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Sample records for fatal neonatal mitochondrial

  1. Fatal acidosis in a neonate with Pearson syndrome.

    Science.gov (United States)

    Gürakan, B; Ozbek, N; Varan, B; Demirhan, B

    1999-01-01

    We report a neonate who presented with hypotonia, hypoglycemia, and severe lactic acidosis. The patient's acidosis did not respond to bicarbonate replacement and dialysis. Postmortem liver samples revealed portal dilatation, fibrosis, canalicular proliferation, cholestasis, and hepatocellular hemosiderosis. Vacuolization of bone marrow precursors suggested a diagnosis of Pearson syndrome. A common mitochondrial DNA deletion of 4,978 bp was found. We emphasize that Pearson syndrome should be considered in neonates with lactic acidosis despite absence of anemia.

  2. Fatal hypertensive crisis as presentation of mitochondrial complex I deficiency.

    NARCIS (Netherlands)

    Lohmeier, K.; Distelmaier, F.; Heuvel, L.P.W.J. van den; Rodenburg, R.J.T.; Smeitink, J.A.M.; Mayatepek, E.; Hoehn, T.

    2007-01-01

    Complex I deficiency is a frequent defect of the mitochondrial electron transport chain. We report on a 3-year-old boy, who rapidly deteriorated after sudden flushing and collapse. This fatal and unusual case was characterized by widely uncontrollable arterial hypertension. It might indicate that

  3. Fatal Neonatal Herpes Simplex Infection Likely from Unrecognized Breast Lesions.

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    Field, Scott S

    2016-02-01

    Type 1 herpes simplex virus (HSV-1) is very prevalent yet in rare circumstances can lead to fatal neonatal disease. Genital acquisition of type 2 HSV is the usual mode for neonatal herpes, but HSV-1 transmission by genital or extragenital means may result in greater mortality rates. A very rare scenario is presented in which the mode of transmission was likely through breast lesions. The lesions were seen by nurses as well as the lactation consultant and obstetrician in the hospital after delivery of the affected baby but not recognized as possibly being caused by herpes. The baby died 9 days after birth with hepatic failure and disseminated intravascular coagulation. Peripartum health care workers need to be aware of potential nongenital (including from the breast[s]) neonatal herpes acquisition, which can be lethal. © The Author(s) 2015.

  4. A fatal case of hypernatraemic dehydration in a neonate.

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    Staub, Eveline; Wilkins, Barry

    2012-09-01

    Problems with lactation can result in hypernatraemic dehydration in the neonate, with potentially severe adverse consequences. This is illustrated in this fatal case of a 10 day old neonate who presented with excessive hypernatraemic dehydration due to insufficient breast milk intake, resulting in cerebral sinus vein thrombosis with cerebral haemorrhage and infarction. Differential diagnosis included excessive sodium intake (through inappropriately mixed formula or house remedies or through hyperaldosteronism) and high water deficit (renal or gastrointestinal losses, nephrogenic or central diabetes insipidus), all of which were ruled out by specific investigations or history. No evidence was found for inborn error of metabolism. The dehydration in this baby, however, was accentuated by trans-epidermal water loss due to an ichthyosiform skin condition. This first ever reported Australian fatality from neonatal hypernatraemic dehydration supports the concern of health care professionals over rising incidences of this entity in exclusively breastfed infants, and should encourage endorsement of improved monitoring of weight loss in newborns and breastfeeding support for their mothers. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  5. Study of Early Predictors of Fatality in Mechanically Ventilated Neonates in NICU

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    Sangeeta S Trivedi

    2009-11-01

    Full Text Available Objective: To evaluate the risk factors associated with fatality in mechanically ventilated neonates using multiple regression analysis. Design & settings: Prospective study conducted at Neonatal ICU at New Civil Hospital, Surat – a tertiary care centre, from December, 2007 to May, 2008 for 6 months. Methods: Fifty neonates in NICU consecutively put on mechanical ventilator during study period were enrolled in the study. The pressure limited time cycled ventilator was used. All admitted neonates were subjected to an arterial blood gas analysis along with a set of investigations to look for pulmonary maturity, infections, renal function, hyperbilirubinemia, intraventricular hemorrhage and congenital anomalies. Different investigation facilities were used as and when required during ventilation of neonates. Multiple logistic regression analysis was done to find out the predictors of fatality among these neonates. Results: Various factors suspected as predictors of fatality of mechanically ventilated neonates were assessed. Hypothermia, prolonged capillary refill time (CRT, initial requirement of oxygen fraction (FiO2 >0.6, alveolar to arterial PO2 difference (AaDO2 >250, alveolar to arterial PO2 ratio (a/A 10 were found statistically highly significant predictors of mortality among mechanically ventilated neonates. Conclusion: Hypothermia and prolonged capillary refill time were independent predictors of fatality in neonatal mechanical ventilation. Risk of fatality can be identified in mechanically ventilated neonates

  6. Fatal Neonatal Peritoneal Candidiasis Mimicking Mucormycosis-A Case Report and Review of Literature.

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    Kashyap, Bineeta; Kusumakar, Kanupriya; Kumar Sarin, Yogesh

    2016-10-01

    Candida species have been implicated as significant contributors to morbidity in the neonatal period and are associated with 25-50% of mortality in invasive neonatal candidiasis. Peritoneal candidiasis, being paucisymptomatic, cannot often be correctly identified in a preterm neonate. The correct approach to diagnosis of neonatal peritoneal candidiasis is taking into account the epidemiology along with a strong clinical suspicion and appropriate timely diagnostic interventions. We report a case of fatal neonatal peritoneal candidiasis which was misdiagnosed as mucormycosis. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. "Stiff neonate" with mitochondrial DNA depletion and secondary neurotransmitter defects.

    LENUS (Irish Health Repository)

    Moran, Margaret M

    2011-12-01

    Mitochondrial disorders comprise a heterogenous group. A neonate who presented with episodes of severe truncal hypertonia and apnea progressed to a hypokinetic rigid syndrome characterized by hypokinesia, tremulousness, profound head lag, absent suck and gag reflexes, brisk deep tendon reflexes, ankle and jaw clonus, and evidence of autonomic dysfunction. Analysis of cerebrospinal fluid neurotransmitters from age 7 weeks demonstrated low levels of amine metabolites (homovanillic acid and 5-hydroxyindoleacetic acid), tetrahydrobiopterin, and pyridoxal phosphate. Mitochondrial DNA quantitative studies on muscle homogenate demonstrated a mitochondrial DNA depletion disorder. Respiratory chain enzymology demonstrated decreased complex IV activity. Screening for mitochondrial DNA rearrangement disorders and sequencing relevant mitochondrial genes produced negative results. No clinical or biochemical response to treatment with pyridoxal phosphate, tetrahydrobiopterin, or l-dopa occurred. The clinical course was progressive, and the patient died at age 19 months. Mitochondrial disorders causing secondary neurotransmitter diseases are usually severe, but are rarely reported. This diagnosis should be considered in neonates or infants who present with hypertonia, hypokinesia rigidity, and progressive neurodegeneration.

