %. There was no impairment of respiratory and cardiovascular systems. In 78 % of cases the symptoms of CNS dysfunction like retardation, bradyphrasia, rapid debilitating symptom and in several cases (8.1 % a sleep disorder were noted. Conclusions. Thus, the clinical picture of the main symptoms of CHF testifies the existence of HS as a main pathogenetic factor of illness which influences the disease course and finally defines the forecast of the disease.

  14. Sensitive and specific detection of Crimean-Congo Hemorrhagic Fever Virus (CCHFV)—Specific IgM and IgG antibodies in human sera using recombinant CCHFV nucleoprotein as antigen in μ-capture and IgG immune complex (IC) ELISA tests

    Science.gov (United States)

    Emmerich, Petra; Mika, Angela; von Possel, Ronald; Rackow, Anne; Liu, Yang; Schmitz, Herbert; Sherifi, Kurtesh; Halili, Barie; Jakupi, Xhevat; Berisha, Lindita; Ahmeti, Salih

    2018-01-01

    As the most widespread tick-borne arbovirus causing infections in numerous countries in Asia, Africa and Europe, Crimean-Congo Hemorrhagic Fever Virus (CCHFV, family Nairoviridae) was included in the WHO priority list of emerging pathogens needing urgent Research & Development attention. To ensure preparedness for potential future outbreak scenarios, reliable diagnostic tools for identification of acute cases as well as for performance of seroprevalence studies are necessary. Here, the CCHFV ortholog of the major bunyavirus antigen, the nucleoprotein (NP), was recombinantly expressed in E.coli, purified and directly labeled with horseradish peroxidase (HRP). Employing this antigen, two serological tests, a μ-capture ELISA for the detection of CCHFV-specific IgM antibodies (BLACKBOX CCHFV IgM) and an IgG immune complex (IC) ELISA for the detection of CCHFV-specific IgG antibodies (BLACKBOX CCHFV IgG), were developed. Test performance was evaluated and compared with both in-house gold standard testing by IgM/IgG indirect immunofluorescence (IIF) and commercially available ELISA tests (VectoCrimean-CHF-IgM/IgG, Vector-Best, Russia) using a serum panel comprising paired samples collected in Kosovo during the years 2013–2016 from 15 patients with an acute, RT-PCR-confirmed CCHFV infection, and 12 follow-up sera of the same patients collected approximately one year after having overcome the infection. Reliably detecting IgM antibodies in all acute phase sera collected later than day 4 after onset of symptoms, both IgM ELISAs displayed excellent diagnostic and analytical sensitivity (100%, 95% confidence interval (CI): 85.2%–100.0%). While both IgG ELISAs readily detected the high IgG titers present in convalescent patients approximately one year after having overcome the infection (sensitivity 100%, 95% CI: 73.5%–100.0%), the newly developed BLACKBOX CCHFV IgG ELISA was superior to the commercial IgG ELISA in detecting the rising IgG titers during the acute phase

  15. 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...

  16. Crimean-Congo haemorrhagic fever virus infection in birds: field investigations in Senegal.

    Science.gov (United States)

    Zeller, H G; Cornet, J P; Camicas, J L

    1994-01-01

    In Senegal, wild ground-feeding birds are frequently infested with immature ticks. In two areas where numerous Crimean-Congo haemorrhagic fever (CCHF) virus isolations were obtained from Hyalomma marginatum rufipes adult ticks collected on ungulates, 175 birds were captured and sera collected. CCHF antibodies were detected by ELISA in 6/22 red-beaked hornbills (Tockus erythrorhynchus), 2/11 glossy starlings (Lamprotornis sp.) and 1/3 guinea fowls. The virus was isolated from H. m. rufipes nymphs collected on a hornbill. The role of wild ground-feeding birds in CCHF virus ecology in West Africa is discussed.

  17. Seroepidemiological study of Crimean-Congo haemorrhagic fever in Greece, 2009-2010.

    Science.gov (United States)

    Sidira, P; Maltezou, H C; Haidich, A-B; Papa, A

    2012-02-01

    To estimate endemic areas for Crimean-Congo haemorrhagic fever (CCHF) in Greece, a country-wide seroepidemiological study was conducted, and 1611 human sera were prospectively collected along with data regarding possible risk factors for acquisition of infection, and tested for CCHF virus IgG antibodies by ELISA. The overall seroprevalence was 4.2%, with significant differences among prefectures, ranging from 0 to 27.5%. Multivariate analysis revealed that slaughtering and agricultural activities were significant risk factors for CCHFV seropositivity. The significantly high seroprevalence in specific prefectures, together with the extremely low number of CCHF cases, suggest that this phenomenon might be strain-related. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.

  18. Surveillance and laboratory detection system of Crimean-Congo haemorrhagic fever in Iran

    DEFF Research Database (Denmark)

    Chinikar, S; Goya, M M; Shirzadi, M R

    2008-01-01

    Crimean-Congo haemorrhagic fever (CCHF) is a viral zoonotic disease with a high mortality rate in humans. The CCHF virus (CCHFV) is transmitted to humans through the bite of Ixodid ticks or by contact with blood or tissues of infected livestock. In addition to zoonotic transmission, CCHFV can be ....... After two decades and observations of CCHF in some provinces of Iran, a CCHF surveillance and detection system was established in 1999, leading to a dramatically decreased mortality rate from 20% (year 2000) to 2% (year 2007)....... symptoms, the diagnosis of CCHF is based on the use of serological tests for the detection of immunoglobulin M and immunoglobulin G antibodies and on the use of molecular tools such as RT-PCR. From 1970 to 1978, serological and epidemiological studies were performed in humans and in livestock of Iran...

  19. Ribavirin: an effective treatment of crimean-congo hemorrhagic fever

    International Nuclear Information System (INIS)

    Sheikh, A.S.

    2004-01-01

    Objective: To determine the efficiency of Ribavirin, an anti-viral drug, in patients diagnosed to have CCHF. Patients and Methods: A total of 94 cases were included in the study on high index of suspicion of CCHF. The major criteria of admission were a short history of high-grade fever associated with bleeding from more than one site, i.e., haematemesis, epistaxis etc. the mean age was 34.71 plus minus 12.81 years. All the suspected cases were kept in isolation unit of the hospital and barrier nursing was advised. Results: All the 94 cases were sent to CDC, Atlanta, USA for confirmation and 39 (41.4%) were confirmed to have CCHF. Symptomatic treatment like platelet concentration transfusions, fresh-blood transfusions and antipyretics were given to all cases. Oral Ribavirin was given only to the confirmed cases. It was started in a dose of 2 gm initially, followed by 1 gm 6 hourly for 4 days and then 500 mg 8 hours for 6 days. After a mean period of 2.30 plus minus 0.69 days to treatment with Ribavirin, the clinical as well as the laboratory parameters started improving and returned to normal level after 10 -day course of treatment. Mild anemia and thrombocytosis were seen as adverse effects in some of the patients. Conclusion: For treatment of this fatal disease, we recommended use of oral Ribavirin in all patients diagnosed to have CCHF in the above-mentioned doses, on the basis of our study results.(author)

  20. Non-fatal case of Crimean-Congo haemorrhagic fever imported into the United Kingdom (ex Bulgaria), June 2014.

    Science.gov (United States)

    Lumley, S; Atkinson, B; Dowall, Sd; Pitman, Jk; Staplehurst, S; Busuttil, J; Simpson, Aj; Aarons, Ej; Petridou, C; Nijjar, M; Glover, S; Brooks, Tj; Hewson, R

    2014-07-31

    Crimean-Congo haemorrhagic fever (CCHF) was diagnosed in a United Kingdom traveller who returned from Bulgaria in June 2014. The patient developed a moderately severe disease including fever, headaches and petechial rash. CCHF was diagnosed following identification of CCHF virus (CCHFV) RNA in a serum sample taken five days after symptom onset. Sequence analysis of the CCHFV genome showed that the virus clusters within the Europe 1 clade, which includes viruses from eastern Europe.

  1. A recombinase polymerase amplification assay for rapid detection of Crimean-Congo Haemorrhagic fever Virus infection.

    Directory of Open Access Journals (Sweden)

    Laura C Bonney

    2017-10-01

    Full Text Available Crimean-Congo Haemorrhagic fever Virus (CCHFV is a rapidly emerging vector-borne pathogen and the cause of a virulent haemorrhagic fever affecting large parts of Europe, Africa, the Middle East and Asia.An isothermal recombinase polymerase amplification (RPA assay was successfully developed for molecular detection of CCHFV. The assay showed rapid (under 10 minutes detection of viral extracts/synthetic virus RNA of all 7 S-segment clades of CCHFV, with high target specificity. The assay was shown to tolerate the presence of inhibitors in crude preparations of mock field samples, indicating that this assay may be suitable for use in the field with minimal sample preparation. The CCHFV RPA was successfully used to screen and detect CCHFV positives from a panel of clinical samples from Tajikistan.The assay is a rapid, isothermal, simple-to-perform molecular diagnostic, which can be performed on a light, portable real-time detection device. It is ideally placed therefore for use as a field-diagnostic or in-low resource laboratories, for monitoring of CCHF outbreaks at the point-of-need, such as in remote rural regions in affected countries.

  2. Crimean-Congo haemorrhagic fever virus in Kazakhstan (1948-2013).

    Science.gov (United States)

    Nurmakhanov, Talgat; Sansyzbaev, Yerlan; Atshabar, Bakhyt; Deryabin, Pavel; Kazakov, Stanislav; Zholshorinov, Aitmagambet; Matzhanova, Almagul; Sadvakassova, Alya; Saylaubekuly, Ratbek; Kyraubaev, Kakimzhan; Hay, John; Atkinson, Barry; Hewson, Roger

    2015-09-01

    Crimean-Congo haemorrhagic fever (CCHF) is a pathogenic and often fatal arboviral disease with a distribution spanning large areas of Africa, Europe and Asia. The causative agent is a negative-sense single-stranded RNA virus classified within the Nairovirus genus of the Bunyaviridae family. Cases of CCHF have been officially recorded in Kazakhstan since the disease was first officially reported in modern medicine. Serological surveillance of human and animal populations provide evidence that the virus was perpetually circulating in a local enzoonotic cycle involving mammals, ticks and humans in the southern regions of the country. Most cases of human disease were associated with agricultural professions such as farming, shepherding and fruit-picking; the typical route of infection was via tick-bite although several cases of contact transmission associated with caring for sick patients have been documented. In total, 704 confirmed human cases of CCHF have been registered in Kazakhstan from 1948-2013 with an overall case fatality rate of 14.8% for cases with a documented outcome. The southern regions of Kazakhstan should be considered endemic for CCHF with cases reported from these territories on an annual basis. Modern diagnostic technologies allow for rapid clinical diagnosis and for surveillance studies to monitor for potential expansion in known risk areas. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  3. Phylogenetic analysis in a recent controlled outbreak of Crimean-Congo haemorrhagic fever in the south of Iran, December 2008

    DEFF Research Database (Denmark)

    Chinikar, S; Ghiasi, Seyed Mojtaba; Mojtaba Ghiasi, S

    2010-01-01

    Crimean-Congo haemorrhagic fever (CCHF) is a viral zoonotic disease with a high mortality rate in humans. The CCHF virus is transmitted to humans through the bite of Ixodid ticks or contact with blood or tissues of CCHF patients or infected livestock. In December 2008, a re-emerging outbreak...... of CCHF occurred in the southern part of Iran. Five people were hospitalised with sudden fever and haemorrhaging, and CCHF was confirmed by RT-PCR and serological assays. One of the cases had a fulminant course and died. Livestock was identified as the source of infection; all animals in the incriminated...

  4. Mean Platelet Volume and Neutrophil-to-Lymphocyte Ratio in Patients with Crimean–Congo Hemorrhagic Fever

    Directory of Open Access Journals (Sweden)

    Derya Koçer

    2015-01-01

    Full Text Available Objectives: Crimean–Congo hemorrhagic fever (CCHF is a tick-borne zoonotic infection caused by Crimean Congo hemorrhagic fever virus (CCHFV. The aim of the present study was to investigate the association between blood neutrophil-to-lymphocyte ratio (NLR and mean platelet volume (MPV which are simple markers of subclinical inflammation and CCHF. We also investigated the relationship of these markers with coagulation parameters.Methods: Thirty-one suspected CCHF patients, who submitted to Training and Research Hospital, Kayseri, Turkey between 2009 and 2013, were evaluated retrospectively. Among thirty-one patients, nineteen were laboratory confirmed CCHF patients diagnosed by RT-PCR or CCHFV-specific IgM positivity. Alanine aminotransferase (ALT, aspartate aminotransferase (AST, lactate dehydrogenase (LDH, creatinin phosphokinase (CK, coagulation parameters, white blood cell counts (WBCs, and platelet counts of patient group were compared with twenty-five healthy individuals.Results: MPV, AST, ALT, LDH, CK and coagulation parameters were significantly higher in patients with CCHF than the controls, whereas WBCs, neutrophil, lymphocyte, hemoglobin, platelet counts and NLR were significantly lower (p<0.05. We found no significant correlation between MPV, NLR and coagulation parameters.Conclusions: Our study demonstrates that MPV and NLR may be beneficial markers in the diagnosis of CCHF. But these parameters should not be considered stand-alone tests for this use owing to nonspecificity with other diseases.

  5. The Co- Infection of Crime Congo Hemorrhagic Fever and Brucellosis: A Case Report

    Directory of Open Access Journals (Sweden)

    A Saghafipour

    2012-07-01

    Full Text Available

    Background and Objectives: Crimean-Congo Hemorrhagic fever (CCHF is a viral disease transmitted to ruminants or human by the bite of mature tick vectors. It can be transmitted through contact with the infectious blood or viraemic tissues during slaughter and hospital contacts. 80% of the cases are sub clinical and the rest of them are presenting with an acute febrile and occasionally hemorrhagic disease. The mortality rate of the fulminate form of the disease is equal to 20% to 50%. The hemorrhage is usually in the form of hematoma, melena, nose, conjunctiva, uterine or subcutaneous bleeding. CCHF complications are: encephalitis, optic neuropathy, hepatitis, renal failure and myocardial necrosis.

     

    Case Report: In this article, we’ve discussed a CCHF patient who presented with high fever, myalgia, headache, nausea, vomiting, abdominal pain, diffuse cutaneous and gingival hemorrhage during the course of the disease while the patient was hospitalized. Profound jaundice, petechia and global ecchymosis were considerable. Lab data showed at the beginning of hospitalization that the number of liver enzymes was increased up to 8-10 times. The number of placates were lower than 150000 ml. Moreover, during the first three days there was a decrease in the number of white blood cells and PTT was abnormal. (AST was higher than 100 units per litre. The results of serologic examination of IgM- ELISA virus for CCHF on day 5 and IgG-ELISA on day 10–which were carried out in pasture Institute-were reported to be positive. According to the patient’s history and clinical symptoms, he was also suspicious for Brucellosis and the lab data demonstrated that he is also infected with Brucella. (Wright=1.320, 2ME=1.160 (The patient was a 22 year old man, sheep farmer, residing in the GhalehKamkar area of Qom City.

     

  6. A serological survey of Crimean-Congo haemorrhagic fever in animals in the Sharkia Governorate of Egypt

    Directory of Open Access Journals (Sweden)

    Amr Murad

    2008-09-01

    Full Text Available A surveillance survey was conducted over a period of 12 months between September 2004 and August 2005 by the Tropical Medicine Department of Zagazig University in collaboration with Naval Medical Research Unit No. 3 (NAMRU-3, Egypt, to evaluate the role of ruminants as a reservoir host for Crimean-Congo haemorrhagic fever virus (CCHFV. A total of 1 022 serum samples from 313 cattle, 264 water buffalo (Bubalus bubalis, 270 sheep and 175 goats were included in the survey. All samples were collected from the Sharkia Governorate of Egypt and were examined for anti-CCHFV IgG. Of the total of 1 022 samples examined, 32 (3.13% were positive to IgG ELISA. Out of 270 sheep examined, 17 (6.30% were confirmed to have anti-CCHFV IgG with the highest titre recorded at 1:800. However, CCHFV-specific IgG-positive cases among the cattle, buffalo and goats were 3.83%, 0.38% and 1.14%, respectively. Positive cases in age group B (=2 years old were significantly higher (p<0.001 than those in age group A (<2 years old (5.7% versus 1.6%. Belbis City was found to have the highest number of positive cases compared to all other localities (p<0.001.

  7. Geographical distribution and surveillance of Crimean-Congo hemorrhagic fever in Iran

    DEFF Research Database (Denmark)

    Chinikar, Sadegh; Ghiasi, Seyed Mojtaba; Moradi, Maryam

    2010-01-01

    . Since 2000, we have shown the disease to be prevalent in 23 out of 30 provinces of Iran. Among those, Sistan-va-Baluchistan, Isfahan, Fars, Tehran, Khorasan, and Khuzestan demonstrated the highest infection, respectively. Notably, Sistan-va-Baluchistan province, southeast of Iran, has the highest...... of the disease has ranged variably in different provinces of Iran. More pathogenesis and phylogenetic studies should therefore be investigated to clarify these differences....

  8. Defining Key Entry Events for Crimean-Congo Hemorrhagic Fever Virus in Mammalian Cells

    Science.gov (United States)

    2012-08-10

    ADR-RES Pleural Effusion Adherent 48 hr K-526 Pleural Effusion - lymphoblast Suspension 48 hr MCF-7 Pleural Effusion Adherent 48 hr MDA-MB-231... Pleural Effusion Adherent 48 hr T-47D Pleural Effusion Adherent 48 hr DU-145 Prostate Adherent 48 hr PC-3 Prostate Adherent 48 hr HT-29 Recto-Sigmoid...fast protein liquid chromatography (FPLC) with a Protein A column for affinity purification of the Fc-tagged GN expression product. We eluted products

  9. Evidence for widespread infection of African bats with Crimean-Congo hemorrhagic fever-like viruses

    Czech Academy of Sciences Publication Activity Database

    Müller, M. A.; Devignot, S.; Lattwein, E.; Corman, V. M.; Maganga, G. D.; Gloza-Rausch, F.; Binger, T.; Vallo, Peter; Emmerich, P.; Cottontail, V. M.; Tschapka, M.; Oppong, S.; Drexler, J. F.; Weber, F.; Leroy, E. M.; Drosten, C.

    2016-01-01

    Roč. 6, č. 26637 (2016), č. článku 26637. ISSN 2045-2322 EU Projects: European Commission(XE) 278976 - ANTIGONE; European Commission(XE) 260427 - CCH Fever Institutional support: RVO:68081766 Keywords : sheep disease virus * family Bunyaviridae * serological relationships * antibody-response * migratory birds * rapid detection * viral load * ticks * nairovirus * genus Subject RIV: FN - Epidemiology, Contagious Diseases ; Clinical Immunology Impact factor: 4.259, year: 2016

  10. Diversity, Replication, Pathogenicity and Cell Biology of Crimean Congo Hemorrhagic Fever Virus

    Science.gov (United States)

    2010-10-01

    1990. Hen egg white lysozyme expressed in, and secreted from, Aspergillus niger is correctly processed and folded. Biotechnology (New York) 8:741–745. 7...in bunyavirus-infected cells. J. Virol. 41:643–648. 18. Garry, C. E., and R. F. Garry. 2004. Proteomics computational analyses suggest that the...2005). Proteomic identification of proteins conjugated to ISG15 in mouse and human cells. Biochem. Biophys. Res. Commun. 336, 496–506. Haas, A.L

  11. Knowledge, attitude and practice of healthcare workers concerning Crimean-Congo hemorrhagic fever in Western Iran

    Directory of Open Access Journals (Sweden)

    Mojtaba Salimi

    2016-06-01

    Conclusions: Knowledge of Kermanshah healthcare staff about CCHF was poor, especially nurses in a high risk job category. Therefore, it is necessary to conduct specific training programs for the disease identification, transmission, prevention, and treatment as well as the use of personal protection and safety devices.

  12. Hyalomma ticks on northward migrating birds in southern Spain: Implications for the risk of entry of Crimean-Congo haemorrhagic fever virus to Great Britain.

    Science.gov (United States)

    England, Marion E; Phipps, Paul; Medlock, Jolyon M; Atkinson, Peter M; Atkinson, Barry; Hewson, Roger; Gale, Paul

    2016-06-01

    Crimean-Congo haemorrhagic fever virus (CCHFV) is a zoonotic virus transmitted by Hyalomma ticks, the immature stages of which may be carried by migratory birds. In this study, a total of 12 Hyalomma ticks were recovered from five of 228 migratory birds trapped in Spring, 2012 in southern Spain along the East Atlantic flyway. All collected ticks tested negative for CCHFV. While most birds had zero Hyalomma ticks, two individuals had four and five ticks each and the statistical distribution of Hyalomma tick counts per bird is over-dispersed compared to the Poisson distribution, demonstrating the need for intensive sampling studies to avoid underestimating the total number of ticks. Rates of tick exchange on migratory birds during their northwards migration will affect the probability that a Hyalomma tick entering Great Britain is positive for CCHFV. Drawing on published data, evidence is presented that the latitude of a European country affects the probability of entry of Hyalomma ticks on wild birds. Further data on Hyalomma infestation rates and tick exchange rates are required along the East Atlantic flyway to further our understanding of the origin of Hyalomma ticks (i.e., Africa or southern Europe) and hence the probability of entry of CCHFV into GB. © 2016 The Society for Vector Ecology.

  13. Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions.

    Science.gov (United States)

    Al-Abri, Seif S; Abaidani, Idris Al; Fazlalipour, Mehdi; Mostafavi, Ehsan; Leblebicioglu, Hakan; Pshenichnaya, Natalia; Memish, Ziad A; Hewson, Roger; Petersen, Eskild; Mala, Peter; Nhu Nguyen, Tran Minh; Rahman Malik, Mamunur; Formenty, Pierre; Jeffries, Rosanna

    2017-05-01

    Crimean-Congo haemorrhagic fever (CCHF) is the most widespread, tick-borne viral disease affecting humans. The disease is endemic in many regions, such as Africa, Asia, Eastern and Southern Europe, and Central Asia. Recently, the incidence of CCHF has increased rapidly in the countries of the World Health Organization Eastern Mediterranean Region (WHO EMR), with sporadic human cases and outbreaks of CCHF being reported from a number of countries in the region. Despite the rapidly growing incidence of the disease, there are currently no accurate data on the burden of the disease in the region due to the different surveillance systems used for CCHF in these countries. In an effort to increase our understanding of the epidemiology and risk factors for the transmission of the CCHF virus (CCHFV; a Nairovirus of the family Bunyaviridae) in the WHO EMR, and to identify the current knowledge gaps that are hindering effective control interventions, a sub-regional meeting was organized in Muscat, Oman, from December 7 to 9, 2015. This article summarizes the current knowledge of the disease in the region, identifies the knowledge gaps that present challenges for the prevention and control of CCHFV, and details a strategic framework for research and development activities that would be necessary to curb the ongoing and new threats posed by CCHFV. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  14. Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions

    Directory of Open Access Journals (Sweden)

    Seif S. Al-Abri

    2017-05-01

    Full Text Available Crimean-Congo haemorrhagic fever (CCHF is the most widespread, tick-borne viral disease affecting humans. The disease is endemic in many regions, such as Africa, Asia, Eastern and Southern Europe, and Central Asia. Recently, the incidence of CCHF has increased rapidly in the countries of the World Health Organization Eastern Mediterranean Region (WHO EMR, with sporadic human cases and outbreaks of CCHF being reported from a number of countries in the region. Despite the rapidly growing incidence of the disease, there are currently no accurate data on the burden of the disease in the region due to the different surveillance systems used for CCHF in these countries. In an effort to increase our understanding of the epidemiology and risk factors for the transmission of the CCHF virus (CCHFV; a Nairovirus of the family Bunyaviridae in the WHO EMR, and to identify the current knowledge gaps that are hindering effective control interventions, a sub-regional meeting was organized in Muscat, Oman, from December 7 to 9, 2015. This article summarizes the current knowledge of the disease in the region, identifies the knowledge gaps that present challenges for the prevention and control of CCHFV, and details a strategic framework for research and development activities that would be necessary to curb the ongoing and new threats posed by CCHFV.

  15. First report on the seroprevalence of the Crimean-Congo haemorrhagic fever virus, a tick-borne virus, in Malaysia's Orang Asli population.

    Science.gov (United States)

    Lani, R; Mohd Rahim, N F; Hassan, H; Yaghoobi, R; Chang, L-Y; AbuBakar, S; Zandi, K

    2015-01-01

    The Crimean-Congo haemorrhagic fever virus (CCHFV), which is transmitted by the ticks of Hyalomma spp. in general and H. marginatumin particular, can cause severe disease in humans, with mortality rates of 3-30%. Other than from the bites of infected ticks, CCHFV can also be transmitted through contact with patients with the acute phase of infection or contact with blood or tissues from viraemic livestock.  Outbreaks of human cases of haemorrhagic manifestations have been documented since 1945 and described in parts of Africa, Asia, Eastern Europe and the Middle East and most recently India in 2011. In addition, serological evidence of the disease has been reported in some countries where no human cases were reported. As regional neighbours China and India have been affected by this virus, this study was conducted to determine the seroprevalence of CCHFV among Orang Asli population of Malaysia as the most at risk people who residing in the deep forests. A total of 682 serum samples were collected from the Orang Asli population residing in eight states in peninsular Malaysia and analysed for the presence of anti-CCHFV immunoglobulin G (IgG) using a commercial enzyme-linked immunosorbent assay kit. The study subjects comprised 277 (40.6%) men and 405 (59.4%) women. However, anti-CCHFV IgG was detected in only one female serum sample (0.1%). The presence of anti-CCHFV IgG could not be correlated to age or sex from these findings. The results of this screening survey showed that the seroprevalence of the anti-CCHFV IgG among Malaysia's Orang Asli population is too low for detection or totally negative compared with that in neighbouring countries, such as India and China.

  16. Investigation of an isolated case of human Crimean–Congo hemorrhagic fever in Central Uganda, 2015

    Directory of Open Access Journals (Sweden)

    Stephen Balinandi

    2018-03-01

    Full Text Available Background: Crimean–Congo hemorrhagic fever (CCHF is the most geographically widespread tick-borne viral infection. Outbreaks of CCHF in sub-Saharan Africa are largely undetected and thus under-reported. On November 9, 2015, the National Viral Hemorrhagic Fever Laboratory at the Uganda Virus Research Institute received an alert for a suspect VHF case in a 33-year-old male who presented with VHF compatible signs and symptoms at Mengo Hospital in Kampala. Methods: A blood sample from the suspect patient was tested by RT-PCR for CCHF and found positive. Serological testing on sequential blood specimens collected from this patient showed increasing anti-CCHFV IgM antibody titers, confirming recent infection. Repeat sampling of the confirmed case post recovery showed high titers for anti-CCHFV-specific IgG. An epidemiological outbreak investigation was initiated following the initial RT-PCR positive detection to identify any additional suspect cases. Results: Only a single acute case of CCHF was detected from this outbreak. No additional acute CCHF cases were identified following field investigations. Environmental investigations collected 53 tick samples, with only 1, a Boophilus decoloratus, having detectable CCHFV RNA by RT-PCR. Full-length genomic sequencing on a viral isolate from the index human case showed the virus to be related to the DRC (Africa 2 lineage. Conclusions: This is the fourth confirmed CCHF outbreak in Uganda within 2 years after more than 50 years of no reported human CCHF cases in this country. Our investigations reaffirm the endemicity of CCHFV in Uganda, and show that exposure to ticks poses a significant risk for human infection. These findings also reflect the importance of having an established national VHF surveillance system and diagnostic capacity in a developing country like Uganda, in order to identify the first cases of VHF outbreaks and rapidly respond to reduce secondary cases. Additional efforts should focus on

  17. Crimean–Congo Hemorrhagic Fever Virus and Borrelia burgdorferi sensu lato in Ticks from Kosovo and Albania

    OpenAIRE

    Kurtesh Sherifi; Agim Rexhepi; Kristaq Berxholi; Blerta Mehmedi; Rreze M. Gecaj; Zamira Hoxha; Anja Joachim; Georg G. Duscher

    2018-01-01

    Tick-borne diseases pose a serious threat to human health in South-Eastern Europe, including Kosovo. While Crimean–Congo hemorrhagic fever (CCHF) is a well-known emerging infection in this area, there are no accurate data on Lyme borreliosis and tick-borne encephalitis (TBE). Therefore, we sampled and tested 795 ticks. Ixodes ricinus (n = 218), Dermacentor marginatus (n = 98), and Haemaphysalis spp. (n = 24) were collected from the environment by flagging (all from Kosovo), while Hyalomma mar...

  18. Sequence Optimized Real-Time RT-PCR Assay for Detection of Crimean-Congo Hemorrhagic Fever Virus

    Science.gov (United States)

    2017-03-21

    on the linear range of the curve 129 using a nonlinear regression analysis. A two-way ANOVA with Sidak’s multiple comparisons test was 130 done to...currently fielded CCHFV assay. 31 TR-17-094 DISTRIBUTION STATEMENT A: Approved for public release; distribution is unlimited. 2 Introduction 32...analyses were performed using GraphPrism 6 (GraphPad Software, San Diego, CA). 128 Assay linearity based on the preliminary LOD was determined based

  19. Interventions Against West Nile Virus, Rift Valley Fever Virus, and Crimean-Congo Hemorrhagic Fever Virus: Where Are We?

    NARCIS (Netherlands)

    Kortekaas, J.A.; Ergonul, O.; Moormann, R.J.M.

    2010-01-01

    ARBO-ZOONET is an international network financed by the European Commission's seventh framework program. The major goal of this initiative is capacity building for the control of emerging viral vector-borne zoonotic diseases, with a clear focus on West Nile virus, Rift Valley fever virus, and

  20. A DNA Vaccine for Crimean Congo Hemorrhagic Fever Protects Against Disease and Death in Two Lethal Mouse Models

    Science.gov (United States)

    2017-09-18

    as above. Data were analyzed as previously reported using 238 GraphPad Prism software (GraphPad Software) (33). 239 CCHFVLP ELISA 240 High Bind... ELISA plates (Corning) were coated overnight at 4°C with approximately 1 ng N 241 equivalent of CCHFVLP diluted in PBS per 96-well plate. The...deep anesthesia, and sera were collected for post-challenge 276 analysis. 277 N ELISA 278 N antibodies in challenged mice were detected by ELISA

  1. Combination of RT-PCR and proteomics for the identification of Crimean-Congo hemorrhagic fever virus in ticks

    Czech Academy of Sciences Publication Activity Database

    Fernández de Mera, I.G.; Chaligiannis, I.; Hernández-Jarguín, A.; Villar, M.; Mateos-Hernández, L.; Papa, A.; Sotiraki, S.; Ruiz-Fons, F.; Cabezas Cruz, Alejandro; Gortázar, C.; de la Fuente, J.

    2017-01-01

    Roč. 3, July (2017), č. článku e00353. ISSN 2405-8440 EU Projects: European Commission(XE) 278976 - ANTIGONE Institutional support: RVO:60077344 Keywords : evolution * genetics * infectious disease * public health * veterinary science * virology Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Biochemistry and molecular biology

  2. Crimean-Congo Haemorrhagic Fever

    Science.gov (United States)

    ... endemic areas, where they have been at the origin of human cases. For example, a former outbreak occurred at an ostrich abattoir in South Africa. There is no apparent disease in these animals. ...

  3. Crimean-Congo Haemorrhagic Fever

    Science.gov (United States)

    ... heart rate), lymphadenopathy (enlarged lymph nodes), and a petechial rash (a rash caused by bleeding into the ... heart rate), lymphadenopathy (enlarged lymph nodes), and a petechial rash (a rash caused by bleeding into the ...

  4. HMGB1 Is a Potential Biomarker for Severe Viral Hemorrhagic Fevers.

    Directory of Open Access Journals (Sweden)

    Katarina Resman Rus

    2016-06-01

    Full Text Available Hemorrhagic fever with renal syndrome (HFRS and Crimean-Congo hemorrhagic fever (CCHF are common representatives of viral hemorrhagic fevers still often neglected in some parts of the world. Infection with Dobrava or Puumala virus (HFRS and Crimean-Congo hemorrhagic fever virus (CCHFV can result in a mild, nonspecific febrile illness or as a severe disease with hemorrhaging and high fatality rate. An important factor in optimizing survival rate in patients with VHF is instant recognition of the severe form of the disease for which significant biomarkers need to be elucidated. To determine the prognostic value of High Mobility Group Box 1 (HMGB1 as a biomarker for disease severity, we tested acute serum samples of patients with HFRS or CCHF. Our results showed that HMGB1 levels are increased in patients with CCHFV, DOBV or PUUV infection. Above that, concentration of HMGB1 is higher in patients with severe disease progression when compared to the mild clinical course of the disease. Our results indicate that HMGB1 could be a useful prognostic biomarker for disease severity in PUUV and CCHFV infection, where the difference between the mild and severe patients group was highly significant. Even in patients with severe DOBV infection concentrations of HMGB1 were 2.8-times higher than in the mild group, but the difference was not statistically significant. Our results indicated HMGB1 as a potential biomarker for severe hemorrhagic fevers.

  5. Crimean–Congo Hemorrhagic Fever Virus and Borrelia burgdorferi sensu lato in Ticks from Kosovo and Albania

    Science.gov (United States)

    Sherifi, Kurtesh; Rexhepi, Agim; Berxholi, Kristaq; Mehmedi, Blerta; Gecaj, Rreze M.; Hoxha, Zamira; Joachim, Anja; Duscher, Georg G.

    2018-01-01

    Tick-borne diseases pose a serious threat to human health in South-Eastern Europe, including Kosovo. While Crimean–Congo hemorrhagic fever (CCHF) is a well-known emerging infection in this area, there are no accurate data on Lyme borreliosis and tick-borne encephalitis (TBE). Therefore, we sampled and tested 795 ticks. Ixodes ricinus (n = 218), Dermacentor marginatus (n = 98), and Haemaphysalis spp. (n = 24) were collected from the environment by flagging (all from Kosovo), while Hyalomma marginatum (n = 199 from Kosovo, all from Kosovo) and Rhipicephalus bursa (n = 130, 126 from Albania) could be collected only by removal from animal pasture and domestic ruminants. Ticks were collected in the years 2014/2015 and tested for viral RNA of CCHF and TBE viruses, as well as for DNA of Borrelia burgdorferi sensu lato by real-time PCR. In Kosovo, nine ticks were positive for RNA of Crimean–Congo hemorrhagic fever virus and seven for DNA of B. burgdorferi s. l. None of the ticks tested positive for TBEV. CCHF virus was detected in one H. marginatum male specimen collected while feeding on grazing cattle from the Prizren region and in eight R. bursa specimens (five females and three males collected while feeding on grazing sheep and cattle) from the Prishtina region (Kosovo). B. burgdorferi s. l. was detected in seven questing ticks (four male and one female D. marginatus, two I. ricinus one female and one male) from the Mitrovica region (Kosovo). Our study confirmed that CCHF virus is circulating in Kosovo mainly in H. marginatum and R. bursa in the central areas of the country. B. burgdorferi s. l. was found in its major European host tick, I. ricinus, but also in D. marginatus, in the north of the Kosovo. In order to prevent the spread of these diseases and better control of the tick-borne infections, an improved vector surveillance and testing of ticks for the presence of pathogens needs to be established. PMID:29560357

  6. Crimean–Congo Hemorrhagic Fever Virus and Borrelia burgdorferi sensu lato in Ticks from Kosovo and Albania

    Directory of Open Access Journals (Sweden)

    Kurtesh Sherifi

    2018-03-01

    Full Text Available Tick-borne diseases pose a serious threat to human health in South-Eastern Europe, including Kosovo. While Crimean–Congo hemorrhagic fever (CCHF is a well-known emerging infection in this area, there are no accurate data on Lyme borreliosis and tick-borne encephalitis (TBE. Therefore, we sampled and tested 795 ticks. Ixodes ricinus (n = 218, Dermacentor marginatus (n = 98, and Haemaphysalis spp. (n = 24 were collected from the environment by flagging (all from Kosovo, while Hyalomma marginatum (n = 199 from Kosovo, all from Kosovo and Rhipicephalus bursa (n = 130, 126 from Albania could be collected only by removal from animal pasture and domestic ruminants. Ticks were collected in the years 2014/2015 and tested for viral RNA of CCHF and TBE viruses, as well as for DNA of Borrelia burgdorferi sensu lato by real-time PCR. In Kosovo, nine ticks were positive for RNA of Crimean–Congo hemorrhagic fever virus and seven for DNA of B. burgdorferi s. l. None of the ticks tested positive for TBEV. CCHF virus was detected in one H. marginatum male specimen collected while feeding on grazing cattle from the Prizren region and in eight R. bursa specimens (five females and three males collected while feeding on grazing sheep and cattle from the Prishtina region (Kosovo. B. burgdorferi s. l. was detected in seven questing ticks (four male and one female D. marginatus, two I. ricinus one female and one male from the Mitrovica region (Kosovo. Our study confirmed that CCHF virus is circulating in Kosovo mainly in H. marginatum and R. bursa in the central areas of the country. B. burgdorferi s. l. was found in its major European host tick, I. ricinus, but also in D. marginatus, in the north of the Kosovo. In order to prevent the spread of these diseases and better control of the tick-borne infections, an improved vector surveillance and testing of ticks for the presence of pathogens needs to be established.

  7. Detection panel for identification of twelve hemorrhagic viruses using real-time RT-PCR.

    Science.gov (United States)

    Fajfr, M; Neubauerová, V; Pajer, P; Kubíčková, P; Růžek, D

    2014-09-01

    Viral hemorrhagic fevers are caused by viruses from four viral families and develop diseases with high fatality rates. However, no commercial diagnostic assay for these pathogens is available. We developed real-time RT-PCR assays for viruses Ebola, Marburg, Lassa, Guanarito, Machupo, Junin, Sabiá, Seoul, Puumala, Hantaan, Crimean-Congo hemorrhagic fever virus and Rift Valley fever virus. The assays were optimized for identical reaction conditions and can be performed using several types of real-time PCR instruments, both capillary and plate, including a portable Ruggedized Advanced Pathogen Identification Device (R.A.P.I.D.) (Idaho Technology, Inc.). In combination with primers and probes from previously published studies, we present a simple system for rapid identification of hemorrhagic filoviruses, arenaviruses and bunyaviruses with sufficient sensitivity for first contact laboratory and diagnosis under field conditions.

  8. Molecular detection of Crimean-Congo Hemorrhagic Fever (CCHF Virus in tick species collected from livestock in Marvdasht, Fars province during 2012-2013

    Directory of Open Access Journals (Sweden)

    F Farhadpour

    2015-03-01

    Conclusion: Due to confirming the cycle of the virus, it can be mentioned that CCHF has recently emerged as an important public health problem in this region and systematic performance monitoring and control programs to reduce the livestock population, distribution, inform and educate high-risk occupations of vectors is required.

  9. TRAINING PROGRAM FOR NURSING STAFF REGARDING VIRAL HEMORRHAGIC FEVERS IN A MILITARY HOSPITAL.

    Science.gov (United States)

    El-Bahnasawy, Mamdouh M; Megahed, Laila Abdel-Mawla; Saleh, Halla Ahmed Abdullah; Abdelfattah, Magda Abdelhamid; Morsy, Tosson Aly

    2015-08-01

    Viral hemorrhagic fevers (VHFs) refer to a group of illnesses caused by several distinct families of viruses. In general, the term "viral hemorrhagic fever" is used to describe a severe multisystem syndrome (multisystem in that multiple organ systems in the bpdy are affected). Characteristically, the overall vascular system is damaged, and the body's ability to regulate itself is impaired. These symptoms are often accompanied by hemorrhage (bleeding); however, the bleeding is it rarely life-threatening. While some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses cause severe, life-threatening disease. The selected disaster diseases for this study included: 1-Crimean-Congo hemorrhagic Fever, 2-Dengue Fever, 3-Ebola Fever, 4-Hem-orrhagic Fever with renal syndrome (HFRS), 5-Hantavirus Pulmonary Syndrome, 6-Lassa Fever, 7-Marburg Fever, 8-Rift Valley Fever and 9-Yellow Fever. The educational training program was given over ten sessions to a group of Staff Nurses. The results showed that the program succeeded in enhancing nurse' knowledge, awareness, responsibility, and obligations toward patients with the Viral Hemorrhagic Fevers The results showed a significant impact of training sessions illuminated in the follow-up test on the knowledge score of nurses in all types of diseases except for the Congo hemorrhagic fever, while, statistical significance varied in some diseases in the study when it comes to the comparison between pretest and post-test. All results confirmed on the positive impact of the training program in enhancing the knowledge of nurses toward VHFs patients and their relevant. There was a significant positive impact of the training sessions on changing the attitude of nurses toward patients with VHFs. This result was confirmed on the collective level since the total scores on tests revealed significant positive impact of the study on changing the attitude of nurses toward relevant patients. The relationship

  10. Immunization with DNA plasmids coding for crimean-congo hemorrhagic fever virus capsid and envelope proteins and/or virus-like particles induces protection and survival in challenged mice

    DEFF Research Database (Denmark)

    Hinkula, Jorma; Devignot, Stéphanie; Åkerström, Sara

    2017-01-01

    , there was no correlation with the neutralizing antibody titers alone, which were higher in the tc-VLP-vaccinated mice. However, the animals with a lower neutralizing titer, but a dominant cell-mediated Th1 response and a balanced Th2 response, resisted the CCHFV challenge. Moreover, we found that in challenged mice...... with a Th1 response (immunized by DNA/DNA and boosted by tc-VLPs), the immune response changed to Th2 at day 9 postchallenge. In addition, we were able to identify new linear B-cell epitope regions that are highly conserved between CCHFV strains. Altogether, our results suggest that a predominantly Th1-type...

  11. Intracerebral Hemorrhage

    Science.gov (United States)

    ... Home » Patients & Families » About Stroke » Intracerebral Hemorrhage Intracerebral Hemorrhage What is a Stroke? Ischemic Stroke Intracerebral Hemorrhage Subarachnoid Hemorrhage Pediatric Stroke Warning Signs Stroke Statistics ...

  12. Simultaneous detection of IgG antibodies associated with viral hemorrhagic fever by a multiplexed Luminex-based immunoassay.

    Science.gov (United States)

    Wu, Wei; Zhang, Shuo; Qu, Jing; Zhang, Quanfu; Li, Chuan; Li, Jiandong; Jin, Cong; Liang, Mifang; Li, Dexin

    2014-07-17

    Viral hemorrhagic fevers (VHFs) are worldwide diseases caused by several kinds of viruses. With the emergence of new viruses, advanced diagnostic methods are urgently needed for identification of VHFs. Based on Luminex xMAP technology, a rapid, sensitive, multi-pathogen and high-throughput method which could simultaneously detect hemorrhagic fever viruses (HFVs) specific IgG antibodies was developed. Recombinant antigens of nine HFVs including Hantaan virus (HTNV), Seoul virus (SEOV), Puumala virus (PUUV), Andes virus (ANDV), Sin Nombre virus (SNV), Crimean-Congo hemorrhagic fever virus (CCHFV), Rift Valley fever virus (RVFV), Severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) and dengue virus (DENV) were produced and purified from a prokaryotic expression system and the influence of the coupling amount was investigated. Cross-reactions among antigens and their rabbit immune sera were evaluated. Serum samples collected from 51 laboratory confirmed hemorrhagic fever with renal syndrome (HFRS) patients, 43 confirmed SFTS patients and 88 healthy donors were analyzed. Results showed that recombinant nucleocapsid protein of the five viruses belonging to the genus Hantavirus, had serological cross-reactivity with their corresponding rabbit immune sera, but not apparent with immune sera of other four viruses. Evaluation of this new method with clinical serum samples showed 98.04% diagnostic sensitivity for HFRS, 90.70% for SFTS detection and the specificity was ranging from 66.67% to 100.00%. The multiplexed Luminex-based immunoassay has firstly been established in our study, which provides a potentially reliable diagnostic tool for IgG antibody detection of VHFs. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. CRIME CONGO HEMORHAGIC FEVER EPIDEMY: A PRELIMINARY REPORT OF ISFAHAN PROVINCE IN IRAN

    Directory of Open Access Journals (Sweden)

    K MOSTAFAVIZADE

    2002-03-01

    Full Text Available Crimean-Congo hemorrhagic fever (CCHF is a viral disease of Buynaviridae family. Disease is primarily zoonosis but sporadic and epidemic human infection can occur. During year 2001 many outbreaks have been reported from Kosovo, Iran, Albania and Pakistan. A Hyalomma tick can transmit the disease and virus reservoirs are rodents, ostrich, ground frequenting birds and hyalomma tick. Another way of human infection is contact with infected animal blood and products or crushing a tick with bare hands. Contact with infected human blood can also transmit the disease. During outbreak, 18 cases were confirmed by serologic methods. 12 men and 6 women aged 20-40 years old. Ten of men and 5 of women had history of contact with infected animal blood or tissue and a lady had been bitten by a tick. A young assistant of internal medicine who came in contact with the first patient, developed the disease. We were not able to determine route of transmission in one case. The most frequent clinical signs included fever, myalgia, weakness, fatique, bleeding tendency, petechia, purpura and jundice. Lab exam revealed thrombocytopenia, elevated liver enzymes and prolongation of prothrombin time. Althoug the most common route of human infection is tick bite, but in this outbreak the main route was contact with infected animal blood and tissue. This point confirms that unsanitary slaughtering of animal could be dangerous. It seems that reeducating physicians, veterinarians and those who take care of such patients maybe helpful to neighboring countries triggered the outbreak, so that educating people who are involved in husbandry may limiting human infection.

  14. Development and preliminary evaluation of a multiplexed amplification and next generation sequencing method for viral hemorrhagic fever diagnostics.

    Directory of Open Access Journals (Sweden)

    Annika Brinkmann

    2017-11-01

    Full Text Available We describe the development and evaluation of a novel method for targeted amplification and Next Generation Sequencing (NGS-based identification of viral hemorrhagic fever (VHF agents and assess the feasibility of this approach in diagnostics.An ultrahigh-multiplex panel was designed with primers to amplify all known variants of VHF-associated viruses and relevant controls. The performance of the panel was evaluated via serially quantified nucleic acids from Yellow fever virus, Rift Valley fever virus, Crimean-Congo hemorrhagic fever (CCHF virus, Ebola virus, Junin virus and Chikungunya virus in a semiconductor-based sequencing platform. A comparison of direct NGS and targeted amplification-NGS was performed. The panel was further tested via a real-time nanopore sequencing-based platform, using clinical specimens from CCHF patients.The multiplex primer panel comprises two pools of 285 and 256 primer pairs for the identification of 46 virus species causing hemorrhagic fevers, encompassing 6,130 genetic variants of the strains involved. In silico validation revealed that the panel detected over 97% of all known genetic variants of the targeted virus species. High levels of specificity and sensitivity were observed for the tested virus strains. Targeted amplification ensured viral read detection in specimens with the lowest virus concentration (1-10 genome equivalents and enabled significant increases in specific reads over background for all viruses investigated. In clinical specimens, the panel enabled detection of the causative agent and its characterization within 10 minutes of sequencing, with sample-to-result time of less than 3.5 hours.Virus enrichment via targeted amplification followed by NGS is an applicable strategy for the diagnosis of VHFs which can be adapted for high-throughput or nanopore sequencing platforms and employed for surveillance or outbreak monitoring.

  15. Development and preliminary evaluation of a multiplexed amplification and next generation sequencing method for viral hemorrhagic fever diagnostics.

    Science.gov (United States)

    Brinkmann, Annika; Ergünay, Koray; Radonić, Aleksandar; Kocak Tufan, Zeliha; Domingo, Cristina; Nitsche, Andreas

    2017-11-01

    We describe the development and evaluation of a novel method for targeted amplification and Next Generation Sequencing (NGS)-based identification of viral hemorrhagic fever (VHF) agents and assess the feasibility of this approach in diagnostics. An ultrahigh-multiplex panel was designed with primers to amplify all known variants of VHF-associated viruses and relevant controls. The performance of the panel was evaluated via serially quantified nucleic acids from Yellow fever virus, Rift Valley fever virus, Crimean-Congo hemorrhagic fever (CCHF) virus, Ebola virus, Junin virus and Chikungunya virus in a semiconductor-based sequencing platform. A comparison of direct NGS and targeted amplification-NGS was performed. The panel was further tested via a real-time nanopore sequencing-based platform, using clinical specimens from CCHF patients. The multiplex primer panel comprises two pools of 285 and 256 primer pairs for the identification of 46 virus species causing hemorrhagic fevers, encompassing 6,130 genetic variants of the strains involved. In silico validation revealed that the panel detected over 97% of all known genetic variants of the targeted virus species. High levels of specificity and sensitivity were observed for the tested virus strains. Targeted amplification ensured viral read detection in specimens with the lowest virus concentration (1-10 genome equivalents) and enabled significant increases in specific reads over background for all viruses investigated. In clinical specimens, the panel enabled detection of the causative agent and its characterization within 10 minutes of sequencing, with sample-to-result time of less than 3.5 hours. Virus enrichment via targeted amplification followed by NGS is an applicable strategy for the diagnosis of VHFs which can be adapted for high-throughput or nanopore sequencing platforms and employed for surveillance or outbreak monitoring.

  16. Marburg hemorrhagic fever associated with multiple genetic lineages of virus

    DEFF Research Database (Denmark)

    Bausch, D G; Nichol, S T; Muyembe-Tamfum, J J

    2006-01-01

    Background An outbreak of Marburg hemorrhagic fever was first observed in a gold-mining village in northeastern Democratic Republic of the Congo in October 1998. Methods We investigated the outbreak of Marburg hemorrhagic fever most intensively in May and October 1999. Sporadic cases and short ch...

  17. Splinter hemorrhages

    Science.gov (United States)

    Fingernail hemorrhage ... Splinter hemorrhages look like thin, red to reddish-brown lines of blood under the nails. They run in the direction of nail growth. They are named splinter hemorrhages because they look like a splinter under the ...

  18. Crimean Crisis and Military Balance in Asia

    Directory of Open Access Journals (Sweden)

    Yongshu Li

    2016-04-01

    Full Text Available As the Crimean Crisis goes on, many analysis have been focusing on the dynamics among parties of Ukraine, the EU, the US and Russia. Very few noticed another important strategic impact the Crisis may cause: the Chinese military rebalancing in East Asia. China has been increasingly confident in assuming both political and military power in the East Asian region. The confidence resulted in the South China Sea disputes with ASEAN countries, “Anti-Secession Law” against Taiwan, and the Diaoyu/Senkaku Islands Dispute with Japan. Behind such confidence of China, the EU has consistently been exporting defence products to China since the end of the Cold War; Ukraine, although sometimes reluctantly, has also been backing China along the process of building up a stronger navy as well as other defense industry construction; Russia has traditionally been supplying China with a wide range of military hardware. It can be noticed that the Crimean Crisis involved three out of four countries and region that have been behind China’s rise. How will the Crimean Crisis influence China’s rebalance in East Asia then? The answers stay opaque. This paper will attempt to answer the questions.

  19. A Multiplex PCR/LDR Assay for the Simultaneous Identification of Category A Infectious Pathogens: Agents of Viral Hemorrhagic Fever and Variola Virus.

    Directory of Open Access Journals (Sweden)

    Sanchita Das

    Full Text Available CDC designated category A infectious agents pose a major risk to national security and require special action for public health preparedness. They include viruses that cause viral hemorrhagic fever (VHF syndrome as well as variola virus, the agent of smallpox. VHF is characterized by hemorrhage and fever with multi-organ failure leading to high morbidity and mortality. Smallpox, a prior scourge, has been eradicated for decades, making it a particularly serious threat if released nefariously in the essentially non-immune world population. Early detection of the causative agents, and the ability to distinguish them from other pathogens, is essential to contain outbreaks, implement proper control measures, and prevent morbidity and mortality. We have developed a multiplex detection assay that uses several species-specific PCR primers to generate amplicons from multiple pathogens; these are then targeted in a ligase detection reaction (LDR. The resultant fluorescently-labeled ligation products are detected on a universal array enabling simultaneous identification of the pathogens. The assay was evaluated on 32 different isolates associated with VHF (ebolavirus, marburgvirus, Crimean Congo hemorrhagic fever virus, Lassa fever virus, Rift Valley fever virus, Dengue virus, and Yellow fever virus as well as variola virus and vaccinia virus (the agent of smallpox and its vaccine strain, respectively. The assay was able to detect all viruses tested, including 8 sequences representative of different variola virus strains from the CDC repository. It does not cross react with other emerging zoonoses such as monkeypox virus or cowpox virus, or six flaviviruses tested (St. Louis encephalitis virus, Murray Valley encephalitis virus, Powassan virus, Tick-borne encephalitis virus, West Nile virus and Japanese encephalitis virus.

  20. A Multiplex PCR/LDR Assay for the Simultaneous Identification of Category A Infectious Pathogens: Agents of Viral Hemorrhagic Fever and Variola Virus.