  8. QIL1 mutation causes MICOS disassembly and early onset fatal mitochondrial encephalopathy with liver disease.

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    Guarani, Virginia; Jardel, Claude; Chrétien, Dominique; Lombès, Anne; Bénit, Paule; Labasse, Clémence; Lacène, Emmanuelle; Bourillon, Agnès; Imbard, Apolline; Benoist, Jean-François; Dorboz, Imen; Gilleron, Mylène; Goetzman, Eric S; Gaignard, Pauline; Slama, Abdelhamid; Elmaleh-Bergès, Monique; Romero, Norma B; Rustin, Pierre; Ogier de Baulny, Hélène; Paulo, Joao A; Harper, J Wade; Schiff, Manuel

    2016-09-13

    Previously, we identified QIL1 as a subunit of mitochondrial contact site (MICOS) complex and demonstrated a role for QIL1 in MICOS assembly, mitochondrial respiration, and cristae formation critical for mitochondrial architecture (Guarani et al., 2015). Here, we identify QIL1 null alleles in two siblings displaying multiple clinical symptoms of early-onset fatal mitochondrial encephalopathy with liver disease, including defects in respiratory chain function in patient muscle. QIL1 absence in patients' fibroblasts was associated with MICOS disassembly, abnormal cristae, mild cytochrome c oxidase defect, and sensitivity to glucose withdrawal. QIL1 expression rescued cristae defects, and promoted re-accumulation of MICOS subunits to facilitate MICOS assembly. MICOS assembly and cristae morphology were not efficiently rescued by over-expression of other MICOS subunits in patient fibroblasts. Taken together, these data provide the first evidence of altered MICOS assembly linked with a human mitochondrial disease and confirm a central role for QIL1 in stable MICOS complex formation.

  9. Mitochondrial phenylalanyl-tRNA synthetase mutations underlie fatal infantile Alpers encephalopathy

    DEFF Research Database (Denmark)

    Elo, Jenni M; Yadavalli, Srujana S; Euro, Liliya

    2012-01-01

    the mitochondrial phenylalanyl transfer RNA (tRNA) synthetase (mtPheRS) in two patients with fatal epileptic mitochondrial encephalopathy. The mutations affected highly conserved amino acids, p.I329T and p.D391V. Recently, a homozygous FARS2 variant p.Y144C was reported in a Saudi girl with mitochondrial...... encephalopathy, but the pathogenic role of the variant remained open. Clinical features, including postnatal onset, catastrophic epilepsy, lactic acidemia, early lethality and neuroimaging findings of the patients with FARS2 variants, resembled each other closely, and neuropathology was consistent with Alpers...... was impaired. Our results imply that the three FARS2 mutations directly impair aminoacylation function and stability of mtPheRS, leading to a decrease in overall tRNA charging capacity. This study establishes a new genetic cause of infantile mitochondrial Alpers encephalopathy and reports a new mitochondrial...

  10. Neonatal multiorgan failure due to ACAD9 mutation and complex I deficiency with mitochondrial hyperplasia in liver, cardiac myocytes, skeletal muscle, and renal tubules.

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    Leslie, Nancy; Wang, Xinjian; Peng, Yanyan; Valencia, C Alexander; Khuchua, Zaza; Hata, Jessica; Witte, David; Huang, Taosheng; Bove, Kevin E

    2016-03-01

    Complex I deficiency causes Leigh syndrome, fatal infant lactic acidosis, and neonatal cardiomyopathy. Mutations in more than 100 nuclear DNA and mitochondrial DNA genes miscode for complex I subunits or assembly factors. ACAD9 is an acyl-CoA dehydrogenase with a novel function in assembly of complex I; biallelic mutations cause progressive encephalomyopathy, recurrent Reye syndrome, and fatal cardiomyopathy. We describe the first autopsy in fatal neonatal lethal lactic acidosis due to mutations in ACAD9 that reduced complex I activity. We identified mitochondrial hyperplasia in cardiac myocytes, diaphragm muscle, and liver and renal tubules in formalin-fixed, paraffin-embedded tissue using immunohistochemistry for mitochondrial antigens. Whole-exome sequencing revealed compound heterozygous variants in the ACAD9 gene: c.187G>T (p.E63*) and c.941T>C (p.L314P). The nonsense mutation causes late infantile lethality; the missense variant is novel. Autopsy-derived fibroblasts had reduced complex I activity (53% of control) with normal activity in complexes II to IV, similar to reported cases of ACAD9 deficiency. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Glutamate antagonism fails to reverse mitochondrial dysfunction in late phase of experimental neonatal asphyxia in rats.

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    Reddy, Nagannathahalli Ranga; Krishnamurthy, Sairam; Chourasia, Tapan Kumar; Kumar, Ashok; Joy, Keerikkattil Paily

    2011-04-01

    Neonatal asphyxia is a primary contributor to neonatal mortality and neuro-developmental disorders. It progresses in two distinct phases, as initial primary process and latter as the secondary process. A dynamic relationship exists between excitotoxicity and mitochondrial dysfunction during the progression of asphyxic injury. Study of status of glutamate and mitochondrial function in tandem during primary and secondary processes may give new leads to the treatment of asphyxia. Neonatal asphyxia was induced in rat pups on the day of birth by subjecting them to two episodes (10min each) of anoxia, 24h apart by passing 100% N(2) into an enclosed chamber. The NMDA antagonist ketamine (20mg/kg/day) was administered either for 1 day or 7 days after anoxic exposure. Tissue glutamate and nitric oxide were estimated in the cerebral cortex, extra-cortex and cerebellum. The mitochondria from the above brain regions were used for the estimation of malondialdehyde, and activities of superoxide dismutase and succinate dehydrogenase. Mitochondrial membrane potential was evaluated by using Rhodamine dye. Anoxia during the primary process increased glutamate and nitric oxide levels; however the mitochondrial function was unaltered in terms of succinate dehydrogenase and membrane potential. Acute ketamine treatment reversed the increase in both glutamate and nitric oxide levels and partially attenuated mitochondrial function in terms of succinate dehydrogenase activity. The elevated glutamate and nitric oxide levels were maintained during the secondary process but however with concomitant loss of mitochondrial function. Repeated ketamine administration reversed glutamate levels only in the cerebral cortex, where as nitric oxide was decreased in all the brain regions. However, repeated ketamine administration was unable to reverse anoxia-induced mitochondrial dysfunction. The failure of glutamate antagonism in the treatment of asphyxia may be due to persistence of mitochondrial

  12. A case of near-fatal flecainide overdose in a neonate successfully treated with sodium bicarbonate.

    Science.gov (United States)

    Jang, David H; Hoffman, Robert S; Nelson, Lewis S

    2013-04-01

    Flecainide is a class IC antidysrhythmic primarily indicated for ventricular dysrhythmias and supraventricular tachycardia (SVT). Class IC antidysrhythmic overdose has a reported mortality of 22%, and death results from dysrhythmias and cardiovascular collapse. We report a near-fatal flecainide overdose in an 18-day-old treated successfully with sodium bicarbonate. An 18-day-old, 2 weeks premature, 4-kg boy developed persistently high heart rates (220-240 beats/min) and electrocardiographic changes consistent with SVT. There was minimal response to vagal maneuvers, adenosine, and esmolol, and a transthoracic echocardiogram showed no underlying structural abnormality. The patient was then started on flecainide 4 mg orally every 8 h (Q8h). After the fourth dose he developed lethargy, cold clammy skin, and a heart rate of 40 beats/min with no palpable pulse. The patient was given 0.1 mg of atropine intravenously, with an increase of the heart rate to 160 beats/min. The child's cardiac monitor revealed a wide-complex tachycardia with left bundle branch morphology, with associated pallor and poor capillary refill. Sodium bicarbonate was administered intravenously due to suspected flecainide toxicity. Approximately 5 min after intravenous administration of 10 mEq of 8.4% sodium bicarbonate twice, his rhythm converted to a narrow-complex tachycardia. A serum flecainide concentration was 1360 μg/L (therapeutic, 200-1000 μg/L) drawn 1 h before the cardiac arrest. It was later discovered that a twofold dosing error occurred: the patient received 8 mg Q8h instead of 4 mg Q8h for four doses. Flecainide toxicity in children is rare, especially in neonates. It is important for clinicians to be able to identify and treat this uncommon poisoning. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Fatal case of influenza B virus pneumonia in a preterm neonate

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    van den Dungen, F. A.; van Furth, A. M.; Fetter, W. P.; Zaaijer, H. L.; van Elburg, R. M.

    2001-01-01

    Influenza B infection typically has low mortality. A 1020-g neonate had a septic clinical picture and pneumonia. Influenza B virus was isolated from nasopharyngeal and tracheal aspirates. The infant died

  14. Føtal og neonatal alloimmun trombocytopeni er en mulig fatal tilstand

    DEFF Research Database (Denmark)

    Morling Taaning, Ellen Birkerod; Kjeldsen-Kragh, Jens; Hedegaard, Morten

    2011-01-01

    Fetal and neonatal alloimmune thrombocytopenia (FNAIT) may lead to intracranial haemorrhage (ICH) resulting in neurological damage or death. In FNAIT, transplacental maternal antibodies cause destruction of fetal platelets. Maternal immunisation occurs to fetal human platelet antigens (HPAs...

  15. Fatal illness associated with pulmonary hypertension in a neonate caused by intrauterine echovirus 11 infection

    NARCIS (Netherlands)

    Willems, A.; Benne, CA; Timmer, A; Bergman, K.A.

    Nonpolio enterovirus (NPEV) infections are known to cause a wide range of illnesses in the neonatal period. In most cases, NPEV is presumed to be contracted during birth. Intrauterine NPEV infections occur infrequently. A case of Intrauterine echovirus 11 infection with pneumonia, persistent

  16. Føtal og neonatal alloimmun trombocytopeni er en mulig fatal tilstand

    DEFF Research Database (Denmark)

    Morling Taaning, Ellen Birkerod; Kjeldsen-Kragh, Jens; Hedegaard, Morten

    2011-01-01

    Fetal and neonatal alloimmune thrombocytopenia (FNAIT) may lead to intracranial haemorrhage (ICH) resulting in neurological damage or death. In FNAIT, transplacental maternal antibodies cause destruction of fetal platelets. Maternal immunisation occurs to fetal human platelet antigens (HPAs......) inherited from the father. In the absence of screening the diagnosis often relies on a serious incident in a previous pregnancy or in a newborn sibling. Thus, a future reduction in the risk of ICH depends on prospective large trials to evaluate different diagnostic, treatment, and prevention strategies....

  17. Novel large-range mitochondrial DNA deletions and fatal multisystemic disorder with prominent hepatopathy

    International Nuclear Information System (INIS)

    Bianchi, Marzia; Rizza, Teresa; Verrigni, Daniela; Martinelli, Diego; Tozzi, Giulia; Torraco, Alessandra; Piemonte, Fiorella; Dionisi-Vici, Carlo; Nobili, Valerio; Francalanci, Paola; Boldrini, Renata; Callea, Francesco; Santorelli, Filippo Maria; Bertini, Enrico

    2011-01-01

    Highlights: ► Expanded array of mtDNA deletions. ► Pearson syndrome with prominent hepatopathy associated with single mtDNA deletions. ► Detection of deletions in fibroblasts and blood avoids muscle and liver biopsy. ► Look for mtDNA deletions before to study nuclear genes related to mtDNA depletion. -- Abstract: Hepatic involvement in mitochondrial cytopathies rarely manifests in adulthood, but is a common feature in children. Multiple OXPHOS enzyme defects in children with liver involvement are often associated with dramatically reduced amounts of mtDNA. We investigated two novel large scale deletions in two infants with a multisystem disorder and prominent hepatopathy. Amount of mtDNA deletions and protein content were measured in different post-mortem tissues. The highest levels of deleted mtDNA were in liver, kidney, pancreas of both patients. Moreover, mtDNA deletions were detected in cultured skin fibroblasts in both patients and in blood of one during life. Biochemical analysis showed impairment of mainly complex I enzyme activity. Patients manifesting multisystem disorders in childhood may harbour rare mtDNA deletions in multiple tissues. For these patients, less invasive blood specimens or cultured fibroblasts can be used for molecular diagnosis. Our data further expand the array of deletions in the mitochondrial genomes in association with liver failure. Thus analysis of mtDNA should be considered in the diagnosis of childhood-onset hepatopathies.

  18. Novel large-range mitochondrial DNA deletions and fatal multisystemic disorder with prominent hepatopathy

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    Bianchi, Marzia; Rizza, Teresa; Verrigni, Daniela [Unit of Molecular Medicine for Neuromuscular and Neurodegenerative Diseases, ' Bambino Gesu' Children' s Hospital, Rome (Italy); Martinelli, Diego [Division of Metabolism, ' Bambino Gesu' Children' s Hospital, Rome (Italy); Tozzi, Giulia; Torraco, Alessandra; Piemonte, Fiorella [Unit of Molecular Medicine for Neuromuscular and Neurodegenerative Diseases, ' Bambino Gesu' Children' s Hospital, Rome (Italy); Dionisi-Vici, Carlo [Division of Metabolism, ' Bambino Gesu' Children' s Hospital, Rome (Italy); Nobili, Valerio [Gastroenterology and Liver Unit, ' Bambino Gesu' Children' s Hospital, Rome (Italy); Francalanci, Paola; Boldrini, Renata; Callea, Francesco [Dept. Pathology, ' Bambino Gesu' Children' s Hospital, Rome (Italy); Santorelli, Filippo Maria [UOC Neurogenetica e Malattie Neuromuscolari, Fondazione Stella Maris, Pisa (Italy); Bertini, Enrico [Unit of Molecular Medicine for Neuromuscular and Neurodegenerative Diseases, ' Bambino Gesu' Children' s Hospital, Rome (Italy); and others

    2011-11-18

    Highlights: Black-Right-Pointing-Pointer Expanded array of mtDNA deletions. Black-Right-Pointing-Pointer Pearson syndrome with prominent hepatopathy associated with single mtDNA deletions. Black-Right-Pointing-Pointer Detection of deletions in fibroblasts and blood avoids muscle and liver biopsy. Black-Right-Pointing-Pointer Look for mtDNA deletions before to study nuclear genes related to mtDNA depletion. -- Abstract: Hepatic involvement in mitochondrial cytopathies rarely manifests in adulthood, but is a common feature in children. Multiple OXPHOS enzyme defects in children with liver involvement are often associated with dramatically reduced amounts of mtDNA. We investigated two novel large scale deletions in two infants with a multisystem disorder and prominent hepatopathy. Amount of mtDNA deletions and protein content were measured in different post-mortem tissues. The highest levels of deleted mtDNA were in liver, kidney, pancreas of both patients. Moreover, mtDNA deletions were detected in cultured skin fibroblasts in both patients and in blood of one during life. Biochemical analysis showed impairment of mainly complex I enzyme activity. Patients manifesting multisystem disorders in childhood may harbour rare mtDNA deletions in multiple tissues. For these patients, less invasive blood specimens or cultured fibroblasts can be used for molecular diagnosis. Our data further expand the array of deletions in the mitochondrial genomes in association with liver failure. Thus analysis of mtDNA should be considered in the diagnosis of childhood-onset hepatopathies.