    Science.gov (United States)

    Das, Sanchita; Rundell, Mark S; Mirza, Aashiq H; Pingle, Maneesh R; Shigyo, Kristi; Garrison, Aura R; Paragas, Jason; Smith, Scott K; Olson, Victoria A; Larone, Davise H; Spitzer, Eric D; Barany, Francis; Golightly, Linnie M

    2015-01-01

    CDC designated category A infectious agents pose a major risk to national security and require special action for public health preparedness. They include viruses that cause viral hemorrhagic fever (VHF) syndrome as well as variola virus, the agent of smallpox. VHF is characterized by hemorrhage and fever with multi-organ failure leading to high morbidity and mortality. Smallpox, a prior scourge, has been eradicated for decades, making it a particularly serious threat if released nefariously in the essentially non-immune world population. Early detection of the causative agents, and the ability to distinguish them from other pathogens, is essential to contain outbreaks, implement proper control measures, and prevent morbidity and mortality. We have developed a multiplex detection assay that uses several species-specific PCR primers to generate amplicons from multiple pathogens; these are then targeted in a ligase detection reaction (LDR). The resultant fluorescently-labeled ligation products are detected on a universal array enabling simultaneous identification of the pathogens. The assay was evaluated on 32 different isolates associated with VHF (ebolavirus, marburgvirus, Crimean Congo hemorrhagic fever virus, Lassa fever virus, Rift Valley fever virus, Dengue virus, and Yellow fever virus) as well as variola virus and vaccinia virus (the agent of smallpox and its vaccine strain, respectively). The assay was able to detect all viruses tested, including 8 sequences representative of different variola virus strains from the CDC repository. It does not cross react with other emerging zoonoses such as monkeypox virus or cowpox virus, or six flaviviruses tested (St. Louis encephalitis virus, Murray Valley encephalitis virus, Powassan virus, Tick-borne encephalitis virus, West Nile virus and Japanese encephalitis virus).

  1. Investigation of hemorrhagic fever viruses inside wild populations of ticks: One of the pioneer studies in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Rania Ali El Hadi Mohamed

    2017-05-01

    Full Text Available Objective: To screen hemorrhagic fever viruses inside wild populations of ticks collected from Riyadh, Saudi Arabia between January and March 2016. Methods: Ticks were identified depending on their morphological features using classical keys then grouped into pools. Ticks in each pool were processed separately using the sterile pestles and mortars. Viral RNA was extracted using Qiagen RNeasy Mini Kit and Qiagen RNAeasy Columns (Qiagen, Hilden, Germany according to the instructions of manufacturers. A total number of 1 282 hard ticks were collected, and 582 of them were precisely identified then screened for the presence of arboviruses using quantitative real-time PCR. The four species were screened for six viruses: Rift Valley fever virus (RVFV, Chikungunya virus (CHIKV, Crimean-Congo hemorrhagic fever virus (CCHFV, Alkhurma virus (INKV, Sindbis virus (SINV, and Pan Hanta virus (HANTA. CT value for the negative control (RNA free water was zero. Negative and positive controls were tested for each test to confirm the specificity of the selected primer pairs. SYBR Green One step RT-PCR Master Mix (KAPA Biosystems, Boston, MA was tested along with primers. Results: Ticks identification resulted into four species: Hyalomma schulzei, Hyalomma onatoli, Boophilus kdhlsi, and Hyalomm dromedarii. All the ticks’ species (except Boophilus kdhlsi were positive for the following viruses: SINV, RVFV, CHIKV, and CCHFV. While HANTA viruses have been detected in a single species (Hyalomm dromedarii. Conclusions: According to our knowledge this research may be one of the pioneer studies in Kingdom of Saudi Arabia. Incrimination of the above mentioned ticks species as well as their vectorial capacity are highly recommended for investigation in the upcoming researches.

  2. CRIMEAN TATAR FACTOR IN CRIMEA: THE CURRENT STATE AND PROSPECTS

    Directory of Open Access Journals (Sweden)

    D. A. Merenkov

    2017-01-01

    Full Text Available The article deals with the current situation of the Crimean Tatars in Crimea after joining Russia. It is considered a number of decisions taken by Russia, which changed the life of this national minority. For example, according an official status to the Crimean-Tatar language or improving living conditions in Crimean Tatars-populated areas. The article highlights the creation of the Spiritual Administration of Muslims of Crimea. The author describes the renewal of the mass media in Crimea and the creation of the TV and Radio company Millet instead of the Ukrainian TV channel ATR. The author stresses the difference in the approaches of the Ukrainian and Russian authorities to the question of the deportation of the Crimean Tatars in 1944. The article touches upon the UN General Assembly resolution A / RES / 71/205, 19 December 2016. It is devoted to “Situation of human rights in the Autonomous Republic of Crimea and the city of Sevastopol (Ukraine”. The author offers to get acquainted with the opinion of the Crimean Tatars, who live in Crimea at present, about their current situation after the reunification of Crimea and Sevastopol with Russia. It is analyzed the Ukrainian authorities’ policy on the Crimean Tatars. The author notes the negative effect of the Ukrainian authorities on radical feelings in Crimea. The process of forming these sentiments is considered in the article. The author notes the increased military activities by the illegal armed groups of the Crimean Tatars in the Ukrainian part of the Russian-Ukrainian state boundary. The article emphasizes the evaluation of the Crimean Tatars’ influence on security and stability on the peninsula, as well as the prospects of it. The author gives recommendations on the establishment of inter-ethnic relations, and notes that there is a potential for further development of inter-ethnic dialogue. The author concludes that the Crimean Tatars can act as a stabilizing and destabilizing

  3. Hospital-based surveillance for viral hemorrhagic fevers and hepatitides in Ghana.

    Directory of Open Access Journals (Sweden)

    Joseph Humphrey Kofi Bonney

    Full Text Available BACKGROUND: Viral hemorrhagic fevers (VHF are acute diseases associated with bleeding, organ failure, and shock. VHF may hardly be distinguished clinically from other diseases in the African hospital, including viral hepatitis. This study was conducted to determine if VHF and viral hepatitis contribute to hospital morbidity in the Central and Northern parts of Ghana. METHODOLOGY/PRINCIPAL FINDINGS: From 2009 to 2011, blood samples of 258 patients with VHF symptoms were collected at 18 hospitals in Ashanti, Brong-Ahafo, Northern, Upper West, and Upper East regions. Patients were tested by PCR for Lassa, Rift Valley, Crimean-Congo, Ebola/Marburg, and yellow fever viruses; hepatitis A (HAV, B (HBV, C (HCV, and E (HEV viruses; and by ELISA for serological hepatitis markers. None of the patients tested positive for VHF. However, 21 (8.1% showed anti-HBc IgM plus HBV DNA and/or HBsAg; 37 (14% showed HBsAg and HBV DNA without anti-HBc IgM; 26 (10% showed anti-HAV IgM and/or HAV RNA; and 20 (7.8% were HCV RNA-positive. None was positive for HEV RNA or anti-HEV IgM plus IgG. Viral genotypes were determined as HAV-IB, HBV-A and E, and HCV-1, 2, and 4. CONCLUSIONS/SIGNIFICANCE: VHFs do not cause significant hospital morbidity in the study area. However, the incidence of acute hepatitis A and B, and hepatitis B and C with active virus replication is high. These infections may mimic VHF and need to be considered if VHF is suspected. The data may help decision makers to allocate resources and focus surveillance systems on the diseases of relevance in Ghana.

  4. Reporting the Crimean War: Misinformation and Misinterpretation

    Directory of Open Access Journals (Sweden)

    Mike Hinton

    2015-05-01

    Full Text Available There is probably no important event in times past whose historiography is free from misinformation, misunderstanding, misinterpretation, or mistakes; and in this regard the Crimean War is no exception to this rule. The misinformation quoted in this article can be placed in at least one of four principal categories. The first involved either the failure to seek out primary sources for the correct information, or a demonstration of ignorance of military protocol, or the misrepresentation of data which in itself is not necessarily inaccurate. The three other examples are characterized by Samuel Butler’s bon mots that ‘though God cannot alter the past, historians can’. The first of these involved flights of fancy that are clearly absurd; the second comprises unkind and sometimes malicious remarks made without any reference to contemporary documents or reliable secondary sources that might support the assertions made; while the third, and possibly the most serious, was the seemingly deliberate falsification of the facts. The purpose of this article is to provide a selection of the many available examples of these misrepresentations which relate to the medical aspects of the Crimean campaign and to provide responses that hopefully go someway to setting the record straight.

  5. The Interethnic and Interreligious Values in Turkish and Crimean Legends

    OpenAIRE

    Anastasiia Zherdieva

    2014-01-01

    The present paper examines interethnic and interreligious values in Turkish and Crimean folk legends. The folklore of both Crimea and Turkey has a multicultural background, which makes both corpuses of texts suitable for research. In the course of the study, a wide range of published Turkish and Crimean legends were reviewed and analysed. There are two deeply-rooted tendencies in the studied legends. First of all, the interethnic and interreligious relationships can be described as ghastly an...

  6. "Congo" red: out of Africa?

    Science.gov (United States)

    Steensma, D P

    2001-02-01

    Congo red is the essential histologic stain for demonstrating the presence of amyloidosis in fixed tissues. To the best of my knowledge, nothing has been written about why the stain is named "Congo." To understand the etymology and history of the Congo red histologic stain. Primary sources were consulted extensively, including 19th-century corporate documents, newspapers, legal briefs, patents, memoirs, and scientific papers. Sources were obtained from multiple university libraries and German corporate archives. To Europeans in 1885, the word Congo evoked exotic images of far-off central Africa known as The Dark Continent. The African Congo was also a political flashpoint during the Age of Colonialism. "Congo" red was introduced in Berlin in 1885 as the first of the economically lucrative direct textile dyes. A patent on Congo red was filed by the AGFA Corporation of Berlin 3 weeks after the conclusion of the well-publicized Berlin West Africa Conference. During these important diplomatic talks, German Chancellor Otto von Bismarck presided over a discussion of free trade issues in the Congo River basin. A challenge to AGFA's Congo red patent led to a precedent-setting decision in intellectual property law. The Congo red stain was named "Congo" for marketing purposes by a German textile dyestuff company in 1885, reflecting geopolitical current events of that time.

  7. Russian nursing in the Crimean war.

    Science.gov (United States)

    Sorokina, T S

    1995-01-01

    Although the practice of military medicine and surgery goes back to antiquity, the British date the proper care of the wounded from the arrival of Florence Nightingale at Scutari in Turkey on 4 November 1854. The 140th anniversary of her work in that winter of the Crimean war is being celebrated by an exhibition at the Florence Nightingale Museum, 2 Lambeth Palace Road SE1 7EW, from 1 December 1994 till 30 April 1995. For the first time in this country it will tell a little of the other side of the story--the exploits of Russian nurses in caring for the casualties from both sides in the conflict--which is the subject of this article.

  8. Preretinal hemorrhage

    Directory of Open Access Journals (Sweden)

    Eduardo Felippe

    2004-12-01

    Full Text Available A case of Valsalva hemorrhagic retinopathy treated with Nd:YAGlaser indescribed. The patient presented decreased visual acuityafter coughing, and a preretinal hemorrhage was diagnosed in theposterior pole; puncturing the posterior hyaloid face was performedwith Nd:Yag laser. Rapid hemorrhage absorption was observedafter the therapy proposed and visual acuity was recovered. Nd:Yaglaser proved to be safe and efficient in the management of preretinalhemorrhage.

  9. Campaigns of the Crimean Tatars and Ottomans against Iran

    Directory of Open Access Journals (Sweden)

    Özer Küpeli

    2014-07-01

    Full Text Available Starting from the 15th century, when the Crimean Khanate recognized the authority of the Ottoman Empire, its forces was actively used by the Ottoman Empire in its foreign policy. Especially the Tatars were indispensable allies in campaigns against Western European countries, Caucasus, and, subsequently, in the containment of the Moscow State. However, Tatar troops of the Crimean Khanate were also used in other political directions of the Ottoman Empire. The main rival of the Ottoman State in the east was the Safavid Iran. Troops of the Crimean Khanate also took part in these campaigns of the Ottomans. The author describes the participation of Tatar troops in the war with Iran. During the Ottoman military campaigns, the Tatars, for the most part, played a role of Akinji moving ahead of the Ottoman forces and collecting trophies and prey in hostile lands, rather than participating in the frontline battles. Initially, the Crimean khans participated only in the wars that took place in the western territories. However, the situation changed in the second half of the 16th century under Sultan Suleiman, when the Crimean cavalry was also involved in the eastern campaigns. The Tatars did not particularly want to participate in campaigns against Iran. There were cases, when these campaigns ended in tears: with the capture of the heir to the Crimean throne (Adil Giray, its execution and the defeat of the Tatar army. However, the Crimean khans participated in every campaign against Iran on the side of the Ottoman Empire. Disobeying the Sultan orders could lead to the replacement of khan (Mehmed Giray II. Archive documents reveal that the number of Tatar troops sent against Iran, ranged from 5 to 10 thousand soldiers, although the Ottoman sources overestimates the amount (30–40 thousand.

  10. Crimean-Congo haemorrhagic fever virus in Kazakhstan (1948-2013

    Directory of Open Access Journals (Sweden)

    Talgat Nurmakhanov

    2015-09-01

    The southern regions of Kazakhstan should be considered endemic for CCHF with cases reported from these territories on an annual basis. Modern diagnostic technologies allow for rapid clinical diagnosis and for surveillance studies to monitor for potential expansion in known risk areas.

  11. Country Presentation Congo

    International Nuclear Information System (INIS)

    Mwata, P.K.; SAKI, A.; KAZADI, J.

    2010-01-01

    Illicit trafficking of radioactive minerals, precious metals and nuclear materials is generally expanded practice in some parts of the Democratic Republic of Congo. The phenomenon took place early in 1990 and amplified from 1998. The main causes of this practice are political instability that led to general poverty among population and the lack of legal framework governing the exploitation of minerals. Nuclear Illicit trafficking in Congo concerns radioactive mineral sand precious metals in eastern and southern parts of the country. The unfavorable political environment that took place in Congo in the 1990s resulted in local manpower and mine workers immigrating to neighboring countries. A great fraction of these new jobless started exploiting abandoned mines residues searching for Cu, Co and Au for survival. First cases of illicit exploitation of uranium minerals were reported very soon after rock sliding that occurred in 2004 on Shinkolobwe site in Katanga region. This uncontrolled mineral exploitation got worse when several mining companies were licensed by GECAMINES company to explore, exploit, purchase minerals from individuals and export raw materials and concentrates.

  12. Subconjunctival hemorrhage

    Science.gov (United States)

    ... the eyes Viral infection Certain eye surgeries or injuries A subconjunctival hemorrhage is common in newborn infants. In this case, the condition is thought to be caused by the pressure changes across the infant's body during childbirth.

  13. Florence Nightingale: her Crimean fever and chronic illness.

    Science.gov (United States)

    Dossey, Barbara M

    2010-03-01

    Florence Nightingale's Crimean fever and chronic illness have intrigued historians for more than a century and a half. The purpose of this article is threefold: (a) to discuss the facts that point to the cause of Nightingale's Crimean fever as brucellosis, (b) to show that her debilitating illness for 32 years (1855-1887) was compatible with the specific form of chronic brucellosis, and (c) to present new evidence that she was still having severe symptoms in December 1887, when it was previously felt that she had no severe symptoms after 1870.

  14. Intracranial Hemorrhage

    Science.gov (United States)

    2011-01-01

    Intracranial hemorrhage is a life-threatening condition, the outcome of which can be improved by intensive care. Intracranial hemorrhage may be spontaneous, precipitated by an underlying vascular malformation, induced by trauma, or related to therapeutic anticoagulation. The goals of critical care are to assess the proximate cause, minimize the risks of hemorrhage expansion through blood pressure control and correction of coagulopathy, and obliterate vascular lesions with a high risk of acute rebleeding. Simple bedside scales and interpretation of computed tomography scans assess the severity of neurological injury. Myocardial stunning and pulmonary edema related to neurological injury should be anticipated, and can usually be managed. Fever (often not from infection) is common and can be effectively treated, although therapeutic cooling has not been shown to improve outcomes after intracranial hemorrhage. Most functional and cognitive recovery takes place weeks to months after discharge; expected levels of functional independence (no disability, disability but independence with a device, dependence) may guide conversations with patient representatives. Goals of care impact mortality, with do-not-resuscitate status increasing the predicted mortality for any level of severity of intraparenchymal hemorrhage. Future directions include refining the use of bedside neuromonitoring (electroencephalogram, invasive monitors), novel approaches to reduce intracranial hemorrhage expansion, minimizing vasospasm, and refining the assessment of quality of life to guide rehabilitation and therapy. PMID:22167847

  15. Saker Falcon on the Crimean Peninsula

    Directory of Open Access Journals (Sweden)

    Igor V. Karyakin

    2016-02-01

    Full Text Available In this article we made a revaluation of a number of the Saker (Falco cherrug on the Crimean Peninsula based on data obtained in an expedition conducted in May 9–26 of 2015. During this expedition Sakers were observed on 58 sites (31 times they were seen on pylons of power lines, 14 – on cliffs in the foothills of Crimean Mountains, 8 – on the coastal cliffs and 4 on the coastal precipices, and one adult male was seen in the forest shelter belt near Syvash lagoon. We revealed 49 breeding territories of Saker including 42 occupied nests with successful breeding. The estimation of the total number of breeding population on peninsula is 145–184 (mean 165 breeding pairs, including 125–159 (mean 142 pairs which breeding attempts were successful in 2015. The distance between the neighboring pairs is 1.95–15.21 km (mean 6.56±3.37 km, n=43. Pylons of power lines were used by 30 breeding pairs (61.22% out of 49, and 29 successful nests (69.05% out of 42 were built on pylons. Supposedly, 63.83% of all breeding pairs in Crimea are bred on pylons, and the percentage of successful nests out of the total number of nests in population is 71.89%. From the 34 nests that were built on pylons, 24 (70.59% were located on the concrete pylons and 10 (29.41% on the metal ones. On cliffs and precipices we found 24 nests in total. Eighteen (75% of them were built on a bare ground, while the others were found in the nests built by other bird species (most of them were made in the former nests of the Raven (Corvus corax, and one pair occupies a nest of the Long-legged Buzzard (Buteo rufinus located on cliff. The percentage of successful nests out of occupied ones was 85.71%. We found broods of 1–4 nestlings, which in average (n=23 makes 2.83±0.78 nestling per successful nest. The majority of broods (65.22% consisted of 3 nestlings. On 20 breeding territories (90.91% male birds were older then 2 years old, and two breeding territories (9.09% were occupied

  16. Pathogenesis of lober intracerebral hemorrhage related to cerebral amyloid angiopathy

    International Nuclear Information System (INIS)

    Sakai, Naoto; Namba, Hiroki; Miura, Katsutoshi; Baba, Satoshi; Isoda, Haruo; Yokoyama, Tetsuo

    2010-01-01

    Cerebral amyloid angiopathy (CAA) is an important cause of lober intracerebral hemorrhage in the elderly. Although leptomeningeal and cortical arteries with the deposition of the amyloid β-protein (Aβ) have been thought to rupture in CAA, the pathogenesis of CAA-related hemorrhage still remains obscure. We studied 10 cases of CAA according to the Boston criteria from April 2006 to July 2009 in Omaezaki Municipal Hospital. Based on clinical data, we examined the primary site of hemorrhage and hypothesized the mechanisms of bleeding. Intracerebral hematoma evacuation was performed to alleviate neurological deteriolation in 2 patients and to make diagnosis in 3 patients. The surgical specimens were pathologically examined. The characteristic MR images of CAA related hemorrhage were characterized by microbleeds, superficial siderosis, subpial or subarachnoid hemorrhage, subcortical hemorrhage and lober intracerebral hemorrhage. Chronological images obtained in 1 patient revealed that lober intracerebral hemorrhage developed from microbleed with subpial hemorrhage without subarachnoid hemorrhage in one side of the cortex in the affected facing cerebral sulci. Operative findings showed subpial and subarachnoid hemorrhages around the cortical veins on the affected cerebral sulci in all cases. Abnormal fragile vessels existed in one side of the cortex of the affected sulci but not in the other side of the cortex. Complete hamatoma evacuation was performed in 4 cases. The surgical specimens of the hematoma and the adjacent brain parenchyma were pathologically examined by tissue staining with hematoxylin-eosin and Congo red. Many vessels in subpial, subcortical and subarachnoid space along the cerebral sulci were deposited with Aβ. From these findings, we speculated that the primary hemorrhage related to CAA occurred from the cortical arteries with Aβ deposition in the subpial space along the cerebral sulci and formed a lober intracerebral hematoma. Subarachnoid

  17. Looking closer at the Congo

    DEFF Research Database (Denmark)

    Jansson, Johanna; Jiang, Wenran

    2011-01-01

    An NGO report on Chinese investment in the Democratic Republic of Congo opens a vital debate, but its methodology leaves the reader wanting a fuller version of the facts, write Johanna Jansson and Jiang Wenran.......An NGO report on Chinese investment in the Democratic Republic of Congo opens a vital debate, but its methodology leaves the reader wanting a fuller version of the facts, write Johanna Jansson and Jiang Wenran....

  18. Development of the State Correspondence Language of the Crimean Khanate

    Directory of Open Access Journals (Sweden)

    R.R. Abduzhemilev

    2016-12-01

    Full Text Available Objectvie and materials of the research: In the article the matter for consideration is the problem of the lingual basis in yarlyks of the Crimean Khanate. The author seeks to trace the process of the formation of the state language of the Crimean Khanate on the material of the official letters and decrees. The main statements characterizing the object of the study are formulated. The article presents the views of the famous orientalists, in which the structure of the yarlyk’s language is reflected. An important attention is focused on the ration of the Kipchak and Oguz elements. The period from the 13th century to the 16th century is marked by the development of the language called «desht tili», i.e. the language of Desht-i Kipchak. Results and novelty of the research: The author emphasizes that the language of the yarlyks of the Crimean Khanate is a heritage of the literary language of the Jochid ulus (Golden Horde, and even earlier one – of Desht-i Kipchak. Kipchaks dominated the extremely vast territory. The Kipchak language for a long time was used in the correspondence between Bakhchisaray and Moscow. As for the correspondence between Bakhchisaray and Istanbul, instead of Kipchak there was used Ottoman language. The correspondence between Crimea and Poland was mixed: both Kipchak and Ottoman languages were in use. Concerning the lexical structure of yarlyks, there are many Arabic and Persian words and forms which became inseparable part of the Crimean Tatar language. While the texts of the early yarlyks are full mostly of Turkic words, then in the late yarlyks Arabic and Persian words in some cases displaced original Turkic words. Therefore, today the issue of the reconstruction of the Turkic basis is of high importance. The language of the official correspondence from the Crimean Khanate’s Office is one of the indicators of the development of integral state formation on the map of the Eastern Europe. On the one hand, the language

  19. The Interethnic and Interreligious Values in Turkish and Crimean Legends

    Directory of Open Access Journals (Sweden)

    Anastasiia Zherdieva

    2014-05-01

    Full Text Available The present paper examines interethnic and interreligious values in Turkish and Crimean folk legends. The folklore of both Crimea and Turkey has a multicultural background, which makes both corpuses of texts suitable for research. In the course of the study, a wide range of published Turkish and Crimean legends were reviewed and analysed. There are two deeply-rooted tendencies in the studied legends. First of all, the interethnic and interreligious relationships can be described as ghastly and cursed. Thus, antagonists in the legends are often from ethnic minorities or strangers in relation to domestic ethnic groups. However, if the texts are analysed thoroughly, we can see that there are important sacred cultural values at the core of the legends, including values of life, health, and divinity.

  20. Collective and Personal Representations of the Crimean Tatars in the Ukrainian Media Discourse: Ideological Implications and Power Relations

    OpenAIRE

    Bezverkha, Anastasia

    2015-01-01

    This study analyzes the Ukrainian national and Crimean media’s collective and individual representations of the Crimean Tatar people during 2010–2012. It demonstrates that this media’s discourse was a sensitive milieu that reflected the unequal power relations between Crimea’s ethnic groups — the Crimean Tatar minority and the Slavic majority — and informed the way individuals constructed their identities and social roles within Crimean society. The discursive mechanisms of the media’s repres...

  1. Results of experimental electromagnetic studies of the Crimean region

    OpenAIRE

    Burakhovich, T. K.; Kushnir, A. M.; Nikolaev, I. Yu.; Sheremet, E. M.; Shirkov, B. I.

    2017-01-01

    Spatial-temporal pattern of distribution of geomagnetic variations and the electric field on the Earth’s surface was obtained as a result of the modern experimental observations conducted in 2007—2013 along 9 profiles (48 points) by the methods of magnetotelluric sounding (MTS) and magnetovariation profiling (MVP). These profiles cross various geological structures of the Crimean region. It is possible to estimate the value of the electrical conductivity and vertical and horizontal geoelectri...

  2. The Formation of the Crimean Tatar Literary Language in the 15th–17th centuries

    Directory of Open Access Journals (Sweden)

    O.D. Rustemov

    2018-03-01

    Full Text Available Research objective: Linguistic analysis of the Crimean Tatar language in official documents against the backdrop of the literary and written traditions of the Golden Horde, a polity to which the Crimean ulus belonged for quite a long time. Research materials: The yarlik of the Crimean khan, Bora Gaza Girey, which we transliterated and translated into Russian, is used as an illustrative text. The language of this yarlik makes it possible to analyze the lexical and grammatical changes in the written language of the Golden Horde which occurred in Crimea under local and Ottoman dialectical influences. Being subjected to changes of this kind, the Golden Horde’s Türki can already be defined as having shifted to the Crimean mixed-Türki of the stated period. The study of the language of the Crimean khans’ yalriks and the parallel study of the language of other Crimean official documents provide an accurate picture of the language processes in the Crimea during the period of the Crimean Khanate, not only at the level of written language, but also at the level of the spoken one. Results and novelty of the research: The efforts of the author on the analysis of the Crimean variant of the Türki language were undertaken for the first time in Turkic studies. As a result, the author revealed not only the substrata of the Ottoman, but also the local Oghuz-Kypchak dialect, recorded in the Codex Cumanicus.

  3. THE CRIMEAN WAR AND ITS EFFECTS ON OTTOMAN SOCIAL LIFE

    OpenAIRE

    GÜNAY, Bekir

    2014-01-01

    THE CRIMEAN WAR AND ITS EFFECTS ON OTTOMAN SOCIAL LIFE     "Westernization" movement of Ottoman State starting with Selim III gained momentum with 1839 Tanzimat. Reference of social structure defined by the Tanzimat is Europe. In 1841 London agreement, Ottoman State's territorial integrity and sovereignity was preserved by European great states.     On January 9th, 1853 in St Petersburg in the historical debate between Tzcar Nicola I and British Ambassador Sir George Hamilton a...

  4. The petroleum economy of the Congo

    International Nuclear Information System (INIS)

    Gualbert-Brice Massengo, Ph.D.

    2005-01-01

    The author aims to explain the petroleum phenomena in Congo as a contribution to the truth. The Congo petroleum experience can be seen as a lesson for the next generations and for the other african countries. The Congo Brazzaville, a little country by its population and well equipped in natural and human resources, is become meanwhile a non security area for its inhabitants because of a decreasing economy and a continuous political crisis. (A.L.B.)

  5. Ebola Virus Disease, Democratic Republic of the Congo, 2014.

    Science.gov (United States)

    Nanclares, Carolina; Kapetshi, Jimmy; Lionetto, Fanshen; de la Rosa, Olimpia; Tamfun, Jean-Jacques Muyembe; Alia, Miriam; Kobinger, Gary; Bernasconi, Andrea

    2016-09-01

    During July-November 2014, the Democratic Republic of the Congo underwent its seventh Ebola virus disease (EVD) outbreak. The etiologic agent was Zaire Ebola virus; 66 cases were reported (overall case-fatality rate 74.2%). Through a retrospective observational study of confirmed EVD in 25 patients admitted to either of 2 Ebola treatment centers, we described clinical features and investigated correlates associated with death. Clinical features were mainly generic. At admission, 76% of patients had >1 gastrointestinal symptom and 28% >1 hemorrhagic symptom. The case-fatality rate in this group was 48% and was higher for female patients (67%). Cox regression analysis correlated death with initial low cycle threshold, indicating high viral load. Cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history. Differences from other outbreaks could suggest guidance for optimizing clinical management and disease control.

  6. A Historical Survey of Military Health Services: The Crimean War and Florence Nigtingale

    OpenAIRE

    Unal Demirtas; Gultekin Ozturk; Aslan Ozden

    2014-01-01

    During the Crimean War freezing cold and contagious diseases was more important than the Russian soldiers for the allied armies. Typhus, scorbut, cholera and malaria prepare the dead of a large number of soldiers. According to the resources, the contagious diseases led to death more than ten times of the military actions. That and #8217;s why, The European armies understood the importance of the treatment diseases in the war and the Crimean War became the beginning point in military health co...

  7. Tick infestation: a 200-patients' series | Guven | African Journal of ...

    African Journals Online (AJOL)

    Conclusions: Although non-of the patients of our study has been diagnosed with Crimean-Congo hemorrhagic fever we informed all of them for the incubation period and call for observation during the time. Tick borne infections may present with vary of symptoms, the most sever of which is hemorrhagic diathesis and ...

  8. Intracerebral hemorrhage (image)

    Science.gov (United States)

    Intracerebral hemorrhage may be caused by trauma (brain injury) or abnormalities of the blood vessels (aneurysm or angioma), but it is most commonly associated with high blood pressure (hypertensive intracerebral hemorrhage).

  9. CT in pontine hemorrhage

    International Nuclear Information System (INIS)

    Iwasaki, Yasuo; Kinoshita, Masao; Ikeda, Ken; Sasaki, Atsushi.

    1988-01-01

    The clinical and CT findings in 10 patients with primary pontine hemorrhage were reviewed. All patients were hypertensive. Pontine hemorrhage can be divided into 3 groups from the viewpoint of location of hematomas. These are the tegmentobasilar type, tegmental type and basilar type. The tegmentobasilar type produces characteristic clinical features for pontine hemorrhage and poor prognosis, otherwise, another two types produce atypical clinical features for pontine hemorrhage and good prognosis. (author)

  10. A survey of Crimean-Congo haemorrhagic fever in livestock and ticks in Ardabil Province, Iran during 2004-2005

    DEFF Research Database (Denmark)

    Telmadarraiy, Z; Ghiasi, Seyed Mojtaba; Moradi, Maryam

    2010-01-01

    for the presence of CCHF virus genome using gel-based and real-time reverse transcriptase polymerase chain reactions (RT-PCR). The results showed CCHF infection in almost 28% of ticks collectively. Also, of 56 livestock sera, around 39% were IgG-positive. The presence of anti-CCHF virus IgG antibodies and the CCHF...... in the adjacent districts. A comprehensive study was carried out to assess the epidemiological aspects of the disease in this province. In the study area, 130 ticks were collected from randomly selected villages and classified into 9 species of hard tick and 2 species of soft tick. All ticks were analyzed...

  11. [Ebola hemorrhagic fever: its extension reflects the African sanitary disaster].

    Science.gov (United States)

    Bourée, Patrice

    2014-09-01

    Ebola virus, described in 1976 in Zaire, causes severe hemorrhagic fever with a high mortality rate in humans and nonhuman primates. Epidemics occurred since this time to nowadays in Sudan, Gabon, Congo and currently in Guinea, Liberia, Sierra-Leone, Nigeria and Senegal. Specific treatment and vaccine are not available. So, to prevent the virus transmission with live and dead patients, we must use strict individual and collective measures which are not always understood by local populations and make contact tracing; it is the only way to curb the epidemic.

  12. Evaluation of Intraventricular Hemorrhage in Pediatric Intracerebral hemorrhage

    OpenAIRE

    Kleinman, Jonathan T; Beslow, Lauren A; Engelmann, Kyle; Smith, Sabrina E; Licht, Daniel J; Ichord, Rebecca N; Jordan, Lori C

    2011-01-01

    Previous studies of pediatric intracerebral hemorrhage have investigated isolated intraparenchymal hemorrhage. We investigated whether detailed assessment of intraventricular hemorrhage enhanced outcome prediction after intracerebral hemorrhage. We prospectively enrolled 46 children, full-term to 17 years, median age 2.7 years with spontaneous intraparenchymal hemorrhage and/or intraventricular hemorrhage. Outcome was assessed with the King’s Outcome Scale for Childhood Head Injury. Twenty-si...

  13. Cerebral Cavernous Malformation and Hemorrhage

    Science.gov (United States)

    ... Text Size: SMALL • LARGE Cerebral Cavernous Angioma and Hemorrhage By Jack Hoch; Reviewed by Dr. Issam Awad ... for years, the mechanism by which these lesions hemorrhage remains poorly understood. Hemorrhage Types Since cavernous angiomas ...

  14. Off the Chart: The Crimean War in British Public Consciousness

    Directory of Open Access Journals (Sweden)

    A. L. Berridge

    2015-05-01

    Full Text Available The Crimean War revealed in this issue of '19' is of such rich and varied historical interest as to make a mystery of its relative obscurity with the general public in the UK. My own article adopts a novelist’s perspective to chart some aspects of this popular decline, exploring the treatment of the Siege of Sebastopol through the media of painting, literature, and cinema, and considering whether those aspects of the war that have made the greatest impression on the public mind are also those that make it least commercially attractive. It also examines the more official legacy, from the treatment of war dead to the changing face of sculpted memorials, and by comparing British commemoration with that of Russians in Crimea, discusses the possible role played in national memory by both shame and pride. In a final brief analysis of the 1968 film 'The Charge of the Light Brigade', I consider the extent to which modern rejection of Victorian values has created historical distortion, and whether a more truthful presentation might better serve the cause of preserving an important war in the British public consciousness.

  15. CRIMEAN WAR AND ESTABLISHING OF PUBLIC HEALTH SYSTEM IN GREAT BRITAIN

    OpenAIRE

    SKLYAROVA ELENA

    2017-01-01

    Crimean War of 1853 1856 is a factor of important socio-political and socio-medical reforms. Study of these cases is characterized as interdisciplinary. At the edge of Crimean War Great Britain press highlighted aspiration of the empire to capture russian territories of Black sea region, also reforms and work of E.Chadwick, founder of public health system, were criticized, he was wanted to be away from members of parliament and London oligarchs due to his extreme reforms and British corruptio...

  16. Treating viral hemorrhagic fever.

    NARCIS (Netherlands)

    Mairuhu, A.T.; Brandjes, D.P.; Gorp, E. van

    2003-01-01

    Viral hemorrhagic fevers are illnesses associated with a number of geographically restricted, mostly tropical areas. Over recent decades a number of new hemorrhagic fever viruses have emerged. Advances in our understanding of the pathophysiology of these diseases have improved our initial supportive

  17. Hemorrhagic prepatellar bursitis

    Energy Technology Data Exchange (ETDEWEB)

    Donahue, F. [Dept. of Radiology, Musculoskeletal Section, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Turkel, D. [Dept. of Radiology, Musculoskeletal Section, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Mnaymneh, W. [Dept. of Orthopedics, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Ghandur-Mnaymneh, L. [Dept. of Pathology, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States)

    1996-04-01

    Simple prepatellar bursitis is easily diagnosed both clinically and by MRI. MRI shows the typical T1 and T2 lengthening of fluid within the bursa. However, because of complex MRI appearance of hemorrhage, chronic hemorrhagic bursitis and the size of the prepatellar mass the clinical and MRI appearance can be very different. (orig.)

  18. HEMORRHAGIC-FEVER VIRUS-INFECTIONS IN AN ISOLATED RAIN-FOREST AREA OF CENTRAL LIBERIA - LIMITATIONS OF THE INDIRECT IMMUNOFLUORESCENCE SLIDE TEST FOR ANTIBODY SCREENING IN AFRICA

    NARCIS (Netherlands)

    van der Waals, F. W.; Pomeroy, K. L.; Goudsmit, J.; Asher, D. M.; Gajdusek, D. C.

    1986-01-01

    Serum samples from 119 healthy individuals and 106 epilepsy patients inhabiting Grand Bassa County, Liberia, were tested for antibodies to hemorrhagic fever viruses (HFV) by indirect immunofluorescence. E6 Vero cells infected with Lassa fever virus (LAS), Rift Valley Fever virus (RVF), Congo

  19. Evaluation of Intraventricular Hemorrhage in Pediatric Intracerebral hemorrhage

    Science.gov (United States)

    Kleinman, Jonathan T; Beslow, Lauren A; Engelmann, Kyle; Smith, Sabrina E; Licht, Daniel J; Ichord, Rebecca N; Jordan, Lori C

    2012-01-01

    Previous studies of pediatric intracerebral hemorrhage have investigated isolated intraparenchymal hemorrhage. We investigated whether detailed assessment of intraventricular hemorrhage enhanced outcome prediction after intracerebral hemorrhage. We prospectively enrolled 46 children, full-term to 17 years, median age 2.7 years with spontaneous intraparenchymal hemorrhage and/or intraventricular hemorrhage. Outcome was assessed with the King’s Outcome Scale for Childhood Head Injury. Twenty-six (57%) had intraparenchymal hemorrhage, 10 (22%) had pure intraventricular hemorrhage, and 10 (22%) had both. There were 2 deaths, both with intraparenchymal hemorrhage + intraventricular hemorrhage volume ≥4% of total brain volume. Presence of intraventricular hemorrhage was not associated with poor outcome, but hydrocephalus showed a trend (p=0.09) toward poor outcome. In receiver operating characteristic curve analysis, combined intraparenchymal hemorrhage + intraventricular hemorrhage volume also showed a trend toward better outcome prediction than intraparenchymal hemorrhage volume alone. Although not an independent outcome predictor, future studies should assess intraventricular hemorrhage qualitatively and quantitatively. PMID:22068828

  20. Stage of the Analysis of the Crimean Khanate Sources: V.D. Smirnov »

    Directory of Open Access Journals (Sweden)

    A.A. Nepomnyashchiy

    2015-09-01

    Full Text Available On the basis of a substantial body of archival documents of the Institute of Oriental Manuscripts of the Russian Academy of Sciences and the little-known publications, the author has restored laborious work of professor of St. Petersburg University Vasiliy Dmitrievich Smirnov who collected, organized and preserved in the central archival repositories sources for the history of the Crimean Khanate. The author has reconstructed the main events in his life and his activities in the Imperial Public Library related to the concentration in this store of the Crimean Tatar documents (article also contains a short list of his main works. Not limited to the literary sources of Turkey and Russia, Vasiliy Dmitrievich repeatedly worked in the libraries of Budapest, Vienna, London, and Paris. In the 1880’s, he continued to develop the theme of his doctoral thesis and combined literary studies and work in the archives with archaeological researches in the Crimea. The author has analyzed the process of creating of the largest work on the history of the Crimean Khanate, which remains hitherto an unrivaled. V.D. Smirnov managed to summarize Turkish sources (medieval Ottoman and Crimean “chronicles”, most of which have not yet been translated and historiography. This work continues to constitute a historiographical interest in the present. He widely covered, in the first place, the political history of the Crimean Khanate. The author have reviewed the research trip of V.D. Smirnov to the Crimea, his work in local archives, and communication with experts in the Crimean Tatar and Ottoman history. The author has considered the epistolary heritage of the scholar and, on this basis, discovered his academic contacts with leading researchers of Crimea of that time. The author found that he corresponded with such researchers as A.I. Markevich, N.A. Sultan Krym Giray, Z.A. Firkovich, S.M. Shapshal. To V.D. Smirnov belong a comprehensive source study on the history of

  1. Northern Black Sea Region in 1400–1442 and the Origin of the Crimean Khanate

    Directory of Open Access Journals (Sweden)

    V.P. Gulevych

    2013-09-01

    Full Text Available The history of the Crimean Khanate’s foundation still remains poorly studied. Also, little is known about the early years of the first Crimean khan Haci I Giray whose ancestors ruled in the Crimea and the Golden Horde. In the 20s of the 15th century the Grand Duke of Lithuania Vytautas actively intervened in the affairs of the Crimea and the Golden Horde trying to establish his sovereignty in the city of Caffa, where he strove to nominate subordinated khans. However, at the end of his reign, he could not exert a serious military pressure because until he died, he was occupied with his coronation. The boundaries of the Crimean tumen extended from the river Dniester in the West to the Volga River in the East, from the mean flow of the Dnieper and Southern Bug River in the North to the coastal cities of the Crimean peninsula in the south. In the first half of 15th century, there were many stationary settlements of Tatars in the Black Sea steppes. Thus, the tumen occupied a large territory. Having a great military power, the Crimean rulers did not separate the Crimean Ulus from the Golden Horde, but used the peninsula as a staging area for the seizure of power in the state capital city of Sarai. The Tatar nobility also sought to enthrone those khans who would be dependent on them. One of their strongest representatives was Tehene-bey who had a residence in Solkhat on the Crimean peninsula. He persuaded Vytautas to give them Ulugh Muhammad as a khan. In response, the khan nominated Tehene-bey as his deputy in the Crimea. A few years later, Ulugh Muhammad quarreled both with Tehene-bey and the Lithuanian ruler Švitrigaila. In 1433, the Grand Duke of Lithuania helped Khan Sayid Ahmad II both to split the Golden Horde and to seize power on the right bank of the Dnieper. According to many historians, Haci Giray seized power in the Crimea and defeated a Genoese military detachment in 1434, but this statement is not confirmed by the written sources and

  2. Mortality after hemorrhagic stroke

    DEFF Research Database (Denmark)

    González-Pérez, Antonio; Gaist, David; Wallander, Mari-Ann

    2013-01-01

    OBJECTIVE: To investigate short-term case fatality and long-term mortality after intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) using data from The Health Improvement Network database. METHODS: Thirty-day case fatality was stratified by age, sex, and calendar year after ICH...... = 0.03). CONCLUSIONS: More than one-third of individuals die in the first month after hemorrhagic stroke, and patients younger than 50 years are more likely to die after ICH than SAH. Short-term case fatality has decreased over time. Patients who survive hemorrhagic stroke have a continuing elevated......, 54.6% for 80-89 years; SAH: 20.3% for 20-49 years, 56.7% for 80-89 years; both p-trend stroke patients...

  3. Recurrent Intracerebral Hemorrhage

    DEFF Research Database (Denmark)

    Schmidt, Linnea Boegeskov; Goertz, Sanne; Wohlfahrt, Jan

    2016-01-01

    BACKGROUND: Intracerebral hemorrhage (ICH) is a disease with high mortality and a substantial risk of recurrence. However, the recurrence risk is poorly documented and the knowledge of potential predictors for recurrence among co-morbidities and medicine with antithrombotic effect is limited....... OBJECTIVES: 1) To estimate the short- and long-term cumulative risks of recurrent intracerebral hemorrhage (ICH). 2) To investigate associations between typical comorbid diseases, surgical treatment, use of medicine with antithrombotic effects, including antithrombotic treatment (ATT), selective serotonin...

  4. Hemorrhagic brain metastases

    International Nuclear Information System (INIS)

    Takahashi, Motoichiro; Takekawa, S.D.; Suzuki, Kenzo

    1986-01-01

    Tumor hemorrhage on computed tomography (CT) was found in 14 patients with brain metastases (7 % of two hundred patients with brain metastases), from April 1979 to July 1983. Primary foci of these lesions were the lung (6 patients), breast (2), kidney (2), uterus (2), colon (1) and adrenal gland (1). ''Stroke'' syndrome was the initial presenting symptom in 3 patients; neurological focal sign or symptoms of increased intracranial pressure in the remaining patients. CT demonstrated peritumoral hemorrhage in all patients with solid mass, intratumoral hemorrhage in a few patients and also cerebral or ventricular hemorrhage, which was fatal complication, in 2 patients (colon and breast cancers). A cystic mass with fluid-blood level was noted in a patient with breast cancer. Several predisposing factors including chemotherapy, thrombocytopenia, radiotherapy or combination of these were recognized in 8 patients. Of these, chemotherapy was the most causative factor of tumor hemorrhage. Brain irradiation for hemorrhagic brain metastases was effective for prolongation of mean survival time of these patients as follows; 10 months in irradiated group, whereas 1.5 months in non-irradiated group. (author)

  5. The Crimean Tatars and Their Influence on the ̀Triangle of Conflict' - Russia-Crimea-Ukraine

    National Research Council Canada - National Science Library

    Daydov, Igor

    2008-01-01

    .... Local Crimean authorities took advantage of the specificity of a demographic situation in Crimea were Ukrainians, the titular nation, are in minority and considerably Russified to claim for autonomy...

  6. Problems in the Study of the Crimean Court Registries of the 17th–18th centuries »

    Directory of Open Access Journals (Sweden)

    O.D. Rustemov

    2016-09-01

    Full Text Available The first mention of the Crimean court registries – sijils – belong to the 1800s. At that time, translations of some texts were made, the content of these monuments was relatively minutely described and their historical and philological significance was evaluated. However, separate volumes of presented documents still have not been published. Neither comprehensive linguistic study nor description of terminology and style of these texts have not been made. Research objectives: study of the Crimean court registries of the 17th–18th centuries. One of the problems lying on the surface of this field of study of the Crimean Tatar language history and the right is the question about the compilers of these judicial materials. Whom we can consider the author or scribe of a court registry? How competent is an assertion that these books are kadiaskers books? Research materials: the court registries, kadylyk, kadiasker defters. The paper also raised the question of authenticity of the Crimean law and the two sources of the entire justice system of this Eastern European Turkic state: Sharia and actual Turkic law – Töre implemented subsequently in various legislative compilations, such as the Yasa of Chinggis Khan. Another issue of research of these monuments is the question of their content. Fedor Lashkov identified the Crimean records of Sharia courts as a sort of land records’ acts. Research results and novelty: As a result of a detailed study, the author found that its own jurisdiction and its own laws, which did not always coincide with the laws of the Ottoman Empire, functioned in the Crimean Khanate. Despite their historical and philological value as well as more than a century of study, Crimean court registries still contain many blank spots. This again points to the need for their early reading, translation into modern Turkish language and publication, which should be carried out in the Crimean Tatar and Russian languages.

  7. Imaging of Hemorrhagic Stroke.

    Science.gov (United States)

    Hakimi, Ryan; Garg, Ankur

    2016-10-01

    Hemorrhagic stroke comprises approximately 15% to 20% of all strokes. This article provides readers with an understanding of the indications and significance of various neuroimaging techniques available for patients presenting with hemorrhagic strokes of distinct causes. The most common initial neuroimaging study is a noncontrast head CT, which allows for the identification of hemorrhage. Once an intracranial hemorrhage has been identified, the pattern of blood and the patient's medical history, neurologic examination, and laboratory studies lead the practitioner to pursue further neuroimaging studies to guide the medical, surgical, and interventional management. Given that hemorrhagic stroke constitutes a heterogeneous collection of diagnoses, the subsequent neuroimaging pathway necessary to better evaluate and care for these patients is variable based on the etiology.With an increasing incidence and prevalence of atrial fibrillation associated with the aging population and the introduction of three new direct factor Xa inhibitors and one direct thrombin inhibitor to complement vitamin K antagonists, oral anticoagulant use continues to increase. Patients on oral anticoagulants have a sevenfold to tenfold increased risk for intracerebral hemorrhage (ICH). Furthermore, patients who have an ICH associated with oral anticoagulant use have a higher mortality rate than those with primary ICH. Despite the reduced incidence of hypertension-related ICH over the past decade, it is expected that the incidence of ICH will continue to increase. Neuroimaging studies are integral to the identification of hemorrhagic stroke, determination of the underlying etiology, prevention of hematoma expansion, treatment of acute complications, and treatment of the underlying etiology, if indicated. Neuroimaging is essential for prognostication and thus directly impacts patient care.

  8. Democratic Republic of Congo Jobs Diagnostic

    OpenAIRE

    Aterido, Reyes; Gonzalez, Alvaro; Merotto, Dino; Petracco, Carly; Sanchez-Reaza, Javier

    2018-01-01

    The economy of the Democratic Republic of Congo is not creating sufficient jobs for its young and rapidly growing workforce. Although the Congolese economy has experienced fast growth and poverty has declined, further reducing poverty will require more dynamic job creation and continued reductions in fertility rates. The current youth bulge and potential demographic dividend will open a un...

  9. Viral hemorrhagic septicemia

    Science.gov (United States)

    Batts, William N.; Winton, James R.

    2012-01-01

    Viral hemorrhagic septicemia (VHS) is one of the most important viral diseases of finfish worldwide. In the past, VHS was thought to affect mainly rainbow trout Oncorhynchus mykiss reared at freshwater facilities in Western Europe where it was known by various names including Egtved disease and infectious kidney swelling and liver degeneration (Wolf 1988). Today, VHS is known as an important source of mortality for cultured and wild fish in freshwater and marine environments in several regions of the northern hemisphere (Dixon 1999; Gagné et al. 2007; Kim and Faisal 2011; Lumsden et al. 2007; Marty et al. 1998, 2003; Meyers and Winton 1995; Skall et al. 2005b; Smail 1999; Takano et al. 2001). Viral hemorrhagic septicemia is caused by the fish rhabdovirus, viral hemorrhagic septicemia virus (VHSV), a member of the genus Novirhabdovirus of the family Rhabdoviridae

  10. Microcatheter embolization of hemorrhages

    International Nuclear Information System (INIS)

    Seppaenen, Seppo K.; Leppaenen, Martti J.; Pimenoff, Georg; Seppaenen, Janne M.

    1997-01-01

    Purpose. To evaluate the efficacy of embolotherapy using microcatheters in patients with hemorrhage from various locations. Methods. Among 29 patients there were 13 with severe epistaxis, 7 with gastrointestinal bleeding, 4 with hemorrhage in the kidney, 4 with bleeding in pelvic organs and 1 with bleeding in the shoulder region. In all cases, a Tracker-18 or Tracker-10 microcatheter was advanced coaxially through a 4.1 Fr guiding catheter in order to reach the bleeding site as distally as possible. Polyvinyl alcohol microparticles and/or platinum microcoils were used as embolic material. Results. The bleeding was stopped in 90% (26 of 29) of cases. In 66% of cases the treatment was curative, in 7% preoperative, and in 17% palliative. There were 3 clinical failures. Conclusion. Microcatheter embolization is an effective and safe means of managing different kinds of hemorrhage of various causes from a variety of sites

  11. Intraventricular hemorrhage of the newborn

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007301.htm Intraventricular hemorrhage of the newborn To use the sharing features on this page, please enable JavaScript. Intraventricular hemorrhage (IVH) of the newborn is bleeding into the ...

  12. [Ebola and Marburg hemorrhagic fever viruses: update on filoviruses].

    Science.gov (United States)

    Leroy, E; Baize, S; Gonzalez, J P

    2011-04-01

    The Ebola and Marburg viruses are the sole members of the Filoviridae family of viruses. They are characterized by a long filamentous form that is unique in the viral world. Filoviruses are among the most virulent pathogens currently known to infect humans. They cause fulminating disease characterized by acute fever followed by generalized hemorrhagic syndrome that is associated with 90% mortality in the most severe forms. Epidemic outbreaks of Marburg and Ebola viruses have taken a heavy toll on human life in Central Africa and devastated large ape populations in Gabon and Republic of Congo. Since their discovery in 1967 (Marburg) and 1976 (Ebola), more than 2,300 cases and 1,670 deaths have been reported. These numbers pale in comparison with the burden caused by malnutrition or other infectious disease scourges in Africa such as malaria, cholera, AIDS, dengue or tuberculosis. However, due to their extremely high lethality, association with multifocal hemorrhaging and specificity to the African continent, these hemorrhagic fever viruses have given rise to great interest on the part not only of the international scientific community but also of the general public because of their perceived potential as biological weapons. Much research has been performed on these viruses and major progress has been made in knowledge of their ecology, epidemiology and physiopathology and in development of vaccine candidates and therapeutic schemes. The purpose of this review is to present the main developments in these particular fields in the last decade.

  13. Ebola hemorrhagic Fever.

    Science.gov (United States)

    Burnett, Mark W

    2014-01-01

    Ebola hemorrhagic fever is an often-fatal disease caused by a virus of the Filoviridae family, genus Ebolavirus. Initial signs and symptoms of the disease are nonspecific, often progressing on to a severe hemorrhagic illness. Special Operations Forces Medical Providers should be aware of this disease, which occurs in sporadic outbreaks throughout Africa. Treatment at the present time is mainly supportive. Special care should be taken to prevent contact with bodily fluids of those infected, which can transmit the virus to caregivers. 2014.

  14. Review of the Book: Yakubovich M.M. Philosophical Thought of the Crimean Khanate

    Directory of Open Access Journals (Sweden)

    R.R. Abduzhemilev

    2017-09-01

    Full Text Available The book “Philosophical Thought of the Crimean Khanate” by Mikhaylo Yakubovich offers a comprehensive study of the religious and philosophical heritage of the Crimean Khanate. It should be mentioned that up to the present there was no such work among the list of available research monographs. There were only some fragmentary works, which did not cover the conceptual essence of the philosophical perspectives and concepts of medieval thinkers whose activity was shaped within the context of the Crimean Khanate. Thus, Mikhaylo Yakubovich’s contribution is obvious and there is no doubt of the work’s significance. The book consists of a preface, an introduction, seven chapters, conclusions, appendixes, list of illustrations (religious sites, libraries and photocopies of manuscripts, and a bibliography. A wide source-base is evident in the work: the bibliography lists manuscripts from various libraries throughout the world. In the first introductory chapter, a review of historiography is carried out and the range of sources within the framework of the study is defined. The prehistory of the formation of philosophical thought of the Crimean khanate, namely the origins of its formation back to the Golden Horde era, is outlined in the second chapter. This section presents the hermeneutical aspects of Sharaf ad-Din al-Kyrymi and Ahmad bin ‘Abd Allah al-Kyrymi’s interpretation of the philosophy of Ibn al-‘Arabi and Sadr al-Din al-Kunavi. The third chapter contains biographical information about Ibrahim al-Kyrymi, the specificity of the Qur’anic hermeneutics in his work, as well as the idea of a spiritual journey as viewed from anthropological and historiosophical perspectives. In the fourth chapter, the creativity of Abu’l-Baka’ al-Kafauvi is considered, while also reflecting on the life and scientific heritage of this philosopher, his work “al-Qulliyyat” in the context of Islamic encyclopedic learning, understanding the divine

  15. Databases of Publications and Observations as a Part of the Crimean Astronomical Virtual Observatory

    Directory of Open Access Journals (Sweden)

    Shlyapnikov A.