  19. Tempol (4 hydroxy-tempo) inhibits anoxia-induced progression of mitochondrial dysfunction and associated neurobehavioral impairment in neonatal rats.

    Science.gov (United States)

    Samaiya, Puneet K; Narayan, Gopeshwar; Kumar, Ashok; Krishnamurthy, Sairam

    2017-04-15

    Anoxia leads to a robust generation of reactive oxygen species/nitrogen species which can result in mitochondrial dysfunction and associated cell death in the cerebral cortex of neonates. The present study investigated the pharmacological role of tempol in the treatment of rat neonatal cortical mitochondrial dysfunction induced insult progression (day-1 to day-7) and associated neurobehavioral alterations post-anoxia. Rat pups of 30h age or postnatal day 2 (PND2) were randomly divided into 5 groups (n=5 per group): (1) Control; (2) Anoxia; (3) Anoxia+Tempol 75mg/kg; (4) Anoxia+Tempol 150mg/kg; and (5) Anoxia+Tempol 300mg/kg, and subjected to two episode of anoxia (10min each) at 24h of time interval in an enclosed chamber supplied with 100% N 2 . Tempol significantly decreased nitric oxide (NO) formation and simultaneously improved superoxide dismutase (SOD) and catalase (CAT) activities. Further, we observed a significantly (Ptempol. Furthermore, tempol decreased expression of mitochondrial Bax, cytochrome-C, caspase-9 and caspase-3 while the increase in expression of cytoplasmic Bax, mitochondrial Bcl-2 on day-7 in cortical region indicating regulation of intrinsic pathway of apoptosis. Further, it improved anoxia-induced neurobehavioral outcome (hanging and reflex latencies). Biochemical, molecular and behavioral studies suggest the role of tempol in preserving mitochondrial function and associated neurobehavioral outcomes after neonatal anoxia. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Ethanol Influences on Bax Associations with Mitochondrial Membrane Proteins in Neonatal Rat Cerebellum

    Science.gov (United States)

    Heaton, Marieta Barrow; Siler-Marsiglio, Kendra; Paiva, Michael; Kotler, Alexandra; Rogozinski, Jonathan; Kubovec, Stacey; Coursen, Mary; Madorsky, Vladimir

    2012-01-01

    These studies investigated interactions taking place at the mitochondrial membrane in neonatal rat cerebellum following ethanol exposure, and focused on interactions between pro-apoptotic Bax and proteins of the permeability transition pore (PTP), voltage-dependent anion channel (VDAC), and adenine nucleotide translocator (ANT), of the outer and inner mitochondrial membranes, respectively. Cultured cerebellar granule cells were used to assess the role of these interactions in ethanol neurotoxicity. Analyses were made at the age of maximal cerebellar ethanol vulnerability (P4), compared to the later age of relative resistance (P7), to determine whether differential ethanol sensitivity was mirrored by differences in these molecular interactions. We found that following ethanol exposure, Bax pro-apoptotic associations with both VDAC and ANT were increased, particularly at the age of greater ethanol sensitivity, and these interactions were sustained at this age for at least two hours post-exposure. Since Bax:VDAC interactions disrupt protective VDAC interactions with mitochondrial hexokinase (HXK), we also assessed VDAC:HXK associations following ethanol treatment, and found such interactions were altered by ethanol treatment, but only at two-hours post-exposure, and only in the P4, ethanol-sensitive cerebellum. Ethanol neurotoxicity in cultured neuronal preparations was abolished by pharmacological inhibition of both VDAC and ANT interactions with Bax, but not by a Bax channel blocker. Therefore, we conclude that at this age, within the constraints of our experimental model, a primary mode of Bax-induced initiation of the apoptosis cascade following ethanol insult involves interactions with proteins of the PTP complex, and not channel formation independent of PTP constituents. PMID:22767450

  1. Fetal and neonatal nicotine exposure in Wistar rats causes progressive pancreatic mitochondrial damage and beta cell dysfunction.

    Directory of Open Access Journals (Sweden)

    Jennifer E Bruin

    Full Text Available Nicotine replacement therapy (NRT is currently recommended as a safe smoking cessation aid for pregnant women. However, fetal and neonatal nicotine exposure in rats causes mitochondrial-mediated beta cell apoptosis at weaning, and adult-onset dysglycemia, which we hypothesize is related to progressive mitochondrial dysfunction in the pancreas. Therefore in this study we examined the effect of fetal and neonatal exposure to nicotine on pancreatic mitochondrial structure and function during postnatal development. Female Wistar rats were given saline (vehicle control or nicotine bitartrate (1 mg/kg/d via subcutaneous injection for 2 weeks prior to mating until weaning. At 3-4, 15 and 26 weeks of age, oral glucose tolerance tests were performed, and pancreas tissue was collected for electron microscopy, enzyme activity assays and islet isolation. Following nicotine exposure mitochondrial structural abnormalities were observed beginning at 3 weeks and worsened with advancing age. Importantly the appearance of these structural defects in nicotine-exposed animals preceded the onset of glucose intolerance. Nicotine exposure also resulted in significantly reduced pancreatic respiratory chain enzyme activity, degranulation of beta cells, elevated islet oxidative stress and impaired glucose-stimulated insulin secretion compared to saline controls at 26 weeks of age. Taken together, these data suggest that maternal nicotine use during pregnancy results in postnatal mitochondrial dysfunction that may explain, in part, the dysglycemia observed in the offspring from this animal model. These results clearly indicate that further investigation into the safety of NRT use during pregnancy is warranted.

  2. Mitochondrial Optic Atrophy (OPA) 1 Processing Is Altered in Response to Neonatal Hypoxic-Ischemic Brain Injury

    Science.gov (United States)

    Baburamani, Ana A.; Hurling, Chloe; Stolp, Helen; Sobotka, Kristina; Gressens, Pierre; Hagberg, Henrik; Thornton, Claire

    2015-01-01

    Perturbation of mitochondrial function and subsequent induction of cell death pathways are key hallmarks in neonatal hypoxic-ischemic (HI) injury, both in animal models and in term infants. Mitoprotective therapies therefore offer a new avenue for intervention for the babies who suffer life-long disabilities as a result of birth asphyxia. Here we show that after oxygen-glucose deprivation in primary neurons or in a mouse model of HI, mitochondrial protein homeostasis is altered, manifesting as a change in mitochondrial morphology and functional impairment. Furthermore we find that the mitochondrial fusion and cristae regulatory protein, OPA1, is aberrantly cleaved to shorter forms. OPA1 cleavage is normally regulated by a balanced action of the proteases Yme1L and Oma1. However, in primary neurons or after HI in vivo, protein expression of YmelL is also reduced, whereas no change is observed in Oma1 expression. Our data strongly suggest that alterations in mitochondria-shaping proteins are an early event in the pathogenesis of neonatal HI injury. PMID:26393574

  3. Mitochondrial Optic Atrophy (OPA) 1 Processing Is Altered in Response to Neonatal Hypoxic-Ischemic Brain Injury.

    Science.gov (United States)

    Baburamani, Ana A; Hurling, Chloe; Stolp, Helen; Sobotka, Kristina; Gressens, Pierre; Hagberg, Henrik; Thornton, Claire

    2015-09-17

    Perturbation of mitochondrial function and subsequent induction of cell death pathways are key hallmarks in neonatal hypoxic-ischemic (HI) injury, both in animal models and in term infants. Mitoprotective therapies therefore offer a new avenue for intervention for the babies who suffer life-long disabilities as a result of birth asphyxia. Here we show that after oxygen-glucose deprivation in primary neurons or in a mouse model of HI, mitochondrial protein homeostasis is altered, manifesting as a change in mitochondrial morphology and functional impairment. Furthermore we find that the mitochondrial fusion and cristae regulatory protein, OPA1, is aberrantly cleaved to shorter forms. OPA1 cleavage is normally regulated by a balanced action of the proteases Yme1L and Oma1. However, in primary neurons or after HI in vivo, protein expression of YmelL is also reduced, whereas no change is observed in Oma1 expression. Our data strongly suggest that alterations in mitochondria-shaping proteins are an early event in the pathogenesis of neonatal HI injury.

  4. Mutation of C20orf7 Disrupts Complex I Assembly and Causes Lethal Neonatal Mitochondrial Disease

    NARCIS (Netherlands)

    Sugiana, Canny; Pagliarini, David J.; McKenzie, Matthew; Kirby, Denise M.; Salemi, Renato; Abu-Amero, Khaled K.; Dahl, Hans-Henrik M.; Hutchison, Wendy M.; Vascotto, Katherine A.; Smith, Stacey M.; Newbold, Robert F.; Christodoulou, John; Calvo, Sarah; Mootha, Vamsi K.; Ryan, Michael T.; Thorburn, David R.

    2008-01-01

    Complex I (NADH:ubiquinone oxidoreductase) is the first and largest multimeric complex of the mitochondrial respiratory chain. Human complex I comprises seven Subunits encoded by mitochondrial DNA and 38 nuclear-encoded subunits that are assembled together in a process that is only partially

  5. Insulin accelerates global and mitochondrial protein synthesis rates in neonatal muscle during sepsis

    Science.gov (United States)

    In neonatal pigs, sepsis decreases protein synthesis in skeletal muscle by decreasing translation initiation. However, insulin stimulates muscle protein synthesis despite persistent repression of translation initiation signaling. To determine whether the insulin-induced increase in global rates of m...

  6. Regulation of mitochondrial contact sites in neonatal, juvenile and diabetic hearts

    Czech Academy of Sciences Publication Activity Database

    Ziegelhöffer-Mihalovičová, B.; Ziegelhöffer, A.; Ravingerová, T.; Kolář, František; Jacob, W.; Tribulová, N.

    2002-01-01

    Roč. 236, 1-2 (2002), s. 37-44 ISSN 0300-8177 Grant - others:VEGA(SK) 2/7157/21; VEGA(SK) 2/6094/21; VEGA(SK) 2/7155/21 Institutional research plan: CEZ:AV0Z5011922 Keywords : mitochondrial creatine phosphokinase * mitochondrial contact sites * diabetic heart Subject RIV: ED - Physiology Impact factor: 1.548, year: 2002

  7. Severe lactic acidosis and neonatal death in Pearson syndrome.

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    Muraki, K; Goto, Y; Nishino, I; Hayashidani, M; Takeuchi, S; Horai, S; Sakura, N; Ueda, K

    1997-03-01

    Pearson marrow-pancreas syndrome, a fatal disease associated with mitochondrial DNA rearrangements, is characterized by refractory sideroblastic anaemia during infancy. Only a few neonates with Pearson syndrome have been reported with metabolic acidosis. A female neonate who exhibited severe metabolic acidosis and anaemia at birth is described here. Her condition progressively worsened, with pancytopenia and uncontrollable metabolic acidosis resulting in death at the age of 14 days. A 4988-base pair deletion of mtDNA was detected in the patient's leukocytes, liver and muscle. When a neonate exhibits severe metabolic acidosis of unknown cause, the possibility of Pearson syndrome should be considered.

  8. Mitochondrial encephalocardio-myopathy with early neonatal onset due to TMEM70 mutation

    Czech Academy of Sciences Publication Activity Database

    Honzík, T.; Tesařová, M.; Mayr, J. A.; Hansíková, H.; Ješina, P.; Bodamer, O.; Koch, J.; Magner, M.; Freisinger, P.; Huemer, M.; Kostková, O.; Van Coster, R.; Kmoch, S.; Houštěk, Josef; Sperl, W.; Zeman, J.

    2010-01-01

    Roč. 95, č. 4 (2010), s. 296-301 ISSN 0003-9888 R&D Projects: GA MZd(CZ) NS9759; GA MŠk(CZ) 1M0520 Institutional research plan: CEZ:AV0Z50110509 Keywords : TMEM70 * ATP synthase * mitochondrial disease Subject RIV: FG - Pediatrics Impact factor: 2.616, year: 2010

  9. TMEM70 mutations cause isolated ATP synthase deficiency and neonatal mitochondrial encephalocardiomyopathy

    Czech Academy of Sciences Publication Activity Database

    Čížková, Alena; Stránecký, V.; Mayr, J. A.; Tesařová, M.; Havlíčková, Vendula; Paul, Jan; Ivánek, R.; Kuss, A. W.; Hansíková, H.; Kaplanová, Vilma; Vrbacký, Marek; Hartmannová, H.; Nosková, L.; Honzík, T.; Drahota, Zdeněk; Magner, M.; Hejzlarová, Kateřina; Sperl, W.; Zeman, J.; Houštěk, Josef; Kmoch, S.

    2008-01-01

    Roč. 40, č. 11 (2008), s. 1288-1290 ISSN 1061-4036 R&D Projects: GA MŠk(CZ) 1M0520; GA ČR GD305/08/H037; GA ČR(CZ) GD303/03/H065 Grant - others:Univerzita Karlova(CZ) 97807 Institutional research plan: CEZ:AV0Z50110509 Keywords : ATPase biogenesis * TMEM70 * mitochondrial disease Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 30.259, year: 2008

  10. Different roles of β-arrestin and the PKA pathway in mitochondrial ROS production induced by acute β-adrenergic receptor stimulation in neonatal mouse cardiomyocytes.

    Science.gov (United States)

    Zhang, Jianshu; Xiao, Han; Shen, Jing; Wang, Nanping; Zhang, Youyi

    2017-08-05

    Reactive oxygen species (ROS) play a crucial role in various physiological and pathological processes mediated by β-adrenergic receptors (β-ARs) in cardiomyocytes. However, the sources and signaling pathways involved in ROS production induced by acute β-AR activation have not yet been fully defined. In primary neonatal mouse cardiomyocytes (NMCMs), the β-AR agonist isoproterenol (ISO) induced a rapid increase in mitochondrial ROS and total ROS production. Both the expression and activity of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2/4 (NOX 2/4) remained unchanged after 2 h of ISO treatment, suggesting that acute ISO stimulation mainly induces mitochondrial ROS production in NMCMs. Knockdown of β-arrestin1, but not β-arrestin2, inhibited ISO-induced mitochondrial ROS production within 1-2 h after ISO treatment. Moreover, forskolin, an adenylyl cyclase (AC) activator, rapidly increased mitochondrial ROS as early as 15 min after ISO treatment. Inhibition of the cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA) pathway abolished the mitochondrial ROS production within 15-60 min after ISO treatment. In conclusion, mitochondria are the major source of ROS production upon acute ISO stimulation. β-arrestin1, but not β-arrestin2, is involved in ISO-induced mitochondrial ROS production. Upon acute β-AR stimulation in NMCMs, the classical cAMP/PKA pathway is responsible for faster mitochondrial ROS production, whereas β-arrestin1 signaling is responsible for slower mitochondrial ROS production. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Fatalism revisited.