    2015-12-01

    Full Text Available We describe the main principles of formation of databases (DBs with information about astronomical objects and their physical characteristics derived from observations obtained at the Crimean Astrophysical Observatory (CrAO and published in the “Izvestiya of the CrAO” and elsewhere. Emphasis is placed on the DBs missing from the most complete global library of catalogs and data tables, VizieR (supported by the Center of Astronomical Data, Strasbourg. We specially consider the problem of forming a digital archive of observational data obtained at the CrAO as an interactive DB related to database objects and publications. We present examples of all our DBs as elements integrated into the Crimean Astronomical Virtual Observatory. We illustrate the work with the CrAO DBs using tools of the International Virtual Observatory: Aladin, VOPlot, VOSpec, in conjunction with the VizieR and Simbad DBs.

  16. Philological Remarks on Two Genealogies of the Crimean-Tatar Clan Shirin

    Directory of Open Access Journals (Sweden)

    Göncöl Cs.

    2017-12-01

    Full Text Available Objectives: Philological analysis of two genealogies of the Crimean-Tatar clan termed the Shirin, and an identification of a possible common source of these genealogies. Research materials: Two genealogies (family-trees of the most prominent clan of the Crimean Khanate, the Shirin, have survived. The earlier one was preserved in the chronicle of the ʿUmdetü l aḫbār ‘Essence of Histories’ (1748, written by ʿAbdu l Ġaffār Qırımī, a historian of the Crimean Khanate and judge on Shirin estates. The later one was presented by clan-members after 1807 to the Crimean Assembly of Nobility (Таврическое дворянское собрание for the recognition of their noble status and estates. This version was translated into Russian and published by Lashkov. Therefore, the question arises: can the two genealogies have a common source? Results and the novelty of the research: Through a philological comparison of the material, the aim of the author was to demonstrate that the genealogies of the Shirin clan show similarities in content, structure, and text. The author supposes that the texts of ʿAbdu l Ġaffār Qırımī and the genealogy preserved in Russian translation could have been compiled from the same source, perhaps a preliminary Shirin genealogy which, judging from its content, the author dates to the 1660s.

  17. STRATEGIC DIRECTIONS IMPROVING THE MANAGEMENT OF MARKETING IN WINERIES OF CRIMEAN REGION

    Directory of Open Access Journals (Sweden)

    Michael Dementiev

    2015-10-01

    Full Text Available The article considers the issues of analyzing market environment and assess the current and strategic competitiveness of winemaking enterprises of Crimea region. On the basis of the conducted analysis, the grouping of winemaking enterprises on the level of potential use of the capabilities of the environment, as well as the proposed strategy for the development of wine-making enterprises of the Crimean region-based matching to realize the potential of market environment and competitive advantages of regional production.

  18. Construction Management South-Ukrainian and North-Crimean channels in 1950−1953

    Directory of Open Access Journals (Sweden)

    Satskyi, P. V.

    2017-08-01

    Full Text Available In the current article the analysis of the mechanisms of the providing of management of the building process of the Southern-Ukrainian and Northern-Crimean channels in the command-administrative system of USSR during the late Stalinist period has been made. The building of Southern-Ukrainian and Northern-Crimea channels had a particular political value for USSR in the beginning of 1950s, while the realization of this project was supposed to create the prerequisites for the economic development of the Southern regions of Ukraine (until 1954 and the Northern regions of the Crimea. The General Directorate 'Ukrvodstroy" of the Ministry of Cotton of USSR was supposed to be responsible for the building of the Southern-Ukrainian and Northern-Crimean channels. However, the Ministry of Cotton as well as other union ministries turned out to be ineffective in the process of administering of "communism construction". On the other hand, the Council of Ministers of Ukrainian SSR and the Communist Party of the Soviet Union were very effective in providing of the building of the Southern-Ukrainian and Northern-Crimean channels. Due to the effective activity of the leadership of Ukrainian SSR related to the providing of the building of Southern-Ukrainian and Northern-Crimean channels, the revival of the social-economic development of the Crimea took place, particularly in the far end regions of the Crimea it happened due to the development of capital investments required for the program of channels building. Thus, the Council of Ministers of Ukrainian Soviet Socialist Republic and the Central Committee of Communist Party (Bolsheviks of Ukraine was actively expanding its territory competence on the territory of the Crimea.

  19. Nursing in the Sardinian-Piedmontese Army during the Crimean War.

    Science.gov (United States)

    La Torre, Anna; Lusignani, Maura

    2013-01-01

    Contemporary history considers the Crimean War one of the most important European military campaign between the Napoleonic Wars and World War I. For the history of nursing this is an historical landmark, where, thanks to Florence Nightingale, the professional nursing was born. At the moment, the organization of health care and nursing of the Sardinian Piedmontese Army has not been the subject of extensive study. This report is meant to start the analysis of their commitment. Through analysis of primary historical sources, we would like to highlight the role of healthcare and nursing in the Sardinian-Piedmontese Army starting from 1855, during the Crimean War. We have analyzed the records stored in the archive of the Ispettorato Generale (part of the Ministry of War) in Turin and the reports by Army chief physician Dr. Comissetti, as well as the surveys in the archive of the Sisters of Charity at the convent of San Salvato in Turin, the letters of Florence Nightingale and the French doctors' testimonies. So we were able to shed light on the people involved in assistance and healthcare in the Sardinian -Piedmontese Army. A new, unprecedented historical research has shown the dedication and the daily work of male military personnel and religious during the Crimean War, a new aspect during this war that of what would later become the basis of the profession nursing.

  20. Management of gastrointestinal hemorrhage.

    OpenAIRE

    Hilsden, R. J.; Shaffer, E. A.

    1995-01-01

    Acute gastrointestinal hemorrhage is a common problem that requires prompt recognition and management to prevent serious morbidity and mortality. Management goals are stabilization of the patient with vigorous fluid resuscitation followed by investigation and definitive treatment of the bleeding source. Endoscopy is often the initial diagnostic test and allows therapeutic measures to be performed at the same time.

  1. Subarachnoid mesencephalic hemorrhage

    International Nuclear Information System (INIS)

    Oviedo, Soledad; De Luca, Silvina; Ceciliano, Alejandro; Mondello, Eduardo; Oviedo, Jorge D.; Lopardo Villarino, Guzman; Eyheremendy, Eduardo

    2004-01-01

    The case of a 57 y.o. male who has had severe headache of sudden onset without neck stiffness or other signs of neurological foci was reported. Initial CT scan showed perimesencephalic subarachnoid hemorrhage. Brain MRI and digital angiography were performed later and bleeding was interpreted as a result of an abnormal hemodynamic status developed by cerebral venous thrombosis. (author)

  2. Hemorrhage and vascular abnormalities

    International Nuclear Information System (INIS)

    Bradley, W.G.

    1990-01-01

    While many brain lesions have a similar appearance on MRI and CT, this is not true of hemorrhage. On CT, acute hemorrhage becomes hyperdense within an hour as the clot forms. This lasts for several days and then fades to isodensity and eventually hypodensity. On MRI, hemorrhage less than 12 to 24 hours old may not be distinguishable from vasogenic edema. Its appearance subsequently is an evolving pattern of variable signal intensity which depends on the specific form of hemoglobin which is present, or whether the red cells are intact or lysed, on the operating field strength, on the type of signal (that is, spin echo or gradient echo), and on contrast (that is, T 1 - or T 2 -weighing). The appearance of hemorrhage also depends on the compartment of the brain involved---subarachnoid, subdural, or intraparenchymal. Finally, for parenchymal hematomas, different zones may be defined from the inner core to the outer rim which all vary in appearance depending on field strength and imaging technique

  3. Massive antenatal fetomaternal hemorrhage

    DEFF Research Database (Denmark)

    Dziegiel, Morten Hanefeld; Koldkjaer, Ole; Berkowicz, Adela

    2005-01-01

    Massive fetomaternal hemorrhage (FMH) can lead to life-threatening anemia. Quantification based on flow cytometry with anti-hemoglobin F (HbF) is applicable in all cases but underestimation of large fetal bleeds has been reported. A large FMH from an ABO-compatible fetus allows an estimation...

  4. Monitoring Forest Carbon Stocks and Fluxes in the Congo Basin

    OpenAIRE

    2010-01-01

    The Central African Forests Commission (COMIFAC) and its partners (OFAC, USAID, EC-JRC, OSFAC, WWF, WRI, WCS, GOFC-GOLD, START, UN-FAO) organized an international conference on "Monitoring of Carbon stocks and fluxes in the Congo Basin" in Brazzaville, Republic of Congo, 2-4 February 2010. The conference brought together leading international specialists to discuss approaches for quantifying stocks and flows of carbon in tropical forests of the Congo Basin. The conference provided a unique op...

  5. Search for the Ebola virus reservoir in Kikwit, Democratic Republic of the Congo

    DEFF Research Database (Denmark)

    Leirs, Herwig; Mills, James N.; Krebs, John W.

    1999-01-01

    A 3-month ecologic investigation was done to identify the reservoir of Ebola virus following the 1995 outbreak in Kikwit, Democratic Republic of the Congo, Efforts focused on the fields where the putative primary case had worked but included other habitats near Kikwit, Samples were collected from...... 3066 vertebrates and tested for the presence of antibodies to Ebola (subtype Zaire) virus: All tests were negative, and attempts to isolate Ebola virus were unsuccessful. The investigation was hampered by a lack of information beyond the daily activities of the primary case, a lack of information...... on Ebola virus ecology, which precluded the detailed study of select groups of animals, and sample-size limitations for rare species, The epidemiology of Ebola hemorrhagic fever suggests that humans have only intermittent contact with the virus, which complicates selection of target species. Further study...

  6. La violencia sexual en Kivu Sur, Congo

    OpenAIRE

    Rodríguez, Claudia

    2007-01-01

    Abordar la violencia sexual y por motivos de género en la República Democrática del Congo (RDC) requerirá más recursos y coordinación. Un sistema judicial débil o inexistente disuade a las sobrevivientes de denunciar a sus agresores. El número de agresiones sigue aumentando y los perpetradores quedan impunes.

  7. Current State and Prospects of Studying Sources on the History of Crimean Khanate in Turkish Archives »

    Directory of Open Access Journals (Sweden)

    Sh.E. Seit-Mametov

    2016-09-01

    Full Text Available Research objectives: to consider the current state of the study of sources on the history of the Crimean Khanate in Turkish archives and determine the prospects for the study of this issue. Research materials: works of domestic and foreign Orientalists in the study of the Crimean sources in Turkish archives. Results and novelty of the research: the author analyzed the current state of the study of sources on the history of the Crimean Khanate in Turkish archives. The works of such prominent scholars as A. Bennigsen, Ö. Gokbilgin, A.N. Kurat, Ch. Lemercier-Quelquejay, V.D. Smirnov and others deserve the most attention. Sophisticated paleography (age and conditions of documents of the Ottoman sources and difficulties with their translation were the main reason for their insufficient use. In their studies, Orientalists presents facsimiles of the originals of letters and their translations, give the transcript values of complex or controversial words, solve problems with the translation of dates into the modern chronology and also produce a detailed external criticism of documents: they describe their length, quality of the paper, handwriting and also decode the khans’ seals. This enables modern researchers to get acquainted with some of the earliest sources on the history of the Crimean Khanate. The author has revealed a number of new challenges that need to be addressed in the further study of sources on the history of the Crimean Khanate: translation of foreign Orientalists’ works into Russian as well as synthesis and integration of predecessors’ works, since each individual work does not cover all the documents of interest to modern scholars. The study of sources on the history of the Crimean Khanate remains a promising challenge for modern researchers, since in Turkish archives are stored unpublished documents waiting for their turn to enter into scholarly circulation.

  8. MR of acute subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Spickler, E.; Lufkin, R.; Frazee, J.; Lylyk, P.; Vinuela, F.; Bentson, J.; Dion, J.

    1987-01-01

    Subarachnoid hemorrhage was produced in four Macaca nemestrina monkeys using the technique of Frazee. CT and MR imaging was performed immediately after the procedure and at frequent intervals up to 2 weeks after hemorrhage. The imaging studies were compared with clinical evaluations and pathologic specimens of all animals. Additional human clinical CT/MR studies of subarachnoid hemorrhage were also studied. Acute hemorrhage was recognized on MR images as an increase in signal in the region of clot compared with surrounding cerebrospinal fluid. This most likely reflects T1 shortening due to proton binding rather than a pure paramagnetic effect. While CT is sensitive to the hemoglobin protein in acute hemorrhage, the superior resolution of MR of the basal cisterns results in equal or better definition of acute subarachnoid hemorrhage on MR studies in many cases

  9. Various phases of intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Kino, Masao; Anno, Izumi; Yano, Yuhiko; Anno, Yasuro.

    1980-01-01

    Cases of intracerebral hemorrhage except typical putamen thalamic hemorrhage were reported. It is not difficult to diagnose typical attacks of cerebral apoplexy in patients older than 40 years with hypertension by CT. When the condition of the onset is not typical, cerebral infarction must be considered. Though conservative treatment is performed for severe cerebral hemorrhage and cerbral infarction, there is no specific medicine curing these diseases completely. On the contrary, the risk that the administration of fibrinolysis activators and STA-MCA anastomosis may induce cerebral hemorrhage is stressed. Not a few patients with cerebral apoplexy accompanied by small hemorrhagic focuses have been found, especially since CT was used widely. However, treatment for this disease has many inconsistencies. From above-mentioned facts, we recognize excellent roles of CT in an application of surgery for cerebral hemorrhage of early stage, and we, general radiologists, are under an obligation to advise most adequate theraphy for each patient. (Tsunoda, M.)

  10. Internet Backbone in the Democratic Republic of Congo : Feasibility ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Internet Backbone in the Democratic Republic of Congo : Feasibility Study and Advocacy. During 7-10 February 2005, representatives of five francophone African countries (Cameroon, Morocco, Niger, Sénégal, and the Democratic Republic of Congo - DRC) met to consider ways and means of galvanizing the appropriation ...

  11. Non-aneurysmal subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Bashir, Asma; Mikkelsen, Ronni; Sørensen, Leif

    2017-01-01

    Purpose Repeat imaging in patients with non-aneurysmal subarachnoid hemorrhage (NASAH) remains controversial. We aim to report our experience with NASAH with different hemorrhage patterns, and to investigate the need for further diagnostic workup to determine the underlying cause of hemorrhage. M...... adequate with absence of hematoma and vasospasm. In contrast, a follow-up DSA should be mandatory for confirming or excluding vascular pathology in case of nPMSAH in order to prevent rebleeding....

  12. The distributions of chemical elements and Caesium-137 in the Northern-Crimean canal ecosystem

    International Nuclear Information System (INIS)

    Lazorenko, G.

    1998-01-01

    The distributions in 1992-1995 of some chemical elements and 137 Cs concentrations in components of the Northern-Crimean Canal (NCC) ecosystem and agricultural fields of the Kherson District and the Northern Crimea irrigated by the Dnieper River water are presented in the work. Five main sampling were selected between the Kakhovka Reservior (at the beginning of the NCC) and the Karkinitsky Bay along the 150 km of the main Canal. Two additional stations were selected in discharge canals to study of the role of irrigated agricultural fields in the accumulation of 137 Cs and chemical elements from water. (author)

  13. On the other side of the battle: Russian nurses in the Crimean War.

    Science.gov (United States)

    Benson, E R

    1992-01-01

    One redeeming feature that emerged from the horrors of the Crimean War was the skilled and compassionate nursing care provided by women. The work of Florence Nightingale and her nurses with the British forces is a familiar story. What is less well-known is that the fighting forces on the other side of the battle lines also had their contingent of nurses who helped to alleviate the suffering of their sick and wounded. This paper discusses the events leading up to the organization of Russia's volunteer nurses who provided care on their side of the battle.

  14. Perimesencephalic hemorrhage: a nonaneurysmal and benign form of subarachnoid hemorrhage

    NARCIS (Netherlands)

    van Gijn, J.; van Dongen, K. J.; Vermeulen, M.; Hijdra, A.

    1985-01-01

    We studied 28 patients with subarachnoid hemorrhage and normal angiograms. On early CT (within 5 days) in 13 cases, blood was seen mainly or only in the cisterns around the midbrain. This pattern of hemorrhage was found in only 1 of 92 patients with a ruptured aneurysm. None of the unexplained

  15. Subconjunctival Hemorrhage (Broken Blood Vessel in Eye)

    Science.gov (United States)

    Subconjunctival hemorrhage (broken blood vessel in eye) Overview A subconjunctival hemorrhage (sub-kun-JUNK-tih-vul HEM-uh-ruj) ... may not even realize you have a subconjunctival hemorrhage until you look in the mirror and notice ...

  16. Will Passive Protection Save Congo Forests?

    Science.gov (United States)

    Galford, Gillian L.; Soares-Filho, Britaldo S.; Sonter, Laura J.; Laporte, Nadine

    2015-01-01

    Central Africa’s tropical forests are among the world’s largest carbon reserves. Historically, they have experienced low rates of deforestation. Pressures to clear land are increasing due to development of infrastructure and livelihoods, foreign investment in agriculture, and shifting land use management, particularly in the Democratic Republic of Congo (DRC). The DRC contains the greatest area of intact African forests. These store approximately 22 billion tons of carbon in aboveground live biomass, yet only 10% are protected. Can the status quo of passive protection — forest management that is low or nonexistent — ensure the preservation of this forest and its carbon? We have developed the SimCongo model to simulate changes in land cover and land use based on theorized policy scenarios from 2010 to 2050. Three scenarios were examined: the first (Historical Trends) assumes passive forest protection; the next (Conservation) posits active protection of forests and activation of the national REDD+ action plan, and the last (Agricultural Development) assumes increased agricultural activities in forested land with concomitant increased deforestation. SimCongo is a cellular automata model based on Bayesian statistical methods tailored for the DRC, built with the Dinamica-EGO platform. The model is parameterized and validated with deforestation observations from the past and runs the scenarios from 2010 through 2050 with a yearly time step. We estimate the Historical Trends trajectory will result in average emissions of 139 million t CO2 year-1 by the 2040s, a 15% increase over current emissions. The Conservation scenario would result in 58% less clearing than Historical Trends and would conserve carbon-dense forest and woodland savanna areas. The Agricultural Development scenario leads to emissions of 212 million t CO2 year-1 by the 2040s. These scenarios are heuristic examples of policy’s influence on forest conservation and carbon storage. Our results

  17. Ebola Hemorrhagic Fever as a Public Health Emergency of International Concern; a Review Article.

    Science.gov (United States)

    Safari, Saeed; Baratloo, Alireza; Rouhipour, Alaleh; Ghelichkhani, Parisa; Yousefifard, Mahmood

    2015-01-01

    Ebola hemorrhagic fever (EHF) was first reported in 1976 with two concurrent outbreaks of acute viral hemorrhagic fever centered in Yambuku (near the Ebola river), Democratic Republic of Congo, and in Nzara, Sudan. The current outbreak of the Ebola virus was started by reporting the first case in March 2014 in the forest regions of southeastern Guinea. Due to infection rates raising over 13,000% within a 6-month period, Ebola is now considered as a global public health emergency and on August 8(th), 2014 the World Health Organization (WHO) declared the epidemic to be a Public Health Emergency of International Concern. With more than 5000 involved cases and nearly 3000 deaths, this event has turned into the largest and most dangerous Ebola virus outbreak in the world. Based on the above-mentioned, the present article aimed to review the virologic characteristics, transmission, clinical manifestation, diagnosis, treatment, and prevention of Ebola virus disease.

  18. Post-tonsillectomy hemorrhage

    DEFF Research Database (Denmark)

    Heidemann, Christian; Wallén, Mia; Aakesson, Marie

    2008-01-01

    Post-tonsillectomy hemorrhage (PTH) is a relatively common and potentially life-threatening complication. The objective of this study was to examine the rate of PTH and identify risk factors. A retrospective cohort study was carried out including all tonsillectomies (430 patients) performed...... as surgical technique" [relative risk (RR) = 5.3], "peritonsillar abscess as indication for surgery" (RR = 0.3) and "age equal to or above 15 years at the time of surgery" (RR = 5.4). It is concluded that patient age, PTA as indication for surgery and the use of coblation significantly affect the occurrence...

  19. Circumstances surrounding aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    Schievink, W. I.; Karemaker, J. M.; Hageman, L. M.; van der Werf, D. J.

    1989-01-01

    The circumstances surrounding aneurysmal subarachnoid hemorrhage were investigated in a group of 500 consecutive patients admitted to a neurosurgical center. Subarachnoid hemorrhage occurred during stressful events in 42.8% of the patients, during nonstrenuous activities in 34.4%, and during rest or

  20. Anosmia After Perimesencephalic Nonaneurysmal Hemorrhage

    NARCIS (Netherlands)

    Greebe, Paut; Rinkel, Gabriel J. E.; Algra, Ale

    Background and Purpose-Anosmia frequently occurs after aneurysmal subarachnoid hemorrhage not only after clipping, but also after endovascular coiling. Thus, at least in part, anosmia is caused by the hemorrhage itself and not only by surgical treatment. However, it is unknown whether anosmia is

  1. Computed Tomography of Interacerebral Hemorrhage

    International Nuclear Information System (INIS)

    Kim, Seung Hyeon; Lee, Jong Beum; Lee, Yong Chul; Lee, Kwan Seh; Park, Soo Soung

    1983-01-01

    Computed tomography (CT) is the most accurate and reliable method for the diagnosis of intracerebral and intraventricular hemorrhage. The precise anatomic extent of the nematoma, associated cerebral edema, ventricular deformity and displacement, and hydrocephalus are all readily assessed. Aside from head trauma, the principal cause of intracerebral hematoma is hypertensive vascular disease. Although hematomas from various causes may present similar CT appearances frequently the correct etiology may be suggested by consideration of patient's age, clinical history, and the location of the hematoma. The analytical study was performed in 180 cases of intracerebral hemorrhages by CT from October 1981 to January 1983. The results were as follows; 1. The most prevalent age group was 6th decade (37.2%). Male was prevalent to female at the ration of 1.6 to 1. 2. The most common symptom and sign was mental disturbance (48.7%), motor weakness (23%), headache (10.6%), nausea and vomiting (9.8%). 3. The causes of hemorrhage were hypertension (53.9%), head trauma (30.6%), aneurysm (6.1%) and A-V malformation (7.2%). 4. The frequent locations of hemorrhage were basal ganglia and thalamus (40.4%), lobes (35%), ventricles (21.8%). 5. The distribution of hemorrhage was intracerebral hemorrhage (65.6%), intracerebral and intraventricular hemorrhage (30.3%), intraventricular hemorrhage (4.4%).

  2. Forest Elephant Crisis in the Congo Basin

    Science.gov (United States)

    Blake, Stephen; Strindberg, Samantha; Boudjan, Patrick; Makombo, Calixte; Bila-Isia, Inogwabini; Ilambu, Omari; Grossmann, Falk; Bene-Bene, Lambert; de Semboli, Bruno; Mbenzo, Valentin; S'hwa, Dino; Bayogo, Rosine; Williamson, Liz; Fay, Mike; Hart, John; Maisels, Fiona

    2007-01-01

    Debate over repealing the ivory trade ban dominates conferences of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). Resolving this controversy requires accurate estimates of elephant population trends and rates of illegal killing. Most African savannah elephant populations are well known; however, the status of forest elephants, perhaps a distinct species, in the vast Congo Basin is unclear. We assessed population status and incidence of poaching from line-transect and reconnaissance surveys conducted on foot in sites throughout the Congo Basin. Results indicate that the abundance and range of forest elephants are threatened from poaching that is most intense close to roads. The probability of elephant presence increased with distance to roads, whereas that of human signs declined. At all distances from roads, the probability of elephant occurrence was always higher inside, compared to outside, protected areas, whereas that of humans was always lower. Inside protected areas, forest elephant density was correlated with the size of remote forest core, but not with size of protected area. Forest elephants must be prioritised in elephant management planning at the continental scale. PMID:17407383

  3. A Historical Survey of Military Health Services: The Crimean War and Florence Nigtingale

    Directory of Open Access Journals (Sweden)

    Unal Demirtas

    2014-02-01

    Full Text Available During the Crimean War freezing cold and contagious diseases was more important than the Russian soldiers for the allied armies. Typhus, scorbut, cholera and malaria prepare the dead of a large number of soldiers. According to the resources, the contagious diseases led to death more than ten times of the military actions. That and #8217;s why, The European armies understood the importance of the treatment diseases in the war and the Crimean War became the beginning point in military health concept development. Florence Nightingale and a staff of 38 volunteers provide clean bedding, improve ventilation and sewage disposal, and reorganize everyday sanitary procedures at British barracks in Istanbul. She was an early theorist of sanitation and one of the founders of the modern nursing profession. Nightingale worked to improve sanitation, nutrition, and activity of patients at hospitals. Death rates were reduced dramatically with the introduction of such measures. [TAF Prev Med Bull 2014; 13(1.000: 1-6

  4. TRACES OF MEMORY. PRELIMINARY REMARKS ON IDENTITY AND BIOGRAPHY OF CRIMEAN TATARS

    Directory of Open Access Journals (Sweden)

    Irena Borowik

    2011-01-01

    Full Text Available The article is devoted to the preliminary analysis of biographical interviews, taken with representatives of Crimean Tatars returning to Crimean Peninsula and settling in the places that they or their ancestors used to live before deportation. The research was conducted in summer of 2008 and 2009, 20 interviews were taken with consideration of age, sex, place of living and level of education. Traces of memory are understood in this article as repeatable elements of biographical narratives. By this virtue those repeated elements refer not only to individual identity but they also build collective identity, more precisely national in this case. The key element of the article is the third part of it where relations between memory and identity are explored in collected biographies. As it appeared in all life-stories deportation from Crimea and return after years are crucial elements of construction of biographies and in all cases it has a form of trajectories. The general conclusion is that memory of these painful events and celebration of it is functional for building the strong collective identity which is based on traditional values, religious and political integration of national minority.

  5. Mehmed Senai: A Crimean Historian at Sarai of Khan Islam Giray »

    Directory of Open Access Journals (Sweden)

    Refat Rustem ogly Abduzhemilev

    2015-09-01

    Full Text Available The article is devoted to the creative work of Mehmed Senai – the Crimean chronicler at the serai of the khan Islam Geray III, as well as his chronicle “Tarih-i Islam Geray khan” (“History of the khan Islam Geray III”, 1651. The researcher gives biographical information about the author and a brief description of the source. The identity of the writer is defined and based on the text of the Preface to the Chronicle: background, education, position, religious status. The meaning of the pseudonym of Senai is under the study, the text of the chronogram in which it occurs is reproduced. Especially noted thing is the originality of the artistic structure of the Chronicle “Tarih-i Islam Geray khan”.The Chronicle “Tarih-i Islam Geray khan” is the panegyric to the Crimean khan Islam Geray whose reign represents the brilliant epoch in the history of the Crimean Khanate. The writing consists of the ceremonies of public appointments, episodes of military campaigns and making treaties, the text of khan Islam Geray’s pedigree (shejere, construction and repair of buildings. There is the brief information about the Chronicle and about M. Senai in “Catalogue of the Turkish Manuscripts in the British Museum” (1888. The primary work on writing was conducted by Polish orientalists who prepared the edition of the original text, its translation and processing, backed with comments. At the time of writing the Chronicle, Mehmed Senai was in his old age, he served as the kadi (religious judge. In his youth he worked as munshi (decorator of papers in the khan’s office. He got education in the Ottoman Empire, and was engaged in the implementation of diplomatic correspondence. The prospect of identification of the author on the basis of other sources is important to clarify the hypothesis of identifying M. Senai with such Crimean Tatar author as Dzhanmuhammed. The Chronıcle’s plot consists of the diary notes on the military expeditions

  6. Nontraumatic temporal subcortical hemorrhage

    International Nuclear Information System (INIS)

    Weisberg, L.A.; Stazio, A.; Shamsnia, M.; Elliott, D.; Charity Hospital, New Orleans, LA

    1990-01-01

    Thirty patients with temporal hematomas were analyzed. Four with frontal extension survived. Of 6 with ganglionic extension, three had residual deficit. Of 8 with parietal extension, 4 had delayed deterioration and died, two patients recovered, and two with peritumoral hemorrhage due to glioblastoma multiforme died. Five patients with posterior temporal hematomas recovered. In 7 patients with basal-inferior temporal hematomas, angiography showed aneurysms in 3 cases, angiomas in 2 cases and no vascular lesion in 2 cases. Of 23 cases with negative angiography and no systemic cause for temporal hematoma, 12 patients were hypertensive and 11 were normotensive. Ten hypertensive patients without evidence of chronic vascular disease had the largest hematomas, extending into the parietal or ganglionic regions. Seven of these patients died; 3 had residual deficit. Eleven normotensive and two hypertensive patients with evidence of chronic vascular change had smaller hematomas. They survived with good functional recovery. (orig.)

  7. Intracerebral hemorrhage in brain tumors

    International Nuclear Information System (INIS)

    Fujita, Katsuzo; Matsumoto, Satoshi

    1980-01-01

    A series of 16 cases of intracerebral hemorrhage associated with brain tumors are described. The literature is reviewed and the incidence of these cases is reported to be low, but we had clinically encountered these cases more commonly than reported, since CT was introduced to the neurosurgical field as a diagnostic aid. The presenting symptoms were those of spontaneous intracerebral hemorrhage or brain tumor. The intracerebral hemorrhage associated with brain tumor may mask the cause of bleeding and confuse the diagnosis. The majority of the tumor causing the intracerebral hemorrhage are highly malignant as glioblastoma or metastatic brain tumor, but there are some benign tumors such as pituitary adenoma, hemangioblastoma, benign astrocytoma and meningioma, which would have good survival rates if discovered early. The mechanisms of massive hemorrhage with brain tumor are not clear. From pathological findings of our cases and other reports, the mechanism seems to be due to the vascular endothelial proliferation with subsequent obliteration of the lumen of the vessel. Thin walled, poorly formed vessels in tumor may also become distorted with growth of the tumor and these may easily rupture and bleed. Necrosis with subsequent loss of vessel support may be a factor in production of hemorrhage. Radiation therapy may be a predisposing factor. Children are rarely involved in these cases. The prognosis in the majority of cases would seen to be poor, since the majority of the tumor are highly malignant and most such patients are seen by the neurosurgeon some time after the hemorrhage has accomplished its fatal mischief. (author)

  8. Neonatal intracranial hemorrhages (perinatal onset)

    International Nuclear Information System (INIS)

    Ban, Sadahiko; Ogata, Masahiro; Yamamoto, Toyoshiro; Nakao, Satoshi; Mizue, Hidenari; Kobayashi, Yutaka.

    1982-01-01

    1. We have reviewed 34 cases of neonatal intracranial hemorrhages (perinatal onset, 23 mature and 11 premature infants) experienced in 10-year period from 1971 to 1980, with special reference to gestational age, birth weight, type of delivery, presence or absence of asphyxia, symptoms and cause of death. 2. Regarding 9 autopsied cases and 7 cases diagnosed by CT-scan, 10 mature infants composed of 3 subarachnoid hemorrhages, 2 intraventricular hemorrhages, 2 subdural hematomas, 2 intracerebral and 1 subependymal hemorrhage; 6 premature infants consisted of 4 subependymal hemorrhages with ventricular rupture and 2 subarachnoid hemorrhages. Most of them presented with respiratory distress, vomiting and convulsive seizures which developed within 5 days after birth. 3. Poor outcome including death amounted 49% of mature and 63% of premature infants. Along with degree of intracranial hematoma, prematurity and pulmonary complication were felt to be important prognostic factors. 4. Introduction of CT-scan led to prompt diagnosis and treatment, thus lowering mortality rate of neonatal intracranial hemorrhages. (author)

  9. Hydrocephalus secondary to subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Koga, Nobunori; Nakamura, Saburo; Kushi, Hidehiko; Yamamoto, Takamitsu; Tsubokawa, Takashi; Moriyasu, Nobuo

    1982-01-01

    The relationship between the extension and severity of subarachnoid hemorrhage, as demonstrated by computed tomography (CT), and hydrocephalus secondary to subarachnoid hemorrhage was studied. In 94 cases with subarachnoid hemorrhage, as analyzed by CT scan performed within 7 days after onset, high-density areas in the subarachnoid space were recognized in 61 cases (64%) and secondary hydrocephalus occurred in 22 cases (23%). 17 cases died within 2 weeks, before the occurrence of the hydrocephalus. The CT findings of subarachnoid hemorrhage was classified into 5 types, according to its severity and extension; especially the degree of high density in the basal cistern and/or cisterns around the brain stem was remarked. Secondary hydrocephalus after subarachnoid hemorrhage was observed in 90% of the cases; they had a density higher than a CT number of 60 in the basal cistern and/or cisterns around the brain stem (Type V). The mean interval between the onset of subarachnoid hemorrhage and the appearance of hydrocephalus was 20.6 days. We conclude that a significantly high density of extravasated blood in the subarachnoid space, especially in the basal cistern and/or the cisterns around the brain stem, can be predictive of secondary hydrocephalus after subarachnoid hemorrhage. (author)

  10. Intracerebral hemorrhage in brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Fujita, K; Matsumoto, S [Kobe Univ. (Japan). School of Medicine

    1980-10-01

    A series of 16 cases of intracerebral hemorrhage associated with brain tumors are described. The literature is reviewed and the incidence of these cases is reported to be low, but we had clinically encountered these cases more commonly than reported, since CT was introduced to the neurosurgical field as a diagnostic aid. The presenting symptoms were those of spontaneous intracerebral hemorrhage or brain tumor. The intracerebral hemorrhage associated with brain tumor may mask the cause of bleeding and confuse the diagnosis. The majority of the tumor causing the intracerebral hemorrhage are highly malignant as glioblastoma or metastatic brain tumor, but there are some benign tumors such as pituitary adenoma, hemangioblastoma, benign astrocytoma and meningioma, which would have good survival rates if discovered early. The mechanisms of massive hemorrhage with brain tumor are not clear. From pathological findings of our cases and other reports, the mechanism seems to be due to the vascular endothelial proliferation with subsequent obliteration of the lumen of the vessel. Thin walled, poorly formed vessels in tumor may also become distorted with growth of the tumor and these may easily rupture and bleed. Necrosis with subsequent loss of vessel support may be a factor in production of hemorrhage. Radiation therapy may be a predisposing factor. Children are rarely involved in these cases. The prognosis in the majority of cases would seen to be poor, since the majority of the tumor are highly malignant and most such patients are seen by the neurosurgeon some time after the hemorrhage has accomplished its fatal mischief.

  11. Embolization for gastrointestinal hemorrhages

    International Nuclear Information System (INIS)

    Kraemer, S.C.; Goerich, J.; Rilinger, N.; Aschoff, A.J.; Vogel, J.; Brambs, H.J.; Siech, M.

    2000-01-01

    Retrospective evaluation of interventional embolization therapy in the treatment of gastrointestinal hemorrhage over a long-term observation period from 1989 to 1997. Included in the study were 35 patients (age range 18-89 years) with gastrointestinal bleeding (GI) referred for radiological intervention either primarily or following unsuccessful endoscopy or surgery. Sources of GI bleeding included gastric and duodenal ulcers (n = 7), diverticula (n = 3), erosion of the intestinal wall secondary to malignancy (n = 6), vascular malformations (n = 4), and hemorrhoids (n = 2), as well as from postoperative (n = 6), posttraumatic (n = 2), postinflammatory (n = 4) or unknown (n = 1) causes. Ethibloc (12 cases) or metal coils (14 cases) were predominantly used as embolisates. In addition, combinations of tissue adhesive and gelfoam particles and of coils and Ethibloc were used (six cases). Finally, polyvinyl alcohol particles, a coated stent, and an arterial wire dissection were utilized in one case each. Bleeding was stopped completely in 29 of 35 cases (83 %). In one case (3 %) the source of bleeding was recognized but the corresponding vessel could not be catheterized. In five other cases (14 %) there was partial success with reduced, though still persistent, bleeding. The rate of complications was 14 %, including four instances of intestinal ischemia with fatal outcome in the first years, and, later, one partial infarction of the spleen without serious consequences. Gastrointestinal hemorrhage can be controlled in a high percentage of patients, including the seriously ill and those who had previously undergone surgery, with the use of minimally invasive interventional techniques. The availability of minicoils instead of fluid embolization agents has reduced the risk of serious complications. (orig.)

  12. Embolization for gastrointestinal hemorrhages

    Energy Technology Data Exchange (ETDEWEB)

    Kraemer, S.C.; Goerich, J.; Rilinger, N.; Aschoff, A.J.; Vogel, J.; Brambs, H.J. [Dept. of Diagnostic Radiology, University of Ulm (Germany); Siech, M. [Dept. of Abdominal Surgery, University of Ulm (Germany)

    2000-05-01

    Retrospective evaluation of interventional embolization therapy in the treatment of gastrointestinal hemorrhage over a long-term observation period from 1989 to 1997. Included in the study were 35 patients (age range 18-89 years) with gastrointestinal bleeding (GI) referred for radiological intervention either primarily or following unsuccessful endoscopy or surgery. Sources of GI bleeding included gastric and duodenal ulcers (n = 7), diverticula (n = 3), erosion of the intestinal wall secondary to malignancy (n = 6), vascular malformations (n = 4), and hemorrhoids (n = 2), as well as from postoperative (n = 6), posttraumatic (n = 2), postinflammatory (n = 4) or unknown (n = 1) causes. Ethibloc (12 cases) or metal coils (14 cases) were predominantly used as embolisates. In addition, combinations of tissue adhesive and gelfoam particles and of coils and Ethibloc were used (six cases). Finally, polyvinyl alcohol particles, a coated stent, and an arterial wire dissection were utilized in one case each. Bleeding was stopped completely in 29 of 35 cases (83 %). In one case (3 %) the source of bleeding was recognized but the corresponding vessel could not be catheterized. In five other cases (14 %) there was partial success with reduced, though still persistent, bleeding. The rate of complications was 14 %, including four instances of intestinal ischemia with fatal outcome in the first years, and, later, one partial infarction of the spleen without serious consequences. Gastrointestinal hemorrhage can be controlled in a high percentage of patients, including the seriously ill and those who had previously undergone surgery, with the use of minimally invasive interventional techniques. The availability of minicoils instead of fluid embolization agents has reduced the risk of serious complications. (orig.)

  13. Imaging features of diffuse pulmonary hemorrhage

    International Nuclear Information System (INIS)

    Schmit, M.; Vogel, W.; Horger, M.

    2006-01-01

    There are diverse etiologies of diffuse pulmonary hemorrhage, so specific diagnosis may be difficult. Conventional radiography tends to be misleading as hemoptysis may lacking in patients with hemorrhagic anemia. Diffuse pulmonary hemorrhage should be differentiated from focal pulmonary hemorrhage resulting from chronic bronchitis, bronchiectasis, active infection (tuberculosis) neoplasia, trauma, or embolism. (orig.)

  14. Accounting for violence in Eastern Congo: Young people's ...

    African Journals Online (AJOL)

    In these accounts, the voices of young people have been largely absent. Although ... in eastern Congo from September to December 2009 as part of the author's doctoral ..... More rarely, young Congolese recognised the contribution made by ...

  15. Decolorisation of Congo Red by Aeromonas hydrophila Under Microaerophilic Conditions

    International Nuclear Information System (INIS)

    El Gizawy, S.; Refae, R.A.; Abd El Kareem, H.; Gomaa, O.M.; Hamed, H.

    2009-01-01

    Among 22 local bacterial isolates, Aeromonas hydrophila isolated from Bolti fish showed a remarkable ability to decolorize congo red under microaerophilic conditions (98.8% in 48 hrs) without prior adaptation. The bacterium had the ability to grow and decolorized high concentrations of congo red which varied from 50 to 1000 mg/l , the decolorisation was irrelevant to bacterial growth. The strain was capable of decolorizing congo red under a wide range of temperatures (20-40 degree C), ph (3-8), NaCl (0-200 mg/l) and also had the ability to decolorized mono, di and poly azo dyes. This bacterium is notable in its ability to decolorized the diazo congo red under extreme conditions of temperature, ph, salinity and high dye concentrations which makes it suitable for decolorisation under extreme industrial conditions

  16. The Congo crisis, the United Nations, and Zimbabwean nationalism ...

    African Journals Online (AJOL)

    United Nations moved swiftly in response to Lumumba's immediate request for assistance .... of apathy towards the white man in Africa and a strong desire to rid .... such actions would legitimatise the intervention of the Congo government in.

  17. Complex conflict in the Democratic Republic of the Congo: Good ...

    African Journals Online (AJOL)

    ... identifi ed business ethics as a way to mitigate the destructive commercial practices that ... Ethical business initiatives have peacebuilding potential; however, the ... of the Congo (DRC) and its surrounding areas by purchasing minerals that fi ...

  18. Hemorrhagic Lacrimation and Epistaxis in Acute Hemorrhagic Edema of Infancy

    Directory of Open Access Journals (Sweden)

    Shireen Mreish

    2016-01-01

    Full Text Available Acute hemorrhagic edema of infancy is an uncommon benign cutaneous vasculitis. Despite its worrisome presentation, it carries good prognosis with rarely reported systemic involvement. Management of these cases has been an area of debate with majority of physicians adopting conservative modalities. We report a case that presented with classic triad of rash, low grade fever, and peripheral edema along with two rarely reported manifestations in literature: hemorrhagic lacrimation and epistaxis.

  19. Bacteriostatics of volatile organic compounds of Crimean pine and environmental meteorological conditions

    Science.gov (United States)

    Chalaya, Elena; Slepykh, Victor; Efimenko, Natalia; Povolotckaia, Nina

    2015-04-01

    Sanitary and hygienic properties of air saturated with volatile organic compounds of plants (VOC) have a fundamental importance for the biosphere. In particular, they make such a feature as the freshness of the air. The energy contained in VOC and made by Earth vegetation can be compared with the energy of lightning discharges in the atmosphere during the year [1]. The influence of natural environment on the dynamics of VOC developed by plants is also of current interest and is, in particular, important for resort study because VOC produced by the vegetation of the resort regions can be seen as a self-contained resort resource [2]. Dynamics of VOC evolution by Crimean pine (Pinus Pallasiana D.Don.) that is the forest forming breed of the resort region Caucasus Mineral Waters (Russia) has been studied by a microbiological method [1]. Dynamics of bacteriostatics was qualified by the extent of oppression of the VOC test- culture (Staphylococcus aureus 209p) of the pine in % in comparison with control. The needles for the experience were selected at noon in the middle of the summer. At the time of the needle selection meteorological indicators were fixed. As the result of the researches we got an empirical equation of dynamics of VOC bacteriostatics of the Crimean pine under the influence of total solar radiation (kW/m2) and relative air humidity (%). The coefficient of the multiple correlation of the VOC bacteriostatics of the Crimean pine, total solar radiation and relative air humidity makes: R=0,83 at the importance of F=7,53>F0 05=3,49. The coefficient of the multiple determination is R2=0,69. The equation is: y = - 35,1020 + 1,7193x + 175,6638p- 0,0181x2 + 0,6054 (xp) - 191,1319p2, where Y - is bacteriostatics (%); x - is relative humidity (%); p - is total solar radiation (kW/m2). The fixed parameters of the equation are: air humidity - 90-30%; total solar radiation - 0.20-1.0 kW/m2; bacteriostatics - 0-61%. The obtained results can be used in the resort study

  20. THE STYLE OF GREEK AND ITALIAN VOCABULARY’S ENTRANCE INTO CRIMEAN TATAR LANGUAGE / ÜNAN VE İTALYAN LEKSİKASINIÑ QIRIMTATAR TİLİNE KELİP KİRMESİNİÑ YOLLARI VE USULLARI

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    Prof. Dr. Ahtem MAZİNOV

    2007-05-01

    Full Text Available A plenty of Greek and Italian words entered into Crimean Tatar language via different ways after some processes, proceeding by the Crimean Tatars and their language. These citations can be made directly as well as they can be gone through other languages. In this article, we focus the vocabularies’, belonged to Greek and Italian languages, style of entrance into Crimean Tatar language.

  1. Diplomatic Documentation of the Crimean Khanate in the 16th century (1515–1596: To the Question about the Current State of Publishing »

    Directory of Open Access Journals (Sweden)

    A.V. Vinogradov

    2016-09-01

    Full Text Available Research objectives: to outline the key issues of the current state of publication of diplomatic documents containing information about the Crimean Khanate’s relations with Russian and Polish-Lithuanian states during the period of 1515–1596. Research materials: the Crimean diplomatic documents and letters of the Crimean khans Muhammad Giray I, Saadet Giray, Islam Giray I, Sahib Giray, Devlet Giray I, Mohammed Giray II, Islam Giray II and Gazi Giray II to the Moscow princes and Polish kings preserved in the archives and library manuscript collections in Russia and Poland. Research results: as a result of research the author has introduced into scholarly circulation a generic list of (both published and unpublished messages of the Crimean khans to the Polish kings and princes of Moscow for the period of 1515–1596 preserved in the archives and library manuscript collections in Russia and Poland. Research novelty: the author is the first to consider the problem of the publication of diplomatic documents of the Crimean Khanate being a part of the Crimean ambassadorial books in the fund 123 (“Russian relations with the Crimea” of Russian State Archive of Ancient Acts.

  2. Mycoremediation of congo red dye by filamentous fungi.

    Science.gov (United States)

    Bhattacharya, Sourav; Das, Arijit; G, Mangai; K, Vignesh; J, Sangeetha

    2011-10-01

    Azo, anthroquinone and triphenylmethane dyes are the major classes of synthetic colourants, which are difficult to degrade and have received considerable attention. Congo red, a diazo dye, is considered as a xenobiotic compound, and is recalcitrant to biodegradative processes. Nevertheless, during the last few years it has been demonstrated that several fungi, under certain environmental conditions, are able to transfer azo dyes to non toxic products using laccases. The aim of this work was to study the factors influencing mycoremediation of Congo red. Several basidiomycetes and deuteromycetes species were tested for the decolourisation of Congo red (0.05 g/l) in a semi synthetic broth at static and shaking conditions. Poor decolourisation was observed when the dye acted as the sole source of nitrogen, whereas semi synthetic broth supplemented with fertilizer resulted in better decolourisation. Decolourisation of Congo red was checked in the presence of salts of heavy metals such as mercuric chloride, lead acetate and zinc sulphate. Decolourisation parameters such as temperature, pH, and rpm were optimized and the decolourisation obtained at optimized conditions varied between 29.25- 97.28% at static condition and 82.1- 100% at shaking condition. Sodium dodecyl sulphate polyacrylamide gel electrophoretic analysis revealed bands with molecular weights ranging between 66.5 to 71 kDa, a characteristic of the fungal laccases. High efficiency decolourisation of Congo red makes these fungal forms a promising choice in biological treatment of waste water containing Congo red.

  3. Mycoremediation of Congo red dye by filamentous fungi

    Directory of Open Access Journals (Sweden)

    Sourav Bhattacharya

    2011-12-01

    Full Text Available Azo, anthroquinone and triphenylmethane dyes are the major classes of synthetic colourants, which are difficult to degrade and have received considerable attention. Congo red, a diazo dye, is considered as a xenobiotic compound, and is recalcitrant to biodegradative processes. Nevertheless, during the last few years it has been demonstrated that several fungi, under certain environmental conditions, are able to transfer azo dyes to non toxic products using laccases. The aim of this work was to study the factors influencing mycoremediation of Congo red. Several basidiomycetes and deuteromycetes species were tested for the decolourisation of Congo red (0.05 g/l in a semi synthetic broth at static and shaking conditions. Poor decolourisation was observed when the dye acted as the sole source of nitrogen, whereas semi synthetic broth supplemented with fertilizer resulted in better decolourisation. Decolourisation of Congo red was checked in the presence of salts of heavy metals such as mercuric chloride, lead acetate and zinc sulphate. Decolourisation parameters such as temperature, pH, and rpm were optimized and the decolourisation obtained at optimized conditions varied between 29.25- 97.28% at static condition and 82.1- 100% at shaking condition. Sodium dodecyl sulphate polyacrylamide gel electrophoretic analysis revealed bands with molecular weights ranging between 66.5 to 71 kDa, a characteristic of the fungal laccases. High efficiency decolourisation of Congo red makes these fungal forms a promising choice in biological treatment of waste water containing Congo red.

  4. Congo red and protein aggregation in neurodegenerative diseases.

    Science.gov (United States)

    Frid, Petrea; Anisimov, Sergey V; Popovic, Natalija

    2007-01-01

    Congo red is a commonly used histological dye for amyloid detection. The specificity of this staining results from Congo red's affinity for binding to fibril proteins enriched in beta-sheet conformation. Unexpectedly, recent investigations indicate that the dye also possesses the capacity to interfere with processes of protein misfolding and aggregation, stabilizing native protein monomers or partially folded intermediates, while reducing concentration of more toxic protein oligomers. Inhibitory effects of Congo red upon amyloid toxicity may also range from blockade of channel formation and interference with glycosaminoglycans binding or immune functions, to the modulation of gene expression. Particularly, Congo red exhibits ameliorative effect in models of neurodegenerative disorders, such as Alzheimer's, Parkinson's, Huntington's and prion diseases. Another interesting application of Congo red analogues is the development of imaging probes. Based on their small molecular size and penetrability through blood-brain barrier, Congo red congeners can be used for both antemortem and in vivo visualization and quantification of brain amyloids. Therefore, understanding mechanisms involved in dye-amyloidal fibril binding and inhibition of aggregation will provide instructive guides for the design of future compounds, potentially useful for monitoring and treating neurodegenerative diseases.

  5. Massive postpartum right renal hemorrhage.

    Science.gov (United States)

    Kiracofe, H L; Peterson, N

    1975-06-01

    All reported cases of massive postpartum right renal hemorrhage have involved healthy young primigravidas and blacks have predominated (4 of 7 women). Coagulopathies and underlying renal disease have been absent. Hematuria was painless in 5 of 8 cases. Hemorrhage began within 24 hours in 1 case, within 48 hours in 4 cases and 4 days post partum in 3 cases. Our first case is the only report in which hemorrhage has occurred in a primipara. Failure of closure or reopening of pyelovenous channels is suggested as the pathogenesis. The hemorrhage has been self-limiting, requiring no more than 1,500 cc whole blood replacement. Bleeding should stop spontaneously, and rapid renal pelvic clot lysis should follow with maintenance of adequate urine output and Foley catheter bladder decompression. To date surgical intervention has not been necessary.

  6. Hypertensive thalamic hemorrhage

    International Nuclear Information System (INIS)

    Munaka, Masahiro; Nishikawa, Michio; Hirai, Osamu; Kaneko, Takaaki; Watanabe, Syu; Fukuma, Jun; Handa, Hajime

    1988-01-01

    In the past six years, we have had experience with 40 patients with hypertensive thalamic hemorrhages, as verified by CT scan at our hospital within 24 hours. These patients were classified into the following three groups according to the location of the bleeding point and the size of the hematoma: (1) anteromedial (4 cases), (2) posterolateral (16 cases), and (3) massive (20 cases). The (1) and (2) hematomas were small (less than 3 cm in diameter), while those in (3) were large (more than 3 cm in diameter). Twenty cases (50% of all the thalamic hematomas) were small hematomas. The characteristic clinical symptoms of the anteromedial type were a mild disturbance of consciousness and thalamic dementia, while those of the posterolateral type were motor and sensory disturbance, and thalamic aphasia, respectively. Twenty cases (50%) were large hematomas. The clinical symptoms of these cases were mainly consciousness disturbance; 7 of them expired. Based on this experience, it may be considered that the patients whose hematoma size was larger than 3 cm had a poor prognosis and that the patients with the posterolateral type had a poor functional diagnosis. (author)

  7. MRI of intracranial hemorrhage

    International Nuclear Information System (INIS)

    Inoue, Yuichi; Takemoto, Kazumasa; Hashimoto, Hiromi

    1986-01-01

    Magnetic resonance (MR) images of 23 patients with putaminal or thalamic hematomas were reviewed. Inversion recovery (IR, TR; 2100 - 2500 msec, TI; 600 msec) and long spin echo (SE, TR; 1800 - 2500 msec, TE; 120 msec) images were obtained with a 0.5T MR scanner. Hematomas within 3 hours after hemorrhage were isointense to the gray matter on both IR and long SE images. Two day-old hematomas were hyperintense in part of it on IR images and hypointense on long SE images. In acute hematomas, there was a marked hyperintense crescent area around hematomas on long SE images which marked hypointense on IR images. Hematomas in the resolving stage had peripheral hyperintensity on IR images and then on long SE images. This hyperintensity filled into the center of hematomas with time. In the resolving stage linear hypointensity was recognized at immedeately adjacent to the hematoma on long SE images. In the chronic stage, hematomas were hypointense on both IR and long SE images. In a few cases, the central portion of hematomas demonstrated hyperintensity on long SE images which indicated the presence of fluid in the old hematoma cavity. (author)

  8. Hypertensive cerebellar hemorrhage and cerebellar hemorrhage caused by cryptic angioma

    International Nuclear Information System (INIS)

    Yoshida, Shinichi; Sano, Keiji; Kwak, Suyong; Saito, Isamu.