    Science.gov (United States)

    Morgan, Phyllis D; Tyler, Indira D; Fogel, Joshua

    2008-11-01

    To review the concept of fatalism among African Americans by discussing how religiosity/spirituality may guide them in seeking cancer care in a positive rather than a fatalistic way. Nursing, social science, and medical journals. Using culturally targeted faith-based interventions to educate African Americans about cancer can serve as a strategy to increase cancer knowledge, decrease cancer fatalism, and ultimately increase cancer screening and treatment resulting in cancer activism. Nurses should advocate for faith-based initiatives to help address fatalism in the African American community, and to assist them in developing a more proactive role in cancer screening, treatment, and survivorship.

  12. Healthcare-Associated Infections in Pediatric and Neonatal Intensive Care Units: Impact of Underlying Risk Factors and Antimicrobial Resistance on 30-Day Case-Fatality in Italy and Brazil.

    Science.gov (United States)

    Folgori, Laura; Bernaschi, Paola; Piga, Simone; Carletti, Michaela; Cunha, Filippe Pirrone; Lara, Paulo Henrique Rodriguez; de Castro Peixoto, Nicholas Cafieiro; Alves Guimarães, Bárbara Gomes; Sharland, Mike; Araujo da Silva, André Ricardo; Ciofi Degli Atti, Marta

    2016-11-01

    OBJECTIVES To describe trends in the epidemiology of healthcare-associated Infections (HAIs) in pediatric/neonatal intensive care units (ICUs) and to evaluate risk factors and impact of multidrug resistance in children admitted to ICUs. DESIGN Multicenter, retrospective, cohort study with a nested case-control study conducted from January 1, 2010, through December 31, 2014. SETTING Three tertiary care pediatric hospitals in Italy and Brazil with a total of 103 ICU beds. PATIENTS Inclusion criteria were admission to ICU during the study period, age at onset less than 18 years, and microbiologically confirmed HAI. RESULTS A total of 538 HAIs in 454 children were included; 93.3% of patients had comorbidities. Bloodstream infections were the leading pattern (45.4%). The cumulative incidence of HAI was 3.6/100 ICU admissions and the crude 30-day fatality rate was 5.7/1,000 admissions. The most frequently isolated pathogens were Enterobacteriaceae, followed by Pseudomonas aeruginosa and Staphylococcus aureus. Forty-four percent of isolates were multidrug-resistant (MDR). Two multivariate logistic regressions were performed. Factors independently associated with an MDR-HAI were country, previous antibiotics, transplantation, major surgery, and colonization by an MDR strain. Factors independently associated with 30-day case fatality were country, previous transplantation, fungal infection, bloodstream infection, lower respiratory tract infection, and infection caused by MDR strains. CONCLUSIONS Infection control and prevention can limit the spread of MDR strains and improve outcomes. Targeted surveillance programs collecting neonatal and pediatric HAI/bloodstream infection data and outcomes would allow global benchmarking. The next step is to identify methods to monitor key HAIs and integrate these into affordable intervention programs. Infect Control Hosp Epidemiol 2016;1-8.

  13. Selective Fatalism.

    OpenAIRE

    Sunstein, Cass R

    1998-01-01

    Human beings are selectively fatalistic. Some risks appear as "background noise," whereas other, quantitatively identical risks cause enormous concern. This essay explores the reasons for selective fatalism and possible legal responses. Sometimes selective fatalism is a product of distributional issues, as people focus especially on risks that face particular groups; sometimes people adapt their preferences and beliefs so as to reduce concern with risks that they perceive themselves unable to...

  14. Complete deficiency of mitochondrial trifunctional protein due to a novel mutation within the beta-subunit of the mitochondrial trifunctional protein gene leads to failure of long-chain fatty acid beta-oxidation with fatal outcome

    NARCIS (Netherlands)

    Schwab, Karl Otfried; Ensenauer, Regina; Matern, Dietrich; Uyanik, Gökhan; Schnieders, Birgit; Wanders, Ronald A.; Lehnert, Willy

    2003-01-01

    The mitochondrial trifunctional protein (MTP) is a multienzyme complex which catalyses three of the four chain-shortening reactions in the beta-oxidation of long-chain fatty acids. Clinically, failure of long-chain fatty acid beta-oxidation leads to hypoketotic hypoglycaemia associated with coma,

  15. Femme fatale

    Directory of Open Access Journals (Sweden)

    Francisco Javier Tardío Gastón

    2011-12-01

    Full Text Available Our history is full of myths and topics. Therefore the image of femme fatale is frequent in the works of all periods and places. The author of this article first analyzes how the history and literature consistently showed and defined these women, and then presents examples that come from ancient Greece. The art is powered by their power of seduction and the article explains how this femme fatale appeared in literature and film. The article concludes with a brief overview of various arguments concerning women and feminism, present in the literary criticism.

  16. Islamic fatalism

    Directory of Open Access Journals (Sweden)

    Helmer Ringgren

    1967-02-01

    Full Text Available The author sketches the historical background, then the teaching of the Koran, and finally, the development of the typical Islamic fatalism. The fatalism of Islam has to be viewed against the background of the ideas of pre-Islamic Arabia. Unfortunately, there is no other evidence from this epoch that a few poems on a very restricted range of topics which have been able to survive Islamic censure. The conventional and stereotyped character of these poems makes it difficult to decide to what extent they reflect commonly accepted views or the ideas of a certain group. In any case, they present a picture of the pagan Arab which is extremely idealized and formed after a rigid pattern. Historically speaking, Islamic 'fatalism' is the result of a combination of pre-Islamic fatalism and Muhammad's belief in God's omnipotence. From another point of view it is an interpretation of destiny that expresses man's feeling of total dependence, not on an impersonal power or universal order, but on an omnipotent God.

  17. A novel mitochondrial DNA deletion in a patient with Pearson syndrome and neonatal diabetes mellitus provides insight into disease etiology, severity and progression.

    Science.gov (United States)

    Chen, Xin-Yu; Zhao, Si-Yu; Wang, Yan; Wang, Dong; Dong, Chang-Hu; Yang, Ying; Wang, Zhi-Hua; Wu, Yuan-Ming

    2016-07-01

    Pearson syndrome (PS) is a rare, mitochondrial DNA (mtDNA) deletion disorder mainly affecting hematopoietic system and exocrine pancreas in early infancy, which is characterized by multi-organ involvement, variable manifestations and poor prognosis. Since the clinical complexity and uncertain outcome of PS, the ability to early diagnose and anticipate disease progression is of great clinical importance. We described a patient with severe anemia and hyperglycinemia at birth was diagnosed with neonatal diabetes mellitus, and later with PS. Genetic testing revealed that a novel mtDNA deletion existed in various non-invasive tissues from the patient. The disease course was monitored by mtDNA deletion heteroplasmy and mtDNA/nucleus DNA genome ratio in different tissues and at different time points, showing a potential genotype-phenotype correlation. Our findings suggest that for patient suspected for PS, it may be therapeutically important to first perform detailed mtDNA analysis on non-invasive tissues at the initial diagnosis and during disease progression.

  18. Neonatal orbital abscess

    Directory of Open Access Journals (Sweden)

    Pratik Y Gogri

    2015-01-01

    Full Text Available Orbital abscess generally occurs in older children but it can rarely affect infants and neonates too. We report a case of community acquired methicillin resistant staphylococcus aureus (CA-MRSA neonatal orbital abscess in a 12-day-old term female neonate with no significant past medical history or risk factor for developing the infection. The case highlights the importance of consideration of CA-MRSA as a causative agent of neonatal orbital cellulitis even in a neonate without any obvious predisposing condition. Prompt initiation of appropriate medical therapy against MRSA and surgical drainage of the abscess prevents life threatening complications of orbital cellulitis which more often tend to be fatal in neonates.