    1981-01-01

    A series of 44 patients with hypertensive cerebellar hemorrhage and nine patients with cerebellar hemorrhage caused by small angiomas is described. Hypertensive hemorrhage occurred most frequently in the patients in their seventies, whereas the onset of angioma-caused hemorrhage was often seen below the age of 40. Clinical syndromes of cerebellar hemorrhages can be categorized into three basic types: the vertigo syndrome, cerebellar dysfunction syndrome and brain stem compression syndrome. Patients with small (>= 2 cm in diameter in CT scans) and medium-sized (2 cm = 3 cm) hematomas deteriorated into unresponsive conditions and developed signs of brain stem compression. Surgical mortality was 32% in the hypertensive group, while it was 0% in the angioma group. Mortality as well as morbidity in both groups was strongly influenced by the preoperative status of consciousness. Our results suggest that substantial improvement could be obtained in the overall outcome of this disease by emergency craniectomy and removal of hematomas in all patients with large hematomas regardless of the levels of consciousness and regardless of the causes of bleeding. Furthermore, when clinical information and CT findings are suggestive of a ''cryptic'' angioma as the causative lesion, posterior fossa surgery may be indicated to extirpate the lesion, even if the hematoma is small. (author)

  9. “Speeches” of Sigismund II’s Courier, Mikhail Garaburda, Addressed to the Crimean Qalga Muhammad Giray (1559

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    A.A. Gorsky

    2017-03-01

    Full Text Available The author of the article for the first time publishes completely the “speeches” of Mikhail Garaburda – the courier of the Polish king and the Great Lithuanian prince Sigismund II – addressed to Qalga of the Crimean Khanate Muhammad Giray, which were intercepted in 1559 by the voivode D.Adashev and presented by Ivan the Terrible to the Lithuanian side in 1562. Both the embassy of Mikhail Garaburda in the Crimea and the Dnieper-Crimean campaign of D.Adashev took place in 1559. The Ambassadorial book of the Grand Duchy of Lithuania speaks about Sigismund’s charter and the “speeches” of his courier. It is noteworthy that Sigismund’s charter and M.Garaburda’s “speeches” were used by the Russian side only in the course of the negotiations in 1562, that is, three years after they had been delivered to Moscow.

  10. Aneurysmal Subarachnoid Hemorrhage

    Science.gov (United States)

    2015-01-01

    Aneurysmal subarachnoid hemorrhage (SAH) is a worldwide health burden with high fatality and permanent disability rates. The overall prognosis depends on the volume of the initial bleed, rebleeding, and degree of delayed cerebral ischemia (DCI). Cardiac manifestations and neurogenic pulmonary edema indicate the severity of SAH. The International Subarachnoid Aneurysm Trial (ISAT) reported a favorable neurological outcome with the endovascular coiling procedure compared with surgical clipping at the end of 1 year. The ISAT trial recruits were primarily neurologically good grade patients with smaller anterior circulation aneurysms, and therefore the results cannot be reliably extrapolated to larger aneurysms, posterior circulation aneurysms, patients presenting with complex aneurysm morphology, and poor neurological grades. The role of hypothermia is not proven to be neuroprotective according to a large randomized controlled trial, Intraoperative Hypothermia for Aneurysms Surgery Trial (IHAST II), which recruited patients with good neurological grades. Patients in this trial were subjected to slow cooling and inadequate cooling time and were rewarmed rapidly. This methodology would have reduced the beneficial effects of hypothermia. Adenosine is found to be beneficial for transient induced hypotension in 2 retrospective analyses, without increasing the risk for cardiac and neurological morbidity. The neurological benefit of pharmacological neuroprotection and neuromonitoring is not proven in patients undergoing clipping of aneurysms. DCI is an important cause of morbidity and mortality following SAH, and the pathophysiology is likely multifactorial and not yet understood. At present, oral nimodipine has an established role in the management of DCI, along with maintenance of euvolemia and induced hypertension. Following SAH, hypernatremia, although less common than hyponatremia, is a predictor of poor neurological outcome. PMID:25272066

  11. Thalamic hemorrhage following carotid angioplasty and stenting

    International Nuclear Information System (INIS)

    Friedman, Jonathan A.; Kallmes, David F.; Wijdicks, Eelco F.M.

    2004-01-01

    Carotid angioplasty and stenting (CAS) has emerged as an alternative treatment of carotid stenosis for patients poorly suited for endarterectomy. Intracerebral hemorrhage following carotid revascularization is rare and thought to be related to hyperperfusion injury in most cases. Early experience suggests an increased incidence of hemorrhage following CAS as compared to endarterectomy. We describe a patient who suffered a thalamic hemorrhage following CAS. Because this hemorrhage occurred in a vascular territory unlikely to have been supplied by the treated artery, this case suggests that the mechanism of intracerebral hemorrhage following CAS may in some cases be different from the hyperperfusion hemorrhage classically described following endarterectomy. (orig.)

  12. Obstetric hemorrhage: A global review.

    Science.gov (United States)

    Goffman, Dena; Nathan, Lisa; Chazotte, Cynthia

    2016-03-01

    Postpartum hemorrhage remains the number one cause of maternal death globally despite the fact that it is largely a preventable and most often a treatable condition. While the global problem is appreciated, some may not realize that in the United States postpartum hemorrhage is a leading cause of mortality and unfortunately, the incidence is on the rise. In New York, obstetric hemorrhage is the second leading cause of maternal mortality in the state. National data suggests that hemorrhage is disproportionally overrepresented as a contributor to severe maternal morbidity and we suspect as we explore further this will be true in New York State as well. Given the persistent and significant contribution to maternal mortality, it may be useful to analyze the persistence of this largely preventable cause of death within the framework of the historic "Three Delays" model of maternal mortality. The ongoing national and statewide problem with postpartum hemorrhage will be reviewed in this context of delays in an effort to inform potential solutions. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Radiation degradation of Congo Red in aqueous solution

    International Nuclear Information System (INIS)

    Ma Hongjuan; Wang Min; Yang Ruiyuan; Wang Wenfeng; Shen Zhongqun; Yao Side

    2006-01-01

    About one-half of the dyes used in textile industry are azo dyes, and as a consequence a lot of azo dyes are released into the environment with industrial wastewater. Because of complex structures of the dyes, biological, physical and chemical treatments of dye effluents are inefficient. In this study, radiation degradation of Congo Red in aqueous solutions was investigated in different reaction systems. Both pulsed radiolysis and laser flash photolysis experiments were carried out for better understandings of degradation mechanisms involved in the treatments. Congo Red solutions saturated by air, N 2 O, O 2 , N 2 O or N 2 and added with tert-butanol were irradiated to 0-14.8 kGy. The absorption spectra, degradation efficiency, TOC (total organic carbon) removal and pH changes of the solutions were investigated. The main radiolytic products from Congo Red samples irradiated in steady-state were determined by HPLC-MS. And probable reaction mechanisms were proposed. Effects of primary species from water radiolysis, such as e aq - , . OH and . O 2 . /HO 2 . on the degradation behavior of the dye were discussed. Below 5 kGy in γ-rays irradiation, the bleaching efficiency of Congo Red was (N 2 +tert-butanol) >O 2 >air>N 2 O>N 2 . Complete degradation of Congo Red was observed at 4.0, 5.5 and 10.2 kGy irradiation of the aqueous solutions saturated by N 2 with tert-butanol added, O 2 and N 2 O, respectively. With just oxidative or reductive species, highly conjugated part of Congo Red molecules could be destroyed. While oxidative species produced from water radiolysis could oxidize the Congo Red more effectively, making the dye to break into fatty acids and CO 2 finally. In the solution saturated with N 2 and air, the primary active species were both of oxidative and reductive and the highly conjugated part of Congo Red molecules could not be destroyed completely up to 14.8 kGy of γ-ray irradiation. It was more difficult to achieve high TOC removal in comparison with

  14. Who Blew the Balaklava Bugle?: The Charge of the Light Brigade and the Afterlife of the Crimean War

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    Lara Kriegel

    2015-05-01

    Full Text Available The signal event of the Crimean War, the Charge of the Light Brigade, transpired on 25 October 1854. Its reverberations would, however, last long after, as a battle that was waged in the popular press and in auction rooms across the twentieth century attests. The battle involved a bugle and its provenance. In question were two competing claims to have sounded the charge at the Battle of Balaklava, fought at the height of the Crimean War. Did the distinction belong to Trumpet Major William Brittain or to Trumpet Major Henry Joy? The case, which preoccupied family members and interested parties, was closed some fifty years ago in favour of Brittain’s partisans. Why did the contest attain such longevity? Why did it rage with such fervour? This article offers an answer beyond the simple question of provenance as it charts the twists and turns in the dispute, from the mid-nineteenth century through the moment of resolution in the 1960s. In the process, it attests to the politics of presence on the field of battle. It points, too, to the long afterlife of the Crimean War and the lingering shadow of the Victorian Age.

  15. Groundwater Quality of Southeastern Brazzaville, Congo

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    Matini Laurent

    2010-01-01

    Full Text Available The groundwater in southeastern Brazzaville (Congo was analyzed for their fluoride contents and others related parameters in rainy season. The fluoride contents in water samples (wells and spring can be gather in three classes in the study area: low, optimal, high. Fluoride concentration in water samples presents a low significant correlation with Ca2+. This suggests that fluoride in the groundwater come from fluoride-bearing minerals such as CaF2 (fluorite. Maps were drawn to show the geographical distribution of EC, Ca2+, Mg2+and F-. Factor analysis and cluster analysis were applied to the dataset. Factor analysis resulted in four factors explained 76.90% of the total groundwater quality variance. Factor 1 (hardness of the groundwater includes total hardness, the concentration of K+, Ca2+ and pH. Factor 2 (low mineralization of the groundwater includes concentrations of TDS, Cl--, SO42+ and EC. Factor 3 (anthropogenic activities with the impact of agricultural fertilizers, farming activities, domestic wastewater, septic tanks includes concentrations of Na+ and NO3-. Factor 4 (weathering of calcium minerals includes concentrations of F-. For cluster analysis, Ward’s method and the Euclidean distance were used. The findings of the cluster analysis are presented in the form of dendrogram of the well water sites (cases. The discriminating parameters between clusters have been highlighted from the Student test. In majority, they are in accordance with those highlighted by factor analysis.

  16. Spontaneous non aneurysmal subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Bian Jieyong; Wang Zhong; Zhou Dai

    2000-01-01

    Objective: To study the etiology and the treatment of spontaneous non-aneurysmal subarachnoid hemorrhage. Methods: Twenty five cases of cerebral vessel angiography negative patients were analysed retrospectively, the majority of them had been undergone CT, DSA, MRI examination in order to define the etiological factor. Results: Among them, there was 1 case of spinal arteria-vena malformation, 1 case of hemorrhagic blood and 2 cases according to the revealing of MRI could be explained as bled vascular-occult malformation or cavernous angioma. Conclusion: The management and prognosis of patients in whom non-aneurysm is founded on the initial angiogram depends on the pattern of hemorrhage of the initial CT scanning, repeated angiography should be avoided for the case of premise encephalic non-aneurysmal SAH and MRI examination may be indicated to defining of etiological factors

  17. FLAIR images of subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Mikami, Takeshi; Saito, Koji; Okuyama, Tohru; Sakamoto, Yasuo; Takahashi, Akira; Shibata, Kazunori [Kushiro Neurosurgical Hospital, Hokkaido (Japan)

    1996-12-01

    We studied MR fluid attenuated inversion recovery (FLAIR) pulse sequences in 37 cases with subarachnoid hemorrhage caused by aneurysmal rupture. FLAIR sequence suppressed the CSF signal and produced very heavy T{sub 2} weighted images. Subarachnoid hemorrhage was able to be demonstrated as high signal intensity on FLAIR sequences in all patients clear visualization of acute subarachnoid hemorrhage was able to be obtained by MR FLAIR sequences in not only Fisher`s group 3 or 4, but also Fisher`s group 2. Moreover it was suited for the detection of intraaxial hematoma, Sylvian hematoma, subdural hematoma and subarachnoid hemorrhage in the posterior fossa and interhemispheric fissure. Especially, it was useful for detecting intraventricular hemorrhage. Therefore, if patients suffering from subarachnoid hemorrhage present slight headache or atypical symptoms, sometimes it may be more suitable to perform MRI FLAIR pulse sequences first. Aneurysms were found in 21 cases (56.8%). When the aneurysmal size is more than 7 mm, the rate of detection becomes 100%. Aneurysms present various MR appearances because of flow characteristics. Aneurysms were demonstrated as low signal intensity except in 3 cases. In one out of 3 cases, aneurysms were revealed as high signal intensity and in the other two cases, it was revealed as mixed signal intensity. According to the previous studies, rapid flow was demonstrated as low signal intensity by vascular flow void, and delayed flow was demonstrated as high or mixed signal intensity by flow related enhancement and even echo rephasing. MR clearly delineates the size, the lumen, the flow, and the extraaxial location of aneurysms. (K.H.)

  18. Cerebral hemorrhage caused by amyloid angiopathy

    International Nuclear Information System (INIS)

    Hanyu, Haruo; Tomonaga, Masanori; Yoshimura, Masahiro; Yamanouchi, Hiroshi; Shimada, Hiroyuki.

    1985-01-01

    Cerebral hemorrhage caused by amyloid angiopathy was studied clinicopathologically, with special attention given to the CT images. Cerebral hemorrhage caused by amyloid angiopathy is characterized, by a lobar-type hemorrhage involving the cortex, with direct extension into the subarachnoid space. Multiple hemorrhages are frequent, and cortical infarctions are present as complications in elderly patients without risk factors. CT scans taken in 5 cases demonstrated lobar hemorrhages in superficial locations, frequently in multiple sites or recurrently, with surrounding edema and mass effect. A subarachnoid extension of the hemorrhage through the superficial cortex, proven pathologically in all cases, was noted by CT in 4 of the 5 cases. However, cortical infarction was not detected by CT in any case. Therefore, CT is of value in the diagnosis of cerebral hemorrhage due to amyloid angiopathy based on distinctive findings such as a lobar hemorrhage in superficial regions, with extension into the subarachnoid space, frequently in multiple sites or recurrently. (author)

  19. Recurrent encephalic hemorrhage associated with cocaine abuse

    International Nuclear Information System (INIS)

    Pumar, J.; Otero, E.; Castineira, A.; Arrojo, L.; Linares, M.; Castineira, J.A.; Vidal, J.

    1994-01-01

    We report a case of recurrent intracerebral hemorrhage secondary to cocaine abuse in a patient with no other predisposing factors. The hemorrhages were located both supra- and infratentorially. (orig.)

  20. PULMONARY HEMORRHAGE. ENDOSCOPIC DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    A. M. Gasanov

    2016-01-01

    Full Text Available In the article, we report the incidence and etiology of pulmonary hemorrhage, and modern classifications according to the literature data. Methods of endoscopic diagnosis and treatment of pulmonary hemorrhage are analyzed.

  1. Pleural liquid during hemorrhagic hypotension.

    Science.gov (United States)

    Tresoldi, Claudio; Porta, Cristina; Zocchi, Luciano; Agostoni, Emilio

    2007-02-15

    The effect of approximately 25% or 35% blood loss (b.l.) on volume, pressure, and protein concentration of pleural liquid has been determined in anesthetized rabbits in lateral or supine posture. Volume and pressure of pleural liquid did not change with 25% b.l. 30 and 60 min after beginning of hemorrhage, and with 35% b.l. at 30 min (bleeding time approximately 10 and 12 min, respectively). With 35% b.l. protein concentration of pleural liquid was 85% greater (PPleural liquid seems protected against derangements from hemorrhage up to 25% b.l. for periods shorter than 1 h.

  2. Chemical composition of the mineral waters of the Congo River

    International Nuclear Information System (INIS)

    Tshiashala, M.D.; Lumu, B.M.; Lobo, K.K.; Tshisumpa, M.; Wembo, L.S.

    2003-01-01

    Atomic absorption spectrophotometry has been applied to river Congo waters for a global monitoring of trace element contents. 15 elements Ag, Au, Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, Pb and Zn have been determined in samples collected at 2 sites along the river Congo. Results are compared with those observed in other river waters collected in Kinshasa and elsewhere and for compliance with the international quality standards elaborated by the Who, USA and SSRU. The waters of river Congo have been found less mineralized than those of river Niger. They are of the same order of magnitude than those observed in some local rivers such as Ndjili, Lubudi, Funa, Tshangu and Tshenke.

  3. Eleven cases of neonatal intracranial hemorrhage

    International Nuclear Information System (INIS)

    Matsuda, Tadashi; Asao, Toyohiko; Shibata, Takeo

    1981-01-01

    Eleven cases of neonatal intracranial hemorrhage were diagnosed and followed up by CT scanning. By CT, hemorrhagic lesions were shown as high density areas in an acute stage and imaged as low density areas after the hemorrhage was absorbed. The time of absorption varies depending upon the site and the severity of hemorrhage. Intraventricular hemorrhage, petechial hemorrhage and subdural hematoma were absorbed rapidly in more than 70% of the exanimed cases, CT scanning 1 - 2 weeks after the onset revealed absorption of hemorrhage. However, the absorption delayed in intracerebral hematoma; CT scan taken after one month showed hemorrhagic lesions remaining in 75% of the cases. In nine cases who survived, following the absorption of the hemorrhagic lesions, cerebral atrophy was observed in 4 cases (44%), ventricular enlargement in 3 cases (33%), and complete recovery in 2 cases (22%). From these results, CT scanning for diagnosis of neonatal intracranial hemorrhage should be done before the hemorrhagic lesion is absorbed (within 7 days of the onset). Follow-up study by CT is important for observing changes and predicting prognosis of intracranial hemorrhage. (Ueda, J.)

  4. Inhibition of Interferon Induction and Action by the Nairovirus Nairobi Sheep Disease Virus/Ganjam Virus

    OpenAIRE

    Holzer, Barbara; Bakshi, Siddharth; Bridgen, Anne; Baron, Michael D.

    2011-01-01

    The Nairoviruses are an important group of tick-borne viruses that includes pathogens of man (Crimean Congo hemorrhagic fever virus) and livestock animals (Dugbe virus, Nairobi sheep disease virus (NSDV)). NSDV is found in large parts of East Africa and the Indian subcontinent (where it is known as Ganjam virus). We have investigated the ability of NSDV to antagonise the induction and actions of interferon. Both pathogenic and apathogenic isolates could actively inhibit the induction of type ...

  5. Virus and Infections 2010 - BIT's first world congress.

    Science.gov (United States)

    Garkavenko, Olga

    2010-10-01

    The World Congress of Virus and Infections, held in Busan, South Korea, included topics reviewing the field of zoonoses. This conference report highlights selected presentations on surveillance, epidemiology and measures for the control and prevention of zoonotic diseases. Topics discussed include human factors influencing zoonoses, the molecular epidemiology of Crimean-Congo hemorrhagic fever, the emerging Nipah virus, and the re-emergence of cowpox virus.

  6. Takotsubo cardiomyopathy following subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Wajnberg, Eduardo

    2012-01-01

    Takotsubo cardiomyopathy corresponds to a syndrome characterized by a transient myocardial dysfunction affecting the left ventricular apex that classically occurs after major physical or emotional stress (also called 'broken heart syndrome' or 'stress-induced cardiomyopathy'). The author describes the case of a patient with takotsubo cardiomyopathy induced by subarachnoid hemorrhage. (author)

  7. Antifibrinolytic treatment in subarachnoid hemorrhage

    NARCIS (Netherlands)

    Vermeulen, M.; Lindsay, K. W.; Murray, G. D.; Cheah, F.; Hijdra, A.; Muizelaar, J. P.; Schannong, M.; Teasdale, G. M.; van Crevel, H.; van Gijn, J.

    1984-01-01

    We enrolled 479 patients with subarachnoid hemorrhage in a multicenter, randomized, double-blind, placebo-controlled trial to determine whether treatment with the antifibrinolytic agent tranexamic acid improves outcome by preventing rebleeding. At three months there was no statistical difference

  8. Reducing postpartum hemorrhage in Africa

    DEFF Research Database (Denmark)

    Lazarus, Jeff; Lalonde, A

    2005-01-01

    Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in sub-Saharan Africa. This is being addressed by leading professional organizations, which point to the importance of a skilled attendant at birth. But they also emphasize that the active management of the third stage of labor...

  9. Cardiac abnormalities after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Bilt, I.A.C. van der

    2016-01-01

    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart

  10. Rebleeding After Aneurysmal Subarachnoid Hemorrhage

    DEFF Research Database (Denmark)

    Larsen, Carl Christian; Astrup, Jens

    2013-01-01

    OBJECTIVE: To summarize the current knowledge of the mechanisms leading to rebleeding and the prevention of rebleeding after subarachnoid hemorrhage (SAH). METHODS: A literature search was performed to investigate factors associated with rebleeding after SAH. RESULTS: The review of the literature...

  11. CT differential diagnosis between hypertensive putaminal hemorrhage and hemorrhagic infarction localized in basal ganglia

    International Nuclear Information System (INIS)

    Tazawa, Toshiaki; Mizukami, Masahiro; Kawase, Takeshi.

    1984-01-01

    The symptoms of hypertensive putaminal hemorrhage and of middle cerebral artery occlusion are sometimes similar to each other. Hemorrhage sometimes occurs following cerebral infarction. We experienced 7 patients with hemorrhages localized in the basal ganglia following cerebral infarction. The CT findings of 55 patients with putaminal hemorrhage and 7 patients with hemorrhagic infarction localized at the basal ganglia were investigated retrospectively in order to discuss their characteristics. The high-density area (HD) of a putaminal hemorrhage was homogeneous on a plain CT within a week of the onset. There was a close correlation between the size of the HD and the timing of its disappearance. The HD with a maximum diameter of A cm generally disappeared A weeks after. On the other hand, the HD of a hemorrhagic infarction was lower in density than that of the putaminal hemorrhage. The HD of a hemorrhagic infarction generally disappeared earlier than that of a putaminal hemorrhage. Ring enhancement was visualized on contrast-enhanced CT (CECT) from 2 or 3 weeks after the onset in patients with putaminal hemorrhages except in the case of small hemorrhages (less than 1 cm diameter). Ring enhancement was also visualized in 6 out of 7 patients with hemorrhagic infarction; one of them was recognized within a week of the onset. Contrast enhancement of the cortex in the territory of the middle cerebral artery was visualized in 4 out of 7 patients with hemorrhagic infarction. This finding seems to indicate one characteristic of hemorrhagic infarction. (author)

  12. Computed tomography in subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Lee, Seung Ro; Chang, Kee Hyun; Choi, Byung Ihn; Han, Man Chung; Sim, Bo Sung

    1981-01-01

    Computed Tomography has become increasingly important diagnostic method as the initial examination in the diagnosis of subarachnoid hemorrhage with direct detection of extravasated blood in basal cistern and cortical sulci. Furthermore, CT provides better and exact visualization of the presence, localization, extent and degree of intracerebral, intraventricular and subdural hemorrhage, infarction, hydrocephalus and rebleeding which may be associated with subarachnoid hemorrhage, and also could detect the causative lesions with contrast enhancement in many cases. The purpose of the paper is to describe the CT findings of subarachnoid hemorrhage due to various causes and to evaluate the diagnostic accuracy of CT in subarachnoid hemorrhage. Authors analysed a total of 153 cases with subarachnoid hemorrhage confirmed by lumbar puncture at Seoul National University Hospital from March 1979 to April 1981, with special emphasis on CT findings. All of the cases took CT scan and 125 cases of them angiography. The results are as follows: 1. Most prevalent age group was 4th to 6th decades (78%). The ratio of male to female was 1.1: 1. 2. Of 125 cases with angiography, aneurysm was a major cause (68%). Others were arterio-venous malformation (9.6%), Moya-moya disease (4%) and unknown (18.4%). 3. Of all 153 cases with CT scan, hemorrhage was demonstrated in 98 cases (64.1%); SAH in 72 cases (47.1%), ICH in 65 cases (42.5%), IVH in 34 cases (22.2%) and SDH in 1 case (0.7%). SAH combined with ICH was a major group (34.7%) in SAH. Detection rate of SAH was 68.3% within the first 7 days and 5.8% after 7 dyas. 4. In aneurysms, SAH was detected in 60 of 85 cases (70.6%); 88.1% within the first 7 dyas and 5.6% after 7 dyas. Anterior communicating artery was the most common site of the aneurysms (40%), in which detection rate of SAH was 100% within the first 7 days. SAH was combined with ICH in 38.3%. 5. On CT, SAH of unilateral Sylvian fissure was pathognomonic for ruptured MCA

  13. Computed tomography in intracranial hemorrhage in leukemia

    International Nuclear Information System (INIS)

    Hanyu, Haruo; Katsunuma, Hideyo; Yoshimura, Masahiro; Tomonaga, Masanori.

    1984-01-01

    In tracranial hemorrhage in leukemia was clinicopathologically studied in 62 cases of autopsy materials, with special attention paid to a morphological comparison of CT images with pathological findings. Intracranial hemorrhage was found in 32 of the 62 leukemic patients (51.6%), and in 13 of these patients (21.0%) it was responsible for death. Leukemic intracranial hemorrhage occurred more often in the acute leukemic type than in the chronic type, and even more often in younger leukemic patinents; it was pathologically characterized by multiple lesions in the white matter of the cerebral hemisphere, prone to combination with SAH or SDH. The hemorrhages could be divided into five types: (1) scattered small hemorrhagic type, (2) hematoma type, (3) fusion type (large hemorrhage composed of assembled small hemorrhages), (4) SAH type, and (5) SDH type. Among these types, the fusion type was considered to be characteristic of leukemia. CT was undertaken in 5 pathologically proven cases, with findings of the scattered small hemorrhagic type in 1, of the SDH type in 3, and of the fusion type in 1. Yet, one case with scattered small hemorrhages and two cases with SDH failed to be detected by CT. However, one case with a typical fusion hemorrhage was found to have multiple, irregular, high-density areas with surrounding edema and a mass effect as well as pathological findings. Therefore, a large-fusion hemorrhage, which is one of the most characteristic types of leukemic intracranial hemorrhage, could be demonstrated as distinctive CT images which reflected neuropathological findings. On the other hand, small parenchymal hemorrhages and relatively thin subdural hemorrhages could not be detected by CT. In conclusion, it seems that CT has value in the diagnosis of intracranial hemorrhage in leukemia. (J.P.N.)

  14. Glycemia in Spontaneous Intracerebral Hemorrhage: Clinical Implications

    Directory of Open Access Journals (Sweden)

    Alvis-Miranda Hernando

    2014-10-01

    Full Text Available Spontaneous cerebral hemorrhage or intracranial hemorrhage accounts for 10-15% of all strokes. Intracranial hemorrhage is much less common than ischemic stroke, but has higher mortality and morbidity, one of the leading causes of severe disability. Various alterations, among these the endocrine were identified when an intracerebral hemorrhage, these stress-mediated mechanisms exacerbate secondary injury. Deep knowledge of the injuries which are directly involved alterations of glucose, offers insight as cytotoxicity, neuronal death and metabolic dysregulations alter the prognosis of patients with spontaneous intracerebral hemorrhage.

  15. Migraine and risk of hemorrhagic stroke

    DEFF Research Database (Denmark)

    Gaist, David; González-Pérez, Antonio; Ashina, Messoud

    2014-01-01

    to select 10,000 controls free from hemorrhagic stroke. Using unconditional logistic regression models, we calculated the risk of hemorrhagic stroke associated with migraine, adjusting for age, sex, calendar year, alcohol, body mass index, hypertension, previous cerebrovascular disease, oral contraceptive......BACKGROUND: We investigated the association between hemorrhagic stroke and migraine using data from The Health Improvement Network database. FINDINGS: We ascertained 1,797 incident cases of intracerebral hemorrhage (ICH) and 1,340 of subarachnoid hemorrhage (SAH). Density-based sampling was used...

  16. British Icons and Catholic perfidy--Anglo-Saxon historiography and the battle for Crimean War nursing.

    Science.gov (United States)

    Wells, John S G; Bergin, Michael

    2016-03-01

    Taking as its starting point Carr's view that historical narrative reflects the preoccupations of the time in which it is written and Foucault's concept of consensual historical discourse as the outcome of a social struggle in which the victor suppresses or at least diminishes contrary versions of historical events in favour of their own, this paper traces and discusses the historical narrative of British nursing in the Crimean war and, in particular, three competing narratives that have arisen in the latter half of the 20th century and the first decade of the 21st. These are the established narrative surrounding Florence Nightingale, the new narrative surrounding Mary Seacole and an Irish narrative surrounding the role of the Sisters of Mercy. It is argued that the increased vehemence of the debate surrounding these narratives is representative of the changes that have taken place in British society. However, we also argue that the Irish narrative and its critique are reflective of deep-rooted Anglo-Protestant attitudes articulated by Nightingale and uncritically accepted by subsequent historians even in modern British historiography. © 2015 John Wiley & Sons Ltd.

  17. The National Liberation Struggle of the Balkan Peoples and the Crimean War

    Directory of Open Access Journals (Sweden)

    Elena V. Belova

    2016-12-01

    Full Text Available The article examines the stages of the national liberation struggle of the peoples of South- Eastern Europe against the Ottoman Empire. The Russian Empire supported the Christian population and helped the southern Slavs and the Greeks to get free from the Ottoman dependency. But Emperor Nicholas I opposed the revolution. The 1850s were marked by the strained political and economic relations between Russia, Turkey, Britain, France and other European States. The Bulgarian and the Greek bourgeoisie had moved from enlightment activity to the political one. Bulgarians, Serbs, Moldovans, Greeks joined the volunteers and defended national interests with the weapon in hands. During the Crimean war the Russian command created military units on the territory of the Danubian principalities. Volunteers fought on the Danube, in Moldavia and Wallachia, and the Crimea. They protected the borders, defended the bastions of Sevastopol. The subject of the research is the organization of volunteer groups, national and social composition of the groups. The role of volunteers was of an exclusive political significance. The number of volunteers in the ranks of Russian troops was insignificant. But the volunteers were guides of Russian policy in the Turkish lands. They represented the fighting core.

  18. Intracranial hemorrhage of the mature newborn infant

    International Nuclear Information System (INIS)

    Takemine, Hisao

    1983-01-01

    Concerning four mature newborn infants with intracranial hemorrhage diagnosed by CT, the labour course, treatment, and prognoses were discussed. Of intracranial hemorrhage, 70.7% was small hemorrhage along the cerebellar tentorium and the falx cerebri, 12.2% subdural hemorrhage in the posterior cranial fossa, and 9.8% subdural hemorrhage in the fornex. Intraventricular or extradural hemorrhage was rarely found. The prognosis is determined by severeness of neurotic symptoms due to cerebral hypoxia. Subdural hemorrhage of the posterior cranial fossa resulted in cerebral palsy in one fifth of the cases, and in slight enlargement of the ventricle in three fifths. Subdural hematoma left porencephaly in one fourth of the patients, but the remaining recovered to normal. (Ueda, J.)

  19. D3.2 The DR. Congo review

    DEFF Research Database (Denmark)

    Mandrup, Thomas

    2017-01-01

    , representatives of the Congolese authorities, NGOs and other IOs. EU involvement started with the deployment of Artemis in 2003, and the study ends with the closure of EUSEC in July 2016. All EU missions in the Democratic Republic of Congo (DRC) have been part of EU support for the transition and implementation...

  20. Climate Change Impacts on the Congo Basin Region

    NARCIS (Netherlands)

    Ludwig, F.; Franssen, W.; Jans, W.W.P.; Kruijt, B.; Supit, I.

    2012-01-01

    This report presents analyses of climate change impacts in the Congo Basin on water for agriculture and hydropower, forest ecosystem functioning and carbon storage and impacts of climate variability and change on future economic development. To quantify the impacts of future climate we developed a

  1. The deforestation of rural areas in the Lower Congo Province.

    Science.gov (United States)

    Iloweka, Ernest Manganda

    2004-12-01

    The Lower Congo is one of eleven provinces in the Democratic Republic of Congo, and is located southwest of Kinshasa Town Province. It has an area of approximately 53.947 km2 with a population of 1,504,361 at an estimated 237 persons per km2. The Province comprises five districts, including Lukaya and Cataracts where rural poverty is severe and the population struggle to make a living through agriculture and woodcutting. These activities result in excessive resource exploitation. The high demand for foodstuffs and the high consumption of wood (for energy, construction and export) in Kinshasa, the capital city of the Democratic Republic of Congo and the expanding towns of Matadi and Boma in the Lower Congo Province, are speeding the deforestation rate and unbalancing forest ecosystems. In addition there is the stress resulting from reduced josher (the rest period for agriculture ground), plus climate change and erosion. The phenomena that that we need to address in these two districts include deforestation, reduced josher, excessive agriculture, erosion, burning and climate change which taken together largely explain the current soil degradation. These areas are marked by excessive post deforestation savannah formation and extended areas of sandy soil, distributed throughout grass and shrub savannahs. This desertification, which is rampant in Lukaya and Cataracts, risks imprisoning the rural population in a vicious cycle of poverty if adequate solutions are not found.

  2. Physiological and biochemical responses of Chlorella vulgaris to Congo red.

    Science.gov (United States)

    Hernández-Zamora, Miriam; Perales-Vela, Hugo Virgilio; Flores-Ortíz, César Mateo; Cañizares-Villanueva, Rosa Olivia

    2014-10-01

    Extensive use of synthetic dyes in many industrial applications releases large volumes of wastewater. Wastewaters from dying industries are considered hazardous and require careful treatment prior to discharge into receiving water bodies. Dyes can affect photosynthetic activities of aquatic flora and decrease dissolved oxygen in water. The aim of this study was to evaluate the effect of Congo red on growth and metabolic activity of Chlorella vulgaris after 96h exposure. Exposure of the microalga to Congo red reduced growth rate, photosynthesis and respiration. Analysis of chlorophyll a fluorescence emission showed that the donor side of photosystem II was affected at high concentrations of Congo red. The quantum yield for electron transport (φEo), the electron transport rate (ETR) and the performance index (PI) also decreased. The reduction in the ability to absorb and use the quantum energy increased non-photochemical (NPQ) mechanisms for thermal dissipation. Overall, Congo red affects growth and metabolic activity in photosynthetic organisms in aquatic environments. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Changing governance arrangements: NTFP value chains in the Congo Basin

    NARCIS (Netherlands)

    Ingram, V.J.

    2017-01-01

    As forest products from Cameroon and DR Congo are commercialised, a value chain is created from harvesters, processors, and retailers to
    consumers worldwide. In contrast to dominant narratives focusing on regulations and customs, these chains are actually governed by dynamic,
    multiple

  4. Risk Assessment: Democratic Republic of Congo Post-Laurent ...

    African Journals Online (AJOL)

    political system as opposed to the view that it was merely a power struggle between Kabila on the .... Local actors and international mining companies built alliances exploiting Congo's minerals to gain a ... They are preparing a contingency plan for their activities in the post-Laurent Kabila era, for ... small arms in the DRC.33.

  5. Phonology and Morphology of Mambay (Niger-Congo, Adamawa)

    NARCIS (Netherlands)

    Anonby, Erik John

    2008-01-01

    Mambay is an Adamawa (Niger-Congo) language spoken by 15,000 people in Chad and Cameroon. The study opens with historical and linguistic background. A phonological inventory of the language is then presented and distribution patterns are examined. Some striking phenomena include a profoundly

  6. Sorption behavior of congo red on different plant leaves (abstract)

    International Nuclear Information System (INIS)

    Khan, M.I.; Mirza, M.L.; Zafar, S.; Khalid, N.

    2011-01-01

    Batch adsorption studies were carried out to evaluate the potential of different plant leaves (Bougainvillaea Glabra and Citrus Sinensis) for the removal of Congo red dye from aqueous solution by optimizing different parameters such as effect of shaking time, adsorbent dose, initial adsorbate concentration, temperature etc. The experimental data was subjected to different types of isotherm models such as Freundlich, Langmuir and Dubinin-Radushkevich. The maximum adsorption capacity was calculated and was comparable for both the leaves through Freundlich isotherm by using the optimized parameters of weight and time at room temperature. The sorption mean free energy from Dubinin-Radushkevich isotherm was also determined and compared. Pseudo-first and Pseudo-second order kinetics models were tested for the adsorption of Congo red on plant leaves powder. The experimental data fitted well for Pseudo-second order model. The uptake of Congo red was also studied with the variation of temperature. Thermodynamic parameters have been calculated. The results indicate that the plant leaves of Bougainvilia Glabra and Citrus Sinensis are efficient adsorbents for Congo red dye from aqueous solutions and can be used for wastewater management. (author)

  7. Opportunities for Hydrologic Research in the Congo Basin

    Science.gov (United States)

    Alsdorf, D. E.; Beighley, E., II; Lee, H.; Tshimanga, R.; Spencer, R. G.; O'Loughlin, F.

    2014-12-01

    We review the published results on the Congo Basin hydrology and find that there are historic data, ongoing measurement recording efforts, and important model results. Annual rainfall is ~2000 mm/yr along an east-west trend, decreasing northward and southward to ~1100 mm/yr. While some studies show rain gauges at specific locations with declines in P greater than 10% from 1960 to 1990, other studies suggest that basin wide decreases from 1951 to 1993 are modest at 4.5% or that the trend is minimal. Studies during the 1950s using lysimeters, pans, and models suggest that the annual potential ET varies little across the basin at a 1100 mm/yr to 1200 mm/yr. Over the past century, river discharge data has been collected at 100s of stream gauges with historic and recent data at 96 locations now publicly available. Discharge of the Congo River at Kinshasa-Brazzaville experienced an increase of 21% during 1960-1970 in comparison to background values of the previous decades and of today. There does not appear to be a long-term discharge trend over the century of record. Satellite altimetry measurements collected during high and low flows show that the Cuvette Centrale wetland water levels are consistently 0.5m to 3m higher in elevation than the immediately adjacent Congo River levels. Wetland water depths are shallow at about 1m whereas the Congo is typically less than 15m deep everywhere upstream of Kinshasa. The wetlands do not appear to be marked by sizable channels such that the flows are diffusive. CO2 and CH4 evasion from the Congo waters directly to the atmosphere are estimated at 1.6 to 3.2 Tg/yr for CH4 from the Cuvette wetland waters and 105 to 204 g C/m2/yr for CO2 from waters of the Oubangui River. Using these published results, we suggest seven hypotheses that may lead to important water and carbon cycle discoveries. These hypotheses focus on the source of the Cuvette waters and how those waters leave the wetland; on river discharge generated by historic

  8. Computed tomography of intraventricular hemorrhage

    International Nuclear Information System (INIS)

    Cho, Bum Shin; Shin, Kyoung Hee; Hahm, Chang Kok

    1982-01-01

    Computed tomography (CT) is a new non-invasive diagnostic imaging method, which has ability to differentiate C.S.F., hematoma, and even edematous brain from normal brain tissue. Prior to the introduction of the CT, the diagnosis of the intraventricular hemorrhage in living patients was difficult and was confirmed by surgery of autopsy. Intracranial hemorrhages are visible on the CT with density higher than brain tissue in acute phase. CT is an accurate method for detecting of intraventricular hemorrhage including detection of nature, location, amount, and associated changes. CT is also useful as a guidance and in the evaluation of fate of the hematomas by easily performable follow up studies. The causes of the intraventricular hemorrhages are hypertension, rupture of aneurysm, arteriovenous malformation, head trauma, brain tumor, and others. This study included evaluation of CT of 69 patients who show the high density in cerebral ventricular system during the period of 31 months from Feb. 1979 to Aug. 1981 in the Department of Radiology, College of Medicine, Hanyang University. The results were as follows. 1. Age distribution of the total 69 patient was broad ranging from 1 month to 80 years. 28% of patients were in the 6th decade. The mate to female ratio was 2 : 1. 2. The consciousness of patients at CT study: Those were conscious in 11 cases, stuporous in 41 cases and unconscious in 17 cases. 3. The causes of intraventricular hemorrhages were hypertension in 28 cases, head trauma in 12 cases, aneurysm in 4 cases, tumor in 2 cases and others in 23 cases. 4. 9 cases showed intraventricular hematomas only, other 60 cases showed associated intracranial hematomas: Those were intracerebral hematomas in 53 cases including 30 cases of basal ganglial and thalamic hematomas, subarachnoid hemorrhage in 17 cases, epidural hematomas in 3 cases, and subdural hematomas in 2 cases. 5. All cases of the intraventricular hematomas except one sowed hematoma in the lateral

  9. CT findings of fundal hemorrhage in subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Munemoto, Shigeru; Ishiguro, Shuzo; Kimura, Akira; Futami, Kazuya; Kogure, Yuzaburo; Wakamatsu, Koichi; Demachi, Hiroshi

    1987-01-01

    The patient was a 66-year-old man. He lost consciousness as a result of a third subarachnoid hemorrhage attack. On neurological examination, he was found to be comatose and to have no spontaneous respiration. A mydriasis was noticed on both eyes. Bilateral retinal bleeding was also observed, with the bleeding of the left side more severe than that of the right side. After his death, his brain and eyes were examined by means of a CT scan. The CT films showed a severe subarachnoid hemorrhage and ventricular hematoma. The thin-sliced CT films showed left retinal bleeding. Retinal bleeding may be caused by a subarachnoid hemorrhage. Usually we make a sketch of the retinal bleeding on the basis of a doctor's report. A photo of an optic fundus is a good record; however, taking a photo is troublesome for severely ill patients. The CT finding of retinal bleeding is gross, but a CT image is one good way to record retinal bleeding. (author)

  10. S.N. BULGAKOV: SOPHIOLOGY WITHOUT OFSOPHIA.“CATHOLIC TEMPTATION“ ANDBREAKING WITHSOPHIOLOGY IN WORKS OF THE CRIMEAN PERIOD

    Directory of Open Access Journals (Sweden)

    VAGANOVAN.A

    2008-04-01

    Full Text Available he Article is dedicated to so called “crimean period“ (1918–1921 and directly vergingto it first emigre years of the life and creative activity of S.N. Bulgakov. Trying comprehendthe history catastrophe, outlived Russia and disappointed in activity of the Council of1917–1918, Bulgakov feels “catholic temptation“, simultaneously losing interest to theme ofSofia. Overcoming of temptation turns out to be, in consciousness of the thinker at least,closely connected with return, in updated type, of the sophiology theme

  11. Evaluation of the contamination level of sea bottom sediments on the Crimean coast of the Black and Azov Seas

    Directory of Open Access Journals (Sweden)

    Tikhonova Elena

    2016-12-01

    At the most stations in the Azov Sea the content of HM exceeded values obtained in the Black Sea. Now (2016 in the open Crimean coast bottom sediments of the Black Sea have properties typical for marine sediments of the studied area. There is an upward trend in the content of chloroform-extracted substances in the Black Sea region, but the sediments are not contaminated with oil products. Taking into account the physical-chemical characteristics of marine sediments, it can be stated that the condition the studied area as a whole is safe.

  12. MR imaging of intraocular hemorrhage

    International Nuclear Information System (INIS)

    Saint-Louis, L.A.; Weiss, R.; Ellsworth, R.; Chang, S.; Deck, M.D.F.

    1987-01-01

    The authors evaluated with MR imaging 11 globes (nine patients) with spontaneous or traumatic intraocular hemorrhage. Subretinal blood was present in eight. Intravitreal bleeding was associated in seven and three subchoroidal. The ages of the hemorrhages ranged from 1 day to 6 months. Six of the subretinal and two subchoroidal cases had clotted blood with different intensity on the short TE images but were markedly hypointense on long TR/long TE images. The intravitreal blood was hyperintense on all sequences except in one. All imaging was performed with .5 T, 256 matrix, and 4- and 7- mm section thickness. Because of the varied appearance of hemorrhages, the authors scanned and are scanning two rabbits with intravitreal blood in vivo. Parameters include: 3-mm sections, T1, PD, T2 scans in .3-T and 1.5-T imagers. Initial results for the first 2 days show no change in signal intensity (hyperintense on all sequences). The T1 images show a diminishing intensity up to 8 days, and T2 scans remained hyperintense. These results so far correlate with the patient findings. The authors present the clinical findings and experimental correlation

  13. Analysis of angiographic findings in cerebral arteriovenous malformation with hemorrhage: comparison between intracerebral and intraventricular hemorrhage

    International Nuclear Information System (INIS)

    Kim, Jae Kyun; Kim, Joon Hyung; Kwon, Jin Sook; Yoon, Soo Woong; Lee, Ho Kyu; Choi, Choong Gon; Suh, Dae Chul

    1998-01-01

    The purpose of this study was to analyze the angioarchitectures of cerebral arteriovenous malformation (AVM) and to determine whether there was correlation between angioarchitectures and patterns of intracranial hemorrhage (intracerebral, intraventricular, and both) in cerebral AVM. One hundred and twenty-eight patients who between November 1989 and December 1994 suffered supratentorial AVM with intracranial hemorrhage were studied retrospectively. Among 128 patients, intracerebral and intraventricular hemorrhage were seen in 68(53%) and 24 patients(19%), respectively, while both types were seen in the remaining 36 (28%). We analyzed the angioarchitectual characteristics of AVM, namely nidi, feeding arteries and draining veins, in three hemorrhagic groups of patients with intracerebral hemorrhage, intraventricular hemorrhage and both. The X 2 test or Fisher's exact test was used for statistical analysis. A cortically located nidus was most common in patients with intracerebral hemorrhage, while a periventricular location was most common in those with intraventricular hemorrhage (p<0.001). Location in the corpus callosum, choroid plexus, or intraventricular area was more frequent in the intraventricular than the intracerebral hemorrhagic group (p<0.05). Superficial venous drainage was most common in patients with intracerebral hemorrhage (p<0.001), and deep venous drainage in those with intraventricular hemorrhage (p=3D0.001). The angioarchitectual characteristics of cerebral arteriovenous malformation correlate significantly with patterns of intracranial hemorrhage, and awareness of the type of hemorrhage could help to manage patients and determine prognosis.=20

  14. Neonatal adrenal hemorrhage presenting as late onset neonatal jaundice

    OpenAIRE

    Qureshi, Umar Amin; Ahmad, Nisar; Rasool, Akhter; Choh, Suhail

    2009-01-01

    Clinical manifestations of adrenal hemorrhage vary depending on the degree and rate of hemorrhage, as well as the amount of adrenal cortex compromised by hemorrhage. We report here a case of neonatal adrenal hemorrhage that presented with late onset neonatal jaundice. The cause of adrenal hemorrhage was birth asphyxia.

  15. Intraretinal hemorrhages in cystoid macular edema.

    Science.gov (United States)

    Bovino, J A; Kelly, T J; Marcus, D F

    1984-08-01

    Retinal hemorrhages can be associated with typical cystoid macular edema. We examined the fundus photographs and fluorescein angiograms of 313 eyes of 264 patients with documented cystoid macular edema to establish the incidence and characteristics of associated intraretinal hemorrhages. As we wanted to study only those hemorrhages unique to cystoid macular edema, we excluded 86 eyes because the patients had diseases known to be associated with retinal hemorrhages. These diseases included diabetes mellitus, branch retinal vein occlusion, hypertensive retinopathy, venous stasis retinopathy, and perifoveal telangiectasia. Of the remaining 227 eyes with cystoid macular edema, 56 (24.7%) were identified with retinal hemorrhages not associated with systemic disease. The hemorrhages were characteristically oval, round, or linear and frequently filled or partially filled the intraretinal cystoid space. In many patients, a blood-fluid level was observed.

  16. MR imaging of acute hemorrhagic brain infarction

    International Nuclear Information System (INIS)

    Uchino, Akira; Ohnari, Norihiro; Ohno, Masato

    1989-01-01

    Six patients with acute hemorrhagic brain infarct were imaged using spin-echo (SE) pulse sequences on a 1.5 Tesla MR scanner. Including two patients with repeated MR imaging, a total of eight examinations, all performed within 15 days after stroke, were analyzed retrospectively. Four patients revealed massive hemorrhages in the basal ganglia or cerebellum and three cases demonstrated multiple linear hemorrhages in the cerebral cortex. On T1-weighted images, hemorrhages were either mildly or definitely hyperintense relative to gray matter, while varied from mildly hypointense to hyperintense on T2-weighted images. T1-weighted images were superior to T2-weighted images in detection of hemorrhgage. CT failed to detect hemorrhage in two of five cases: indicative of MR superiority to CT in the diagnosis of acute hemorrhagic infarcts. (author)

  17. MR imaging of acute subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Spickler, E.; Lufkin, R.B.; Frazee, J.; Lylyk, P.; Vinuela, F.; Bentson, J.R.; Dion, J.E.

    1987-01-01

    Subarachnoid hemorrhage was produced in four Macaca nemestrina monkeys using the technique of Frazee. CT and MR imaging were performed immediately after the procedure and at frequent intervals up to 2 weeks after hemorrhage. The imaging studies were compared with clinical evaluations and pathologic specimens of all animals. Additional human clinical CT/MR studies of subarachnoid hemorrhage were also studied. Acute hemorrhage was recognized on MR as an increase in signal in the region of clot compared with surrounding cerebrospinal fluid. This most likely reflects T1 shortening due to proton binding rather than a pure paramagnetic effect. While CT is sensitive to the hemoglobin protein in acute hemorrhage, the superior resolution of the basal cisterns on MR images results in equal or better definition of acute subarachnoid hemorrhage on MR in many cases

  18. Literary Depictions i n Ghazavâtnâmahs That Adress the Crimean War

    Directory of Open Access Journals (Sweden)

    Kürşat Şamil ŞAHİN

    2015-07-01

    Full Text Available The Crimean War that started in 1853 between the Ottoman Empire and Russia lasted until 1856. It ended with the defeat of the Russians as England and France sided with the Ottoman Empire. A great number of work has been written then and since about this war which deeply affect our social and politica l life. Among these, there are ghazavâtnâmahs that describe what happened down - to - line, usually by the pen of the poets and writers who closely witnessed the war. The causes of war, the preparations, what happened at the time of expedition and measures tha t were taken, the outcome of the events during the war and afterwards are all brought into sharp relief in most of these works. Whether in verse, prose or mixed typed, these works of art have gradually increased after 15 th century in Turkish literature. Th is genre has decreased by the Ottoman Empire began to decline and the raids were scarce; and it totally disappeared after the tradition of ghaza were ceased. In this study the literary depictions in - the last examples of the genre - Salih Hayri’s Kırım Zafe rnamesi (Hayrâbât, Ahmed Rızâ Trabzonî’s Manzume - i Sivastopol and Süleyman Şâdî’s Muzaffernâme are presented. There are not many studies that focus on literary depictions in ghazavâtnâmahs, particularly on literary war depictions. The characteristics of t hese literary depictions are tried to be explained with reference to ghazavâtnâmahs belonging to the Empire's last era.

  19. A Model of System and Strategic Financial Analysis of the Crimean Health Resorts

    Directory of Open Access Journals (Sweden)

    Vadim Anatolyevich Malyshenko

    2016-06-01

    Full Text Available The subject matter of the research is the system of strategically focused financial analysis regarding an assessment of the financial condition of the enterprise. The hypothesis of the study is to assume the possibility of developing the financial and strategic model of the comprehensive assessment of the financial condition taking into account the integrated impact of environmental factors (general for the most Crimean health resorts. The methodology of the work is based on the most general principles of system analysis. The basic method of the research is the matrix method as the most common one for the system analysis. The graphical and statistical methods are also used. The result of the work is the comprehensive method of financial analysis developed as a model based on the matrix relation between the original visual profile of the internal environment and the dynamic type of external environment. The difference of the visual model of financial state from the existing graphic methods consists in fixing of the new strategic types of financial state on the basis of financial stability in visually grouped areas of financial coefficients in theme groups (configurationsprofiles with certain combinations of the forms and sizes. The new analytical instrument of «frigate model» can be applied in all analytical activities of the health resorts departments related to the analytical assessment of financial state. The advantage of «frigate model» in comparison with a classical method of the forming of the types of financial condition is that the proposed model allows to allocate more differentiated types and in addition, to identify the stages of enterprise life cycle based on the relative indicators of the analysis of financial state (objects-coefficients, and not just on the financial management. Through this, the consistency of interaction between the financial analysis and management is achieved.

  20. Rehabilitation Outcomes: Ischemic versus Hemorrhagic Strokes

    OpenAIRE

    Perna, Robert; Temple, Jessica

    2015-01-01

    Background. Ischemic and hemorrhagic strokes have different pathophysiologies and possibly different long-term cerebral and functional implications. Hemorrhagic strokes expose the brain to irritating effects of blood and ischemic strokes reflect localized or diffuse cerebral vascular pathology. Methods. Participants were individuals who suffered either an ischemic (n = 172) or hemorrhagic stroke (n = 112) within the past six months and were involved in a postacute neurorehabilitation program....