  19. [The twofold face of fatalism: collectivist fatalism and individualist fatalism].

    Science.gov (United States)

    Blanco, Amalio; Díaz, Darío

    2007-11-01

    Fatalism has been a central framework for understanding the psychological processes in cultures with pronounced collectivism that are economically poorly developed. In this context, fatalism emerges as cognitive schema defined by passive and submissive acceptance of an irremediable destiny, governed by some natural force or the will of some God. This image has now lost such a clear profile. But currently, fatalism also accompanies the life of people from individualist cultures, who live in a highly developed, or even opulent, economic context. In this case, fatalism is like some mood of uncertainty, insecurity, and helplessness following the events that characterize the society of global risk. In this paper, we propose a theory to develop the two faces of fatalism.

  20. Maternal and neonatal tetanus

    Science.gov (United States)

    Thwaites, C Louise; Beeching, Nicholas J; Newton, Charles R

    2017-01-01

    Maternal and neonatal tetanus is still a substantial but preventable cause of mortality in many developing countries. Case fatality from these diseases remains high and treatment is limited by scarcity of resources and effective drug treatments. The Maternal and Neonatal Tetanus Elimination Initiative, launched by WHO and its partners, has made substantial progress in eliminating maternal and neonatal tetanus. Sustained emphasis on improvement of vaccination coverage, birth hygiene, and surveillance, with specific approaches in high-risk areas, has meant that the incidence of the disease continues to fall. Despite this progress, an estimated 58 000 neonates and an unknown number of mothers die every year from tetanus. As of June, 2014, 24 countries are still to eliminate the disease. Maintenance of elimination needs ongoing vaccination programmes and improved public health infrastructure. PMID:25149223

  1. Fatalism and Savings

    OpenAIRE

    Stephen, Wu; Joel, Shapiro

    2010-01-01

    We examine the impact of fatalism, the belief that one has little or no control over future events, on the decision of whether or not to save. We develop a model that predicts that fatalism decreases savings for moderately risk averse individuals, increases savings for highly risk averse individuals, and otherwise has no impact. Furthermore, fatalism decreases effort in learning about savings and investment options. We use data from National Longitudinal Survey of Youth (NLSY) and find genera...

  2. Fatal hepatic short-chain L-3-hydroxyacyl-coenzyme A dehydrogenase deficiency: clinical, biochemical, and pathological studies on three subjects with this recently identified disorder of mitochondrial beta-oxidation

    NARCIS (Netherlands)

    Bennett, M. J.; Spotswood, S. D.; Ross, K. F.; Comfort, S.; Koonce, R.; Boriack, R. L.; IJlst, L.; Wanders, R. J.

    1999-01-01

    This report describes the clinical, biochemical, and pathological findings in three infants with hepatic short-chain L-3-hydroxyacyl-coenzyme A dehydrogenase (SCHAD) deficiency, a recently recognized disorder of the mitochondrial oxidation of straight-chain fatty acids. Candidate subjects were

  3. Mitochondrial Dynamics in Mitochondrial Diseases

    Directory of Open Access Journals (Sweden)

    Juan M. Suárez-Rivero

    2016-12-01

    Full Text Available Mitochondria are very versatile organelles in continuous fusion and fission processes in response to various cellular signals. Mitochondrial dynamics, including mitochondrial fission/fusion, movements and turnover, are essential for the mitochondrial network quality control. Alterations in mitochondrial dynamics can cause neuropathies such as Charcot-Marie-Tooth disease in which mitochondrial fusion and transport are impaired, or dominant optic atrophy which is caused by a reduced mitochondrial fusion. On the other hand, mitochondrial dysfunction in primary mitochondrial diseases promotes reactive oxygen species production that impairs its own function and dynamics, causing a continuous vicious cycle that aggravates the pathological phenotype. Mitochondrial dynamics provides a new way to understand the pathophysiology of mitochondrial disorders and other diseases related to mitochondria dysfunction such as diabetes, heart failure, or Hungtinton’s disease. The knowledge about mitochondrial dynamics also offers new therapeutics targets in mitochondrial diseases.

  4. Neonatal Sepsis in Haiti.

    Science.gov (United States)

    Boulos, Alexandre; Rand, Katherine; Johnson, Josh A; Gautier, Jacqueline; Koster, Michael

    2017-02-01

    Infections (including sepsis, meningitis, pneumonia and tetanus) stand as a major contributor to neonatal mortality in Haiti (22%). Infants acquire bacteria that cause neonatal sepsis directly from the mother's blood, skin or vaginal tract either before or during delivery. Nosocomial and environmental pathogens introduce further risk after delivery. The absence of cohesive medical systems and methods for collecting information limits the available data in countries such as Haiti. This study seeks to add more information on the burden of severe bacterial infections and their etiology in neonates of Haiti. Researchers conducted a secondary retrospective analysis of a de-identified database from the Neonatal Intensive Care Unit (NICU) at Nos Petit Frères et Soeurs-St. Damien Hospital (NPFS-SDH). Records from 1292 neonates admitted to the NICU at NPFS-SDH in Port-au-Prince Haiti from 2013 to 2015 were reviewed. Sepsis accounted for 708 of 1292 (54.8%) of all admissions to the NICU. Infants admitted for sepsis had a mortality rate of 23% (163 of 708 infants admitted for sepsis). The most common organism cultured was Streptococcus agalactiae, followed by Klebsiella pneumoniae, Pseudomonas aeroginusa, Enterobacter aerogenes, Staphylococcus aureus and Proteus mirabillis Failure to order or obtain a culture was associated with an increased fatality (odds ratio 2.4) for infants with sepsis. Resistance should be a concern when treating empirically. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Pathogenicity of Bovine Neonatal Pancytopenia-associated vaccine-induced alloantibodies correlates with Major Histocompatibility Complex class 1 expression

    NARCIS (Netherlands)

    Benedictus, L.; Luteijn, Rutger D.; Otten, H.; Lebbink, Robert Jan; Kooten, van P.J.S.; Wiertz, E.J.H.J.; Rutten, Victor P.M.G.; Koets, A.P.

    2015-01-01

    Bovine Neonatal Pancytopenia (BNP), a fatal bleeding syndrome of neonatal calves, is caused by maternal alloantibodies absorbed from colostrum and is characterized by lymphocytopenia, thrombocytopenia and bone marrow hypoplasia. An inactivated viral vaccine is the likely source of alloantigens

  6. Allogeneic haematopoietic stem cell transplantation for mitochondrial neurogastrointestinal encephalomyopathy

    NARCIS (Netherlands)

    Halter, Joerg P.; Schuepbach, W. Michael M.; Mandel, Hanna; Casali, Carlo; Orchard, Kim; Collin, Matthew; Valcarcel, David; Rovelli, Attilio; Filosto, Massimiliano; Dotti, Maria T.; Marotta, Giuseppe; Pintos, Guillem; Barba, Pere; Accarino, Anna; Ferra, Christelle; Illa, Isabel; Beguin, Yves; Bakker, Jaap A.; Boelens, Jaap J.; de Coo, Irenaeus F. M.; Fay, Keith; Sue, Carolyn M.; Nachbaur, David; Zoller, Heinz; Sobreira, Claudia; Simoes, Belinda Pinto; Hammans, Simon R.; Savage, David; Marti, Ramon; Chinnery, Patrick F.; Elhasid, Ronit; Gratwohl, Alois; Hirano, Michio