  1. Obstetric Emergencies: Shoulder Dystocia and Postpartum Hemorrhage.

    Science.gov (United States)

    Dahlke, Joshua D; Bhalwal, Asha; Chauhan, Suneet P

    2017-06-01

    Shoulder dystocia and postpartum hemorrhage represent two of the most common emergencies faced in obstetric clinical practice, both requiring prompt recognition and management to avoid significant morbidity or mortality. Shoulder dystocia is an uncommon, unpredictable, and unpreventable obstetric emergency and can be managed with appropriate intervention. Postpartum hemorrhage occurs more commonly and carries significant risk of maternal morbidity. Institutional protocols and algorithms for the prevention and management of shoulder dystocia and postpartum hemorrhage have become mainstays for clinicians. The goal of this review is to summarize the diagnosis, incidence, risk factors, and management of shoulder dystocia and postpartum hemorrhage. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Surgical management of spontaneous hypertensive brainstem hemorrhage

    Directory of Open Access Journals (Sweden)

    Bal Krishna Shrestha

    2015-09-01

    Full Text Available Spontaneous hypertensive brainstem hemorrhage is the spontaneous brainstem hemorrhage associated with long term hypertension but not having definite focal or objective lesion. It is a catastrophic event which has a poor prognosis and usually managed conservatively. It is not uncommon, especially in eastern Asian populations, accounting approximately for 10% of the intracerebral hemorrhage. Before the advent of computed tomography, the diagnosis of brainstem hemorrhage was usually based on the clinical picture or by autopsy and believed to be untreatable via surgery. The introduction of computed tomography permitted to categorize the subtypes of brainstem hemorrhage with more predicted outcome. Continuous ongoing developments in the stereotactic surgery and microsurgery have added more specific surgical management in these patients. However, whether to manage conservatively or promptly with surgical evacuation of hematoma is still a controversy. Studies have shown that an accurate prognostic assessment based on clinical and radiological features on admission is critical for establishing a reasonable therapeutic approach. Some authors have advocate conservative management, whereas others have suggested the efficacy of surgical treatment in brainstem hemorrhage. With the widening knowledge in microsurgical techniques as well as neuroimaging technology, there seems to have more optimistic hope of surgical management of spontaneous hypertensive brainstem hemorrhage for better prognosis. Here we present five cases of severe spontaneous hypertensive brainstem hemorrhage patients who had undergone surgery; and explore the possibilities of surgical management in patients with the spontaneous hypertensive brainstem hemorrhage.

  3. CT findings of fulminant subarachnoid hemorrhages

    International Nuclear Information System (INIS)

    Ikeda, Yukio; Isayama, Kazuo; Yajima, Kouzo; Nakazawa, Shozo; Yano, Masami; Otsuka, Toshibumi

    1985-01-01

    We studied the clinical features and CT findings of 20 cases with fulminant subarachonid hemorrhages in the acute stage. They were admitted to our hospital within 3 hours after the attack as DOA (dead on arrival) or near DOA. CT-visualized subarachnoid hemorrhages were located in the basal cisterns surrounding the brain stem in all cases. In 90 % of the cases, the subarachnoid hemorrhage formed a clot or a thick layer. Massive intracerebral hematomas were observed in 10 % of the cases. Acute intraventricular hemorrhages were seen in 80 % of the cases. The mechanism of intraventricular hemorrhage in 70 % of the cases was of the reflux type, which was characterized by a reflux of the severe subarachnoid hemorrhage in the basal cistern. Acute and diffuse brain swelling on CT scan was observed in several cases, which also showed initial increased intracranial pressures. The major mechanisms leading to acute death or a very severe state soon after subarachnoid hemorrhage might be caused by acute brain-stem failure due to severe subarachnoid hemorrhages in the basal cisterns surrounding the brain-stem and an acute increase in intracranial pressure by cerebral edema following subarachnoid hemorrhage and secondary cerebral ischemia due to cardiac and respiratory arrest. (author)

  4. The Roles of Thrombospondins in Hemorrhagic Stroke

    Directory of Open Access Journals (Sweden)

    Xuan Wu

    2017-01-01

    Full Text Available Hemorrhagic stroke is a devastating cerebrovascular disease with significant morbidity and mortality worldwide. Thrombospondins (TSPs, as matricellular proteins, belong to the TSP family which is comprised of five members. All TSPs modulate a variety of cellular functions by binding to various receptors. Recently, TSPs gained attention in the area of hemorrhagic stroke, especially TSP-1. TSP-1 participates in angiogenesis, the inflammatory response, apoptosis, and fibrosis after hemorrhagic stroke through binding to various molecules including but not limited to CD36, CD47, and TGF-β. In this review, we will discuss the roles of TSPs in hemorrhagic stroke and focus primarily on TSP-1.

  5. Water level fluctuations in the Congo basin derived from ENVISAT satellite altimetry

    OpenAIRE

    Becker, M.; da Silva, J. S.; Calmant, Stéphane; Robinet, V.; Linguet, L.; Seyler, Frédérique

    2014-01-01

    In the Congo Basin, the elevated vulnerability of food security and the water supply implies that sustainable development strategies must incorporate the effects of climate change on hydrological regimes. However, the lack of observational hydro-climatic data over the past decades strongly limits the number of studies investigating the effects of climate change in the Congo Basin. We present the largest altimetry-based dataset of water levels ever constituted over the entire Congo Basin. This...

  6. Notes of John Smith as a Source for the Crimean Khanate History in the early 17th century »

    Directory of Open Access Journals (Sweden)

    N.I. Khrapunov

    2015-12-01

    Full Text Available The paper analyses the account of Tataria collected by famous English adventurer John Smith. In 1602, Smith, a mercenary in Transylvania, was captivated by pillagers and, later, sold into slavery. In spring of 1603 he found himself a slave somewhere in the Azov Sea Area, in the land of the Crimean Khanate. A few months later, Smith succeeded to escape, he reached the Moscow czar’s country, and whence returned to Transylvania. Twenty years after, Smith published his life story in short (1625 and then long version (1630. A considerable part of the story was the account of the author’s adventures among the Turks and the Tatars. Smith widely used other travellers’ accounts (William Biddulph, Antony Jenkinson, William of Rubruck, and Martin Broniovius, collected by famous Samuel Purchas, the first publisher of Smith’s own story. Now we can determine original materials by Smith, based on his personal experience, which describe the Crimean Khanate’s daily life and warfare.

  7. Abdulgaffar Qyrymi. Excerpt from “Umdet ul-Ahbar”. From the History of Crimean Khans »

    Directory of Open Access Journals (Sweden)

    Nariman Seitametovich Seyityahya

    2015-12-01

    Full Text Available This publication contains a fragment about the history of Crimean khans from the historical work “Umdet al-Akhbar” written by a Crimean author Abdulgaffar Kyrymi. In particular, this publication contains a translation of the story about the descendants of Bash-Timur (Tash-Timur according to another version. In this story, Abdulgaffar Kyrymi thoroughly reveals the history of the descendants of Bash-Timur – Gyyaseddin and Devlet-Berdi. He also tells how Haji Giray, Devlet-Berdi’s son, became Khan. In addition, he provides information about khan Ulugh Muhammad, Bash-Timur’s cousin. The author provides us with a very interesting and supporting information in a separate addition to the margins of the manuscript. In particular, this addition contains a brief history of the Turkic tribes and inhabitants of Tataristan, birthplace of the Seljuks and Osman family from the Kayi clan. It also tells how the Ottomans took control of Crimea, examines in detail the reasons for this event, it speaks both about Mengli Giray’s education together with Ottoman princes and on the establishment of relations with Emenek-Bek Shirinsky, Chief Karachi of the Khanate. Then it tells about the rule of Muhammad Giray and his death in the war against the Nogays, about the reign of Saadet Giray, a son of Mengli Giray, during whose reign the uprising of Islam Giray took place.

  8. Congo Basin precipitation: Assessing seasonality, regional interactions, and sources of moisture

    Science.gov (United States)

    Dyer, Ellen L. E.; Jones, Dylan B. A.; Nusbaumer, Jesse; Li, Harry; Collins, Owen; Vettoretti, Guido; Noone, David

    2017-07-01

    Precipitation in the Congo Basin was examined using a version of the National Center for Atmospheric Research Community Earth System Model (CESM) with water tagging capability. Using regionally defined water tracers, or tags, the moisture contribution from different source regions to Congo Basin precipitation was investigated. We found that the Indian Ocean and evaporation from the Congo Basin were the dominant moisture sources and that the Atlantic Ocean was a comparatively small source of moisture. In both rainy seasons the southwestern Indian Ocean contributed about 21% of the moisture, while the recycling ratio for moisture from the Congo Basin was about 25%. Near the surface, a great deal of moisture is transported from the Atlantic into the Congo Basin, but much of this moisture is recirculated back over the Atlantic in the lower troposphere. Although the southwestern Indian Ocean is a major source of Indian Ocean moisture, it is not associated with the bulk of the variability in precipitation over the Congo Basin. In wet years, more of the precipitation in the Congo Basin is derived from Indian Ocean moisture, but the spatial distribution of the dominant sources is shifted, reflecting changes in the midtropospheric circulation over the Indian Ocean. During wet years there is increased transport of moisture from the equatorial and eastern Indian Ocean. Our results suggest that reliably capturing the linkages between the large-scale circulation patterns over the Indian Ocean and the local circulation over the Congo Basin is critical for future projections of Congo Basin precipitation.

  9. Photoluminescence study of Congo red molecules under high pressure

    International Nuclear Information System (INIS)

    Wang, Z.P.; Zhang, Z.M.; Ding, Z.J.

    2007-01-01

    Pressure-induced changes on fluorescence spectra of Congo red molecules were examined up to 8.7 GPa using a diamond anvil cell at room temperature. The spectra changes are demonstrated to be sensitive to the pressure and solvent conditions. At hydrostatic pressure and with a solvent used as a pressure transmitting medium the fluorescence spectra show increase of intensity with elevated pressure up to about 2.3 GPa and then drop at higher pressures. For Congo red crystal under quasi-hydrostatic condition without solvent the fluorescence intensity decreases monotonically and the lower energy band becomes dominant with the pressure increasing. The three vibronic bands show red shifts with increase of pressure

  10. Democratic Republic of Congo: Background and U.S. Policy

    Science.gov (United States)

    2013-06-29

    ethnic Hutu extremists who fled to Congo from Rwanda after helping to carry out the 1994 genocide there; “Mai Mai,” a term that broadly refers to a... Rwanda , Uganda, Angola, and South Africa. U.S. policymakers, including in Congress, continue to debate the relative effectiveness of various policy tools...institutions and the military progressively deteriorated, while regional civil conflicts and the genocide in neighboring Rwanda spilled over the border

  11. Mycoremediation of congo red dye by filamentous fungi

    OpenAIRE

    Bhattacharya, Sourav; Das, Arijit; G, Mangai.; K, Vignesh.; J, Sangeetha.

    2011-01-01

    Azo, anthroquinone and triphenylmethane dyes are the major classes of synthetic colourants, which are difficult to degrade and have received considerable attention. Congo red, a diazo dye, is considered as a xenobiotic compound, and is recalcitrant to biodegradative processes. Nevertheless, during the last few years it has been demonstrated that several fungi, under certain environmental conditions, are able to transfer azo dyes to non toxic products using laccases. The aim of this work was t...

  12. Going for the play: Structural interpretation in offshore Congo

    Energy Technology Data Exchange (ETDEWEB)

    Platt, N.; Philip, P. (GECO-PRAKLA Exploration Services, Woking (United Kingdom)); Walter, S. (ARK Geophysics Ltd., Milton Keynes, (United Kingdom))

    1993-01-01

    Looking for new hydrocarbons in frontier areas, geologists and geophysicists use very trick in the book: plate tectonics, magnetic and gravity data, plain old geological horse sense and lots of seismic data. An interpretation team is followed, as they pick their way through a seismic survey shot in offshore Congo, Africa, searching for those areas (the plays) that show the greatest promise. 17 figs., 9 refs.

  13. Pulmonary hemorrhage resulting from leptospirosis

    Directory of Open Access Journals (Sweden)

    Mauro Razuk Filho

    2016-07-01

    Full Text Available Leptospirosis is one of the most widespread zoonoses in the world, although the mechanisms responsible for the pathogenesis of spirochetes of the genus Leptospira are largely unknown. Human infection occurs either by direct contact with infected animals or indirectly, through contact with water or soil contaminated with urine, as the spirochetes easily penetrate human skin. The present report exposes the case of a female patient, diagnosed with leptospirosis after having had contact with a dog infected by Leptospira sp. that developed pulmonary hemorrhage, acute respiratory distress syndrome and acute renal failure.

  14. Subarachnoid hemorrhage in pituitary tumor

    Directory of Open Access Journals (Sweden)

    Ashis Patnaik

    2013-01-01

    Full Text Available Subarachnoid hemorrhage (SAH is the bleeding into the subarachnoid space containing cerebrospinal fluid. The most common cause of SAH is trauma. Rupture of aneurysms, vascular anomalies, tumor bleeds and hypertension are other important etiologies. SAH in the setting of pituitary tumor can result from various causes. It can be due to intrinsic tumor related pathology, injury to surrounding the vessel during the operative procedure or due to an associated aneurysm. We discuss the pathological mechanisms and review relevant literature related to this interesting phenomenon. Early and accurate diagnosis of the cause of the SAH in pituitary tumors is important, as this influences the management.

  15. Intravascular volume after aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    Hoff, R.G.

    2009-01-01

    Intravascular volume after aneurysmal subarachnoid hemorrhage A subarachnoid hemorrhage (SAH) from a ruptured cerebral aneurysm is a devastating disorder with an often poor prognosis. The occurrence of delayed cerebral ischemia (DCI) is one of the most important factors determining outcome in

  16. Genetics Home Reference: hereditary hemorrhagic telangiectasia

    Science.gov (United States)

    ... Central OMIM: JUVENILE POLYPOSIS/HEREDITARY HEMORRHAGIC TELANGIECTASIA SYNDROME McDonald J, Bayrak-Toydemir P, Pyeritz RE. Hereditary hemorrhagic ... 10.1097/GIM.0b013e3182136d32. Review. Citation on PubMed McDonald J, Wooderchak-Donahue W, VanSant Webb C, Whitehead ...

  17. Spontaneous Retroperitoneal Hemorrhage from Adrenal Artery Aneurysm

    International Nuclear Information System (INIS)

    Gonzalez Valverde, F.M.; Balsalobre, M.; Torregrosa, N.; Molto, M.; Gomez Ramos, M.J.; Vazquez Rojas, J.L.

    2007-01-01

    Spontaneous adrenal hemorrhage is a very rare but serious disorder of the adrenal gland that can require emergent treatment. We report on a 42-year-old man who underwent selective angiography for diagnosis and treatment of retroperitoneal hemorrhage from small adrenal artery aneurysm. This case gives further details about the value of transluminal artery embolization in the management of visceral aneurysm rupture

  18. Neonatal adrenal hemorrhage mimicking an acute scrotum.

    Science.gov (United States)

    Adorisio, O; Mattei, R; Ciardini, E; Centonze, N; Noccioli, B

    2007-02-01

    Twenty-two cases of scrotal hematoma caused by neonatal adrenal hemorrhage are reported in the literature and unnecessary surgical exploration was performed in nine (41%), suspecting testicular torsion. In this paper, we present a newborn male with right adrenal gland hemorrhage causing right scrotal swelling and discoloration of groin managed conservatively.

  19. Primary brain tumor presenting as intracranial hemorrhage

    International Nuclear Information System (INIS)

    Tsunoda, Shigeru; Sakaki, Toshisuke; Miyamoto, Seiji; Kyoi, Kikuo; Utsumi, Shozaburo; Kamada, Kitaro; Inui, Shoji; Masuda, Akio.

    1989-01-01

    Ten cases of primary brain tumor presenting as intracranial hemorrhage were studied in terms of the radiological and histological findings. The cases having hemorrhage in the tumor, as established through CT or histologically, were excluded if their onsets were not sudden due to intracranial hemorrhages. The results obtained may be summarized as follows: 1) From an anatomical point of view, cerebral subcortical hemorrhages account for 80%; hemorrhages in the cerebellopontine angle, 10%, and hemorrhages in the basal ganglia, 10%. 2) Plain CT findings showed perifocal low-density areas within 24 hours after onset in all 10 cases. 3) Enhanced CT findings showed enhanced areas in 4 or 6 cases. 4) Angiographic findings revealed abnormalities besides the mass effect in 5 of the 10 cases. 4) Angiographic findings revealed abnormalities besides the mass effect in 5 of the 10 cases. 5) From a histological point of view, glioblastomas account for 30%; malignant astrocytomas, 20%; astrocytomas, 20%; malignant ependymomas, 10%; hemangioblastoma, 10%, and transitional meningiomas, 10%. In conclusion, a perifocal low-density area on CT within 24 hours after onset is the most meaningful indication of intracranial hemorrhage originating from a brain tumor. A histological 'perinuclear halo' in an astrocytoma as an artifact due to hemorrhage may often be misleading in diagnosing mixed oligo-astrocytomas. (author)

  20. Neonatal adrenal hemorrhage presenting as acute scrotum

    African Journals Online (AJOL)

    Introduction. In newborns, adrenal hemorrhage is not an uncommon event. The large size of the adrenal cortex contributes to an increased vulnerability to trauma during a difficult delivery [1]. However, the neonatal adrenal hemorrhage may rarely present as inguinoscrotal swelling [2,3]. This condition can simulate torsion of ...

  1. Detecting fetomaternal hemorrhage by flow cytometry

    DEFF Research Database (Denmark)

    Dziegiel, Morten Hanefeld; Nielsen, Leif Kofoed; Berkowicz, Adela

    2006-01-01

    The aim of this review is to summarize the most recent developments in the area of detection of fetomaternal hemorrhage by flow cytometry.......The aim of this review is to summarize the most recent developments in the area of detection of fetomaternal hemorrhage by flow cytometry....

  2. Recurrent spontaneous intracerebral hemorrhage associated with ...

    African Journals Online (AJOL)

    Spontaneous intracerebral hemorrhage (ICH) accounts for 15% of stroke cases in the US and Europe and up to 30% in Asian populations. Intracerebral hemorrhage is a relatively uncommon form of stroke-it causes only 10 to 15 percent of all strokes. It is more disabling and has a higher mortality rate than ischemic stroke, ...

  3. Recurrent Bleeding After Perimesencephalic Hemorrhage.

    Science.gov (United States)

    Kauw, Frans; Velthuis, Birgitta K; Kizilates, Ufuk; van der Schaaf, Irene C; Rinkel, Gabriel J E; Vergouwen, Mervyn D I

    2017-12-01

    Perimesencephalic hemorrhage (PMH) is a type of subarachnoid hemorrhage with excellent long-term outcomes. Only 1 well-documented case of in-hospital rebleeding after PMH is described in the literature, which occurred after initiating antithrombotic treatment because of myocardial ischemia. We describe a patient with PMH without antithrombotic treatment who had 2 episodes of recurrent bleeding on the day of ictus. To validate the radiologic findings, we conducted a case-control study. Six neuroradiologists and 2 neuroradiology fellows performed a blinded assessment of serial unenhanced head computed tomography (CT) scans of 8 patients with a perimesencephalic bleeding pattern (1 index patient, 6 patients with PMH, 1 patient with perimesencephalic bleeding pattern and basilar artery aneurysm) to investigate a potential increase in amount of subarachnoid blood. A 56-year-old woman with a perimesencephalic bleeding pattern and negative CT angiography had 2 episodes after the onset headache with a sudden increase of the headache. Blinded assessment of serial head CT scans of 8 patients with a perimesencephalic bleeding pattern identified the patient who was clinically suspected to have 2 episodes of recurrent bleeding to have an increased amount of subarachnoid blood on 2 subsequent CT scans. Recurrent bleeding after PMH may also occur in patients not treated with antithrombotics. Even after early rebleeding, the prognosis of PMH is excellent. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Hydrocephalus associated with subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Nosaka, Yoshiki

    1981-01-01

    Thirteen patients exhibited a communicating hydrocephalus following subarachnoid hemorrhage secondary to ruptured intracranial aneurysms and were treated with shunt procedures. The interval between subarachnoid hemorrhage and surgery averaged 9 weeks. Seven of the patients showed improvement. The prognostic value for surgical management was evaluated on the basis of three different diagnostic examinations (computed tomography (CT), cisternography and constant infusion test). A correct diagnosis was obtained in 78 per cent in cisternography, and 63 per cent in infusion test and CT. All patients responding to surgery showed a typical pattern in cisternography, consisting of ventricular retention of radiopharmaceutical tracer for 48 h or longer in association with no radioactivity over the cerebral hemispheres. The constant infusion test correlated well with typical cisternographic patterns. CT is useful in demonstrating pathophysiological changes in hydrocephalus. Periventricular hypodensity was visible in patients with normal or slightly elevated intracranial pressure, accompanied by fairly rapid deterioration. All of them responded well to shunting. In most cases which benefited from the shunt, the postoperative CT showed not only normal-sized ventricles but also marked regression of the hypodensity over a short period. (author)

  5. Lateral type of intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Yamagami, Tatsuhito; Gotoh, Yasunobu; Imataka, Kiyoharu; Niijima, Kyo; Handa, Hajime.

    1987-01-01

    The magnetic resonance imaging (MRI) of intracerebral hemorrhages (lateral type) was studied. The strength of the magnetic field was 0.2 Tesla. Four cases were studied with inversion recovery (IR) and saturation recovery (SR) images. The findings of the acute stage (within 1 week) were a central isointensity and a peripheral low intensity on the IR image. On the SR image we recognized a central isointensity and a peripheral high intensity holding a faintly high intensity area around the hematoma. The findings of the subacute stage (from 1 to 3 weeks) were characterized by a central isointensity and a peripheral high-intensity ring, with a low-intensity area outside the hematoma on the IR image. A widespread high-intensity area including the hematoma itself and the surrounding white matter was observed on the SR image. The findings of the chronic stage (over 3 weeks) were the disapperance of a high-intensity ring and a change to a low-intensity area on the IR image. The hematoma itself and surrounding white matter had a high intensity, which has decreased in size in comparison with that of the subacute stage. The hypointensity rim was found in the immediately adjacent part of the original hematoma on the SR image. The MRI of a small hematoma 70 days from the onset showed an almost normal brain structure. Some magnetic resonance findings of intracerebral hemorrhage were reviewed. (author)

  6. Modelling the Congo basin ecosystems with a dynamic vegetation model

    Science.gov (United States)

    Dury, Marie; Hambuckers, Alain; Trolliet, Franck; Huynen, Marie-Claude; Haineaux, Damien; Fontaine, Corentin M.; Fayolle, Adeline; François, Louis

    2014-05-01

    The scarcity of field observations in some parts of the world makes difficult a deep understanding of some ecosystems such as humid tropical forests in Central Africa. Therefore, modelling tools are interesting alternatives to study those regions even if the lack of data often prevents sharp calibration and validation of the model projections. Dynamic vegetation models (DVMs) are process-based models that simulate shifts in potential vegetation and its associated biogeochemical and hydrological cycles in response to climate. Initially run at the global scale, DVMs can be run at any spatial scale provided that climate and soil data are available. In the framework of the BIOSERF project ("Sustainability of tropical forest biodiversity and services under climate and human pressure"), we use and adapt the CARAIB dynamic vegetation model (Dury et al., iForest - Biogeosciences and Forestry, 4:82-99, 2011) to study the Congo basin vegetation dynamics. The field campaigns have notably allowed the refinement of the vegetation representation from plant functional types (PFTs) to individual species through the collection of parameters such as the specific leaf area or the leaf C:N ratio of common tropical tree species and the location of their present-day occurrences from literature and available database. Here, we test the model ability to reproduce the present spatial and temporal variations of carbon stocks (e.g. biomass, soil carbon) and fluxes (e.g. gross and net primary productivities (GPP and NPP), net ecosystem production (NEP)) as well as the observed distribution of the studied species over the Congo basin. In the lack of abundant and long-term measurements, we compare model results with time series of remote sensing products (e.g. vegetation leaf area index (LAI), GPP and NPP). Several sensitivity tests are presented: we assess consecutively the impacts of the level at which the vegetation is simulated (PFTs or species), the spatial resolution and the initial land

  7. Medulla Oblongata Hemorrhage and Reverse Takotsubo Cardiomyopathy.

    Science.gov (United States)

    Gobeske, Kevin T; Sarano, Maurice E; Fugate, Jennifer E; Wijdicks, Eelco F

    2017-12-19

    Acute brain injury with strong surges of adrenergic outflow has resulted in takotsubo cardiomyopathy, but there are surprisingly few reports of takotsubo cardiomyopathy after intracranial hemorrhage, and none have been described from hemorrhage within the brainstem. We describe a patient with reverse and reversible cardiomyopathy following a hemorrhage in the lateral medulla oblongata. While it is limited in size, the location of the hemorrhage caused acute systolic failure with left ventricular ejection fraction of 27% and vasopressor requirement for cardiogenic shock and pulmonary edema. There was full recovery after 7 days. Detailed case report. Hemorrhage into medulla oblongata pressor centers may result in acute, reversible, stress-induced cardiomyopathy, affirming the adrenergic origin of this condition.

  8. Neck and scleral hemorrhage in drowning.

    Science.gov (United States)

    Alexander, Russell T; Jentzen, Jeffrey M

    2011-03-01

    The determination of the cause and manner of death for a body recovered from the water can be difficult because of a lack of autopsy findings specific for drowning. This case report describes a 30-year-old man found submerged at the bottom of a hotel pool. An autopsy revealed scleral hemorrhages and fascial hemorrhages of multiple muscles of the anterior and posterior neck bilaterally. No evidence of traumatic injury was on the surface of the body. An investigation by law enforcement found no evidence of foul play. The occurrence of petechial and neck hemorrhage in a body recovered from the water is controversial, and a review of this literature will be given. We suggest that fascial hemorrhages of the muscles of the neck, as well as cephalic hemorrhages, can be explained by drowning-related elevated central venous pressure that is communicated to the head through the valveless veins of the neck. © 2010 American Academy of Forensic Sciences.

  9. A case of idiopathic omental hemorrhage

    Directory of Open Access Journals (Sweden)

    Toshimitsu Hosotani

    2016-05-01

    Full Text Available With the exception of trauma, intraperitoneal hemorrhage in young women is caused by the high frequency of ectopic pregnancy and ovarian bleeding. Here, we describe a case of idiopathic omental hemorrhage, which is a rare cause of intraperitoneal hemorrhage. Intraperitoneal hemorrhage was suspected in a 38-year-old Japanese woman based on contrast-enhanced computed tomography. Her last menstrual period was 23 days prior, and ovarian bleeding was considered based on bloody ascites revealed by culdocentesis. She underwent emergency surgery for hypovolemic shock. Although both ovaries were of normal size and no abnormal findings were observed, we performed a partial omentectomy because multiple clots were attached only to the greater omentum. Postoperatively, no rebleeding occurred, and she was discharged 11 days after the surgery. Because she did not have a clear history of trauma and underlying disease, idiopathic omental hemorrhage was diagnosed.

  10. A case of traumatic intraventricular hemorrhage

    International Nuclear Information System (INIS)

    Ikeda, Yukio; Yamakawa, Kazuomi; Nakazawa, Shozo.

    1980-01-01

    CT scan is recognized to be a rapid, noninvasive and informative examination in evaluation of the head injured patient. It is also possible to evaluate the presence of the intracerebral hematoma without remarkable mass effect, cerebral contusion, associated cerebral edema and ventricular hemorrhage. We present a case of traumatic intraventricular hemorrhage. The patient was a 40-year-old male admitted to our hospital in a drowsy state following a fall from about one meter high. Craniogram showed a linear fracture in the left parietotemporal regions. In the CT scan, intraventricular hemorrhage associated with subarachnoid hemorrhage without intracerebral hematoma was shown. A symmetrical moderate dilatation of both lateral ventricles was also shown. Cerebral angiography revealed no abnormality. His condition deteriorated progressively, so ventricular drainage was performed, but he expired 5 days later. Considering this case, the mechanisms of pure intraventricular hemorrhage following head injury were discussed. (author)

  11. Vocal fold varices and risk of hemorrhage.

    Science.gov (United States)

    Tang, Christopher Guan-Zhong; Askin, Gülce; Christos, Paul J; Sulica, Lucian

    2016-05-01

    To establish risk of hemorrhage in patients with varices compared to those without, determine additional risk factors, and make evidence-based treatment recommendations. Retrospective cohort study. Patients who were vocal performers presenting for care during a 24-month period were analyzed to determine incidence of hemorrhage. Patients with varices were compared to those without. Demographic information and examination findings (presence, location, character, and size of varices; presence of mucosal lesions or paresis) were analyzed to determine predictors of hemorrhage. A total of 513 patients (60.4% female, mean age 36.6 years ± 13.95 years) were evaluated; 14 patients presenting with hemorrhage were excluded. One hundred and twelve (22.4%) patients had varices; 387 (77.6%) did not. The rate of hemorrhage in patients with varices was 2.68% at 12 months compared to 0.8% in patients without. Cox proportional hazard regression analysis revealed a hazard ratio of 10.1 for patients with varix developing hemorrhage compared to nonvarix patients (P hemorrhage was 3.3 cases per 1,000 person-months for varix patients compared to 0.5 cases per 1,000 person-months in the nonvarix group. There was no significant difference in the incidence of paresis, mucosal lesions, location of varix (left or right side; medial or lateral), or varix morphology (pinpoint, linear, lake) between patients who hemorrhaged and those that did not. The presence of varices increases the risk of hemorrhage. Varix patients had 10 times the rate of hemorrhage compared to nonvarix patients, although the overall incidence is low. This data may be used to inform treatment of patients with varices. 4. Laryngoscope, 126:1163-1168, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  12. The neglected arboviral infections in mainland China.

    Directory of Open Access Journals (Sweden)

    Xiaoyan Gao

    2010-04-01

    Full Text Available The major arboviral diseases in mainland China include Japanese encephalitis, dengue fever, Crimean-Congo hemorrhagic fever (also known as Xinjiang hemorrhagic fever, and tick-borne encephalitis. These and other newly found arbovirus infections due to Banna virus and Tahyna virus contribute to a large and relatively neglected disease burden in China. Here we briefly review the literature regarding these arboviral infections in mainland China with emphasis on their epidemiology, primary vectors, phylogenetic associations, and the prevention programs associated with these agents in China.

  13. Adventures in Infectious Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Fisher-Hoch, Susan [University of Texas School of Public Health

    2011-11-01

    Dr. Susan Fisher-Hoch, Virologist and Epidemiologist, will discuss her research and travels associated with viral hemorrhagic fevers. From the Ebola outbreak in Reston, Virginia to outbreaks of Crimean Congo Hemorrhagic Fever in South Africa, Senegal, and Saudi Arabia, Dr. Fisher-Hoch has studied and tracked the pathophysiology of these viral diseases. These studies have led her from the Center for Disease Control in the United States, to Lyon, France where she was instrumental in designing, constructing, and rendering operational a laboratory capable of containing some of the world's most dangerous diseases.

  14. Acute hemorrhagic edema of infancy

    Directory of Open Access Journals (Sweden)

    Sultan Ecer Menteş

    2009-03-01

    Full Text Available Acute hemorrhagic edema of infancy is a rare form of leukocytoclastic vasculitis. Mostly it appears under three years of age and is characterized by purpuric skin lesions, fever and edema. A three years-old boy, who has cough and coryzea was admitted to our clinic for fever and red spots on legs and arms. In physical examination; ecimotic skin lesions on right ear, face, arms, dorsal of the hands, buttocks, legs and dorsal of the feet were found. In the laboratory tests acute phase reactants were elevated and blood coagulation tests were in normal range. Hepatit A,B,C and TORCH markers were negative. Punch biopsy obtained from gluteal area showed leukositoclastic vasculity. Focal fibrinogen accumulation was detected by immun fluorescent microscopy. Regression on lesions was not observed despite supportive therapy, so prednisolone (1 mg/kg/day therapy was started. On the third day of the steroid therapy, complete recovery was achived.

  15. Imaging of Hereditary Hemorrhagic Telangiectasia

    International Nuclear Information System (INIS)

    Carette, Marie-France; Nedelcu, Cosmina; Tassart, Marc; Grange, Jean-Didier; Wislez, Marie; Khalil, Antoine

    2009-01-01

    This pictorial review is based on our experience of the follow-up of 120 patients at our multidisciplinary center for hereditary hemorrhagic telangiectasia (HHT). Rendu-Osler-Weber disease or HHT is a multiorgan autosomal dominant disorder with high penetrance, characterized by epistaxis, mucocutaneous telangiectasis, and visceral arteriovenous malformations (AVMs). The research on gene mutations is fundamental and family screening by clinical examination, chest X-ray, research of pulmonary shunting, and abdominal color Doppler sonography is absolutely necessary. The angioarchitecture of pulmonary AVMs can be studied by unenhanced multidetector computed tomography; however, all other explorations of liver, digestive bowels, or brain require administration of contrast media. Magnetic resonance angiography is helpful for central nervous system screening, in particular for the spinal cord, but also for pulmonary, hepatic, and pelvic AVMs. Knowledge of the multiorgan involvement of HHT, mechanism of complications, and radiologic findings is fundamental for the correct management of these patients.

  16. Management of aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Etminan, N; Macdonald, R L

    2017-01-01

    Spontaneous subarachnoid hemorrhage (SAH) affects people with a mean age of 55 years. Although there are about 9/100 000 cases per year worldwide, the young age and high morbidity and mortality lead to loss of many years of productive life. Intracranial aneurysms account for 85% of cases. Despite this, the majority of survivors of aneurysmal SAH have cognitive deficits, mood disorders, fatigue, inability to return to work, and executive dysfunction and are often unable to return to their premorbid level of functioning. The main proven interventions to improve outcome are aneurysm repair in a timely fashion by endovascular coiling rather than neurosurgical clipping when feasible and administration of nimodipine. Management also probably is optimized by neurologic intensive care units and multidisciplinary teams. Improved diagnosis, early aneurysm repair, administration of nimodipine, and advanced neurointensive care support may be responsible for improvement in survival from SAH in the last few decades. © 2017 Elsevier B.V. All rights reserved.

  17. Asymptomatic cerebral hemorrhage detected by MRI

    International Nuclear Information System (INIS)

    Nakajima, Yumi; Ohsuga, Hitoshi; Yamamoto, Masahiro; Shinohara, Yukito

    1991-01-01

    Detection of previous cerebral infarction on CT films of patients with no history of stroke is a common occurrence. The incidence of silent cerebral infarction was reported to be about 10 to 11 percent, but very few reports concerning asymptomatic cerebral hemorrhage available. However, recent clinical application of MRI has resulted in the detection of old asymptomatic hemorrhage in patients with no history known stroke-like episodes. The purpose of this study was to elucidate the incidence, the cause and the character of the asymptomatic cerebral hemorrhage among patients who had undergone MRI examinations. From September 1987 through June 1990, 2757 patients have undergone 3474 MR scans of the brain with 1.0 Tesla Siemens Magneton unit in our hospital. Seventeen patients showed no clinical signs or symptoms suggesting a stroke episode corresponding to the detected hemorrhagic lesion. The 17 patients corresponded to 0.6% of the patients who underwent MRI, 1.5% of the patients with cerebrovascular disease and 9.5% of the patients with intracerebral hemorrhage(ICH), which was rather higher than expected. Among the 17 patients, 12 were diagnosed as primary ICH and 5 as secondary ICH. Most of the primary asymptomatic hemorrhage were hypertensive ones and slit-like curvilinear lesions between the putamen and claustrum or external capsule. The secondary asymptomatic hemorrhage were due to AVM and angiomas in the frontal cortex, thalamus and pons. (author)

  18. Asymptomatic cerebral hemorrhage detected by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Yumi; Ohsuga, Hitoshi; Yamamoto, Masahiro; Shinohara, Yukito [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine

    1991-03-01

    Detection of previous cerebral infarction on CT films of patients with no history of stroke is a common occurrence. The incidence of silent cerebral infarction was reported to be about 10 to 11 percent, but very few reports concerning asymptomatic cerebral hemorrhage available. However, recent clinical application of MRI has resulted in the detection of old asymptomatic hemorrhage in patients with no history known stroke-like episodes. The purpose of this study was to elucidate the incidence, the cause and the character of the asymptomatic cerebral hemorrhage among patients who had undergone MRI examinations. From September 1987 through June 1990, 2757 patients have undergone 3474 MR scans of the brain with 1.0 Tesla Siemens Magneton unit in our hospital. Seventeen patients showed no clinical signs or symptoms suggesting a stroke episode corresponding to the detected hemorrhagic lesion. The 17 patients corresponded to 0.6% of the patients who underwent MRI, 1.5% of the patients with cerebrovascular disease and 9.5% of the patients with intracerebral hemorrhage(ICH), which was rather higher than expected. Among the 17 patients, 12 were diagnosed as primary ICH and 5 as secondary ICH. Most of the primary asymptomatic hemorrhage were hypertensive ones and slit-like curvilinear lesions between the putamen and claustrum or external capsule. The secondary asymptomatic hemorrhage were due to AVM and angiomas in the frontal cortex, thalamus and pons. (author).

  19. Hemodynamics in Korean Hemorrhagic Fever

    International Nuclear Information System (INIS)

    Han, Ji Young; Lee, Jung Sang; Koh, Chang Soon; Lee, Mun Ho

    1974-01-01

    The author in an attempt to evaluate hemodynamic changes in the clinical stages of Korean hemorrhagic fever measured plasma volume, cardiac output and effective renal plasma flow utilizing radioisoto as during various phases of the disease. Cardiac output was measured by radiocardiography with external monitoring method using RIHSA. Effective renal plasma flow was obtained from blood clearance curve drawn by external monitoring after radiohippuran injection according to the method described by Razzak et al. The study was carried out in thirty-eight cases of Korean hemorrhagic fever and the following conclusions were obtained. 1) Plasma volume was increased in the patients during the oliguric and hypertensive-diuretic phases, while it was normal in the patients during the normotensive-diuretic phase. 2) Cardiac index was increased in the patients during the oliguric phase and was slightly increased in the patients at the hypertensive diuretic phase. It was normal in the other phases. 3) Total peripheral resistance was increased in the hypertensive patients during diuretic phase, while it was normal in the rest of phases. 4) Effective renal plasma flow was significantly reduced in the patients during the oliguric and diuretic phases as well as at one month after the oliguric onset. There was no significant difference between the oliguric and the early diuretic phases. Renal plasma flow in the group of patients at one month after the oliguric onset was about 45% of the normal, however, it returned to normal level at six months after the onset. 5) Clinical syndrome of relative hypervolemia was observed in some patients during the oliguric phase or hypertensive diuretic phase. Characteristic hemodynamic findings were high cardiac output and normal to relatively increased peripheral resistance these cases. Relatively increased circulating blood volumes due to decreased effective vascular space was suggested for the mechanism of relative hypervolemia. 6) Cardiac

  20. Troponin elevation in subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Ioannis N. Mavridis

    2015-03-01

    Full Text Available Troponin (tr elevation in aneurysmal subarachnoid hemorrhage (SAH patients is often difficult to be appropriately assessed by clinicians, causing even disagreements regarding its management between neurosurgeons and cardiologists. The purpose of this article was to review the literature regarding the clinical interpretation of tr elevation in SAH. We searched for articles in PubMed using the key words: “troponin elevation” and “subarachnoid hemorrhage”. All of them, as well as relative neurosurgical books, were used for this review. Some type of cardiovascular abnormality develops in most SAH patients. Neurogenic stunned myocardium is a frequent SAH complication, due to catecholamine surge which induces cardiac injury, as evidenced by increased serum tr levels, electrocardiographic (ECG changes and cardiac wall motion abnormalities. Tr elevation, usually modest, is an early and specific marker for cardiac involvement after SAH and its levels peak about two days after SAH. Cardiac tr elevation predictors include poor clinical grade, intraventricular hemorrhage, loss of consciousness at ictus, global cerebral edema, female sex, large body surface area, lower systolic blood pressure, higher heart rate and prolonged Q-Tc interval. Elevated tr levels are associated with disability and death (especially tr >1 μg/L, worse neurological grade, systolic and diastolic cardiac dysfunction, pulmonary congestion, longer intensive care unit stay and incidence of vasospasm. Tr elevation is a common finding in SAH patients and constitutes a rightful cause of worry about the patients' cardiac function and prognosis. It should be therefore early detected, carefully monitored and appropriately managed by clinicians.

  1. Detecting Ebola with limited laboratory access in the Democratic Republic of Congo: evaluation of a clinical passive surveillance reporting system.

    Science.gov (United States)

    Ashbaugh, Hayley R; Kuang, Brandon; Gadoth, Adva; Alfonso, Vivian H; Mukadi, Patrick; Doshi, Reena H; Hoff, Nicole A; Sinai, Cyrus; Mossoko, Mathias; Kebela, Benoit Ilunga; Muyembe, Jean-Jacques; Wemakoy, Emile Okitolonda; Rimoin, Anne W

    2017-09-01

    Ebola virus disease (EVD) can be clinically severe and highly fatal, making surveillance efforts for early disease detection of paramount importance. In areas with limited access to laboratory testing, the Integrated Disease Surveillance and Response (IDSR) strategy in the Democratic Republic of Congo (DRC) may be a vital tool in improving outbreak response. Using DRC IDSR data from the nation's four EVD outbreak periods from 2007-2014, we assessed trends of Viral Hemorrhagic Fever (VHF) and EVD differential diagnoses reportable through IDSR. With official case counts from active surveillance of EVD outbreaks, we assessed accuracy of reporting through the IDSR passive surveillance system. Although the active and passive surveillance represent distinct sets of data, the two were correlated, suggesting that passive surveillance based only on clinical evaluation may be a useful predictor of true cases prior to laboratory confirmation. There were 438 suspect VHF cases reported through the IDSR system and 416 EVD cases officially recorded across the outbreaks examined. Although collected prior to official active surveillance cases, case reporting through the IDSR during the 2007, 2008 and 2012 outbreaks coincided with official EVD epidemic curves. Additionally, all outbreak areas experienced increases in suspected cases for both malaria and typhoid fever during EVD outbreaks, underscoring the importance of training health care workers in recognising EVD differential diagnoses and the potential for co-morbidities. © 2017 John Wiley & Sons Ltd.

  2. Evaluation of computed tomography of intraventricular hemorrhage

    International Nuclear Information System (INIS)

    Yoo, Seon Young; Lee, Young Sik; Suh, Jeong Soo; Rhee, Chung Sik; Kim, Hee Seup

    1983-01-01

    Prior to the introduction of computed tomography, the clinical and radiological diagnosis of the intraventricular hemorrhage in living patients was difficult. C.T. scanning is an invaluable investigation providing the rapid and noninvasive diagnosis of intracerebral and intraventricular hemorrhage. It reliably demonstrates the presence and distribution of fresh blood within the ventricular system. C.T. is also useful as a surgical guidance and in the evaluation of fate of the hematoma by easily performable follow-up studies. We reviewed 31 cases of intraventricular hemorrhage in C.T. in the department of radiology of Ewha Womans University Hospital during the period from August, 1982 to August, 1983. The results were as follows: 1. The most patients were encountered in the 5th decade and the male to female ratio was 1.2 : 1. 2. Hypertension was the main cause of the intraventricular hemorrhage; 18 out of 31 patients. Remaining 13 patients were caused by hypoxia, aneurysm, Moya Moya disease, coagulation defect, trauma and undetermined etiology. 3. 18 out of 31 patients showed hemorrhage in the lateral ventricles only and all ventricles in 10 patients. 4. 28 out of 31 patients showed associated with intracranial hematoma; Those were intracerebral hematomas in 16 patients, intracerebral hematoma with subarachnoid hemorrhage in 4 patients and extracerebral hematoma in 2 patients. 5. Outcome was assessed using the Glasgow scale. According to them, the total mortality rates was 54.8%, however, 32.3% of patients returned to normal or minor disability. Patients, who had hypertension and marked degree of hemorrhage in the ventricular systems had a poor outcome. Patients with only ventricular hemorrhage had better outcome than associated intracranial hematoma. 6. 16 out of 31 patients were treated by surgical methods and 15 out of 31 patients by conservative methods. 75% of patients were died in conservative treatment. 7. Conclusively, causes, degree of intraventricular

  3. Hemorrhagic chondroid chordoma mimicking pituitary apoplexy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, H.J.; Kalnin, A.J.; Holodny, A.I. [Dept. of Radiology, University Hospital, Newark, NJ (United States); Schulder, M.; Grigorian, A. [Dept. of Neurosurgery, University Hospital, Newark, NJ (United States); Sharer, L.R. [Dept. of Pathology, University Hospital, Newark, NJ (United States)

    1998-11-01

    We describe a hemorrhagic chondroid chordoma involving the sella turcica with suprasellar extension. The CT and MRI appearances mimiked a hemorrhagic pituitary adenoma. Chondroid chordoma is a variant composed of elements of both chordoma and cartilaginous tissue. An uncommon bone neoplasm, located almost exclusively in the spheno-occipital region, it is usually not considered in the differential diagnosis of a tumor with acute hemorrhage in the sellar region. We discuss the clinical and radiological characteristics which may allow one to differentiate chondroid chordoma from other tumors of this area. (orig.) With 3 figs., 9 refs.

  4. Subconjunctival hemorrhage: risk factors and potential indicators

    Directory of Open Access Journals (Sweden)

    Tarlan B

    2013-06-01

    Full Text Available Bercin Tarlan,1 Hayyam Kiratli21Department of Ophthalmology, Kozluk State Hospital, Batman, Turkey; 2Ocular Oncology Service, Hacettepe University Schoolof Medicine, Ankara, TurkeyAbstract: Subconjunctival hemorrhage is a benign disorder that is a common cause of acute ocular redness. The major risk factors include trauma and contact lens usage in younger patients, whereas among the elderly, systemic vascular diseases such as hypertension, diabetes, and arteriosclerosis are more common. In patients in whom subconjunctival hemorrhage is recurrent or persistent, further evaluation, including workup for systemic hypertension, bleeding disorders, systemic and ocular malignancies, and drug side effects, is warranted.Keywords: subconjunctival hemorrhage, contact lens, hypertension, red eye

  5. Spontaneous muscle hematomas in a patient with Dengue hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Jency Maria Koshy

    2014-01-01

    Full Text Available Dengue hemorrhagic fever (DHF and Dengue shock syndrome manifest in various forms, ranging from petechial skin hemorrhage to life threatening cerebral, pulmonary, gastrointestinal and genitourinary hemorrhages. However it is very rare to have muscle hematomas in DHF. We report a rare case of spontaneous Iliopsoas hematoma complicating Dengue hemorrhagic fever.

  6. Imaging features of diffuse pulmonary hemorrhage; Roentgenmorphologie von diffusen Lungenhaemorrhagien

    Energy Technology Data Exchange (ETDEWEB)

    Schmit, M.; Vogel, W.; Horger, M.

    2006-09-15

    There are diverse etiologies of diffuse pulmonary hemorrhage, so specific diagnosis may be difficult. Conventional radiography tends to be misleading as hemoptysis may lacking in patients with hemorrhagic anemia. Diffuse pulmonary hemorrhage should be differentiated from focal pulmonary hemorrhage resulting from chronic bronchitis, bronchiectasis, active infection (tuberculosis) neoplasia, trauma, or embolism. (orig.)

  7. CT findings of subarachnoid hemorrhage due to ruptured cerebral aneurysm with fundal hemorrhage

    International Nuclear Information System (INIS)

    Kashihara, Kengo; Yamashima, Tetsumori; Hasegawa, Takeshi; Kida, Shinya; Nitta, Hisashi; Yamamoto, Shinjiro

    1985-01-01

    CT scan and fundus oculi of subarachnoid hemorrhage due to ruptured cerebral aneurysm were investigated in 42 patients who were admitted between January, 1980, and August, 1984. Fundal hemorrhage (FH) was observed in 22 patients. The patients with FH showed a worse clinical grade (Hunt Kosnik) on admission than those without FH. The mortality rate of patients with FH was 64 %, much higher than the 5 % rate of those without FH. Moreover, the patients with FH showed more trouble in daily living than those without FH. CT scans of patients with FH usually showed severe subarachnoid hemorrhage (SAH), whereas those of patients without FH showed only mild hemorrhage. These findings suggest that fundal hemorrhage is caused by acute intracranial hypertension following subarachnoid hemorrhage due to a ruptured cerebral aneurysm. However, no significant correlation between the laterality of FH and the hemispheric dominancy of SAH could be demonstrated. (author)

  8. Background Report on Eastern Democratic Republic of the Congo

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Tracy A [ORNL

    2011-05-01

    Each month, approximately 45,000 people die from violence, hunger, disease, and other effects of displacement as a result of war in the Democratic Republic of the Congo (DRC). The country is often said to be plagued by a 'resource curse.' During each period in history since its discovery by the West, the DRC has possessed the resources the world craves and the world has sought these without regard for the consequences to the Congolese people. The catastrophic consequences of Congo's history of natural resource exploitation are the direct and indirect death of millions of Congolese people. The current war in Congo is multi-causal in nature but explanations are often reduced to describing it as an ethic conflict based on objective grievance. Objective grievance such as inequality, ethnic tensions, land disputes, and lack of democracy do exist, but they are neither necessary nor sufficient to explain the cause of the violent conflict, and more importantly, they fall short in explaining why this conflict has continued for years. The reality is the conflict is an economic war in which the trade of conflict minerals, gold and the 3Ts (tin, tantalum, tungsten), is directly linked to the financial sustainability of the groups fighting each other in eastern DRC. Objective grievance is a by-product of the conflict, used to create a false but plausible moral justification to continue violence. This paper examines the history of conflict in the DRC and the socio-economic variables contributing to the current war fought over conflict minerals.

  9. Contribution of placenta accreta to the incidence of postpartum hemorrhage and severe postpartum hemorrhage.

    Science.gov (United States)

    Mehrabadi, Azar; Hutcheon, Jennifer A; Liu, Shiliang; Bartholomew, Sharon; Kramer, Michael S; Liston, Robert M; Joseph, K S

    2015-04-01

    To quantify the contribution of placenta accreta to the rate of postpartum hemorrhage and severe postpartum hemorrhage. All hospital deliveries in Canada (excluding Quebec) for the years 2009 and 2010 (N=570,637) were included in a retrospective cohort study using data from the Canadian Institute for Health Information. Placenta accreta included placental adhesion to the uterine wall, musculature, and surrounding organs (accreta, increta, or percreta). Severe postpartum hemorrhage included postpartum hemorrhage with blood transfusion, hysterectomy, or other procedures to control bleeding (including uterine suturing and ligation or embolization of pelvic arteries). Rates, rate ratios, population-attributable fractions (ie, incidence of postpartum hemorrhage attributable to placenta accreta), and 95% confidence intervals (CIs) were estimated. Logistic regression was used to quantify associations between placenta accreta and risk factors. The incidence of placenta accreta was 14.4 (95% CI 13.4-15.4) per 10,000 deliveries (819 cases among 570,637 deliveries), whereas the incidence of placenta accreta with postpartum hemorrhage was 7.2 (95% CI 6.5-8.0) per 10,000 deliveries. Postpartum hemorrhage among women with placenta accreta was predominantly third-stage hemorrhage (41% of all cases). Although placenta accreta was strongly associated with postpartum hemorrhage (rate ratio 8.3, 95% CI 7.7-8.9), its low frequency resulted in a small population-attributable fraction (1.0%, 95% CI 0.93-1.16). However, the strong association between placenta accreta and postpartum hemorrhage with hysterectomy (rate ratio 286, 95% CI 226-361) resulted in a population-attributable fraction of 29.0% (95% CI 24.3-34.3). Placenta accreta is too infrequent to account for the recent temporal increase in postpartum hemorrhage but contributes substantially to the proportion of postpartum hemorrhage with hysterectomy.

  10. Hemorrhage-Adjusted Iron Requirements, Hematinics and Hepcidin Define Hereditary Hemorrhagic Telangiectasia as a Model of Hemorrhagic Iron Deficiency

    Science.gov (United States)

    Finnamore, Helen; Le Couteur, James; Hickson, Mary; Busbridge, Mark; Whelan, Kevin; Shovlin, Claire L.

    2013-01-01

    Background Iron deficiency anemia remains a major global health problem. Higher iron demands provide the potential for a targeted preventative approach before anemia develops. The primary study objective was to develop and validate a metric that stratifies recommended dietary iron intake to compensate for patient-specific non-menstrual hemorrhagic losses. The secondary objective was to examine whether iron deficiency can be attributed to under-replacement of epistaxis (nosebleed) hemorrhagic iron losses in hereditary hemorrhagic telangiectasia (HHT). Methodology/Principal Findings The hemorrhage adjusted iron requirement (HAIR) sums the recommended dietary allowance, and iron required to replace additional quantified hemorrhagic losses, based on the pre-menopausal increment to compensate for menstrual losses (formula provided). In a study population of 50 HHT patients completing concurrent dietary and nosebleed questionnaires, 43/50 (86%) met their recommended dietary allowance, but only 10/50 (20%) met their HAIR. Higher HAIR was a powerful predictor of lower hemoglobin (p = 0.009), lower mean corpuscular hemoglobin content (pstopped. Conclusions/significance HAIR values, providing an indication of individuals’ iron requirements, may be a useful tool in prevention, assessment and management of iron deficiency. Iron deficiency in HHT can be explained by under-replacement of nosebleed hemorrhagic iron losses. PMID:24146883

  11. Incidence of Intraventricular Hemorrhage and Post Hemorrhagic Hydrocephalus in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Negar Sajjadian

    2010-07-01

    Full Text Available "nGerminal matrix-intraventricular hemorrhage (IVH is the most common variety of neonatal intracranial hemorrhage and is characteristics of the premature infant. The importance of the lesion relates not only to its high incidence but to their attendant complications (IC: hydrocephalus. Brain sonography is the procedure of choice in diagnosis of germinal matrix- intraventricular hemorrhage and hydrocephalus. In this study we have used brain sonography for detection of intraventricular hemorrhage and post hemorrhagic hydrocephalus and their incidences. The studied population was consisted of premature neonate (birth weight equal or less than 1500g and gestational age equal or less than 37 weeks who admitted in Mofid Hospital NICU (Tehran, Iran during a one year period. For all neonate (including criteria brain sonography in first week of life was done and in presence of IVH, serial Brain sonography was done weekly for detection of hydrocephalus. A total of 57 neonate entered the study. Intraventicular-germinal matrix hemorrhage was seen in 64.4% (35 patients. Forty percent of patients with intraventricular-germinal matrix hemorrhage had grade I, 11% grade II, 25.7% grade III, 2.8% grade VI. Hydrocephalus was detected in 20 percent of patients who had intraventricular-germinal matrix hemorrhage. That incidence of IVH in our study in comparison with other area and situation is higher. Hydrocephaly had direct relation with severity of IVH. This shows that with control of risk factor of IVH, we can control Post hemorrhagic hydrocephalus.

  12. Hemorrhagic Retinopathy after Spondylosis Surgery and Seizure.

    Science.gov (United States)

    Kord Valeshabad, Ali; Francis, Andrew W; Setlur, Vikram; Chang, Peter; Mieler, William F; Shahidi, Mahnaz

    2015-08-01

    To report bilateral hemorrhagic retinopathy in an adult female subject after lumbar spinal surgery and seizure. A 38-year-old woman presented with bilateral blurry vision and spots in the visual field. The patient had lumbar spondylosis surgery that was complicated by a dural tear with persistent cerebrospinal fluid leak. Visual symptoms started immediately after witnessed seizure-like activity. At presentation, visual acuity was 20/100 and 20/25 in the right and left eye, respectively. Dilated fundus examination demonstrated bilateral hemorrhagic retinopathy with subhyaloid, intraretinal, and subretinal involvement. At 4-month follow-up, visual acuity improved to 20/60 and 20/20 in the right and left eye, respectively. Dilated fundus examination and fundus photography showed resolution of retinal hemorrhages in both eyes. The first case of bilateral hemorrhagic retinopathy after lumbar spondylosis surgery and witnessed seizure in an adult was reported. Ophthalmic examination may be warranted after episodes of seizure in adults.

  13. Intracerebral hemorrhage complicating viral hepatitis A | Belfquih ...

    African Journals Online (AJOL)

    HVA IgM. Eight 8 weeks after, she developed hemorrhagic syndrome coupled with fever associated and persistent jaundice. The blood count showed aregenerative pancytopenia secondary to aplastic anemia confirmed by bone marrow biopsy.

  14. Hemorrhagic Fever with Renal Syndrome (HFRS)

    Science.gov (United States)

    ... Care includes careful management of the patient’s fluid (hydration) and electrolyte (e.g., sodium, potassium, chloride) levels, ... TG, Peters CJ. Viral Hemorrhagic Fevers. Seminars in Pediatric Infectious Diseases 1997;8(Suppl 1):64-73 . ...

  15. Current management of massive hemorrhage in trauma

    DEFF Research Database (Denmark)

    Johansson, Pär I; Stensballe, Jakob; Ostrowski, Sisse R

    2012-01-01

    ABSTRACT: Hemorrhage remains a major cause of potentially preventable deaths. Trauma and massive transfusion are associated with coagulopathy secondary to tissue injury, hypoperfusion, dilution, and consumption of clotting factors and platelets. Concepts of damage control surgery have evolved...

  16. Glioblastoma Multiforme Presenting as Spontaneous Intracerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Cagatay Ozdol

    2014-06-01

    Full Text Available Brain tumors with concomitant intracerebral hemorrhage are rarely encountered. Hemorrhage as the initial presentation of a brain tumour may pose some diagnostic problems, especially if the tumour is small or the hemorrhage is abundant. We present a 47-year-old man who admitted to the emergency department with sudden onset headache, right blurred vision and gait disturbance. A non-contrast cranial computerized tomography scan performed immediately after his admission revealed a well circumscribed right occipitoparietal haematoma with intense peripheral edema causing compression of the ipsilateral ventricles. On 6th hour of his admission the patient%u2019s neurological status deteriorated and he subsequently underwent emergent craniotomy and microsurgical evacuation of the haematoma. The histopathological examination of the mass was consistent with a glioblastoma multiforme. Neoplasms may be hidden behind each case of spontaneous intracerebral hemorrhage. Histological sampling and investigation is mandatory in the presence of preoperative radiological features suggesting a neoplasm.

  17. Previously undiagnosed hemophilia patient with intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Eray Atalay

    2015-09-01

    Full Text Available Intracranial bleeding in hemophilia patients is a rare but a mortal complication. Diagnosis of hemophilia in adulthood is an uncommon occurrence. In this case report an adult patient with intracranial hemorrhage is presented.

  18. Alkhurma Hemorrhagic Fever in Saudi Arabia

    Centers for Disease Control (CDC) Podcasts

    This podcast looks at the epidemiologic characteristics of Alkhurma Hemorrhagic Fever in humans in Najran City, Saudi Arabia. CDC epidemiologist Dr. Adam MacNeil discusses the severity and risk factors for the illness.

  19. Splenic Involvement in Hereditary Hemorrhagic Telangiectasia

    Directory of Open Access Journals (Sweden)

    Susumu Takamatsu

    2016-01-01

    Full Text Available A 33-year-old man who presented with prolonged epigastric pain was referred to our hospital. He had experienced recurrent epistaxis and had a family history of hereditary hemorrhagic telangiectasia. Computed tomography and magnetic resonance imaging revealed splenomegaly and a 9 cm hypervascular mass in his spleen. Computed tomography also showed a pulmonary arteriovenous malformation and heterogeneous enhancement of the liver parenchyma, suggesting the presence of arteriosystemic shunts and telangiectases. Based on these findings, the patient was definitely diagnosed with hereditary hemorrhagic telangiectasia according to Curaçao criteria. He underwent splenectomy, and his symptoms disappeared after surgery. Pathological examination of the resected specimen revealed that the hypervascular lesion of the spleen was not a tumor but was composed of abnormal vessels associated with hereditary hemorrhagic telangiectasia. Symptomatic splenic involvement may be a rare manifestation of hereditary hemorrhagic telangiectasia but can be revealed by imaging modalities.

  20. Potentialities of embolization of life threatening hemorrhages

    International Nuclear Information System (INIS)

    Moskvichev, V.G.

    1985-01-01

    The author analysed experience in the embolization of the abdominal vessels in 79 patients with diseases and lesions of the peritoneal cavity and retroperitoneal space accompanied by life threatening hemorrhage. In 51 cases embolization was used as an independent method of hemorrhage arrest and in 28 cases for patients' preoperative preparation. A hemostatic sponge combined with a superselective administration of 150-200 ml of aminocaproic acid was used as an emboilizing material. Complications attributed to embolization were noted in 5 patients: pancreatitis, subdiaphragmatic abscess, paranephritis, ischemia of the gluteal soft tissues, sciatic neuritis. An analysis has shown that urgent embolization of the abdominal vessels in diseases and lesions of the organs of the peritoneal cavity and retroperitoneal space accompanied by massive hemorrhage, can be used as an independent method for hemorrhage arrest

  1. How I treat patients with massive hemorrhage

    DEFF Research Database (Denmark)

    Johansson, Pär I; Stensballe, Jakob; Oliveri, Roberto

    2014-01-01

    Massive hemorrhage is associated with coagulopathy and high mortality. The transfusion guidelines up to 2006 recommended that resuscitation of massive hemorrhage should occur in successive steps using crystalloids, colloids and red blood cells (RBC) in the early phase, and plasma and platelets...... in the late phase. With the introduction of the cell-based model of hemostasis in the mid 1990ties, our understanding of the hemostatic process and of coagulopathy has improved. This has contributed to a change in resuscitation strategy and transfusion therapy of massive hemorrhage along with an acceptance...... outcome, although final evidence on outcome from randomized controlled trials are lacking. We here present how we in Copenhagen and Houston, today, manage patients with massive hemorrhage....

  2. Fetomaternal hemorrhage during external cephalic version.

    Science.gov (United States)

    Boucher, Marc; Marquette, Gerald P; Varin, Jocelyne; Champagne, Josette; Bujold, Emmanuel

    2008-07-01

    To estimate the frequency and volume of fetomaternal hemorrhage during external cephalic version for term breech singleton fetuses and to identify risk factors involved with this complication. A prospective observational study was performed including all patients undergoing a trial of external cephalic version for a breech presentation of at least 36 weeks of gestation between 1987 and 2001 in our center. A search for fetal erythrocytes using the standard Kleihauer-Betke test was obtained before and after each external cephalic version. The frequency and volume of fetomaternal hemorrhage were calculated. Putative risk factors for fetomaternal hemorrhage were evaluated by chi(2) test and Mann-Whitney U test. A Kleihauer-Betke test result was available before and after 1,311 trials of external cephalic version. The Kleihauer-Betke test was positive in 67 (5.1%) before the procedure. Of the 1,244 women with a negative Kleihauer-Betke test before external cephalic version, 30 (2.4%) had a positive Kleihauer-Betke test after the procedure. Ten (0.8%) had an estimated fetomaternal hemorrhage greater than 1 mL, and one (0.08%) had an estimated fetomaternal hemorrhage greater than 30 mL. The risk of fetomaternal hemorrhage was not influenced by parity, gestational age, body mass index, number of attempts at version, placental location, or amniotic fluid index. The risk of detectable fetomaternal hemorrhage during external cephalic version was 2.4%, with fetomaternal hemorrhage more than 30 mL in less than 0.1% of cases. These data suggest that the performance of a Kleihauer-Betke test is unwarranted in uneventful external cephalic version and that in Rh-negative women, no further Rh immune globulin is necessary other than the routine 300-microgram dose at 28 weeks of gestation and postpartum. II.

  3. Treatment for Supra-tentorial Intracerebral Hemorrhage

    OpenAIRE

    長島, 梧郎; 藤本, 司; 鈴木, 龍太; 浅井, 潤一郎; 松永, 篤子; 張, 智為; 永井, 美穂; Goro, NAGASHIMA; Tsukasa, FUJIMOTO; Ryuta, SUZUKI; Jun-ichiro, ASAI; Atsuko, MATSUNAGA; Tomoo, CHANG; Miho, NAGAI; 昭和大学藤が丘病院脳神経外科

    2002-01-01

    Only vague guidelines exist for the surgical management of intracerebral hemorrhage (ICH). We investigated the indications for surgical management of intracerebral hemorrhage and compared the outcomes of computed tomography (CT)-guided stereotactic hematoma aspiration with those after hematoma removal under craniotomy. Our indications for CT-guided stereotactic hematoma aspiration were an age < 80 years old, a hematoma volume ≧ 10 ml, and a Glasgow Coma Scale (GCS) score ≦ 14. Those for hemat...

  4. Reperfusion hemorrhage following superior mesenteric artery stenting.

    LENUS (Irish Health Repository)

    Moore, Michael

    2012-02-03

    Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

  5. Ultrasound diagnosis of adrenal hemorrhage in meningococcemia

    International Nuclear Information System (INIS)

    Sarnaik, A.P.; Sanfilippo, D.J.K.; Slovis, T.L.; Children's Hospital of Michigan, Detroit; Wayne State Univ., Detroit, MI

    1988-01-01

    Adrenal hemorrhage (AH) is a well-described complication of the neonatal period, anticoagulant therapy, and overwhelming bacterial infection especially with N. meningitis. Until recently the diagnosis of acute AH was based predominantly on autopsy findings. Ultrasound and computed tomography examinations have been successfully used for antemortem detection of AH in neonates and anticoagulated patients. We report two patients with fulminant meningococcal infection who demonstrated bilateral adrenal hemorrhages on ultrasonography. (orig.)

  6. A Case of Rivaroxaban Associated Intracranial Hemorrhage

    Directory of Open Access Journals (Sweden)

    Jean Chin-Yu Lo

    2014-07-01

    Full Text Available Rivaroxaban is a newer anticoagulant initially approved by the Food and Drug Administration to treat nonvalvular atrial fibrillation. Rivaroxaban has several characteristics that are more favorable than warfarin. One of the characteristics is decreased risk of hemorrhage. We report one of the first case reports of severe intracranial hemorrhage associated with rivaroxaban in an elderly patient with decreased renal function. We aim to alert emergency medicine providers regarding the likelihood of encountering these patient as newer anticoagulants rise in popularity.

  7. Isolated trochlear nerve palsy with midbrain hemorrhage

    Directory of Open Access Journals (Sweden)

    Raghavendra S

    2010-01-01

    Full Text Available Midbrain hemorrhage causing isolated fourth nerve palsy is extremely rare. Idiopathic, traumatic and congenital abnormalities are the most common causes of fourth nerve palsy. We report acute isolated fourth nerve palsy in an 18-year-old lady due to a midbrain hemorrhage probably due to a midbrain cavernoma. The case highlights the need for neuroimaging in selected cases of isolated trochlear nerve palsy.

  8. PATHOGENESIS OF HEMORRHAGIC DUE TO DENGUE VIRUS

    Directory of Open Access Journals (Sweden)

    Arief Suseno

    2015-01-01

    Full Text Available Dengue is a viral disease that is mediated by a mosquito, which causes morbidity and mortality. Viruses can increase vascular permeability which can lead to hemorrhagic diathesis or disseminated intravascular coagulation (DIC known as dengue hemorrhagic fever (DHF. In Indonesia, dengue hemorrhagic fever (DHF are caused by dengue virus infection which was found to be endemic accompanied by an explosion of extraordinary events that appear at various specified period. The diagnosis of dengue is determined based on the criteria of the World Health Organization (WHO, 1999, which are sudden high fever accompanied by a marked tendency to hemorrhage positive tourniquet test, petechiae, ecchymosis, purpura, mucosal hemorrhagic, hematemesis or melena and thrombocytopenia. The problem that still exists today is the mechanism of thrombocytopenia in patients with varying degrees of dengue involving levels of vWF (von Willebrand factor and prostaglandin I2 (PGI2 can not be explained. The mechanism of hemorrhagic in dengue virus infections acquired as a result of thrombocytopenia, platelet disfunction decreased coagulation factors, vasculopathy with endothelial injury and disseminated intravascular coagulation (DIC.

  9. Impaired Fracture Healing after Hemorrhagic Shock

    Directory of Open Access Journals (Sweden)

    Philipp Lichte

    2015-01-01

    Full Text Available Impaired fracture healing can occur in severely injured patients with hemorrhagic shock due to decreased soft tissue perfusion after trauma. We investigated the effects of fracture healing in a standardized pressure controlled hemorrhagic shock model in mice, to test the hypothesis that bleeding is relevant in the bone healing response. Male C57/BL6 mice were subjected to a closed femoral shaft fracture stabilized by intramedullary nailing. One group was additionally subjected to pressure controlled hemorrhagic shock (HS, mean arterial pressure (MAP of 35 mmHg for 90 minutes. Serum cytokines (IL-6, KC, MCP-1, and TNF-α were analyzed 6 hours after shock. Fracture healing was assessed 21 days after fracture. Hemorrhagic shock is associated with a significant increase in serum inflammatory cytokines in the early phase. Histologic analysis demonstrated a significantly decreased number of osteoclasts, a decrease in bone quality, and more cartilage islands after hemorrhagic shock. μCT analysis showed a trend towards decreased bone tissue mineral density in the HS group. Mechanical testing revealed no difference in tensile failure. Our results suggest a delay in fracture healing after hemorrhagic shock. This may be due to significantly diminished osteoclast recruitment. The exact mechanisms should be studied further, particularly during earlier stages of fracture healing.

  10. Risk factors for post-tonsillectomy hemorrhage.

    Science.gov (United States)

    Ikoma, Ryo; Sakane, Sayaka; Niwa, Kazutomo; Kanetaka, Sayaka; Kawano, Toshiro; Oridate, Nobuhiko

    2014-08-01

    The aim of the present study was to investigate the rate of post-tonsillectomy hemorrhage (PTH) in a single institution and to evaluate the clinical risk factors for PTH. We reviewed the records of 692 patients who underwent tonsillectomy (TE) at Yokohama Minami Kyosai Hospital in Japan. PTH grades were grouped into three categories according to the severity of the hemorrhagic episode: (I) minimal hemorrhage that stopped after noninvasive treatment, (II) hemorrhage requiring treatment with local anesthesia, and (III) hemorrhage requiring reoperation under general anesthesia in the operating room. Clinical risk factors such as sex, age (adults vs. children), TE indication, surgeon's skill level, operative time, ligature type, and duration of antibiotic administration for PTH were investigated. Among the 692 patients, 80 (11.6%) showed PTH, with primary and secondary hemorrhage accounting for 1.6% and 10.0%, respectively. A category III PTH was observed in 18 patients; thus, the overall risk of reoperation was 2.6%. The PTH episode most frequently occurred on postoperative days 5 and 6. The frequency of PTH was significantly higher in male patients and in adults (Pdefinition of PTH. Clinical risk factors for PTH were adult age and male gender. The surgeon's skill level was an additional risk factor for category III PTH. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Vocal fold hemorrhage: factors predicting recurrence.

    Science.gov (United States)

    Lennon, Christen J; Murry, Thomas; Sulica, Lucian

    2014-01-01

    Vocal fold hemorrhage is an acute phonotraumatic injury treated with voice rest; recurrence is a generally accepted indication for surgical intervention. This study aims to identify factors predictive of recurrence based on outcomes of a large clinical series. Retrospective cohort. Retrospective review of cases of vocal fold hemorrhage presenting to a university laryngology service. Demographic information was compiled. Videostroboscopic exams were evaluated for hemorrhage extent, presence of varix, mucosal lesion, and/or vocal fold paresis. Vocal fold hemorrhage recurrence was the main outcome measure. Follow-up telephone survey was used to complement clinical data. Forty-seven instances of vocal fold hemorrhage were evaluated (25M:22F; 32 professional voice users). Twelve of the 47 (26%) patients experienced recurrence. Only the presence of varix demonstrated significant association with recurrence (P = 0.0089) on multivariate logistic regression. Vocal fold hemorrhage recurred in approximately 26% of patients. Varix was a predictor of recurrence, with 48% of those with varix experiencing recurrence. Monitoring, behavioral management and/or surgical intervention may be indicated to treat patients with such characteristics. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  12. CT findings of falical and tentorial subdural hemorrhage

    International Nuclear Information System (INIS)

    Kim, Ok Keun; Jung, Nam Keun; Kim, Kab Tae; Sol, Chang Hyo; Kim, Byung Soo

    1987-01-01

    Computed tomography has been established as an indispensable tool in the detection of intracranial hemorrhages. Extra axial fluid collections are usually easily distinguished from intracerebral hemorrhages. However, hemorrhages in atypical locations, such as in falx and tentorial regions, can be difficult to diagnose with CT. The tentorial and falcial collection of subdural blood are rather unusual. Authors report here 84 cases of falcial and tentorial subdural hemorrhages with reference data that we have encountered in the last two years. The results were as follows; 1. In 589 cases of intracranial hemorrhage, the incidence of subdural hemorrhage was 372 cases (63.2%). 2. Among 372 cases with subdural hemorrhage, 84 cases (22.6%) had falcial and/or tentorial subdural hemorrhage. In 84 cases with falcial and/or tentorial subdural hemorrhage, there were 50 cases (13.4%) of falcial subdural hemorrhages, 21 cases (5.7%) of tentorial subdural hemorrhage and 13 cases (3.5%) of combined falcial and tentorial subdural hemorrhage. 3. The location of falcial subdural hemorrhage was anterior in 30 cases (60%), posterior in 15 cases (30%) and middle in 5 cases (10%). 4. The location of tentorial subdural hemorrhage was petrous edge in 7 cases (33.3%), occipital attachment in 6 cases (28.6%), tentorial hiatus in 5 cases (23.8%), and diffuse in 3 cases (14.3%). 5. In 13 cases showing combined falcial and tentorial subdural hemorrhage, there was 3 cases (23.1%) of posterior falx and tentorial hiatus, 2 cases (15.4%) of anterior falx and petrous edge, 2 cases of anterior falx and tentorial hiatus, 2 cases of posterior falx and petrous edge, 2 cases of posterior falx and occipital attachment, 1 case (7.7%) of posterior falx and diffuse, and 1 case of posterior, middle falx and diffuse. 6. In the cases with falcial and/or tentorial subdural hemorrhage, the incidence of associated intracranial hemorrhage were intracrania subdural hemorrhage in 40 cases (47.6%), hemorrhagic brain

  13. Hemorrhagic Aspects of Gaucher Disease

    Directory of Open Access Journals (Sweden)

    Hanna Rsenbaum

    2014-10-01

    Full Text Available Gaucher disease (GD is an inherited lysosomal disorder, originating from deficient activity of the lysosomal enzyme glucocerebrosidase (GCase. Normally, GCase hydrolyzes glucocerebroside (GC to glucose and ceramide; however, impaired activity of this enzyme leads to the accumulation of GC in macrophages, termed “Gaucher cells.” Gaucher disease is associated with hepatosplenomegaly, cytopenias, skeletal complications and in some forms involves the central nervous system. Coagulation abnormalities are common among GD patients due to impaired production and chronic consumption of coagulation factors. Bleeding phenomena are variable (as are other symptoms of GD and include mucosal and surgical hemorrhages. Four main etiological factors account for the hemostatic defect in GD: thrombocytopenia, abnormal platelet function, reduced production of coagulation factors, and activation of fibrinolysis. Thrombocytopenia relates not only to hypersplenism and decreased megakaryopoiesis by the infiltrated bone marrow but also to immune thrombocytopenia. Autoimmunity, especially the induction of platelet antibody production, might cause persistent thrombocytopenia. Enzyme replacement therapy reverses only part of the impaired coagulation system in Gaucher disease. Other therapeutic and supportive measures should be considered to prevent and/or treat bleeding in GD. Gaucher patients should be evaluated routinely for coagulation abnormalities especially prior to surgery and dental and obstetric procedures.

  14. [Hemorrhagic adrenal pseudocyst: case report].

    Science.gov (United States)

    Basile, G; Buffone, A; Cicciarella, G; di Mari, P; Cirino, E

    2004-01-01

    Adrenal cysts are usually asymptomatic; they are usually identified occasionally during ultrasound or C.T. scans (incidentaloma). Among adrenal cysts the most common types are epithelial cysts and pseudocysts. Intracystic haemorrhage is one of the possible complications of adrenal pseudocysts. We report a case of a young woman with right superior abdominal pain, fever and acute anemia. A C.T. scan showed a 10 cm. mass between the liver and the right kidney. To be sure of the nature of this mass also M.R., urography and C.T.-guided biopsy were carried out. This latter only let us make the final diagnosis of hemorrhagic adrenal pseudocyst. Thereafter, a laparotomic right adrenalectomy was performed, with full recovery of the patient. Adrenal cysts may cause differential diagnostic problems with masses of contiguous organs like kidney, liver and gallbladder. For this reason, ultrasound and C.T. scans may not be sufficient and must be completed by M.R., urography and/or C.T.-guided biopsy. Intracystic hamorrhage, spontaneous or post-traumatic, may cause to the patient acute anemia which, as soon as the diagnosis is confirmed, indicates surgery. The operation usually is a laparotomic adrenalectomy, since the laparoscopic approach is not sufficient to control large masses with active bleeding inside.

  15. Reaction of congo red in water after irradiation by pulsed intense relativistic electron beam

    International Nuclear Information System (INIS)

    Kikuchi, Takashi; Kondo, Hironobu; Sasaki, Toru; Harada, Nob.; Moriwaki, Hiroshi; Nakanishi, Hiromitsu; Imada, Go

    2011-01-01

    The reaction of congo red, a well-known toxic azo dye, occurred after irradiation by a pulsed intense relativistic electron beam (PIREB). An aquation of congo red was irradiated by PIREB (2 MeV, 0.36 kA, 140 ns). After PIREB irradiation, the solution was measured by electrospray ionization-mass spectrometry and liquid chromatography/mass spectrometry. It was found that congo red underwent a reaction (77% conversion after five shots of PIREB irradiation) and the hydroxylated compounds of the dye were observed as reaction products. (author)

  16. Adsorption of procion red and congo red dyes using microalgae Spirulina sp

    Directory of Open Access Journals (Sweden)

    Risfidian Mohadi

    2017-10-01

    Full Text Available Adsorption of procion red and congo red dyes using microalgae Spirulina sp was conducted. Spirulina sp was obtained by cultivation and production in laboratory scale. Spirulina sp was used as adsorbent for adsorption of dyes. Adsorption process was studied by kinetic and thermodynamic in order to know the adsorption phenomena. The results showed that kinetically congo red is reactive than procion red on Spirulina sp. On the other hand, thermodynamically procion red was stable than congo red on Spirulina sp which was indicated by adsorption capacity, enthalpy, and entropy.

  17. Crimean Khanate, Polish-Lithuanian Commonwealth and Russian State in 1524–1571: The Diplomatic Correspondence from the Archive of the Grand Duchy of Lithuania

    Directory of Open Access Journals (Sweden)

    Erusalimskiy K.Yu.

    2017-12-01

    Full Text Available The manuscript of the Czartoryskis’ Library in Krakow № 2893 contains, among other sources, the correspondence of the Crimean-Kazan Gireys with the kings of Polish Crown and Grand Duchy of Lithuania in Ruthenian translation (“prosta mowa”. The collection of letters springs from the Radziwills’ archive and can be dated back to 1524–1571 based on the reasons outlined in this article. The manuscript from the Warsaw Main Archive of the Ancient Acts (Radziwills coll., part II, № 3294 contains a part of the same correspondence, which is present in the Czartoryski manuscript № 2893. The author reinterprets the historical context of the Warsaw manuscript. The senders of the letters are Sahib-Giray (to Sigismund I, 1st: ca. 1521–1524, 2nd: June–July 1530, 3rd: September–October 1537, Safa-Giray (two letters to Sigismund I, spring or summer of 1524, Amin-Giray-Saltan (a letter to Sigismund I, September–October 1537 and Poland’s King Sigismund I the Old (to Khan Sahib-Giray at end of December 1537 or the beginning of January 1538. The latest-dated part of the Polish-Lithuanian and Crimean-Kazan correspondence in the Czartoryski manuscript contains the materials of Devlet-Giray’s diplomatic correspondence with Sigismund II Augustus, which sheds a new light on the Crimean march against the Muscovite state in 1571. These materials are contextualized and studied with respect to the new information they may provide on the history of Russian-Crimean relations (letter to Sigismund II ca. April 5, 1571 and Ardy-Berdey’s embassy ca. July 5, 1571. The author found a list of 27 towns devastated by the khan during the war against Moscow recorded in the embassy accounts of the Polish Royal Treasury at the Warsaw Archive. It was composed as a means of propaganda, but it reflects the marching route of the Crimean troops to Moscow and the ravaging of other Russian districts after Moscow had been burned on May 24, 1574.

  18. How Hemorrhage Control Became Common Sense.

    Science.gov (United States)

    Hawk, Alan James

    2018-02-27

    Just over 200 years ago, surgeons were puzzled that the use of the tourniquet to control hemorrhage as common sense during surgery was a relatively recent development. Within the last 20 years, much progress has been made to controlling hemorrhage in the prehospital context. Then, as now, it was surprising that progress on something that appeared obvious had occurred only recently, begging the question how controlling blood loss was common sense in a surgical context, but not for emergency treatment. Paper is a historical survey of the evolution of the medical understanding of hemorrhage along with technological response. The danger of blood loss had historically been consistently underestimated as physicians looked at other explanations for symptoms of how the human body responded to trauma. As the danger from hemorrhage became apparent, even obvious, responsibility for hemorrhage control was delegated down from the surgeon to the paramedic and eventually to individual service members and civilian bystanders with training to "Stop the Bleed." Hippocratic medicine assumed that blood diffused centrifugally into periphery through arteries. William Harvey's observation in 1615 that blood ran through a closed circulatory system gradually transformed conventional wisdom about blood loss, leading to the development of the tourniquet about a century later by Jean-Louis Petit, which made amputation of limbs survivable. However, physicians were cautious about their application during the First World War over concerns over effects on patient recovery. Hemorrhage had generally been seen as symptom to be managed until the patient would be seen by a surgeon who would stop the bleeding. More thorough collection and analysis of data related to case histories of soldiers wounded during the Vietnam Conflict transformed how surgeons understood the importance to hemorrhage leading to development of the doctrine of Tactical Combat Casualty Care in the late 1990's. economic

  19. Fast FLAIR MR images of intracranial hemorrhage

    International Nuclear Information System (INIS)

    Chun, Eun Ju; Choi, Hye Young; Cho, Young A; Kim, Wha Young

    1998-01-01

    The purpose of this study is to evaluate the signal characteristics of intracranial hemorrhage, as seen on fluid attenuated inversion recovery (FLAIR) MR imaging according to various stages, and to compare FLAIR imaging with spin-echo T1- and T2-weighted MR imaging. We retrospectively evaluated fast FLAIR images along with spin-echo T1- and T2 weighted MR images of 32 lesions in 25 patients (12 males and 14 females, aged 3 - 84 yrs) with intracranial hemorrhagic lesions. For imaging, 1.5 T unit was used, and the nature of the lesions was found to be as follows : intracranial hemorrhage (n=15); tumor (n=9); infarction (n=4); arteriovenous malformation (n=3); and arachnoid cyst with hemorrhage (n=1). On the basis of spin-echo MR imaging, lesions were classified as acute, early subacute, late subacute, early chronic, or late chronic stage. The signal characteristics of intracranial hemorrhage were analysed in accordance with each staging, as seen on MR FLAIR imaging, and compared to the staging seen on spin-echo T1- and T-2 weighted MR imaging. The signal intensity of intracranial hemorrhage, as seen on FLAIR imaging, was not characteristic; it was similar to that of T2WI during the acute and subacute stages, and similiar to that of T1WI during the chronic stage. When used together with spin-echo T1- and T2-weighted MR imaging, however, FLAIR imaging may be useful for the classification of chronic intracranial hemorrhage as either early or late stage. (author). 20 refs., 2 tabs., 6 figs

  20. Aphasia following left thalamic hemorrhage

    International Nuclear Information System (INIS)

    Makishita, Hideo; Miyasaka, Motomaro; Tanizaki, Yoshio; Yanagisawa, Nobuo; Sugishita, Morihiro.

    1984-01-01

    We reported 7 patients with left thalamic hemorrhage in the chronic stage (from 1.5 months to 4.5 months), and described language disorders examined by Western Aphasia Battery (WAB) and measured cerebral blood flow by single photon emission CT. Examination of language by WAB revealed 4 aphasics out of 7 cases, and 3 patients had no language deficit. The patient with Wernicke's aphasia showed low density area only in the left posterior thalamus in X-ray CT, and revealed severe low blood flow area extending to left temporal lobe in emission CT. In the case with transcortical sensory aphasia, although X-ray CT showed no obvious low density area, emission CT revealed moderate low flow area in watershed area that involved the territory between posterior cerebral and middle cerebral arteries in the left temporooccipital region in addition to low blood flow at the left thalamus. In one of the two patients classified as anomic aphasia, whose score of repetition (8.4) was higher than that of comprehension (7.4), emission CT showed slight low flow area at the temporo-occipital region similarly as the case with transcortical sensory aphasia. In another case with anomic aphasia, scored 9 on both fluensy and comprehension subtests and 10 on repetition, there was wide low density area all over the left thalamus and midline shift to the right in X-ray CT, and emission CT showed severe low blood flow in the same region spreading widely toward the cerebral surface. On the other hand, in all of the 3 patients without aphasia, emission CT showed low flow region restricted to the left thalamus. (J.P.N.)

  1. [Neonatal adrenal hemorrhage revealed by jaundice: a case report].

    Science.gov (United States)

    Oulmaati, A; Hays, S; Mory-Thomas, N; Bretones, P; Bensaid, M; Jordan, I; Bonfils, M; Godbert, I; Picaud, J-C

    2012-04-01

    The clinical presentation of adrenal hemorrhage varies, depending on the extent of hemorrhage as well as the amount of adrenal cortex involved by the hemorrhage. We report here a case of neonatal adrenal hemorrhage revealed by late onset of neonatal jaundice. This adrenal hemorrhage most probably resulted from shoulder dystocia. The aim of this work was to focus on the fact that jaundice can be caused by adrenal hemorrhage and to emphasize the crucial importance of abdominal ultrasound in cases of persistent jaundice. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  2. MR detection of retinal hemorrhages: correlation with graded ophthalmologic exam

    International Nuclear Information System (INIS)

    Beavers, Angela J.; Allbery, Sandra M.; Stagner, Anna M.; Hejkal, Thomas W.; Lyden, Elizabeth R.; Haney, Suzanne B.

    2015-01-01

    Dilated fundoscopic exam is considered the gold standard for detecting retinal hemorrhage, but expertise in obtaining this exam is not always immediately available. MRI can detect retinal hemorrhages, but correlation of the grade or severity of retinal hemorrhage on dilated fundoscopic exam with retinal hemorrhage visibility on MRI has not been described. To determine the value of standard brain protocol MRI in detecting retinal hemorrhage and to determine whether there is any correlation with MR detection of retinal hemorrhage and the dilated fundoscopic exam grade of hemorrhage. We conducted a retrospective chart review of 77 children <2 years old who were seen for head trauma from April 2007 to July 2013 and had both brain MRI and dilated fundoscopic exam or retinal camera images. A staff pediatric radiologist and radiology resident reviewed the MR images. Retinal hemorrhages were graded by a chief ophthalmology resident on a 12-point scale based on the retinal hemorrhage type, size, location and extent as seen on review of retinal camera images and detailed reports by ophthalmologists. Higher scores indicated increased severity of retinal hemorrhages. There was a statistically significant difference in the median grade of retinal hemorrhage examination between children who had retinal hemorrhage detected on MRI and children who did not have retinal hemorrhage detected on MRI (P = 0.02). When examination grade was categorized as low-grade (1-4), moderate-grade (5-8) or high-grade (>8) hemorrhage, there was a statistically significant association between exam grade and diagnosis based on MRI (P = 0.008). For example, only 14% of children with low-grade retinal hemorrhages were identified on MRI compared to 76% of children with high-grade hemorrhages. MR detection of retinal hemorrhage demonstrated a sensitivity of 61%, specificity of 100%, positive predictive value of 100% and negative predictive value of 63%. Retinal hemorrhage was best seen on the gradient

  3. [Population planning unit is developed in the Congo].

    Science.gov (United States)

    Amouali, C; Poukouta, P

    1989-01-01

    This article is an update on the demographic situation in the Congo and the institutionalization of a population unit in The Ministry of Plan. From 1974-84 the population increased 44.9% going from 1,319,790 to 1,912,429 at a growth rate of 3.48% and possibly doubling in 20 years (2005). However, the major transformation has been the growth of the urban areas over the rural. From 1974-84 the rural population went from 819,430 to 934,849 while the urban population went from 500,360 in 1974 to 977,580 in 1984. The growth rate of the rural areas was 1.22% while that for the urban was 6.38% Infant mortality rate stands at 73/1000; life expectancy is 46.9 for men and 50.0 for women. The average fertility rate is 6. This demographic situation with the inherent problems of the rapidly growing urbanization of the 2 principal cities, Brazzaville and Pointe-Noire, has led to problems in health services and high morbidity and mortality rates. The Government has created 3 national organizations to coordinate population activities in the country: 1) The National Council on Population, (1988) an interministerial council, presided over by the Prime Minister, that defines and formulates national population policies as integral components to the country's socioeconomic development plans; 2) The National Commission on Population (CONAPO), headed by the Minister of Plan, Finance and Economics as the administrative organ of The National Council on Population, and responsible for the technical and evaluation activities of The National Council on Population; and 3) The Population Planning Unit headed by the Director of Human Resources in the Ministry of Plan responsible for identifying, formulating and evaluating population policies in the Congo. These institutions were created as a result of the 1974 Bucharest Conference and the 1984 Arusha Conference were population and development were considered integral components, and of results of 2 censuses and population surveys highlighting

  4. Putaminal hemorrhage: Clinical-computed tomographic correlations

    International Nuclear Information System (INIS)

    Weisberg, L.A.; Stazio, A.; Elliott, D.; Shamsnia, M.; Veterans Administration Hospital, New Orleans, LA

    1990-01-01

    Ninety-two percent of 100 patients with putaminal hemorrhage were hypertensive. Of the eight normotensive patients, seven were substance abusers or had bilateral putaminal hemorrhages. The one other normotensive patient was less than 40 years old. The 100 hemorrhages had the following locations: 1. Medial putaminal (17 cases; six were normotensive and less than 40 years old and five were substance abusers); 2. lateral putaminal extending through the external capsule (eleven cases); 3. putaminal-capsular and subcortical white matter (32 cases); 4. putaminal cerebral hemispheric (19 cases); 5. putaminal-thalamic (19 cases); 6. bilateral (two cases). A disproportionate number of black patients suffered hematoma extension to the cerebral hemispheres or thalamus (46%) compared to Caucasians (23%). Overall mortality was 20% (17 blacks and three Caucasians) and occurred in patients with hematoma extension to the thalamus or cerebral hemispheres. Contrast-enhanced CT was performed in all 100 patients and provided no additional diagnostic yield. This indicates limited use for enhanced CT in hypertensive patients with putaminal hemorrhage who have a characteristic appearance of the acute hemorrhage on the nonenhanced CT. (orig.)

  5. Freehand technique for putaminal hemorrhage. Technical note

    International Nuclear Information System (INIS)

    Yokosuka, Kimihiko; Uno, Masaaki; Hirano, Kazuhiro; Toi, Hiroyuki; Matsuzaki, Kazuhito; Matsubara, Shunji

    2011-01-01

    We designed a new endoscopic surgical procedure for putaminal hemorrhage (freehand technique) and evaluated its effectiveness and safety in patients with putaminal hemorrhage. Computed tomography (CT) data sets from 40 healthy patients were used. The CT data were transformed into three-dimensional images using AZE VirtualPlace Plus. The nasion and external auditory foramen were the intraoperative reference points. The median point from medial of the globus pallidus to the insula was the target point. The location of the burr hole point was 80-125 mm above and 27.5 mm lateral to the nasion, and the direction was parallel to the midline and a line drawn from the burr hole to the ipsilateral external auditory foramen. This point was used for 15 patients with putaminal hemorrhage. In all cases, only one puncture was required, and there were no complications. The median surgical time was 91.7 minutes, and the median hematoma removal rate was 95.9%. No recurrent bleeding or operative complications occurred. The freehand technique is a simple and safe technique for patients with putaminal hemorrhage. We believe that this technique of endoscopic hematoma evacuation may provide a less-invasive method for treating patients with putaminal hemorrhage. (author)

  6. The Afterlife of Thomas Campbell and ‘The Soldier’s Dream’ in the Crimean War

    Directory of Open Access Journals (Sweden)

    Tai-Chun Ho

    2015-05-01

    Full Text Available Studies of Crimean War poetry tend to focus on Alfred Tennyson’s celebrated war poem ‘The Charge of the Light Brigade’ (1854, a civilian poetic rewriting of 'The Times'’s despatches. While recent scholarship has highlighted the impact of modern forms of reportage on artistic representations of the Crimean War, this article will argue that the two-year military campaign waged at a long distance was not only a media war but also a literary one, during which civilians drew on established forms of war poetry to make sense of the pressing issues provoked by the conflict overseas. This literary war was manifest in the myriad ways armchair poets and artists rewrote Thomas Campbell’s ‘The Soldier’s Dream’ (1804 to address the reading public’s anxieties and expectations about the welfare of the common soldier. The rewritings of Campbell’s poem this article will consider include: 'Punch'’s ‘The Soldier’s Dream’ alongside an accompanying cartoon by John Tenniel of 1 April 1854; the poem ‘A Night on the Heights’, penned by the pseudonymous poet ‘Private Jones’ in 'Tait’s Edinburgh Magazine' in December 1854; a piece of commemorative pottery designed by George Eyre in January 1855; and Part III of Tennyson’s ‘Maud’, published in 'Maud and Other Poems' in July 1855. By examining these works at specific moments of the conflict, I will demonstrate that mid-Victorians deployed Campbell’s dream-vision framework to negotiate the soldier’s public duties and private emotions, as well as the government’s responsibilities for the soldier and his family. While in general mid-century commentators utilized Campbell’s dream vision to foreground a benign government’s efforts to care for the soldier, Tennyson’s conclusion of ‘Maud’' 'offered an ironic rendition of this interpretation. Instead, a civilian’s dream of fighting a glorious war becomes a nightmarish vision of the government’s military incompetence

  7. Discharge and other hydraulic measurements for characterizing the hydraulics of Lower Congo River

    Science.gov (United States)

    Oberg, Kevin; Shelton, John M.; Gardiner, Ned; Jackson, P. Ryan

    2009-01-01

    The first direct measurements of discharge of the Lower Congo River below Malebo Pool and upstream from Kinganga, Democratic Republic of Congo (DRC) were made in July 2008 using acoustic Doppler current profilers, differential GPS, and echo sounders. These measurements were made in support of research that is attempting to understand the distribution of fish species in the Lower Congo River and reasons for separation of species within this large river. Analyses of these measurements show that the maximum depth in the Lower Congo River was in excess of 200 m and maximum water velocities were greater than 4 m/s. The discharge measured near Luozi, DRC was 35,800 m3/s, and decreased slightly beginning midway through the study. Local bedrock controls seem to have a large effect on the flow in the river, even in reaches without waterfalls and rapids. Dramatic changes in bed topography are evident in transects across the river.

  8. Computed tomography and intracranial hemorrhages in the neonate

    International Nuclear Information System (INIS)

    Shibata, Iekado; Kushida, Yoshimasa; Shishido, Masaru; Nagasawa, Sadatsugu; Seiki, Yoshikatsu

    1983-01-01

    Thirty-two of 290 neonates admitted to the Perinatal Intensive Care Unit, Toho University Medical School, were examined by CT scan because of tentative clinical diagnosis of intracranial hemorrhage. CT scanner employed in this study was TCT-60 A from the Toshiba The Electric Co., Ltd. Fourteen cases (44%) were confirmed by the CT scan to have intracranial hemorrhage. Four cases had hemorrhage in the ventricle, while the remaining ten cases had subarachnoid hemorrhage. Subdural hemorrhage was not revealed in our series. Three of the four cases with intraventricular hemorrhage showed a typical subependymal germinal matrix hemorrhage. The prognosis of intraventricular hemorrhage in neonates seemed to be poor; two of the four cases died within a week. Their body weight at birth was apparently under the standard, and their Apgar score was 3 points. The subarachnoid hemorrhage was the main type of intracranial neonatal hemorrhages. In our series, it was constituted approximately 70% of the intracranial hemorrhages. The CT images of the subarachnoid hemorrhage in neonate were greatly different from those in adults. An irregular, wide high-density area around the falxtentorial junction was characteristic of the CT in many neonatal subarachnoid hemorrhages. In severe subarachnoid hemorrhages, a characteristic Y-shaped, high-density figure was demonstrated. In cases of subarachnoid hemorrhage from the deep venous system, high-density spreading immediately ventral to the falx-tentrium junction was demonstrated. These high-density areas due to blood in the subarachnoid space rapidly disappeared with the lapse of time. On the other hand, high-density areas in cerebral cisterns and/or fissures were rarely demonstrated in neonatal subarachnoid hemorrhages. The prognosis of subarachnoid hemorrhage in neonates was fairly good in the sense of life and cerebral functions. (author)

  9. Cerebral microbleeds and intracerebral hemorrhages in patients on maintenance hemodialysis

    International Nuclear Information System (INIS)

    Watanabe, Akira

    2006-01-01

    Cerebrovascular diseases are important causes of death in patients on maintenance hemodialysis. Recently, it has become clear that the presence of cerebral microbleeds (MBs) on T2 * -weighted magnetic resonance imaging (MRI) is closely related to intracerebral hemorrhages. This study investigated the incidence of MBs in chronic dialysis patients and prospective hemorrhagic complications of chronic dialysis patients with old intracerebral hemorrhages. Eighty patients (34 males, 46 females) with chronic renal failure, whose mean age was 62.9±11.4 years, were examined by MRI. The mean duration of hemodialysis was 7.8±6.3 years. MBs were found in 28 patients (35%) by T2 * -weighted MRI. Old intracerebral hemorrhages were seen in seven of the patients, and MBs were found in five (71%) of these seven patients. The frequency of old intracerebral hemorrhages was significantly higher in patients with MBs than in those without (p=0.048), and the numbers of MBs were significantly larger in patients with old intracerebral hemorrhages than in those without (p=0.0065). Three of the seven patients with old intracerebral hemorrhages had new hemorrhagic complications (two intracerebral hemorrhages and one cerebral microbleed) within a year. These intracerebral hemorrhages occurred in areas without MBs on the first T2 * -weighted MRI. T2 * -weighted MRI is useful for the detection of MBs, which may be a predictor of intracerebral hemorrhage. When a patient has a large number of MBs and old intracerebral hemorrhages, the risk of intracerebral hemorrhage undoubtedly increases. (author)

  10. Congo Basin rainfall climatology: can we believe the climate models?

    Science.gov (United States)

    Washington, Richard; James, Rachel; Pearce, Helen; Pokam, Wilfried M; Moufouma-Okia, Wilfran

    2013-01-01

    The Congo Basin is one of three key convective regions on the planet which, during the transition seasons, dominates global tropical rainfall. There is little agreement as to the distribution and quantity of rainfall across the basin with datasets differing by an order of magnitude in some seasons. The location of maximum rainfall is in the far eastern sector of the basin in some datasets but the far western edge of the basin in others during March to May. There is no consistent pattern to this rainfall distribution in satellite or model datasets. Resolving these differences is difficult without ground-based data. Moisture flux nevertheless emerges as a useful variable with which to study these differences. Climate models with weak (strong) or even divergent moisture flux over the basin are dry (wet). The paper suggests an approach, via a targeted field campaign, for generating useful climate information with which to confront rainfall products and climate models.

  11. Democratic Republic of Congo A Fertile Ground for Instability in the Great Lakes Region States

    Science.gov (United States)

    2017-06-09

    ravaged by a brutal armed conflict. In comparison to the three past presidents, Joseph Kabila has managed to restore political stability and calm to much...DEMOCRATIC REPUBLIC OF CONGO-A FERTILE GROUND FOR INSTABILITY IN THE GREAT LAKES REGION STATES A thesis presented to the Faculty of...From - To) AUG 2016 – JUNE 2017 4. TITLE AND SUBTITLE Democratic Republic of Congo-A Fertile Ground for Instability in the Great Lakes Region

  12. Lightning climatology in the Congo Basin: detailed analysis

    Science.gov (United States)

    Soula, Serge; Kigotsi, Jean; Georgis, Jean-François; Barthe, Christelle

    2016-04-01

    The lightning climatology of the Congo Basin including several countries of Central Africa is analyzed in detail for the first time. It is based on World Wide Lightning Location Network (WWLLN) data for the period from 2005 to 2013. A comparison of these data with the Lightning Imaging Sensor (LIS) data for the same period shows the WWLLN detection efficiency (DE) in the region increases from about 1.70 % in the beginning of the period to 5.90 % in 2013, relative to LIS data, but not uniformly over the whole 2750 km × 2750 km area. Both the annual flash density and the number of stormy days show sharp maximum values localized in eastern of Democratic Republic of Congo (DRC) and west of Kivu Lake, regardless of the reference year and the period of the year. These maxima reach 12.86 fl km-2 and 189 days, respectively, in 2013, and correspond with a very active region located at the rear of the Virunga mountain range characterised with summits that can reach 3000 m. The presence of this range plays a role in the thunderstorm development along the year. The estimation of this local maximum of the lightning density by taking into account the DE, leads to a value consistent with that of the global climatology by Christian et al. (2003) and other authors. Thus, a mean maximum value of about 157 fl km-2 y-1 is found for the annual lightning density. The zonal distribution of the lightning flashes exhibits a maximum between 1°S and 2°S and about 56 % of the flashes located below the equator in the 10°S - 10°N interval. The diurnal evolution of the flash rate has a maximum between 1400 and 1700 UTC, according to the reference year, in agreement with previous works in other regions of the world.

  13. Arterial embolization therapy of traumatic renal hemorrhage

    International Nuclear Information System (INIS)

    Wu Changxu; Chen Xiaolin; Huang Changhai; Pu Ge

    2000-01-01

    Objective: To study the angiographic manifestations and arterial embolizatin for traumatic renal hemorrhage when conservative treatment had failed. methods: 5 cases, all male, ranging in age from 12-29 years. All cases had history of injury. the main symptoms included severe abdominal pain, hematuria or coffee colored urine, rapid heart rate, hypotension. 3 suffered hemorrhagic shock. All cases underwent angiographic exam and the diagnosis was confirmed. Embolization materials were mainly self-blood clot and gelfoam. Results: Symptoms in all cases subsided quickly after embolization. Blood pressure recovered to normal within 12 hours; Hematuresis and abdominal pain disappeared or reduced in 1-2 days. One month later, intravenous urographic exam revealed recovered function of the injured kidneys. Conclusion: Renal arterial embolization in treating traumatic renal hemorrhage can control the bleeding while preserving the injured kidneys

  14. Frequency and determinants for hemorrhagic transformation of posterior cerebral stroke : Posterior ischemic stroke and hemorrhagic transformation.

    Science.gov (United States)

    Valentino, Francesca; Gentile, Luana; Terruso, Valeria; Mastrilli, Sergio; Aridon, Paolo; Ragonese, Paolo; Sarno, Caterina; Savettieri, Giovanni; D'Amelio, Marco

    2017-11-13

    hemorrhagic transformation is a threatening ischemic stroke complication. Frequency of hemorrhagic transformation differs greatly among studies, and its risk factors have been usually studied in patients with anterior ischemic stroke who received thrombolytic therapy. We evaluated, in a hospital-based series of patients with posterior ischemic stroke not treated with thrombolysis, frequency and risk factors of hemorrhagic transformation. Patients with posterior circulation stroke were seen in our Department during the period January 2004 to December 2009. Demographic and clinical information were collected. We estimated risk for spontaneous hemorrhagic transformation by means of uni- and multivariate logistic regression analyses. 119 consecutive patients were included (73 males, 61.3%). Hemorrhagic transformation was observed in 7 patients (5.9%). Only clinical worsening was significantly associated with hemorrhagic transformation (OR 6.8, 95% CI 1.3-34.5). Our findings indicate that patients with posterior have a low risk of spontaneous hemorrhagic transformation, suggesting that these patients might have greater advantage from intravenous thrombolysis.

  15. [Approach to sexuality in an AIDS context in Congo].

    Science.gov (United States)

    Courtois, R; Mullet, E; Malvy, D

    2001-01-01

    The pandemic due to the human immunodeficiency virus (HIV) is extensive in Sub-Saharan Africa and especially in Congo. Congo is a small country on the Atlantic coast and characterized by plentiful equatorial forests and low population density (essentially urban). In Congo, there is a high prevalence of HIV. The social and economic consequences of AIDS add to those of a recent civil war in 1997. There were fratricidal confrontations before and after this period. These confrontations have led to a massive exodus of the inhabitants of the capital, Brazzaville, to the forests and neighbouring cities, essentially towards Pointe-Noire. Pointe-Noire, chief place of the region of Kouilou, in the South of the country, is the second city of Congo and the economic Capital. It is undoubtedly for this reason that it has been globally saved. In this context, a sanitary policy of prevention of sexual risky behavior can appear as a challenge. While it supposes a better knowledge of the sexual activity of the young people, it cannot be dissociated from the analysis of the other factors. These factors can be of socio-economic political or cultural order. Thus the influence of cultural variables in the field of sexuality is certainly preponderant in African countries, where sexuality is taboo. Sexuality is a private matter (personal intimacy and the couple), but concerns also the family (in the sense of membership in an extended domestic group or in a system of relationship) in its aspects related to procreation and to the social field (power, alliances). Such individual behaviour can be lived as a questioning of the social order. In this article, the authors question the place of sexuality in Congo, particularly based on the work of anthropologists [2, 6, 7, 9]. Research in the field of sexuality at adolescence is rather recent in France and investigations that have been done in Congo these last ten years do not exist. Meetings and exchanges in 1998 with high-school pupils and

  16. Characterization of Terrestrial Water Dynamics in the Congo Basin Using GRACE and Satellite Radar Altimetry

    Science.gov (United States)

    Lee, Lyongki; Beighley, R. Edward; Alsdorf, Douglas; Jung, Hahn Chul; Shum, C. K.; Duan, Jianbin; Guo, Junyi; Yamazaki, Dai; Andreadis, Konstantinos

    2011-01-01

    The Congo Basin is the world's third largest in size (approximately 3.7 million km^2), and second only to the Amazon River in discharge (approximately 40,200 cms annual average). However, the hydrological dynamics of seasonally flooded wetlands and floodplains remains poorly quantified. Here, we separate the Congo wetland into four 3 degree x 3 degree regions, and use remote sensing measurements (i.e., GRACE, satellite radar altimeter, GPCP, JERS-1, SRTM, and MODIS) to estimate the amounts of water filling and draining from the Congo wetland, and to determine the source of the water. We find that the amount of water annually filling and draining the Congo wetlands is 111 km^3, which is about one-third the size of the water volumes found on the mainstem Amazon floodplain. Based on amplitude comparisons among the water volume changes and timing comparisons among their fluxes, we conclude that the local upland runoff is the main source of the Congo wetland water, not the fluvial process of river-floodplain water exchange as in the Amazon. Our hydraulic analysis using altimeter measurements also supports our conclusion by demonstrating that water surface elevations in the wetlands are consistently higher than the adjacent river water levels. Our research also highlights differences in the hydrology and hydrodynamics between the Congo wetland and the mainstem Amazon floodplain.

  17. Congo grass grown in rotation with soybean affects phosphorus bound to soil carbon

    Directory of Open Access Journals (Sweden)

    Alexandre Merlin

    2014-06-01

    Full Text Available The phosphorus supply to crops in tropical soils is deficient due to its somewhat insoluble nature in soil, and addition of P fertilizers has been necessary to achieve high yields. The objective of this study was to examine the mechanisms through which a cover crop (Congo grass - Brachiaria ruziziensis in rotation with soybean can enhance soil and fertilizer P availability using long-term field trials and laboratory chemical fractionation approaches. The experimental field had been cropped to soybean in rotation with several species under no-till for six years. An application rate of no P or 240 kg ha-1 of P2O5 had been applied as triple superphosphate or as Arad rock phosphate. In April 2009, once more 0.0 or 80.0 kg ha-1 of P2O5 was applied to the same plots when Congo grass was planted. In November 2009, after Congo grass desiccation, soil samples were taken from the 0-5 and 5-10 cm depth layer and soil P was fractionated. Soil-available P increased to the depth of 10 cm through growing Congo grass when P fertilizers were applied. The C:P ratio was also increased by the cover crop. Congo grass cultivation increased P content in the soil humic fraction to the depth of 10 cm. Congo grass increases soil P availability by preventing fertilizer from being adsorbed and by increasing soil organic P.

  18. ADSORPSI CONGO RED PADA HUMIN HASIL ISOLASI DARI TANAH HUTAN DAMAR BATURRADEN PURWOKERTO

    Directory of Open Access Journals (Sweden)

    Roy Andreas

    2008-05-01

    Full Text Available Congo red is one of dyes-stuff in textile industry wastwater. If it is thrown directly without waste management process, the dyes could pollute environtment, especially soil. Humin has OH phenolic and carboxylic functional group which can interacted with congo red. The aim of this study is recognize humin characteristic from the soil of Baturraden resin forest, determine the adsorption capacity and isotherm adsorption pattern of congo red by humin from the soil of Baturraden resin forest. Humin in this study is isolated from the soil of Baturraden resin forest. soil cleared of gravel and dirt, then it extracted by using NaOH of nitrogen atmosphere and purified to applies mixture HCl:HF. Humin that is obtained is used to be interacted with dyes with various contact time, various of pH and concentration of congo red so that the adsorption capacities and isotherm adsorption pattern can be obtained. Result of the study showed that the humin has water content 34.92 %, dust content 8.64 %, total acidity 475 cmol/Kg, carboxylic rate 272.5 cmol/Kg, and OH Phenolic rate 202.5 cmol/Kg. The optimum contact time of congo red adsorption by humin is 40 minutes, with optimum pH is 7, adsorption capacities 57.14 mg/g and isotherm adsorption pattern of congo red by humin is follow the pattern of Langmuir isotherm adsorption.

  19. Alterations of Mg2+ After Hemorrhagic Shock.

    Science.gov (United States)

    Lee, Mun-Young; Yang, Dong Kwon; Kim, Shang-Jin

    2017-11-01

    Hemorrhagic shock is generally characterized by hemodynamic instability with cellular hypoxia and diminishing cellular function, resulting from an imbalance between systemic oxygen delivery and consumption and redistribution of fluid and electrolytes. Magnesium (Mg) is the fourth most abundant cation overall and second most abundant intracellular cation in the body and an essential cofactor for the energy production and cellular metabolism. Data for blood total Mg (tMg; free-ionized, protein-bound, and anion-bound forms) and free Mg 2+ levels after a traumatic injury are inconsistent and only limited information is available on hemorrhagic effects on free Mg 2+ as the physiologically active form. The aim of this study was to determine changes in blood Mg 2+ and tMg after hemorrhage in rats identifying mechanism and origin of the changes in blood Mg 2+ . Hemorrhagic shock produced significant increases in blood Mg 2+ , plasma tMg, Na + , K + , Cl - , anion gap, partial pressures of oxygen, glucose, and blood urea nitrogen but significant decreases in RBC tMg, blood Ca 2+ , HCO 3 - , pH, partial pressures of carbon dioxide, hematocrit, hemoglobin, total cholesterol, and plasma/RBC ATP. During hemorrhagic shock, K + , anion gap, and BUN showed significant positive correlations with changes in blood Mg 2+ level, while Ca 2+ , pH, and T-CHO correlated to Mg 2+ in a negative manner. In conclusion, hemorrhagic shock induced an increase in both blood-free Mg 2+ and tMg, resulted from Mg 2+ efflux from metabolic damaged cell with acidosis and ATP depletion.

  20. Differences in Neuropeptide Y Secretion Between Intracerebral Hemorrhage and Aneurysmal Subarachnoid Hemorrhage.

    Science.gov (United States)

    Schebesch, Karl-M; Bründl, Elisabeth; Schödel, Petra; Hochreiter, Andreas; Scheitzach, Judith; Bele, Sylvia; Brawanski, Alexander; Störr, Eva-M; Lohmeier, Anette; Proescholdt, Martin

    2017-07-01

    Neuropeptide Y (NPY) is one of the most potent endogenous vasoconstrictors, and its contribution to the multifactorial cascade of cerebral vasospasm due to nontraumatic subarachnoid hemorrhage (SAH) is not yet fully understood. This experimental study compared the hemorrhage-specific course of NPY secretion into cerebrospinal fluid (CSF) and into plasma between 2 groups: patients with SAH and patients with basal ganglia hemorrhage (BGH) or cerebellar hemorrhage (CH) over the first 10 days after hemorrhage. Seventy-nine patients were prospectively included: SAH patients (n=66) (historic population) and intracerebral hemorrhage patients (n=13). All patients received an external ventricular drain within 24 hours of the onset of bleeding. CSF and plasma were drawn daily from day 1 to day 10. The levels of NPY were determined by means of competitive enzyme immunoassay. The CSF samples of 29 patients (historic population) who had undergone spinal anesthesia due to orthopedic surgery served as the control group. NPY levels in CSF were significantly higher in the 2 hemorrhage groups than in the control group. However, the 2 hemorrhage groups showed significant differences in NPY levels in CSF (SAH mean, 0.842 ng/mL vs. BGH/CH mean, 0.250 ng/mL; P<0.001) as well as in the course of NPY secretion into CSF over the 10-day period. NPY levels in plasma did not differ significantly among SAH, BGH/CH, and controls. Our findings support the hypothesis that excessive release of NPY into CSF but not into plasma is specific to aneurysmal SAH in the acute period of 10 days after hemorrhage. In BGH/CH, CSF levels of NPY were also increased, but the range was much lower.

  1. Early Vitrectomy for Vitreous Hemorrhage Associated With Retinal Tears

    NARCIS (Netherlands)

    Tan, H. Stevie; Mura, Marco; Bijl, Heico M.

    2010-01-01

    PURPOSE: To evaluate outcome of early surgery in vitreous hemorrhage, presumably associated with retinal tears. DESIGN: Retrospective, noncomparative interventional case series. METHODS: We included 40 consecutive cases in 39 patients treated with early vitrectomy for vitreous hemorrhage. Main

  2. Magnetic resonance appearance of adrenal hemorrhage in a neonate

    International Nuclear Information System (INIS)

    Willemse, A.P.P.; Feldberg, M.A.M.; Witkamp, T.D.; Coppes, M.J.; Kramer, P.P.G.

    1989-01-01

    The Magnetic Resonance (MR) appearance of adrenal hemorrhage in a neonate is described and compared with Ultrasound (US). The value of US studies in adrenal neonatal hemorrhage is well known. We present the MR appearance of this common condition. (orig.)

  3. Hemorrhage Detection and Segmentation in Traumatic Pelvic Injuries

    Science.gov (United States)

    Davuluri, Pavani; Wu, Jie; Tang, Yang; Cockrell, Charles H.; Ward, Kevin R.; Najarian, Kayvan; Hargraves, Rosalyn H.

    2012-01-01

    Automated hemorrhage detection and segmentation in traumatic pelvic injuries is vital for fast and accurate treatment decision making. Hemorrhage is the main cause of deaths in patients within first 24 hours after the injury. It is very time consuming for physicians to analyze all Computed Tomography (CT) images manually. As time is crucial in emergence medicine, analyzing medical images manually delays the decision-making process. Automated hemorrhage detection and segmentation can significantly help physicians to analyze these images and make fast and accurate decisions. Hemorrhage segmentation is a crucial step in the accurate diagnosis and treatment decision-making process. This paper presents a novel rule-based hemorrhage segmentation technique that utilizes pelvic anatomical information to segment hemorrhage accurately. An evaluation measure is used to quantify the accuracy of hemorrhage segmentation. The results show that the proposed method is able to segment hemorrhage very well, and the results are promising. PMID:22919433

  4. Fatal hemorrhage in irr[iated esophageal cancer patients

    International Nuclear Information System (INIS)

    Nemoto, Kenji; Takai, Yoshihiro; Ogawa, Yoshihiro; Kakuto, Yoshihisa; Ariga, Hisanori; Matsushita, Haruo; Wada, Hitoshi; Yamada, Shogo

    1998-01-01

    Between 1980 and 1994, 423 patients with esophageal cancer were given curative r[iation therapy. Of these patients, 31 died of massive hemorrhage and were used as the subjects of analysis in this study. The incidence of massive hemorrhage in all patients was 7% (31/423). In the 31 patients who died of massive hemorrhage, 27 h[ local tumors and two h[ no tumors at hemorrhage (two unknown cases). The mean time interval from the start of r[iation to hemorrhage was 9.2 months. In 9 autopsy cases the origin of hemorrhage was a tear of the aorta in 5 cases, necrotic local tumor in 3 cases and esophageal ulcer in 1 case. The positive risk factors for this complication seemed to be excess total dose, infection, metallic stent, and tracheoesophageal fistula. Chest pain or sentinel hemorrhage proceeding to massive hemorrhage was observed in about half of the patients. (orig.)

  5. Two cases of neonatal adrenal hemorrhage presenting with persistent jaundice.

    Science.gov (United States)

    Ruffini, E; De Petris, L; Zorzi, G; Paoletti, P; Mambelli, G; Carlucci, A

    2013-01-01

    The adrenal hemorrhage is a relatively rare event in newborns but must be considered in the presence of a persistent unexplained jaundice, especially in presence of predisposing factors. Serial ultrasonography is the modality of choice for initial diagnosis and follow-up of neonatal adrenal hemorrhage. We report two cases of neonatal adrenal hemorrhage presenting with persistent jaundice. The causes of the neonatal adrenal hemorrhages were a difficult vaginal delivery in macrosomic infant and a neonatal infection.

  6. Hemorrhage-adjusted iron requirements, hematinics and hepcidin define hereditary hemorrhagic telangiectasia as a model of hemorrhagic iron deficiency.

    Directory of Open Access Journals (Sweden)

    Helen Finnamore

    Full Text Available Iron deficiency anemia remains a major global health problem. Higher iron demands provide the potential for a targeted preventative approach before anemia develops. The primary study objective was to develop and validate a metric that stratifies recommended dietary iron intake to compensate for patient-specific non-menstrual hemorrhagic losses. The secondary objective was to examine whether iron deficiency can be attributed to under-replacement of epistaxis (nosebleed hemorrhagic iron losses in hereditary hemorrhagic telangiectasia (HHT.The hemorrhage adjusted iron requirement (HAIR sums the recommended dietary allowance, and iron required to replace additional quantified hemorrhagic losses, based on the pre-menopausal increment to compensate for menstrual losses (formula provided. In a study population of 50 HHT patients completing concurrent dietary and nosebleed questionnaires, 43/50 (86% met their recommended dietary allowance, but only 10/50 (20% met their HAIR. Higher HAIR was a powerful predictor of lower hemoglobin (p = 0.009, lower mean corpuscular hemoglobin content (p<0.001, lower log-transformed serum iron (p = 0.009, and higher log-transformed red cell distribution width (p<0.001. There was no evidence of generalised abnormalities in iron handling Ferritin and ferritin(2 explained 60% of the hepcidin variance (p<0.001, and the mean hepcidinferritin ratio was similar to reported controls. Iron supplement use increased the proportion of individuals meeting their HAIR, and blunted associations between HAIR and hematinic indices. Once adjusted for supplement use however, reciprocal relationships between HAIR and hemoglobin/serum iron persisted. Of 568 individuals using iron tablets, most reported problems completing the course. For patients with hereditary hemorrhagic telangiectasia, persistent anemia was reported three-times more frequently if iron tablets caused diarrhea or needed to be stopped.HAIR values, providing an indication of

  7. The influence of Congo River discharges in the surface and deep layers of the Gulf of Guinea

    OpenAIRE

    Vangriesheim, A.; Pierre, C.; Aminot, A.; Metzl, N.; Baurand, François; Caprais, J. C.

    2009-01-01

    The main feature of the Congo-Angola margin in the Gulf of Guinea is the Congo (ex-Zaire) deep-sea fan composed of a submarine canyon directly connected to the Congo River, a channel and a [sediment] lobe area. During the multi-disciplinary programme called BIOZAIRE conducted by Ifremer from 2000 to 2005, two CTD-O2 sections with discrete water column samples were performed (BIOZAIRE3 cruise: 2003-2004) to study the influence of the Congo River discharges, both in the surface layer and in the...

  8. Spinal vascular malformations in non-perimesencephalic subarachnoid hemorrhage

    NARCIS (Netherlands)

    Germans, M. R.; Pennings, F. A.; Sprengers, M. E. S.; Vandertop, W. P.

    2008-01-01

    OBJECTIVE: In patients with non-traumatic subarachnoid hemorrhage (SAH) and no evidence for a cerebral aneurysm on angiography, a frequent cause of the hemorrhage is perimesencephalic hemorrhage or other cerebral vascular pathology. In some patients no cause is found. The exact incidence of a spinal

  9. Angiographic diagnosis of hemorrhage tumours of the small intestine

    International Nuclear Information System (INIS)

    Vadon, G.; Ehngloner, L.; Petri, K.

    1980-01-01

    2 angiographic investigations in small intestine tumors, accompanied with hemorrhage are considered. Conclusion is made that the most suitable moment for estimation of small intestine hemorrhage, according to the proper and literature data, is selective angiography. Wide application of the technique for preoperative detection of gastro-inestinal hemorrhage is recommended

  10. Gestion participative du sanctuaire de gorilles de plaine de l'ouest (Gorilla gorilla gorilla de Lossi en République du Congo- Brazzaville: première analyse de résultats et des contraintes

    Directory of Open Access Journals (Sweden)

    Mbété, RA.

    2007-01-01

    Full Text Available Participative Management of the Sanctuary of Western Lowland Gorillas (Gorilla gorilla gorilla of Lossi in Republic of Congo-Brazzaville: Preliminary Results and Constraints Analysis. The gorilla sanctuary of Lossi experiments the synergy between scientific research and nature conservation. Three partners are involved in a management participative process. These partners include the Republic of Congo, the local community of Lossi and the European programme on the forest ecosystems in Central Africa. An investigation was carried out on the sanctuary of Lossi in 2003, in order to study in situ the effects generated by the participative management and to identify the constraints linked to the participative approach. The work of primatologists allowed the habituation of the gorillas to the human presence and opened eyesight tourism of western lowland gorillas. A camp for tourists and the access road to the sanctuary have been constructed. The tourism generated jobs in favour of the local population which is also a take-partner of contracts on road repairing. The income from the tourism allowed the construction of a health centre. However, the works of researchers and tourism activities failed during the outbreaks of the Ebola hemorrhagic fever and during the three civil war episodes. The consolidation and the long term of this process of co-management of natural resources of Lossi remains the establishment of a management that should include conservation, rural development and scientific research, with equitably in the distribution of gain between the partnerses.

  11. Ethnic Disparities in Ischemic Stroke, Intracerebral Hemorrhage, and Subarachnoid Hemorrhage Incidence in The Netherlands

    DEFF Research Database (Denmark)

    Agyemang, Charles; van Oeffelen, Aloysia A M; Nørredam, Marie Louise

    2014-01-01

    BACKGROUND AND PURPOSE: Data on the incidence of stroke subtypes among ethnic minority groups are limited. We assessed ethnic differences in the incidence of stroke subtypes in the Netherlands. METHODS: A Dutch nationwide register-based cohort study (n=7 423 174) was conducted between 1998 and 2010....... We studied the following stroke subtypes: ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. Cox proportional hazard models were used to estimate incidence differences between first-generation ethnic minorities and the Dutch majority population (ethnic Dutch). RESULTS: Compared.......16-0.72), and subarachnoid hemorrhage (0.42; 0.20-0.88 and 0.34; 0.17-0.68) compared with ethnic Dutch counterparts. The results varied by stroke subtype and sex for the other minority groups. For example, Turkish women had a reduced incidence of subarachnoid hemorrhage, whereas Turkish men had an increased incidence...

  12. [Selective embolization to treat obstetric hemorrhage].

    Science.gov (United States)

    Ferrer Puchol, M D; Lanciego, C; Esteban, E; Ciampi, J J; Edo, M A; Ferragud, S

    2014-01-01

    To describe cases of obstetric hemorrhage that have called for selective intra-arterial embolization and the different embolization techniques used. To assess the clinical outcomes and postprocedural fertility. We studied 27 women with obstetric hemorrhage. In 24 patients, embolization was performed by catheterizing both uterine arteries and in 2 patients only one uterine artery was catheterized (pseudoaneurysm). The materials used for embolization consisted of Spongostan in 17/27, particles in 9/27, and coils in 1/27. Clinical follow-up included an analysis of early and late complications and of postprocedural fertility. Hemorrhage was classified as primary (25/27) or secondary (2/27). The cause of bleeding was vaginal delivery (20), cesarean sections (5), abortion (1), and cervical ectopic pregnancy (1). The initial technical success rate was 100% and the clinical success rate was 92.6% (25 of the 27 patients). Bleeding ceased and the outcome was satisfactory in 25 patients. During clinical follow-up ranging from one to seven years, 23 patients had normal menstruation and 6 patients completed 7 full-term pregnancies. Intra-arterial embolization for obstetric hemorrhage leads to good outcomes and few complications and it preserves fertility. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  13. Alkhurma Hemorrhagic Fever in Saudi Arabia

    Centers for Disease Control (CDC) Podcasts

    2010-10-28

    This podcast looks at the epidemiologic characteristics of Alkhurma Hemorrhagic Fever in humans in Najran City, Saudi Arabia. CDC epidemiologist Dr. Adam MacNeil discusses the severity and risk factors for the illness.  Created: 10/28/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/17/2010.

  14. Hereditary hemorrhagic telangiectasia clinical and molecular genetics

    NARCIS (Netherlands)

    Letteboer, T.G.W.

    2010-01-01

    Hereditary hemorrhagic telangiectasia (HHT) or Rendu-Osler-Weber (ROW) syndrome is an autosomal dominant disease characterized by vascular malformations in multiple organ systems. HHT has an age-related penetrance and variable clinical expression. The clinical symptoms are caused by direct

  15. Symptomatic hemorrhagic complications associated with dural substitutes

    Directory of Open Access Journals (Sweden)

    Po-Yuan Chen

    2018-01-01

    Conclusion: The increased risk of hemorrhagic complications associated with craniotomy is modified by choice of dural replacement. Our results could assist clinicians in their decision-making with respect to the optimal timing for synthetic dural substitutes in patients with tumor infiltration of the patient's dura, severe brain swelling in traumatic brain injury, or a result of shrinkage from exposure and electrocautery.

  16. Continuous EEG Monitoring in Aneurysmal Subarachnoid Hemorrhage

    DEFF Research Database (Denmark)

    Kondziella, Daniel; Friberg, Christian Kærsmose; Wellwood, Ian

    2015-01-01

    BACKGROUND: Continuous EEG (cEEG) may allow monitoring of patients with aneurysmal subarachnoid hemorrhage (SAH) for delayed cerebral ischemia (DCI) and seizures, including non-convulsive seizures (NCSz), and non-convulsive status epilepticus (NCSE). We aimed to evaluate: (a) the diagnostic...

  17. Russia and Mexico in the 19th – Beginning of the 20th Century: on the Crimean War’s Influence on Russia-Mexico Relations

    Directory of Open Access Journals (Sweden)

    Olga Yu. Redkina

    2016-12-01

    Full Text Available The article deals with the prerequisites and establishment of the first Russia-Mexico contacts, which took place after the Crimean War (1853-1856. It was revealed that Mexico’s interest in the collaboration with Russia began to reveal in a higher degree after the Crimean War. The factors, which had led to the diplomatic rapprochement of the two states, include the Mexico’s search for allies in the contradiction to increased aggression of European states and the USA in the Central American region, and the increase of Russian intellectuals’ emigration, resettlement of religious groups of the Old Russian sectarians to the region. At the turn of 19th – 20th centuries many Russian travelers and writers, such as S.D. Protopopov and K.D. Balmont, visited Mexico for the purpose of studying the culture of ancients Indians, who lived in Central America during many centuries before the Spanish colonization. Besides of the impressions on ancient Indian culture, these travelers described the life of ordinary Mexican people of that time. They mentioned their poverty and hopelessness in the years of Porfirio Dias’s dictatorship. Nevertheless, political and cultural contacts had begun to established in the late 19th century between the Russian Empire and Mexico, because after the Crimean War the Mexico’s interest to Russians increased. In addition, Russia tried to strengthen its position in Central American region. In total, these factors had led to the strengthening of political, social and cultural contacts between Russia and Mexico.

  18. Derin Paşaoǧlu D. Genealogy of the Crimean Khans according to “Umdet al-Akhbar” by Abdulgaffar Kyrymi

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    Derya Derin Paşaoǧlu

    2017-03-01

    Full Text Available The article considers the genealogy of the Girayids contained in “Umdet al-Akhbar” by Abdulgaffar Kyrymi. Abdulgaffar Kyrymi was a great connoisseur of the Turkic-Tatar history. He wrote his historical work in 1747 according to the Ottoman-Turkish tradition, that is, the author gave detailed information about the history of the prophets since Adam, the history of Islam, Islamic Turkic states, the State of Seljuks and the Ottoman State, Chinggis Khan and his sons. Moreover, he collected most of the information from local sources of that period. But the main part of the work contains the history of Juchi Khan, his children and the history of the Crimea. It is for this reason that Abdulgaffar Kyrymi gives such a detailed genealogy of the Girayids and the sequence of their rules in the Crimean Khanate. Abdulgaffar Kyrymi’s genealogy begins with Chinggis Khan and his daughters (Kuchi Bike, Chechgan Bigim, Tumalyn Bigim, Elyatun Bigim, Turaly Bigim as well as with his 500 wives. But only five of them were respected: Borte Kuchin Biim, Kulan Bigim, Suyugan Khatun Bigim, Kökchi Bigim, Jeksulu Bigim. List of the Crimean dynasty of the Girayids is offered here to specialists, beginning with Haji Giray to Arslan Giray. Comparison of the list of the Girayid khans contained in “Umdet al-Akhbar” with researches on this topic reveals some differences. In the opinion of the author, to solve these problems, along with genealogical and other narrative sources, it is also necessary to use the numismatics data and a large corpus of letters of the Crimean khans to the rulers of various countries.

  19. Russian Chronicles and Diplomatic Documents on the Moscow-Crimean-Kazan Relations at the end of the 15th – the first half of the 16th centuries

    Directory of Open Access Journals (Sweden)

    A.V. Aksanov

    2016-12-01

    Full Text Available Research objective: The article analyzes chronicles’ and diplomatic information about joining of the Kazan Khanate to the Moscow-Crimean alliance in 1487, about the joint actions of these three states against the Great Horde in 1491–1492 and about the Moscow-Crimean-Kazan peace negotiations of 1537–1542. Research materials: Special attention is given to inconsistencies in the sources that often has not been considered in the historiography. In official chronicles the campaign of 1487 marks the submission of Kazan. Whereas diplomatic documents represent the expedition of the Moscow troops of 1487 as the military aid of Ivan III to the khan Mahomed-Amin in his struggle for the Kazan throne. According to official chronicles, in 1491 the Kazan khan warred against the Horde on the side of the Crimea by the order of the Moscow sovereign. In turn, in the Novgorod chronicle the campaign of 1491 is represented as the act of the help of Ivan III to the sultan Satylgan and khan Mahomed-Amin in their fight against the Great Horde. The data of diplomatic documents are consistent with the estimate of the Novgorod chronicle. Research results and novelty: Therefore, it can be assumed that Mahomed-Amin participated in the war against the Great Horde as he was in allied relations with Moscow and the Crimea. Diplomatic documents confirm the point of view of official chroniclers of rather intermediary role of the Crimean khan in the Moscow-Kazan negotiations of 1537–1542. Thus, they display a completely different character of the relations between Moscow, the Crimea and Kazan. The Moscow boyars demanded from the Kazan khan to recognize the supremacy of the Moscow sovereign. In turn, the governors of the Crimea and Kazan called for equal relations. Possibly, this contradiction was the main reason for a failure of the peace negotiations.

  20. The Efforts to Reintroduce the Mongol Tradition in the Crimean Khanate at the beginning of the 17th century: Baysa, Tat ve Tavgach »

    Directory of Open Access Journals (Sweden)

    Dariusz Kołodziejczyk

    2015-09-01

    Full Text Available The author examines the different ways, by which foreign borrowings were adopted in the Office of the Crimean Khanate. On the one hand, Tatars adopted specimens from the Moscow and Polish-Lithuanian Chancelleries (e.g. pendant seal, on the other hand, they sought to maintain and even restore ancient terminology related to the Genghisid and Central Asian tradition. Baysa with inscription providing certain rights and privileges on behalf of the ruler was used in the Genghisid Empire and ulus of Jochi. The first Crimean Tatar document, where we meet the term baysa, is a Charter of Shert sent by khan Mehmed III Giray to tsar Mikhail Fedorovich Romanov in September 1624. In 1634, Janibek Giray also wrote about the “golden baysa” apparently as a synonym of seal. Until the mid–17th century, mention of baysa occurs only in the text of the Crimean Charters of Shert sent to Moscow. From 1654, charters with a golden baysa was sent to the Polish king as well. A new form of solemn khan’s charters began to change under the influence of the development of office practice in Moscow and Warsaw. In the same period in the khan’s intitulation appears the formula “the great Padishah of Tat ve Tavgach” – new elements related to the Genghisid and ancient Turkic tradition of Central Asia. Consequently, according to the author, the latter change could be associated with the activities of Shahin Giray and his stay in Persia, or this innovation was imported from the Siberian Khanate.

  1. Unraveling the distinctive features of hemorrhagic and non-hemorrhagic snake venom metalloproteinases using molecular simulations

    Science.gov (United States)

    de Souza, Raoni Almeida; Díaz, Natalia; Nagem, Ronaldo Alves Pinto; Ferreira, Rafaela Salgado; Suárez, Dimas

    2016-01-01

    Snake venom metalloproteinases are important toxins that play fundamental roles during envenomation. They share a structurally similar catalytic domain, but with diverse hemorrhagic capabilities. To understand the structural basis for this difference, we build and compare two dynamical models, one for the hemorrhagic atroxlysin-I from Bothrops atrox and the other for the non-hemorraghic leucurolysin-a from Bothrops leucurus. The analysis of the extended molecular dynamics simulations shows some changes in the local structure, flexibility and surface determinants that can contribute to explain the different hemorrhagic activity of the two enzymes. In agreement with previous results, the long Ω-loop (from residue 149 to 177) has a larger mobility in the hemorrhagic protein. In addition, we find some potentially-relevant differences at the base of the S1' pocket, what may be interesting for the structure-based design of new anti-venom agents. However, the sharpest differences in the computational models of atroxlysin-I and leucurolysin-a are observed in the surface electrostatic potential around the active site region, suggesting thus that the hemorrhagic versus non-hemorrhagic activity is probably determined by protein surface determinants.

  2. Therapeutic efficacy of uterine arterial embolization for intractable uterine hemorrhage

    International Nuclear Information System (INIS)

    Liu Lang; Lu Lianwei; Ke Mengjia; Zhao Ru'en; Zeng Shaolan

    2010-01-01

    Objective: To evaluate the therapeutic efficacy of uterine arterial embolization (UAE) for intractable uterine hemorrhage. Methods: 16 patients with intractable uterine hemorrhage underwent bilateral UAE after failed conventional conservative treatment. Results: Uterine hemorrhage ceased within 12 hours in 15 patients (93.8%) after bilateral super-selective UAE. Internal iliac artery embolization was performed on one patient (6.2%) and hysterectomy was eventually carried out because of recurrent hemorrhage. Conclusion: UAE is a rapid and effective treatment method obviating hysterectomy for intractable uterine hemorrhage. (authors)

  3. Lesula: a new species of Cercopithecus monkey endemic to the Democratic Republic of Congo and implications for conservation of Congo's central basin.

    Directory of Open Access Journals (Sweden)

    John A Hart

    Full Text Available In June 2007, a previously undescribed monkey known locally as "lesula" was found in the forests of the middle Lomami Basin in central Democratic Republic of Congo (DRC. We describe this new species as Cercopithecus lomamiensis sp. nov., and provide data on its distribution, morphology, genetics, ecology and behavior. C. lomamiensis is restricted to the lowland rain forests of central DRC between the middle Lomami and the upper Tshuapa Rivers. Morphological and molecular data confirm that C. lomamiensis is distinct from its nearest congener, C. hamlyni, from which it is separated geographically by both the Congo (Lualaba and the Lomami Rivers. C. lomamiensis, like C. hamlyni, is semi-terrestrial with a diet containing terrestrial herbaceous vegetation. The discovery of C. lomamiensis highlights the biogeographic significance and importance for conservation of central Congo's interfluvial TL2 region, defined from the upper Tshuapa River through the Lomami Basin to the Congo (Lualaba River. The TL2 region has been found to contain a high diversity of anthropoid primates including three forms, in addition to C. lomamiensis, that are endemic to the area. We recommend the common name, lesula, for this new species, as it is the vernacular name used over most of its known range.

  4. Functional recovery and surgical indication in putaminal hemorrhage

    International Nuclear Information System (INIS)

    Fujitsu, Kazuhiko

    1983-01-01

    Forty-one cases of varied sized putaminal hemorrhage were classified into 4 types according to the precise localization on CT (Fig. 1). All cases with large-sized hemorrhage (more than 4-5 cm in the actual diameter) were treated surgically regardless of their types in CT classification. ADL was assessed 6 months after the onset in all 41 cases, and in 17 of these Standard Language Test of Aphasia (SLTA) was also given 1 to 3 months after the dominant hemispheric hemorrhage. Type I hemorrhage usually showed excellent ADL independently of the size of the hemorrhage (Table 3). In type II hemorrhage, the ADL is determined by the extent of the lesion and tended to deteriorate as the size of the hemorrhage increased (Table 4). Type III hemorrhage resumed less favorable ADL than the type II did (Table 5), and there was scarcely any functional recovery in Type IV hemorrhage (Table 6). On SLTA, impairment of the speaking ability was the prominant feature when the hemorrhage was primarily located in the anterior portion of the insula, while the hearing ability was more markedly impaired in the posteriorly located lesion. These location-dependent specific patterns of impairment on SLTA are schematically presented in Fig. 12. From these results described above, the author's CT classification is considered to be very useful not only in forecasting the prospects of functional recovery, but in determining the surgical indication in putaminal hemorrhage. (author)

  5. Arterial spin-labeling MR imaging of cerebral hemorrhages

    International Nuclear Information System (INIS)

    Noguchi, Tomoyuki; Nishihara, Masashi; Egashira, Yoshiaki; Azama, Shinya; Hirai, Tetsuyoshi; Kitano, Isao; Irie, Hiroyuki; Yakushiji, Yusuke; Kawashima, Masatou

    2015-01-01

    The purpose of this study is to identify the characteristics of brain perfusion measured by arterial spin-labeling magnetic resonance imaging (ASL-MRI) in cerebral hemorrhages. Brain blood flow values (CBF-ASL values) for cerebral and cerebellar hemispheres and segmented cerebral regions were measured by ASL-MRI in 19 putaminal hemorrhage patients and 20 thalamic hemorrhage patients in acute or subacute stages. We assessed the lateralities of CBF-ASL values and the relationships between CBF-ASL values and other imaging findings and clinical manifestations. Both the 19 putaminal hemorrhage patients and the 20 thalamic hemorrhage patients had significantly low CBF-ASL values of the contralateral cerebellum in subacute stage, suggesting that ASL-MRI might delineate crossed cerebellar diaschisis (CCD). Ipsilateral low CBF-ASL values were observed in frontal lobes and thalami with a putaminal hemorrhage and lentiform nuclei, temporal lobes, and parietal lobes with a thalamic hemorrhage, suggesting that ASL-MRI showed the ipsilateral cerebral diaschisis (ICD). In the putaminal hemorrhage patients, the hematoma volume negatively affected both the bilateral cerebellar and cerebral hemispheric CBF-ASL values. In the thalamic hemorrhage patients, a concomitant intraventricular hemorrhage caused low cerebral hemispheric CBF-ASL values. The use of ASL-MRI is sensitive to the perfusion abnormalities and could thus be helpful to estimate functional abnormalities in cerebral hemorrhage patients. (orig.)

  6. Arterial spin-labeling MR imaging of cerebral hemorrhages

    Energy Technology Data Exchange (ETDEWEB)

    Noguchi, Tomoyuki [Department of Radiology, National Center for Global Health and Medicine, Tokyo (Japan); Saga University, Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Nishihara, Masashi; Egashira, Yoshiaki; Azama, Shinya; Hirai, Tetsuyoshi; Kitano, Isao; Irie, Hiroyuki [Saga University, Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Yakushiji, Yusuke [Saga University, Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Kawashima, Masatou [Saga University, Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Saga (Japan)

    2015-11-15

    The purpose of this study is to identify the characteristics of brain perfusion measured by arterial spin-labeling magnetic resonance imaging (ASL-MRI) in cerebral hemorrhages. Brain blood flow values (CBF-ASL values) for cerebral and cerebellar hemispheres and segmented cerebral regions were measured by ASL-MRI in 19 putaminal hemorrhage patients and 20 thalamic hemorrhage patients in acute or subacute stages. We assessed the lateralities of CBF-ASL values and the relationships between CBF-ASL values and other imaging findings and clinical manifestations. Both the 19 putaminal hemorrhage patients and the 20 thalamic hemorrhage patients had significantly low CBF-ASL values of the contralateral cerebellum in subacute stage, suggesting that ASL-MRI might delineate crossed cerebellar diaschisis (CCD). Ipsilateral low CBF-ASL values were observed in frontal lobes and thalami with a putaminal hemorrhage and lentiform nuclei, temporal lobes, and parietal lobes with a thalamic hemorrhage, suggesting that ASL-MRI showed the ipsilateral cerebral diaschisis (ICD). In the putaminal hemorrhage patients, the hematoma volume negatively affected both the bilateral cerebellar and cerebral hemispheric CBF-ASL values. In the thalamic hemorrhage patients, a concomitant intraventricular hemorrhage caused low cerebral hemispheric CBF-ASL values. The use of ASL-MRI is sensitive to the perfusion abnormalities and could thus be helpful to estimate functional abnormalities in cerebral hemorrhage patients. (orig.)

  7. CLINICAL AND MORPHOLOGICAL CLASSIFICATION OF CEREBRAL INTRAVENTRICULAR HEMORRHAGES

    Directory of Open Access Journals (Sweden)

    V. V. Vlasyuk

    2013-01-01

    Full Text Available Inconsistency of the current classification of cerebral intraventricular hemorrhages is discussed in the article. The author explains divergence of including of the subependymal (1st stage and intracerebral (4th stage hemorrhages into this classification. A new classification of cerebral intraventricular hemorrhages including their origin, phases and stages is offered. The most common origin of intraventricular hemorrhages is subependymal hemorrhage (82,2%. Two phases of hemorrhage were distinguished: bleeding phase and resorption phase. Stages of intraventricular hemorrhages reflecting the blood movement after the onset of bleeding are the following: 1 — infill of the up to ½ of the lateral ventricles without their enlargement; 2 — infill of more than ½ of the lateral ventricles with their enlargement; 3 — infill of the IV ventricle, of the cerebellomedullary cistern and its dislocation into the subarachnoid space of the cerebellum, pons varolii, medulla oblongata and spinal cord.

  8. Characterization of hemorrhages in the tenderloins of slaughter pigs

    DEFF Research Database (Denmark)

    Dich-Jørgensen, Kristine; McEvoy, Fintan; Larsen, Helle Daugaard

    2016-01-01

    . Furthermore, all columns were radiographed and two were CT scanned. Histologically, the muscle hemorrhages contained cells from bone marrow and growth line cartilage. Ventral epiphysiolysis in either the cranial or caudal epiphysis of the first lumbar vertebrae (L1) in 8 out of the 9 vertebral columns......Muscle hemorrhages are regularly observed in especially the tip of the tenderloin muscles of slaughter pigs. In order to characterize the hemorrhages, a macro- and microscopic examination of tenderloins with (n = 5) and without (n = 4) hemorrhages and the associated vertebral column was carried out...... was present. In the 5 cases with tenderloin hemorrhage, similar hemorrhage with growth line cartilage was found within the fracture of the epiphysis. The hemorrhages develop secondarily to epiphysiolysis in the lumbar vertebrae, where the tenderloin attaches to the spine. The lesions probably develop around...

  9. Trace metal distributions in the sediments from river-reservoir systems: case of the Congo River and Lake Ma Vallée, Kinshasa (Democratic Republic of Congo).

    Science.gov (United States)

    Mwanamoki, Paola M; Devarajan, Naresh; Niane, Birane; Ngelinkoto, Patience; Thevenon, Florian; Nlandu, José W; Mpiana, Pius T; Prabakar, Kandasamy; Mubedi, Josué I; Kabele, Christophe G; Wildi, Walter; Poté, John

    2015-01-01

    The contamination of drinking water resources by toxic metals is a major problem in many parts of the world, particularly in dense populated areas of developing countries that lack wastewater treatment facilities. The present study characterizes the recent evolution with time of some contaminants deposited in the Congo River and Lake Ma Vallée, both located in the vicinity of the large city of Kinshasa, capital of Democratic Republic of Congo (DRC). Physicochemical parameters including grain size distribution, organic matter and trace element concentrations were measured in sediment cores sampled from Congo River (n = 3) and Lake Ma Vallée (n = 2). The maximum concentration of trace elements in sediment profiles was found in the samples from the sites of Pool Malebo, with the values of 107.2, 111.7, 88.6, 39.3, 15.4, 6.1 and 4.7 mg kg(-1) for Cr, Ni, Zn, Cu, Pb, As and Hg, respectively. This site, which is characterized by intense human activities, is especially well known for the construction of numerous boats that are used for regular navigation on Congo River. Concerning Lake Ma Vallée, the concentration of all metals are generally low, with maximum values of 26.3, 53.6, 16.1, 15.3, 6.5 and 1.8 mg kg(-1) for Cr, Ni, Zn, Cu, Pb and As, respectively. However, the comparison of the metal profiles retrieved from the different sampled cores also reveals specific variations. The results of this study point out the sediment pollution by toxic metals in the Congo River Basin. This research presents useful tools for the evaluation of sediment contamination of river-reservoir systems.

  10. Water Level Fluctuations in the Congo Basin Derived from ENVISAT Satellite Altimetry

    Directory of Open Access Journals (Sweden)

    Mélanie Becker

    2014-09-01

    Full Text Available In the Congo Basin, the elevated vulnerability of food security and the water supply implies that sustainable development strategies must incorporate the effects of climate change on hydrological regimes. However, the lack of observational hydro-climatic data over the past decades strongly limits the number of studies investigating the effects of climate change in the Congo Basin. We present the largest altimetry-based dataset of water levels ever constituted over the entire Congo Basin. This dataset of water levels illuminates the hydrological regimes of various tributaries of the Congo River. A total of 140 water level time series are extracted using ENVISAT altimetry over the period of 2003 to 2009. To improve the understanding of the physical phenomena dominating the region, we perform a K-means cluster analysis of the altimeter-derived river level height variations to identify groups of hydrologically similar catchments. This analysis reveals nine distinct hydrological regions. The proposed regionalization scheme is validated and therefore considered reliable for estimating monthly water level variations in the Congo Basin. This result confirms the potential of satellite altimetry in monitoring spatio-temporal water level variations as a promising and unprecedented means for improved representation of the hydrologic characteristics in large ungauged river basins.

  11. Investigation on the rapid degradation of congo red catalyzed by activated carbon powder under microwave irradiation

    International Nuclear Information System (INIS)

    Zhang Zhaohong; Shan Yabo; Wang Jun; Ling Hongjie; Zang Shuliang; Gao Wei; Zhao Zhe; Zhang Huachun

    2007-01-01

    Azo dyestuff-congo red in aqueous solution can be degraded rapidly under microwave irradiation in the presence of activated carbon powder. The results showed that the degradation ratio could reach 87.79% for 25 mL total volume with 50 mg/L congo red and 2.0 g/L activated carbon powder under 1.5 min microwave irradiation. Furthermore, within the same irradiation time, congo red could be degraded fully by increasing addition amount (e.g. 3.6 g/L) of activated carbon powder and the degradation ratio was up to 96.49%. Otherwise, with the same addition amount, congo red also could be degraded completely by prolonging irradiation time (e.g. 2.5 min) and the degradation ratio was up to 97.88%. In addition, the influences of microwave irradiation time, initial concentration of congo red, addition amount and used times of activated carbon powder as well as solution acidity on the degradation were discussed in details adopting UV-vis spectra, FT-IR spectra, ion chromatography, high phase liquid chromatography (HPLC) and TOC analysis technologies. Here, the method using activated carbon powder as catalyst under microwave irradiation shows many advantages including high degradation ratios, short reaction time, low costs, no intermediates and no secondary pollution. Therefore, it may be fit for dealing with various azo dyestuff wastewaters on a large scale

  12. The state of emergency care in Democratic Republic of Congo

    Directory of Open Access Journals (Sweden)

    Luc Malemo Kalisya

    2015-12-01

    Full Text Available The Democratic Republic of Congo (DRC is the second largest country on the African continent with a population of over 70 million. It is also a major crossroad through Africa as it borders nine countries. Unfortunately, the DRC has experienced recurrent political and social instability throughout its history and active fighting is still prevalent today. At least two decades of conflict have devastated the civilian population and collapsed healthcare infrastructure. Life expectancy is low and government expenditure on health per capita remains one of the lowest in the world. Emergency Medicine has not been established as a specialty in the DRC. While the vast majority of hospitals have emergency rooms or salle des urgences, this designation has no agreed upon format and is rarely staffed by doctors or nurses trained in emergency care. Presenting complaints include general and obstetric surgical emergencies as well as respiratory and diarrhoeal illnesses. Most patients present late, in advanced stages of disease or with extreme morbidity, so mortality is high. Epidemics include HIV, cholera, measles, meningitis and other diarrhoeal and respiratory illnesses. Lack of training, lack of equipment and fee-for-service are cited as barriers to care. Pre-hospital care is also not an established specialty. New initiatives to improve emergency care include training Congolese physicians in emergency medicine residencies and medic ranger training within national parks.

  13. [Hypertensive emergencies at the University Hospital Center in Brazzaville, Congo].

    Science.gov (United States)

    Ellenga, Mbolla B F; Gombet, T R; Mahoungou, Guimbi K C; Otiobanda, G F; Ossou, Nguiet P M; Ikama, M S; Kimbally-Kaky, G; Etitiele, F

    2011-02-01

    The purpose of this retrospective study conducted in the emergency department of the University Hospital Center in Brazzaville, Congo was to determine the prevalence and clinical characteristics of hypertensive emergencies. With a total of 76 patients admitted during the study period, the prevalence of hypertensive emergency was 4%. The sex ratio was 1 and mean patient age was 57.3 years (range, 30 to 80 years). Risk factors included obesity in 62 cases (81.6%), history of hypertension in 65 (85.5%) and low socioeconomic level in 58 (76.3%). Mean delay for consultation was 50 hours (range, 1 to 240 hours). The disease underlying the hypertensive emergency was stroke with 38 cases (50%), heart failure in 20 (26.3%), hypertensive encephalopathy in 11 (14.4%), malignant hypertension in 9 (11.8%), and renal failure in 10 (13.1%). The mean length of emergency treatment was 14.7 hours (range, 5 to 48 hours). Eight deaths (10.5%) occurred during hospitalization in the emergency department.

  14. Ocular pentastomiasis in the Democratic Republic of the Congo.

    Directory of Open Access Journals (Sweden)

    Mihály Sulyok

    2014-07-01

    Full Text Available Ocular pentastomiasis is a rare infection caused by the larval stage of pentastomids, an unusual group of crustacean-related parasites. Zoonotic pentastomids have a distinct geographical distribution and utilize reptiles or canids as final hosts. Recently, an increasing number of human abdominal infections have been reported in Africa, where pentastomiasis is an emerging, though severely neglected, tropical disease. Here we describe four ocular infections caused by pentastomids from the Democratic Republic of the Congo. Two cases underwent surgery and an Armillifer grandis infection was detected by morphological and molecular approaches. Thus far, 15 other cases of ocular pentastomiasis have been reported worldwide. Twelve cases were caused by Armillifer sp., recorded almost exclusively in Africa, where such infections occur as a consequence of hunting and consuming snakes, their final hosts. Seven further cases were caused by Linguatula serrata, a cosmopolitan pentastomid whose final hosts are usually canids. Intraocular infections caused permanent visual damage in 69% and a total loss of vision in 31% of reported cases. In contrast, ocular adnexal cases had a benign clinical course. Further research is required to estimate the burden, therapeutic options and pathogenesis of this neglected disease.

  15. Diet and kwashiorkor: a prospective study from rural DR Congo

    Directory of Open Access Journals (Sweden)

    Hallgeir Kismul

    2014-04-01

    Full Text Available The etiology of kwashiorkor remains enigmatic and longitudinal studies examining potential causes of kwashiorkor are scarce. Using historical, longitudinal study data from the rural area of Bwamanda, Democratic Republic of Congo, we investigated the potential causal association between diet and the development of kwashiorkor in 5 657 preschool children followed 3-monthly during 15 months. We compared dietary risk factors for kwashiorkor with those of marasmus. Kwashiorkor was diagnosed as pitting oedema of the ankles; marasmus as abnormal visibility of skeletal structures and palpable wasting of the gluteus muscle. A 24-h recall was administered 3-monthly to record the consumption of the 41 locally most frequent food items. We specified Hanley–Miettinen smooth-in-time risk models containing potential causal factors, including food items, special meals prepared for the child, breastfeeding, disease status, nutritional status, birth rank, age, season and number of meals. Bayesian Information Criteria identified the most plausible causal model of why some children developed kwashiorkor. In a descriptive analysis of the diet at the last dietary assessment prior to development of kwashiorkor, the diet of children who developed kwashiorkor was characterized by low consumption of sweet potatoes, papaya and “other vegetables” [0.0% , 2.3% (95% CI [0.4, 12.1] and 2.3% (95% CI [0.4, 12.1

  16. The Ritual "Play of the Congos" of North-Central Panama: Its Sociolinguistic Implications. Sociolinguistic Working Paper Number 85.

    Science.gov (United States)

    Joly, Luz Graciela

    An excerpt from the "Play of the Congos," given in Congo, Spanish, and English, exemplifies the sociolinguistic features of the combined play and ritual language used by the Afro-Hispanic population in the Caribbean region of the Costa Abajo in north-central Panama. The sociolinguistic norms are an important part of the "regulation…

  17. Four new species of deep water agglutinated foraminifera from the Oligocene-Miocene of the Congo Fan (offshore Angola)

    OpenAIRE

    Kender, S.; Kaminski, M. A.; Jones, R. W.

    2006-01-01

    Four new species of deep-water agglutinated benthic foraminifera are described from the Oligocene and Miocene of the Congo Fan, offshore Angola. Scherochorella congoensis n.sp., Paratrochamminoides goroyskiformis n.sp., Haplophragmoides nauticus n.sp. and Portatrochammina profunda n.sp. all occur in deep-sea turbiditic shales and sands from the distal section of the Congo Fan.

  18. Intracranial drug delivery for subarachnoid hemorrhage.

    Science.gov (United States)

    Macdonald, Robert Loch; Leung, Ming; Tice, Tom

    2012-01-01

    Tice and colleagues pioneered site-specific, sustained-release drug delivery to the brain almost 30 years ago. Currently there is one drug approved for use in this manner. Clinical trials in subarachnoid hemorrhage have led to approval of nimodipine for oral and intravenous use, but other drugs, such as clazosentan, hydroxymethylglutaryl CoA reductase inhibitors (statins) and magnesium, have not shown consistent clinical efficacy. We propose that intracranial delivery of drugs such as nimodipine, formulated in sustained-release preparations, are good candidates for improving outcome after subarachnoid hemorrhage because they can be administered to patients that are already undergoing surgery and who have a self-limited condition from which full recovery is possible.

  19. Neurogenic stunned myocardium following hemorrhagic cerebral contusion

    International Nuclear Information System (INIS)

    Deleu, D.; Miyares, F.; Kettern, M.; Kumar, S.; Hassens, Y.; Salim, K.

    2007-01-01

    Neurogenic stunned myocardium NSM is a well-known complication of subarachnoidal hemorrhage, but has been reported rarely in association with other central nervous system disorders. A case of NSM is described in a patient with hemorrhagic brain contusion associated with cerebral edema. An 18-year-old man was admitted with severe cranial trauma following a car roll-over. Six days after admission, he developed findings suggestive for NSM. The troponin T and creatine kinase-MB level were elevated and echocardiogram showed apical and inferoposterior hypokinesis and diffuse left ventricular akinesis with severely reduced ejection fraction 18%. Invasive measurements confirmed low cardiac output. His cardiac function resolved completely within 6 days after decompressive craniotomy. This case supports the presumed unifying role of the increased intracranial pressure, probably triggering a vigorous sympathetic outflow hyperactivity leading to NSM. (author)

  20. Infection control during filoviral hemorrhagic fever outbreaks

    Directory of Open Access Journals (Sweden)

    N Raabe Vanessa

    2012-01-01

    Full Text Available Breaking the human-to-human transmission cycle remains the cornerstone of infection control during filoviral (Ebola and Marburg hemorrhagic fever outbreaks. This requires effective identification and isolation of cases, timely contact tracing and monitoring, proper usage of barrier personal protection gear by health workers, and safely conducted burials. Solely implementing these measures is insufficient for infection control; control efforts must be culturally sensitive and conducted in a transparent manner to promote the necessary trust between the community and infection control team in order to succeed. This article provides a review of the literature on infection control during filoviral hemorrhagic fever outbreaks focusing on outbreaks in a developing setting and lessons learned from previous outbreaks. The primary search database used to review the literature was PUBMED, the National Library of Medicine website.

  1. Intracerebral Hemorrhage, Oxidative Stress, and Antioxidant Therapy

    Science.gov (United States)

    Duan, Xiaochun; Wen, Zunjia; Shen, Haitao; Shen, Meifen

    2016-01-01

    Hemorrhagic stroke is a common and severe neurological disorder and is associated with high rates of mortality and morbidity, especially for intracerebral hemorrhage (ICH). Increasing evidence demonstrates that oxidative stress responses participate in the pathophysiological processes of secondary brain injury (SBI) following ICH. The mechanisms involved in interoperable systems include endoplasmic reticulum (ER) stress, neuronal apoptosis and necrosis, inflammation, and autophagy. In this review, we summarized some promising advances in the field of oxidative stress and ICH, including contained animal and human investigations. We also discussed the role of oxidative stress, systemic oxidative stress responses, and some research of potential therapeutic options aimed at reducing oxidative stress to protect the neuronal function after ICH, focusing on the challenges of translation between preclinical and clinical studies, and potential post-ICH antioxidative therapeutic approaches. PMID:27190572

  2. Intracerebral Hemorrhage, Oxidative Stress, and Antioxidant Therapy

    Directory of Open Access Journals (Sweden)

    Xiaochun Duan

    2016-01-01

    Full Text Available Hemorrhagic stroke is a common and severe neurological disorder and is associated with high rates of mortality and morbidity, especially for intracerebral hemorrhage (ICH. Increasing evidence demonstrates that oxidative stress responses participate in the pathophysiological processes of secondary brain injury (SBI following ICH. The mechanisms involved in interoperable systems include endoplasmic reticulum (ER stress, neuronal apoptosis and necrosis, inflammation, and autophagy. In this review, we summarized some promising advances in the field of oxidative stress and ICH, including contained animal and human investigations. We also discussed the role of oxidative stress, systemic oxidative stress responses, and some research of potential therapeutic options aimed at reducing oxidative stress to protect the neuronal function after ICH, focusing on the challenges of translation between preclinical and clinical studies, and potential post-ICH antioxidative therapeutic approaches.

  3. [Ixodid ticks in the mountainous part of the Crimea].

    Science.gov (United States)

    Markeshin, S Ia; Evstaf'ev, I L; Kovin, V V; Evstratov, Iu V

    1992-01-01

    About a hundred of patients with tick-borne encephalitis (TBE) were recorded over the latest decade in the Crimea, and 60 TBE virus strains were isolated from the ticks collected on the peninsula. The results of studies carried out in 1986-1990 helped define the borders of 4 local natural foci of TBE, study their acarifauna, detect the principal TBE vector--Ixodes ricinus (with a mean virophority of 0.6%), and distinguish two foci with a combination of TBE and Crimean-Congo hemorrhagic fever.

  4. Exosomes Enter Vaccine Development: Strategies Meeting Global Challenges of Emerging Infections.

    Science.gov (United States)

    Jungbauer, Alois

    2018-04-01

    New approaches for vaccination must be developed in order to meet the grand challenges for emerging infectious diseases. Exosomes now enter vaccine development and these are strategies are meeting these global challenges, as demonstrated by Anticoli et al., in this issue of Biotechnology Journal. Using exosome vaccines has been now been demonstrated in vivo for several viruses such as Ebola Virus VP24, VP40, and NP, Influenza Virus NP, Crimean-Congo Hemorrhagic Fever NP, West Nile Virus NS3, and Hepatitis C Virus NS3. Now this technology must be tested in clinics. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Stereotactic aspiration for hypertensive pontine hemorrhage

    International Nuclear Information System (INIS)

    Takahama, Hidetoshi; Morii, Ken; Sato, Mitsuya; Sekiguchi, Kentaro; Sato, Susumu

    1989-01-01

    Recently, CT-guided stereotactic aspiration has been attempted as a useful method for hypertensive intracerebral hemorrhage. Since the CT scanner was introduced in our clinic, we have experienced 55 cases with hypertensive pontine hemorrhage. We carried out stereotactic aspiration in nine cases consisting of four men and five women, ranging in age from 34 to 66 years. Operation was performed between 4 and 22 days after the hemorrhage (mean: 7.7 days). On the other hand, 46 cases were conservatively treated. They consisted of 31 men and 15 women, aged from 31 to 79 years, with a mean age of 55.5 years. The purpose of this study is to review the outcome at three months after the onset, and then to evaluate the clinical value of this method for hypertensive pontine hemorrhage. We have analyzed the outcome from the viewpoint of consciousness level, CT classification, and maximum transverse hematoma diameter on CT scan. In the present study, there was a statistically significant correlation between consciousness level and outcome in the conservative group. The outcome in the operated-on group tended to be superior to that in the conservatively treated group. Particularly, in cases of Japan Coma Scale 10 to 100, functionally favorable effects were considered to be obtained by stereotactic aspiration. According to CT classification, operation was considered to have exerted functionally favorable effects on unilateral basis tegmentum type and bilateral tegmentum type. The conservatively treated group showed a statistically significant correlation between maximum transverse hematoma diameter and outcome. A favorable prognosis was considered to be induced by operation in cases of 22 to 28 mm in maximum transverse hematoma diameter. (author)

  6. Acute atrial fibrillation during dengue hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Henrique Horta Veloso

    Full Text Available Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.

  7. Hemorrhagic Encephalopathy From Acute Baking Soda Ingestion.

    Science.gov (United States)

    Hughes, Adrienne; Brown, Alisha; Valento, Matthew

    2016-09-01

    Baking soda is a readily available household product composed of sodium bicarbonate. It can be used as a home remedy to treat dyspepsia. If used in excessive amounts, baking soda has the potential to cause a variety of serious metabolic abnormalities. We believe this is the first reported case of hemorrhagic encephalopathy induced by baking soda ingestion. Healthcare providers should be aware of the dangers of baking soda misuse and the associated adverse effects.

  8. Hemorrhagic Encephalopathy From Acute Baking Soda Ingestion

    Directory of Open Access Journals (Sweden)

    Adrienne Hughes

    2016-09-01

    Full Text Available Baking soda is a readily available household product composed of sodium bicarbonate. It can be used as a home remedy to treat dyspepsia. If used in excessive amounts, baking soda has the potential to cause a variety of serious metabolic abnormalities. We believe this is the first reported case of hemorrhagic encephalopathy induced by baking soda ingestion. Healthcare providers should be aware of the dangers of baking soda misuse and the associated adverse effects.

  9. Asymptomatic endoalveolar hemorrhage in a young male

    Directory of Open Access Journals (Sweden)

    Alain Kafyeke

    2016-06-01

    Full Text Available We describe the case of a young male affected by granulomatosis with polyangiitis presenting with non-specific complaints and complicated by the occurrence of a diffuse endoalveolar hemorrhage characterized by atypical clinical and radiological features. The importance of a rapid and aggressive diagnostic and therapeutic approach has to be strongly underlined. Available data regarding prevalence, clinical and radiological characteristics and treatment of this uncommon manifestation have also been hereby reviewed.

  10. A study on hypertensive intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Miura, Naohisa

    1982-01-01

    We studied 235 patients with hypertensive intracerebral hemorrhage by CT for about five years. An acute intracerebral hematoma is characterized by sharply delineated high density area. Repeated CT examinations demonstrate reduction in size of the high density hematoma after intervals of 20 - 40 days. And then, in general, the areas formerly occupied with hematoma show normal or reduced density. One or two days after hemorrhage, the high density is surrounded by a thin low density zone. After a few days the low density area is seen at the anterior and posterior pole of the high density in the white matter. These low density are produced by edema or resolving hematoma. About five days after hemorrhage, high density area is associated with wide surrounding low density zone of edema and then gradually diminishes in size. The wide low density zone surrounding the high density of hematoma persisting for over 15 days is probably composed not only of edema, but also of liquefied hematoma, necrotic brain tissue and so on. Enlarged hematoma and surrounding low density area extend to anterior, posterior, superior and inferior direction in the white matter. CT studies with i.v. contrast enhancement demonstrate from the 2nd to 4th weeks a ring-shaped high density around the hematoma. We classified each of the putaminal and thalamic hemorrhage into four types based on CT findings of hematoma advancement. In this study, a statistical method of Speareman's coefficients of rank correlation was utilized. According to this investigation, the important factors influencing prognosis and operative results were found to be the CT findings including the location and size of a hematoma, as well as the rapidity and the direction of its evolution. (J.P.N.)

  11. Acute atrial fibrillation during dengue hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Veloso Henrique Horta

    2003-01-01

    Full Text Available Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.

  12. Emergency Neurological Life Support: Intracerebral Hemorrhage.

    Science.gov (United States)

    Jauch, Edward C; Pineda, Jose A; Hemphill, J Claude

    2015-12-01

    Intracerebral hemorrhage (ICH) is a subset of stroke due to bleeding within the parenchyma of the brain. It is potentially lethal, and survival depends on ensuring an adequate airway, reversal of coagulopathy, and proper diagnosis. ICH was chosen as an Emergency Neurological Life Support protocol because intervention within the first critical hour may improve outcome, and it is critical to have site-specific protocols to drive care quickly and efficiently.

  13. Impaired Work Productivity After Aneurysmal Subarachnoid Hemorrhage.

    Science.gov (United States)

    Crago, Elizabeth A; Price, Thomas J; Bender, Catherine M; Ren, Dianxu; Poloyac, Samuel M; Sherwood, Paula R

    2016-10-01

    Aneurysmal subarachnoid hemorrhage (aSAH) is a sudden debilitating condition affecting individuals during the most productive times of their lives. Treatment advances have reduced mortality rates but increased the number of survivors facing deficits in physical and neuropsychological function. This study examined associations between neuropsychological function and work productivity after aSAH. Fifty-two patients with aSAH, employed before hemorrhage, were recruited from an ongoing National Institutes of Health study. Work Limitations Questionnaire (WLQ), neuropsychological tests (executive function, psychomotor speed, attention and mental flexibility, memory), and Patient Assessment of Own Function were completed at 3 and 12 months after aSAH. Subjects in this analysis reported some level of difficulty in work productivity at 3 and 12 months (35% and 30%, respectively) after hemorrhage. Lower WLQ scores in time management and mental/interpersonal subscales were associated with poorer performance in psychomotor function (r = .5, p = .04 and r = .42, p = .09). Poorer mental flexibility and working memory correlated with time management difficulty at 3 months (r = -.4, p = .09 and r = .54, p = .02). Patients performing poorly on story recall tests were more likely to report difficulty with job physical performance (r = -.42, p = .09) and completing work effectively (r = .61, p = .009). Poorer working memory performance was associated with lower scores on mental/interpersonal WLQ subscales (r = .45, p = .05) and overall health-related work productivity loss (r = .47, p = .04). WLQ areas also correlated with participants' perception of their neuropsychological function after aSAH. These results suggest that neuropsychological deficits impact work quality after hemorrhage and provide strong impetus for future studies so that domain-specific interventions can be implemented to improve outcomes that affect quality of life including work productivity.

  14. [Hemorrhagic syndrome after transfusion of incompatible blood].

    Science.gov (United States)

    Fedorova, Z D; Bsryshev, B A; Khanin, A Z; Chuslov, A G

    1979-11-01

    The patients were observed by a reanimation-hematological team of the Leningrad emergency service. It has been established that the hemorrhagic syndrome is the main one deterimining the unity of pathogenesis and clinical picture of the hemotransfusional complication. Phase character of the changes in the homeostasis system during the transfusion of incompatible blood was noted. The express diagnosis of the disorders and a scheme of the sequence of administration of hemostatic drugs are proposed. Mortality among such patients was reduced.

  15. Optical properties of amyloid stained by Congo red: history and mechanisms.

    Science.gov (United States)

    Howie, Alexander J; Brewer, Douglas B

    2009-04-01

    Amyloid stained by Congo red has striking optical properties that generally have been poorly described and inadequately explained, although they can be understood from principles of physical optics. Molecules of Congo red are orientated on amyloid fibrils, and so the dye becomes dichroic and birefringent. The birefringence varies with wavelength in accordance with a fundamental property of all light-transmitting materials called anomalous dispersion of the refractive index around an absorption peak. The combination of this and absorption of light, with modification by any additional birefringence in the optical system, explains the various colours that can be seen in Congo red-stained amyloid between crossed polariser and analyser, and also when the polariser and analyser are progressively uncrossed. These are called anomalous colours.

  16. Rehabilitation Outcomes: Ischemic versus Hemorrhagic Strokes.

    Science.gov (United States)

    Perna, Robert; Temple, Jessica

    2015-01-01

    Background. Ischemic and hemorrhagic strokes have different pathophysiologies and possibly different long-term cerebral and functional implications. Hemorrhagic strokes expose the brain to irritating effects of blood and ischemic strokes reflect localized or diffuse cerebral vascular pathology. Methods. Participants were individuals who suffered either an ischemic (n = 172) or hemorrhagic stroke (n = 112) within the past six months and were involved in a postacute neurorehabilitation program. Participants completed three months of postacute neurorehabilitation and the Mayo Portland Adaptability Inventory-4 (MPAI-4) at admission and discharge. Admission MPAI-4 scores and level of functioning were comparable. Results. Group ANOVA comparisons show no significant group differences at admission or discharge or difference in change scores. Both groups showed considerably reduced levels of productivity/employment after discharge as compared to preinjury levels. Conclusions. Though the pathophysiology of these types of strokes is different, both ultimately result in ischemic injuries, possibly accounting for lack of findings of differences between groups. In the present study, participants in both groups experienced similar functional levels across all three MPAI-4 domains both at admission and discharge. Limitations of this study include a highly educated sample and few outcome measures.

  17. Rehabilitation Outcomes: Ischemic versus Hemorrhagic Strokes

    Directory of Open Access Journals (Sweden)

    Robert Perna

    2015-01-01

    Full Text Available Background. Ischemic and hemorrhagic strokes have different pathophysiologies and possibly different long-term cerebral and functional implications. Hemorrhagic strokes expose the brain to irritating effects of blood and ischemic strokes reflect localized or diffuse cerebral vascular pathology. Methods. Participants were individuals who suffered either an ischemic (n=172 or hemorrhagic stroke (n=112 within the past six months and were involved in a postacute neurorehabilitation program. Participants completed three months of postacute neurorehabilitation and the Mayo Portland Adaptability Inventory-4 (MPAI-4 at admission and discharge. Admission MPAI-4 scores and level of functioning were comparable. Results. Group ANOVA comparisons show no significant group differences at admission or discharge or difference in change scores. Both groups showed considerably reduced levels of productivity/employment after discharge as compared to preinjury levels. Conclusions. Though the pathophysiology of these types of strokes is different, both ultimately result in ischemic injuries, possibly accounting for lack of findings of differences between groups. In the present study, participants in both groups experienced similar functional levels across all three MPAI-4 domains both at admission and discharge. Limitations of this study include a highly educated sample and few outcome measures.

  18. Computed tomography in hypertensive cerebellar hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Nose, T; Maki, Y; Ono, Y; Yoshizawa, T; Tsuboi, K [Tsukuba Univ., Sakura, Ibaraki (Japan)

    1981-11-01

    Fourteen cases of cerebellar hemorrhage were analysed from the point of CT-scan, and the following results were obtained. 1. The number of cases of cerebellar hemorrhage forms 4.4% of that of total intracranial hemorrhage. 2. Most of the cerebellar hematomas extend upward. Downward extension is rare. 3. In acute dead cases hematomas are 5 cm or more in diameter and lie over bilateral hemispheres with the extension to third or fourth ventricles in CT-scans. 4. Slowly progressive cases are detriorated by the secondary hydrocephalus. 5. In mild cases hematomas are 3cm or less in diameter on CT-scans and the hematoma evacuation is not indicated for these cases. 6. The shunt operation alone is sufficient for the life saving of the slowly progressive cases, but the hematoma evacuation is indicated in these cases if the functional prognosis is taken into consideration. 7. Immediate hematoma evacuation together with the ventricular drainage is considered to be effective for the life saving of the acute fulminant cases.

  19. Computed tomography in hypertensive cerebellar hemorrhage

    International Nuclear Information System (INIS)

    Nose, Tadao; Maki, Yutaka; Ono, Yukio; Yoshizawa, Takashi; Tsuboi, Kohji

    1981-01-01

    Fourteen cases of cerebellar hemorrhage were analysed from the point of CT-scan, and the following results were obtained. 1. The number of cases of cerebellar hemorrhage forms 4.4% of that of total intracranial hemorrhage. 2. Most of the cerebellar hematomas extend upward. Downward extension is rare. 3. In acute dead cases hematomas are 5 cm or more in diameter and lie over bilateral hemispheres with the extension to third or fourth ventricles in CT-scans. 4. Slowly progressive cases are detriorated by the secondary hydrocephalus. 5. In mild cases hematomas are 3cm or less in diameter on CT-scans and the mematoma evacuation is not indicated for these cases. 6. The shunt operation alone is sufficient for the life saving of the slowly progressive cases, but the hematoma evacuation is indicated in these cases if the functional prognosis is taken into consideration. 7. Immediate hematoma evacuation togather with the ventricular dranage is considered to be effective for the life saving of the acute fulminant cases. (author)

  20. Clinical features of multiple spontaneous intracerebral hemorrhages

    Directory of Open Access Journals (Sweden)

    Tao CHANG

    2016-01-01

    Full Text Available Objective To analyze the clinical features of multiple spontaneous intracerebral hemorrhages (MICH. Methods Conservative therapy, puncture and drainage, hematoma removal and/or decompressive craniectomy were used in the treatment of 630 intracerebral hemorrhage (ICH patients, who were divided into 2 groups: 30 cases with MICH and another 600 cases with solitary intracerebral hemorrhage (SICH. Three months after onset, modified Rankin Scale (mRS was used to evaluate the prognosis of all cases. Results Compared with patients in SICH group, the occurrence rate of hypertension > 5 years (P = 0.008, diabetes mellitus (P = 0.024, hypercholesterolemia (P = 0.050 and previous ischemic stroke (P = 0.026 were all significantly higher in MICH group. The mean arterial pressure (MAP level (P = 0.002 and the incidence of limb movement disorder (P = 0.000 were significantly higher in patients with MICH than those with SICH. Basal ganglia and thalamus were the predilection sites of hematoma (P = 0.001. Patients with MICH had worse prognosis compared to those with SICH 3 months after onset (P = 0.006. Conclusions Hypertension > 5 years, diabetes mellitus, hypercholesterolemia and ischemic stroke were identified to be the pathophysiological basis of MICH in this study. All patients with MICH had more serious clinical manifestations after onset and worse prognosis. DOI: 10.3969/j.issn.1672-6731.2016.01.008

  1. Remote cerebellar hemorrhage after lumbar spinal surgery

    International Nuclear Information System (INIS)

    Cevik, Belma; Kirbas, Ismail; Cakir, Banu; Akin, Kayihan; Teksam, Mehmet

    2009-01-01

    Background: Postoperative remote cerebellar hemorrhage (RCH) as a complication of lumbar spinal surgery is an increasingly recognized clinical entity. The aim of this study was to determine the incidence of RCH after lumbar spinal surgery and to describe diagnostic imaging findings of RCH. Methods: Between October 1996 and March 2007, 2444 patients who had undergone lumbar spinal surgery were included in the study. Thirty-seven of 2444 patients were scanned by CT or MRI due to neurologic symptoms within the first 7 days of postoperative period. The data of all the patients were studied with regard to the following variables: incidence of RCH after lumbar spinal surgery, gender and age, coagulation parameters, history of previous arterial hypertension, and position of lumbar spinal surgery. Results: The retrospective study led to the identification of two patients who had RCH after lumbar spinal surgery. Of 37 patients who had neurologic symptoms, 29 patients were women and 8 patients were men. CT and MRI showed subarachnoid hemorrhage in the folia of bilateral cerebellar hemispheres in both patients with RCH. The incidence of RCH was 0.08% among patients who underwent lumbar spinal surgery. Conclusion: RCH is a rare complication of lumbar spinal surgery, self-limiting phenomenon that should not be mistaken for more ominous pathologic findings such as hemorrhagic infarction. This type of bleeding is thought to occur secondary to venous infarction, but the exact pathogenetic mechanism is unknown. CT or MRI allowed immediate diagnosis of this complication and guided conservative management.

  2. Hemorrhage control by microsecond electrical pulses

    Science.gov (United States)

    Mandel, Yossi; Manivanh, Richard; Dalal, Roopa; Huie, Phil; Wang, Jenny; Brinton, Mark; Palanker, Daniel

    2013-02-01

    Non-compressible hemorrhages are the most common preventable cause of death on battlefield or in civilian traumatic injuries. We report the use of sub-millisecond pulses of electric current to induce rapid constriction in femoral and mesenteric arteries and veins in rats. Extent of vascular constriction could be modulated by pulse duration, amplitude and repetition rate. Electrically-induced vasoconstriction could be maintained at steady level until the end of stimulation, and blood vessels dilated back to their original size within a few minutes after the end of stimulation. At higher settings, a blood clotting could be introduced, leading to complete and permanent occlusion of the vessels. The latter regime dramatically decreased the bleeding rate in the injured femoral and mesenteric arteries, with a complete hemorrhage arrest achieved within seconds. The average blood loss from the treated femoral artery was about 7 times less than that of a non-treated control. This new treatment modality offers a promising approach to non-damaging control of bleeding during surgery, and to efficient hemorrhage arrest in trauma patients.

  3. Morbidity after Hemorrhage in Children with Untreated Brain Arteriovenous Malformation

    Science.gov (United States)

    Ma, Li; Kim, Helen; Chen, Xiao-Lin; Wu, Chun-Xue; Ma, Jun; Su, Hua; Zhao, Yuanli

    2017-01-01

    Background Children with untreated brain arteriovenous malformations (bAVM) are at risk of encountering life-threatening hemorrhage very early in their lives. The primary aim of invasive treatment is to reduce unfavorable outcome associated with a bAVM rupture. A better understanding of the morbidity of bAVM hemorrhage might be helpful for weighing the risks of untreated bAVM and invasive treatment. Our aim was to assess the clinical outcome after bAVM rupture and identify features to predict severe hemorrhage in children. Methods We identified all consecutive children admitted to our institution for bAVMs between July 2009 and December 2014. Clinical outcome after hemorrhagic presentation and subsequent hemorrhage was evaluated using the modified Rankin Scale (mRS) for children. The association of demographic characteristics and bAVM morphology with severe hemorrhage (mRS >3 or requiring emergency hematoma evacuation) was studied using univariate and multivariable regression analyses. A nomogram based on multivariable analysis was formulated to predict severe hemorrhage risk for individual patients. Results A total of 134 patients were identified with a mean treatment-free follow-up period of 2.1 years. bAVM ruptured in 83 (62%) children: 82 had a hemorrhage at presentation and 6 of them experienced a recurrent hemorrhage during follow-up; 1 patient had other diagnostic symptoms but bled during follow-up. Among them, 49% (41/83) had a severe hemorrhage; emergency hematoma evacuation was required in 28% of them (23/83), and 24% (20/83) remained as disabled (mRS ≥ 3) at last follow-up. Forty-six percent (38/82) of children with hemorrhagic presentation were severely disabled (mRS >3). Forty-three percent (3/7) were severely disabled after subsequent hemorrhage. The annual rate of severe subsequent hemorrhage was 1% in the overall cohort and 3.3% in children with ruptured presentation. All the subsequent severe hemorrhage events occurred in children with severe

  4. Anatomie de la Corruption en République Démocratique du Congo

    OpenAIRE

    Kodila Tedika, Oasis

    2013-01-01

    This article analysis a nature of corruption in Democratic Republic of Congo. It shows, with arguments, on the one hand the deserved reputation for a highly corrupt country, that one reads regularly in different collations on corruption and says to the complexity and depth of the corruption. The basis of the systemic side of corruption in this country. Cet article a pour objectif de décortiquer la nature de la corruption en République démocratique du Congo. Il démontre, avec arguments, d’une ...

  5. Effective Removal of Congo Red by Triarrhena Biochar Loading with TiO2 Nanoparticles

    Directory of Open Access Journals (Sweden)

    Peng Yu

    2018-01-01

    Full Text Available A composite of pyrolytic Triarrhena biochar loading with TiO2 nanoparticles has been synthesized by the sol-gel method. The composite shows a well-developed hollow mesoporous and macropore structure as characterized by XRD, BET, and SEM. When used as an absorbent to remove Congo red from aqueous solution, it was found that as-prepared composite performed better absorption capacity than single biochar or TiO2. The results suggest that biochar loading with TiO2 could be promisingly implemented as an environmentally friendly and inexpensive adsorbent for Congo red removal from wastewater.

  6. Intracranial Hemorrhage Following a 3-week Headache

    Directory of Open Access Journals (Sweden)

    John Jiao

    2017-01-01

    Full Text Available History of present illness: A 35-year-old female presented to the ED with a Glasgow Coma Scale (GCS of 11. Per her boyfriend, the patient was having headaches for the past 3 weeks. She was initially taken to an outside hospital where her GCS was reported as 13. A non-contrast head computed tomography (CT revealed a large lobar intraparenchymal hemorrhage within the left frontal parietal lobe with midline shift. Upon examination, vitals were notable for blood pressure of 209/88mmHg, and her left pupil was fixed and dilated. The patient had extension of her right arm to noxious stimuli, paralysis of her right leg, and purposeful movement of the left arm and left leg. The patient was started on a nicardipine drip in the ED and subsequently taken to the operating room for a decompressive craniectomy. Significant findings: The patient’s head CT showed a significant area of hyperdensity consistent with an intracranial hemorrhage located within the left frontal parietal lobe (red arrow. Additionally, there is rightward midline shift up to 1.1cm (green arrow and entrapment of the right lateral ventricle (blue arrow. Discussion: Intraparenchymal hemorrhage (IPH is associated with high morbidity and mortality. Although the mortality for subarachnoid hemorrhage (SAH has declined steadily over the past several decades, the mortality for IPH mortality has not significantly.1 One of the most serious considerations when treating a patient with IPH is the management of intracranial pressure (ICP.2 Once an IPH is identified, immediate steps should be taken to bring ICP within acceptable levels including elevating the head of the bed to 30 degrees, sedation, and controlling hypertension with medications.2-3 Even with early and aggressive care, the prognosis for IPH remains poor; the 30-day mortality rate for IPH is estimated to be less than 50%, and a 2010 systematic review estimated only 12-39% of IPH patients achieve independent function.4-5 Predictors of

  7. Radiologic findings of diffuse Pulmonary hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Mi Ra; Song, Koun Sik; Lee, Jin Seong; Lim, Tae Hwan [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-12-01

    To describe the chest radiographic and CT findings of diffuse pulmonary hemorrhage. Two radiologists retrospectively analysed the chest radiographic and CT findings of six patients with diffuse pulmonary hemorrhage. Using open lung biopsy(n=3D2) and transbronchial lung biopsy or bronchoalveolar lavage(n=3D4), diagnosis was based on the presence of hemosiderin-laden macrophage or intra-alveolar hemorrhage. Underlying diseases were Wegener's granulomatosis(n=3D2), antiphospholipid antibody syndrome(n=3D2), Henoch-Schonlein purpura(n=3D1), and idopathic pulmonary hemosiderosis(n=3D1). In all patients, sequential chest radiographs, obtained during a one to six-month period, were available. HRCT scans were obtained in five patinets, and conventional CT scans in one. Follow-up HRCT scans were obtained in two. We also analyzed the patterns of involvement, distribution and sequential changes in the pulmonary abnormalities seen on chest radiographs and CT scans. Chest radiographs showed multifocal patchy consolidation(n=3D6), ground-glass opacity(n=3D3), and multiple granular or nodular opacity(n=3D3). These lesions were intermingled in five patients, while in one there was consolidation only. Sequential chest radiographs demonstrated the improvement of initial pulmonary abnormalities and appearance of new lesions elsewhere within 5-6 days, though within 7-25 (average, 13) days, these had almost normalized. HRCT scans showed patchy consolidation(n=3D5), multiple patchy ground-glass opacity(n=3D5), or ill-defined air space nodules(n=3D4). These lesions were intermingled in five patients, and in one, ground-glass opacity only was noted. In two patients there were interlobular septal thickening and intalobular reticular opacity. The distribution of these abnormalities was almost always bilateral, diffuse with no zonal predominancy, and spared the apex of the lung and subpleural region were less affected. Although chest radiographic and CT findings of diffuse pulmonary

  8. Radiologic findings of diffuse Pulmonary hemorrhage

    International Nuclear Information System (INIS)

    Seo, Mi Ra; Song, Koun Sik; Lee, Jin Seong; Lim, Tae Hwan

    1998-01-01

    To describe the chest radiographic and CT findings of diffuse pulmonary hemorrhage. Two radiologists retrospectively analysed the chest radiographic and CT findings of six patients with diffuse pulmonary hemorrhage. Using open lung biopsy(n=3D2) and transbronchial lung biopsy or bronchoalveolar lavage(n=3D4), diagnosis was based on the presence of hemosiderin-laden macrophage or intra-alveolar hemorrhage. Underlying diseases were Wegener's granulomatosis(n=3D2), antiphospholipid antibody syndrome(n=3D2), Henoch-Schonlein purpura(n=3D1), and idopathic pulmonary hemosiderosis(n=3D1). In all patients, sequential chest radiographs, obtained during a one to six-month period, were available. HRCT scans were obtained in five patinets, and conventional CT scans in one. Follow-up HRCT scans were obtained in two. We also analyzed the patterns of involvement, distribution and sequential changes in the pulmonary abnormalities seen on chest radiographs and CT scans. Chest radiographs showed multifocal patchy consolidation(n=3D6), ground-glass opacity(n=3D3), and multiple granular or nodular opacity(n=3D3). These lesions were intermingled in five patients, while in one there was consolidation only. Sequential chest radiographs demonstrated the improvement of initial pulmonary abnormalities and appearance of new lesions elsewhere within 5-6 days, though within 7-25 (average, 13) days, these had almost normalized. HRCT scans showed patchy consolidation(n=3D5), multiple patchy ground-glass opacity(n=3D5), or ill-defined air space nodules(n=3D4). These lesions were intermingled in five patients, and in one, ground-glass opacity only was noted. In two patients there were interlobular septal thickening and intalobular reticular opacity. The distribution of these abnormalities was almost always bilateral, diffuse with no zonal predominancy, and spared the apex of the lung and subpleural region were less affected. Although chest radiographic and CT findings of diffuse pulmonary

  9. Widespread decline of Congo rainforest greenness in the past decade.

    Science.gov (United States)

    Zhou, Liming; Tian, Yuhong; Myneni, Ranga B; Ciais, Philippe; Saatchi, Sassan; Liu, Yi Y; Piao, Shilong; Chen, Haishan; Vermote, Eric F; Song, Conghe; Hwang, Taehee

    2014-05-01

    Tropical forests are global epicentres of biodiversity and important modulators of climate change, and are mainly constrained by rainfall patterns. The severe short-term droughts that occurred recently in Amazonia have drawn attention to the vulnerability of tropical forests to climatic disturbances. The central African rainforests, the second-largest on Earth, have experienced a long-term drying trend whose impacts on vegetation dynamics remain mostly unknown because in situ observations are very limited. The Congolese forest, with its drier conditions and higher percentage of semi-evergreen trees, may be more tolerant to short-term rainfall reduction than are wetter tropical forests, but for a long-term drought there may be critical thresholds of water availability below which higher-biomass, closed-canopy forests transition to more open, lower-biomass forests. Here we present observational evidence for a widespread decline in forest greenness over the past decade based on analyses of satellite data (optical, thermal, microwave and gravity) from several independent sensors over the Congo basin. This decline in vegetation greenness, particularly in the northern Congolese forest, is generally consistent with decreases in rainfall, terrestrial water storage, water content in aboveground woody and leaf biomass, and the canopy backscatter anomaly caused by changes in structure and moisture in upper forest layers. It is also consistent with increases in photosynthetically active radiation and land surface temperature. These multiple lines of evidence indicate that this large-scale vegetation browning, or loss of photosynthetic capacity, may be partially attributable to the long-term drying trend. Our results suggest that a continued gradual decline of photosynthetic capacity and moisture content driven by the persistent drying trend could alter the composition and structure of the Congolese forest to favour the spread of drought-tolerant species.

  10. Bilateral hypertensive intracerebral hemorrhage diagnosed by CT scan

    International Nuclear Information System (INIS)

    Miyasaka, Yoshio; Nakayama, Kenji; Matsumori, Kuniaki

    1982-01-01

    Five (9.6%) of 52 cases of supretentorial hypertensive intracerebral hemorrhage which suffered rehemorrhage in the contralateral regions were analyzed in the present study, and the 28 cases reported since 1950 were reviewed. The literature suggests that the time between the first hemorrhage and the second was quite long. However, the present series showed that re-hemorrhage in the contralateral side developed within one month in three out of five cases. In case 1, hemorrhages developed almost simultaneously in the left thalamus and in the right putamen. Three characteristics were observed: The symptoms including hemiparesis and/or hemispheric signs related to the first hemorrhage had a tendency to exacerbate after the second attack in other the contralateral region in the second attack, symptoms excessively severe for the size of the hematoma developed. Finally, the clinical course after the second hemorrhage was poor. (author)

  11. [Renal hemorrhage after ESWL: From small hematoma to renal blowout].

    Science.gov (United States)

    Panach-Navarrete, Jorge; Palmero Martí, Jose Luis; Ganau Ituren, Amparo; Pastor Lence, Juan Carlos; Benedicto Redón, Antonio

    2016-04-01

    To report two cases of renal hemorrhage after extracorporeal shock wave lithotripsy (ESWL) and their therapeutic management. Description of the clinical cases, together with the diagnosis and therapeutic management of these complications. We present two cases of patients with renal hemorrhage after ESWL, which were performed without immediate complications. One of the cases, after detecting an important laceration of the renal parenchyma, needed two embolization sessions for its short-term resolution; however, the patient finally passed away due to the complications derived from hemorrhage. The other case was solved through conservative management. Even though hemorrhage is an infrequent complication after ESWL, it should be suspected when the patient presents compatible clinical symptoms, since even though most cases are resolved in a conservative manner, on some occasions specific treatments for the hemorrhage are necessary. Old age and the presence of vascular comorbidities seem to be related to a higher risk of hemorrhage after ESWL.

  12. Dynamic study on digital cineangiography of acute digestive tract hemorrhage

    International Nuclear Information System (INIS)

    Yu Jianming; Feng Gansheng; Zeng Jun; Xu Caiyuan

    2000-01-01

    Objective: To study dynamically acute gastrointestinal tract hemorrhage with digital cine angiography. Methods: Fifty patients with acute gastrointestinal tract hemorrhage were performed with digital cineangiography and observed dynamically during arterial, capillary and venous phases. Results: Among 50 cases, there were positive results in 44 ones including gastrointestinal hemorrhage in 14, biliary hemorrhage in 2, splenic arterial bleeding in 3, left gastric arterial bleeding in 4, right gastroepiploic arterial bleeding in 5, SMA bleeding in 7 and IMA bleeding in 9.17 cases underwent a permanent embolization through artery and 11 with temporary embolization as well as 9 with infusion of hemostatic agent via artery. Conclusions: Serial digital cineangiogram can dynamically show acute digestive tract hemorrhage within different phase. It is helpful to detect the location and cause of hemorrhage

  13. Pressor and hemodilution responses compensate for acute hemorrhage in bluefish.

    Science.gov (United States)

    Ogilvy, C S; Tremml, P G; DuBois, A B

    1988-01-01

    1. After hemorrhage of 21% blood volume (0.9% body weight) blood pressure (BP) and heart rate (H.R.) of unanesthetized bluefish (Pomatomus saltatrix) recovered within 5 min. 2. Phentolamine blocked this recovery. 3. Atropine increased control H.R. from 48 to 87 per min, and to 108 after hemorrhage, with delay of BP recovery to 10 min. 4. With small, repeated hemorrhages every 20 min, hemodilution and recovery of BP occurred between hemorrhages. Removal of 27% blood volume resulted in only temporary recovery. 5. Thirty min after hemorrhage, plasma epinephrine was 5 x and norepinephrine 8 x control. 6. Thus, bluefish tolerate hemorrhage with initial vasoconstriction via alpha-adrenergic pathways, and hemodilution.

  14. Obstructive Sleep Apnea: An Unusual Cause of Hemorrhagic Stroke.

    Science.gov (United States)

    Pawar, Nilesh H; O'Riordan, Jennifer A; Malik, Preeti; Vasanwala, Farhad F

    2017-09-27

    Stroke is one of the most common causes of mortality and morbidity worldwide. Hemorrhagic stroke comprises 10-20% of strokes. Here, we present a case report of hemorrhagic stroke that may have been secondary to untreated Obstructive Sleep Apnea (OSA) in a young man with no other cardiovascular risk factors or features of metabolic syndrome. A 32-year-old man was admitted for hemorrhagic stroke. An initial thorough workup for the etiology of stroke was inconclusive. Eventually, a polysomnography was done, which demonstrated OSA suggesting that untreated OSA may have contributed to his stroke. OSA may cause hemorrhagic stroke by nocturnal blood pressure surge. So, all physicians should consider doing polysomnography for unexplained hemorrhagic stroke or in patients at risk. Diagnosing and treating OSA would be critical in preventing hemorrhagic stroke and its recurrences.

  15. Spontaneous expulsive suprachoroidal hemorrhage caused by decompensated liver disease

    Directory of Open Access Journals (Sweden)

    Krishnagopal Srikanth

    2013-01-01

    Full Text Available Expulsive suprachoroidal hemorrhage can be surgical or spontaneous. Spontaneous expulsive suprachoroidal hemorrhage (SESCH is a rare entity. Most of the reported cases of SESCH were caused by a combination of corneal pathology and glaucoma. We are reporting a rare presentation of SESCH with no pre-existing glaucoma or corneal pathology and caused by massive intra- and peri-ocular hemorrhage due to decompensated liver disease.

  16. Mechanisms of Hydrocephalus after Neonatal and Adult Intraventricular Hemorrhage

    OpenAIRE

    Strahle, Jennifer; Garton, Hugh J.L.; Maher, Cormac O.; Muraszko, Karin M.; Keep, Richard F.; Xi, Guohua

    2012-01-01

    Intraventricular hemorrhage (IVH) is a cause of significant morbidity and mortality and is an independent predictor of a worse outcome in intracerebral hemorrhage (ICH) and germinal matrix hemorrhage (GMH). IVH may result in both injuries to the brain as well as hydrocephalus. This paper reviews evidence on the mechanisms and potential treatments for IVH-induced hydrocephalus. One frequently cited theory to explain hydrocephalus after IVH involves obliteration of the arachnoid villi by microt...

  17. A clinical study on neonatal intracranial hemorrhage, 2

    International Nuclear Information System (INIS)

    Matsuda, Hiroo; Inoue, Takao; Shimura, Kohji

    1980-01-01

    Clinical pigns, laboratory data, CT findings, CSF spectrophotometric findings and CSF/blood glucose ratio were reviewed on thirty six newborns with intracranial hemorrhage confirmed by CT and/or autopsy and the following findings were obtained. The sites of hemorrhage were: intraventricular 14, intracerebral 4, subdural 2, subarachnoidal 16. 1) Convulsion (39%), hypotonia (58%), apnea (47%), and bradycardia (58%) were seen, but those were not regarded as specific for the intracranial hemorrhage. 2) Severe anemia of hemoglobin value less than 14 g/dl (17%), more than 10% fall of hematocrit (10%), and hyperglycemia of blood glucose more than 200 mg/gl (42%) were seen almost equally in every type of hemorrhage. 3) On CSF spectrophotometry, ajj twelve cases of intraventricular and four cases of intracerebral hemorrhage had the oxyhemoglobin peak absorbance. However, of fourteen cases of subarachnoidal hemorrhage, three had the oxyhemoglobin peak absorbance but the other eleven cases had the bilirubin peak absorbance. 4) Hypoglycorrachia, defined as CSF/blood glucose ratio less than 0.4, was recognized only in the intraventricular hemorrhage group (5/9, 56%). It was concluded that lumbar puncture should be done first of all when intracranial hemorrhage is suspected. If hypoglycorrachia or oxyhemoglobin peak absorbance is recognized, computed tomography should be performed immediately to know the accurate site and extent of hemorrhage. Although hypoglycorrachia is more specific for the intraventricular hemorrhage, it is usually found several days after the hemorrhage. On the other hand, oxyhemoglobin can be identified in CSF within a day after the episode of hemorrhage and this method is more benifical for the early diagnosis. (author)

  18. Calcified subdural hematoma associated with hypertensive intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Ishige, Naoki; Sunami, Kenro; Sato, Akira; Watanabe, Osamu

    1984-01-01

    A case of calcified subdural hematoma associated with hypertensive intracerebral hemorrhage is reported. A left frontal subdural hematoma with left putaminal hemorrhage was incidentally found when a CT scan was performed to evaluate right hemiparesis and aphasia in a 55-year-old man. The putaminal hemorrhage was not very extensive, but his clinical symptoms were rather serious. Not only the putaminal hemorrhage, but also the presence of the calcified subdural hematoma was considered to have caused his clinical deterioration. The subtotal removal of the calcified subdural hematoma brought about a good result. (author)

  19. Intranasal Fentanyl Intoxication Leading to Diffuse Alveolar Hemorrhage.

    Science.gov (United States)

    Ruzycki, Shannon; Yarema, Mark; Dunham, Michael; Sadrzadeh, Hossein; Tremblay, Alain

    2016-06-01

    Increasing rates of opioid abuse, particularly fentanyl, may lead to more presentations of unusual effects of opioid toxicity. Diffuse alveolar hemorrhage is a rare complication of fentanyl overdose. A 45-year-old male presented in hypoxic respiratory failure secondary to diffuse alveolar hemorrhage requiring intubation. Comprehensive drug screening detected fentanyl without exposure to cocaine. Further history upon the patient's recovery revealed exposure to snorted fentanyl powder immediately prior to presentation. Diffuse alveolar hemorrhage is a potential, though rare, presentation of opioid intoxication. Recognition of less common complications of opioid abuse such as diffuse alveolar hemorrhage is important in proper management of overdoses.

  20. Herpes Simplex Encephalitis Complicated by Cerebral Hemorrhage during Acyclovir Therapy.

    Science.gov (United States)

    Harada, Yukinori; Hara, Yuuta

    2017-01-01

    Herpes simplex encephalitis (HSE) can be complicated by adverse events in the acute phase. We herein present the case of a 71-year-old woman with HSE complicated by cerebral hemorrhage. She presented with acute deterioration of consciousness and fever and was diagnosed with HSE based on the detection of herpes simplex virus-1 in the cerebrospinal fluid by a polymerase chain reaction. The cerebral hemorrhage developed during acyclovir therapy; however, its diagnosis was delayed for 2 days. After the conservative treatment of the cerebral hemorrhage, the patient made a near-complete recovery. Cerebral hemorrhage should be considered as an acute-phase complication of HSE.

  1. CT appearance of renal hemorrhage after extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Kanazawa, Susumu; Araki, Toru; Takamoto, Hitoshi; Hata, Kazuhiro

    1988-07-01

    Computed Tomography (CT) was performed in three patients who were suspicious of renal hemorrhage after extracorporeal shock wave lithotripsy (ESWL). Post-ESWL scans demonstrated subcapsular hematoma in all three cases, and intrarenal hemorrhage in two cases, one of which had fluid collection in the pararenal space and hemorrhage in the posterior pararenal space on CT. Thickening of gerota fascia and bridging septa in the perirenal space was visualized on CT in all of them. CT demonstrated clearly the anatomic distribution and extent of renal hemorrhage, and it is important to comprehend the imaging anatomy of the perirenal area for CT evaluation.

  2. Acute viral hemorrhage disease: A summary on new viruses

    Directory of Open Access Journals (Sweden)

    Somsri Wiwanitkit

    2015-10-01

    Full Text Available Acute hemorrhagic disease is an important problem in medicine that can be seen in many countries, especially those in tropical world. There are many causes of acute hemorrhagic disease and the viral infection seems to be the common cause. The well-known infection is dengue, however, there are many new identified viruses that can cause acute hemorrhagic diseases. In this specific short review, the authors present and discuss on those new virus diseases that present as “acute hemorrhagic fever”.

  3. Spontaneous adrenal hemorrhage during pregnancy: a case with horseshoe kidney

    Directory of Open Access Journals (Sweden)

    Mohadeseh Amini

    2017-11-01

    Full Text Available Spontaneous adrenal hemorrhage is an acute hemorrhage during pregnancy, which can be tragic for the mother and the baby. We report a unique spontaneous hemorrhage during pregnancy in a case with horseshoe kidney with separated adrenal, presented for the first time in the world. Computed tomography scan showed a horseshoe kidney fused with left normal kidney. Interestingly the adrenal gland was remained in right flank and separated from the horseshoe kidney, which prepares a probable physical stress for the hemorrhage. Diagnosis and surgery were done successfully and the case was fully recovered after several days.

  4. Hemorrhage into a choledochal cyst in a hemophiliac child

    International Nuclear Information System (INIS)

    Stein, M.; Oates, E.

    1989-01-01

    A hemophiliac child presented with acute abdominal pain due to hemorrhage into an unsuspected choledochal cyst. Sonography delineated the cystic mass; hepatobiliary scintigraphy confirmed the diagnosis. (orig.)

  5. Hemorrhage into a choledochal cyst in a hemophiliac child

    Energy Technology Data Exchange (ETDEWEB)

    Stein, M.; Oates, E. (Tufts-New England Medical Center, Boston, MA (USA). Dept. of Radiology)

    1989-11-01

    A hemophiliac child presented with acute abdominal pain due to hemorrhage into an unsuspected choledochal cyst. Sonography delineated the cystic mass; hepatobiliary scintigraphy confirmed the diagnosis. (orig.).

  6. CT appearance of renal hemorrhage after extracorporeal shock wave lithotripsy

    International Nuclear Information System (INIS)

    Kanazawa, Susumu; Araki, Toru; Takamoto, Hitoshi; Hata, Kazuhiro

    1988-01-01

    Computed Tomography (CT) was performed in three patients who were suspicious of renal hemorrhage after extracorporeal shock wave lithotripsy (ESWL). Post-ESWL scans demonstrated subcapsular hematoma in all three cases, and intrarenal hemorrhage in two cases, one of which had fluid collection in the pararenal space and hemorrhage in the posterior pararenal space on CT. Thickening of gerota fascia and bridging septa in the perirenal space was visualized on CT in all of them. CT demonstrated clearly the anatomic distribution and extent of renal hemorrhage, and it is important to comprehend the imaging anatomy of the perirenal area for CT evaluation. (author)

  7. Dysphonia and vocal fold telangiectasia in hereditary hemorrhagic telangiectasia.

    Science.gov (United States)

    Chang, Joseph; Yung, Katherine C

    2014-11-01

    This case report is the first documentation of dysphonia and vocal fold telangiectasia as a complication of hereditary hemorrhagic telangiectasia (HHT). Case report of a 40-year-old man with HHT presenting with 2 years of worsening hoarseness. Hoarseness corresponded with a period of anticoagulation. Endoscopy revealed vocal fold scarring, vocal fold telangiectasias, and plica ventricular is suggestive of previous submucosal vocal fold hemorrhage and subsequent counterproductive compensation with ventricular phonation. Hereditary hemorrhagic telangiectasia may present as dysphonia with vocal fold telangiectasias and place patients at risk of vocal fold hemorrhage. © The Author(s) 2014.

  8. Evaluation of sugar-cane bagasse as bioadsorbent in the textile wastewater treatment contaminated with carcinogenic congo red dye

    Directory of Open Access Journals (Sweden)

    Aline Sartório Raymundo

    2010-08-01

    Full Text Available A methodology involving sugar cane bagasse bioadsorbent was developed in order to remove the carcinogenic congo red dye from aqueous medium. The results showed high efficiency with retention of 64 ± 6% in synthetic congo red solution and 94 ± 5% in effluent enriched with congo red, at 10.0 g of the bioadsorbent. The adsorption system provided a maximum adsorption capacity of 4.43 mg/g. Tests showed independence adsorption properties, when compared with the column flow rates. The treatment units could be operated with flexibility. From the results, it was possible to conclude that sugar cane bagasse could be an adequate bioadsorbent.Neste trabalho foi desenvolvida uma metodologia de remoção do corante carcinogênico congo red de sistemas aquosos. Os resultados mostraram uma elevada eficiência de remoção sendo de 64 ± 6% para soluções sintéticas de vermelho congo, e 94 ± 5% para efluente industrial enriquecido com vermelho congo utilizando 10 g de bioadsorvente. A capacidade máxima adsotiva encontrada foi de 4,43 mg/g. Os testes de percolação revelaram independência das porcentagens adsortivas em relação às vazões das colunas. Estes resultados indicam viabilidade de uso do bagaço de cana-de-açucar no tratamento de efluentes contendo o congo red.

  9. Commitment to a Lady’s First WIN : Banking Innovation in the Democratic Republic of Congo

    OpenAIRE

    Vivian Awiti Owuor

    2011-01-01

    Doing business is challenging in the Democratic Republic of Congo and presents opportunities for innovative approaches to banking, especially for micro, small, and medium enterprises (MSMEs) - and particularly for women entrepreneurs. But it is getting easier, thanks to innovating banking. This SmartLesson reviews some of the early lessons learned from the ongoing implementation of a Women...

  10. Congo, de missie en de literatuur: Over David van Reybrouck, J. G. ...

    African Journals Online (AJOL)

    However, the travel books written by Lieve Joris and Bart Castelein and the play Missie (Mission) written by David van Reybrouck (2007) sketched a positive and nostalgic image of the missionary. Keywords: Dutch (post)colonial literature, Congo, missionaries, colonialism. Tydskrif vir Letterkunde Vol. 46 (1) 2009: pp. 123- ...

  11. Les effets du changement climatique dans le bassin du Congo : la ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    22 avr. 2016 ... Dans le bassin du fleuve Congo, plus de 80 % des habitants vivent exclusivement de l'agriculture, de la pêche, de l'élevage et de la cueillette, qui sont des activités largement tributaires du climat.

  12. Heath sector network governance and State-building in South Kivu, Democratic Republic of Congo

    NARCIS (Netherlands)

    Bwimana, Aembe

    2017-01-01

    Longstanding patterns of interaction exist between state and non-state actors seeking to improve public health in Democratic Republic of Congo (DRC). DRC is a weak state, and, in many cases, private actors have stepped in to fill the void created by the lack of state health care provision. However,

  13. Mapping monkeypox transmission risk through time and space in the Congo Basin

    Science.gov (United States)

    Nakazawa, Yoshinori J.; Lash, R. Ryan; Carroll, Darin S.; Damon, Inger K.; Karem, Kevin L.; Reynolds, Mary G.; Osorio, Jorge E.; Rocke, Tonie E.; Malekani, Jean; Muyembe, Jean-Jacques; Formenty, Pierre; Peterson, A. Townsend

    2013-01-01

    Monkeypox is a major public health concern in the Congo Basin area, with changing patterns of human case occurrences reported in recent years. Whether this trend results from better surveillance and detection methods, reduced proportions of vaccinated vs. non-vaccinated human populations, or changing environmental conditions remains unclear. Our objective is to examine potential correlations between environment and transmission of monkeypox events in the Congo Basin. We created ecological niche models based on human cases reported in the Congo Basin by the World Health Organization at the end of the smallpox eradication campaign, in relation to remotely-sensed Normalized Difference Vegetation Index datasets from the same time period. These models predicted independent spatial subsets of monkeypox occurrences with high confidence; models were then projected onto parallel environmental datasets for the 2000s to create present-day monkeypox suitability maps. Recent trends in human monkeypox infection are associated with broad environmental changes across the Congo Basin. Our results demonstrate that ecological niche models provide useful tools for identification of areas suitable for transmission, even for poorly-known diseases like monkeypox.

  14. A model to predict when a cholera outbreak might hit the Congo

    Science.gov (United States)

    Schultz, Colin

    2014-09-01

    In 2011, as many as 600,000 people in 58 countries contracted cholera, with thousands succumbing to the disease. In most countries, cholera is rare. In others, like the Democratic Republic of the Congo, cholera is an endemic threat, always lurking in the background waiting for the right set of conditions to spark an outbreak.

  15. Governing Congo Basin forests in a changing climate: actors, discourses and institutions for adaptation and mitigation

    NARCIS (Netherlands)

    Somorin, O.A.

    2014-01-01

    Governing Congo Basin Forests in a Changing Climate: Actors, Discourses and Institutions for Adaptation and Mitigation

    OA Somorin

    Abstract

    The thesis deals with the central question of the governance processes of making

  16. Les écoles au Congo belge en 1924. Le rapport De Jonghe ...

    African Journals Online (AJOL)

    enseignement au Congo, exprimé dans le projet de 1922, De Jonghe a entrepris un voyage de reconnaissance en 1924. Une nouvelle version du Projet paraissait en 1925 et la version définitive est approuvée en 1928 et publiée en 1929.

  17. Scorpion envenomation in pygmies from Democratic Republic of Congo, the example of Pelenge Center, Lomela, DRC

    Directory of Open Access Journals (Sweden)

    E Biezakala Mudiandambu

    2012-01-01

    Full Text Available In a survey among the pygmies of central Democratic Republic of Congo, the incidence of scorpion stings seemed very high with a severity greater than expected. Species responsible were not identified. Specific studies are needed to clarify the risk emerging in the equatorial African forest.

  18. To Tip or Not to Tip: The Case of the Congo Basin Rainforest Realm

    Science.gov (United States)

    Pietsch, S.; Bednar, J. E.; Fath, B. D.; Winter, P. A.

    2017-12-01

    The future response of the Congo basin rainforest, the second largest tropical carbon reservoir, to climate change is still under debate. Different Climate projections exist stating increase and decrease in rainfall and different changes in rainfall patterns. Within this study we assess all options of climate change possibilities to define the climatic thresholds of Congo basin rainforest stability and assess the limiting conditions for rainforest persistence. We use field data from 199 research plots from the Western Congo basin to calibrate and validate a complex BioGeoChemistry model (BGC-MAN) and assess model performance against an array of possible future climates. Next, we analyze the reasons for the occurrence of tipping points, their spatial and temporal probability of occurrence, will present effects of hysteresis and derive probabilistic spatial-temporal resilience landscapes for the region. Additionally, we will analyze attractors of forest growth dynamics and assess common linear measures for early warning signals of sudden shifts in system dynamics for their robustness in the context of the Congo Basin case, and introduce the correlation integral as a nonlinear measure of risk assessment.

  19. Enhanced adsorptive degradation of Congo red in aqueous solutions using polyaniline/Fe0 composite nanofibers

    CSIR Research Space (South Africa)

    Bhaumik, M

    2015-01-01

    Full Text Available In this study, a simple approach was described for the fabrication of composite nanofibers (CNFs) of polyaniline/Fe0 (PANI/Fe0) using a template-free method for the reductive degradation and removal of Congo red (CR) from aqueous solutions. The PANI...

  20. Phytochemical analysis and biological evaluation of selected African propolis samples from Cameroon and Congo

    NARCIS (Netherlands)

    Papachroni, D.; Graikou, K.; Kosalec, I.; Damianakos, H.; Ingram, V.J.; Chinou, I.

    2015-01-01

    The objective of this study was the chemical analysis of four selected samples of African propolis (Congo and Cameroon) and their biological evaluation. Twenty-one secondary metabolites belonging to four different chemical groups were isolated from the 70% ethanolic extracts of propolis and their