    2015-01-01

    Haematopoietic stem cell transplantation has been proposed as treatment for mitochondrial neurogastrointestinal encephalomyopathy, a rare fatal autosomal recessive disease due to TYMP mutations that result in thymidine phosphorylase deficiency. We conducted a retrospective analysis of all known

  7. Allogeneic haematopoietic stem cell transplantation for mitochondrial neurogastrointestinal encephalomyopathy

    NARCIS (Netherlands)

    J.P. Halter (Joerg P.); W. Michael; M. Schüpbach; H. Mandel (Hanna); C. Casali (carlo); K. Orchard (Kim); M. Collin (Matthew); D. Valcarcel (David); A. Rovelli (Attilio); M. Filosto (Massimiliano); M.T. Dotti (Maria Teresa); G. Marotta (Giuseppe); G. Pintos (Guillem); P. Barba (Pere); A. Accarino (Anna); C. Ferra (Christelle); I. Illa (Isabel); Y. Beguin (Yves); J.A. Bakker (Jaap A.); J.J. Boelens (Jaap Jan); I.F.M. de Coo (René); K. Fay (Keith); C.M. Sue (Carolyn M.); D. Nachbaur (David); H. Zoller (Heinz); C. Sobreira (Claudia); B. Pinto Simoes (Belinda); S.R. Hammans (Simon R.); D. Savage (David); R. Martí (Ramon); P.F. Chinnery (Patrick); R. Elhasid (Ronit); A. Gratwohl (Alois); M. Hirano (Michio); G. Barros Navarro; J.F. Benoist; J. Bierau (Jörgen); A. Bucalossi; M.A. Carluccio; J. Coll-Canti; M.S. Cotelli; T. Diesch; R. Di Fabio (Roberto); M.A. Donati (Maria); J.H. Garvin; K. Hill; L. Kappeler; T. Ku Hne; M.C. Lara; M. Lenoci; G. Lucchini (Giovanna); W. Marques; H. Mattle; A. Meyer; R. Parini; J. Passweg (Jakob Robert); F. Pieroni; A. Rodriguez-Palmero; F. Santus; M. Scarpelli; P. Schlesser; F. Sicurelli; M. Stern; A.B. Stracieri; P. Tonin; J. Torres-Torronteras; J.C. Voltarelli; I. Zaidman

    2015-01-01

    textabstractHaematopoietic stem cell transplantation has been proposed as treatment for mitochondrial neurogastrointestinal encephalomyopathy, a rare fatal autosomal recessive disease due to TYMP mutations that result in thymidine phosphorylase deficiency. We conducted a retrospective analysis of

  8. Mitochondrial Diseases

    Science.gov (United States)

    ... disorder, something goes wrong with this process. Mitochondrial diseases are a group of metabolic disorders. Mitochondria are ... cells and cause damage. The symptoms of mitochondrial disease can vary. It depends on how many mitochondria ...

  9. Neonatal sepsis

    Science.gov (United States)

    ... 1 week and before 3 months of age. Causes Neonatal sepsis can be caused by bacteria such as Escherichia ... and Tests Lab tests can help diagnose neonatal sepsis and identify the cause of the infection. Blood tests may include: Blood ...

  10. Isolated and repeated stroke-like episodes in a middle-aged man with a mitochondrial ND3 T10158C mutation: a case report.

    Science.gov (United States)

    Mezuki, Satomi; Fukuda, Kenji; Matsushita, Tomonaga; Fukushima, Yoshihisa; Matsuo, Ryu; Goto, Yu-Ichi; Yasukawa, Takehiro; Uchiumi, Takeshi; Kang, Dongchon; Kitazono, Takanari; Ago, Tetsuro

    2017-12-13

    Mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome, is the most common phenotype of mitochondrial disease. It often develops in childhood or adolescence, usually before the age of 40, in a maternally-inherited manner. Mutations in mitochondrial DNA (mtDNA) are frequently responsible for MELAS. A 55-year-old man, who had no family or past history of mitochondrial disorders, suddenly developed bilateral visual field constriction and repeated stroke-like episodes. He ultimately presented with cortical blindness, recurrent epilepsy and severe cognitive impairment approximately 6 months after the first episode. Genetic analysis of biopsied biceps brachii muscle, but not of peripheral white blood cells, revealed a T10158C mutation in the mtDNA-encoded gene of NADH dehydrogenase subunit 3 (ND3), which has previously been thought to be associated with severe or fatal mitochondrial disorders that develop during the neonatal period or in infancy. A T10158C mutation in the ND3 gene can cause atypical adult-onset stroke-like episodes in a sporadic manner.

  11. Pearson syndrome in the neonatal period: two case reports and review of the literature.

    Science.gov (United States)

    Manea, Elena Maria; Leverger, Guy; Bellmann, Francoise; Stanescu, Popp Alina; Mircea, Adam; Lèbre, Anne-Sophie; Rötig, Agnes; Munnich, Arnold

    2009-12-01

    Pearson syndrome is a multiorgan mitochondrial cytopathy that results from defective oxidative phosphorylation owing to mitochondrial DNA deletions. Prognosis is severe and death occurs in infancy or early childhood. This article describes 2 cases with a severe neonatal onset of the disease. A review of the literature reveals the atypical presentation of the disease in the neonatal period, which is often overlooked and underdiagnosed.

  12. Neonatal hypokalemia

    Directory of Open Access Journals (Sweden)

    Sarici D

    2012-03-01

    Full Text Available Dilek Sarici1, S Umit Sarici21Kecioren Research and Education Hospital, Kecioren, Ankara, 2Chief of Division of Neonatology, Division of Neonatology, Department of Pediatrics, Gulhane Military Medical Academy, Ankara, TurkeyAbstract: In this article, distribution of potassium (K+ in body fluids, pathophysiology, causes, clinical signs and symptoms, and the evaluation and treatment of neonatal hypokalemia are reviewed. K+ is the most important intracellular cation and normal serum K+ is stabilized between 3.5 and 5.5 mEq/L. Hypokalemia may be caused by increased renal losses, increased extrarenal (gastrointestinal losses, redistribution or prolonged insufficient K+ intake. Clinical signs and symptoms occur as the result of functional changes in striated muscle, smooth muscle, and the heart. Hypokalemia is usually asymptomatic when K+ levels are between 3.0 and 3.5 mEq/L; however, there may sometimes be slight muscle weakness. Moderate hypokalemia is observed when serum K+ is between 2.5 and 3.0 mEq/L. Proximal muscle weakness is observed most commonly in lower extremities; cranial muscles are normal, but constipation and distention are prominent. Severe hypokalemia develops when serum K+ falls below 2.5 mEq/L. Rhabdomyolysis, myoglobinuria, severe muscle weakness, paralysis, respiratory distress, and respiratory arrest are observed. The clinical signs and symptoms may be unremarkable in cases of chronically developing hypokalemia; however, appropriate treatment is essential when serum K+ level falls below 2.5 mEq/L as the most dangerous complication of hypokalemia is fatal cardiac arrythmia, and changes visible with electrocardiography may not always correlate with the level of hypokalemia. Sodium (Na+, K+, chloride (Cl-, bicarbonate, creatinine, blood sugar, magnesium (Mg, plasma renin activity, aldosterone, and blood gases should be investigated by laboratory testing. Aspartate aminotransferase, alanine aminotransferase, creatinine kinase, and

  13. Mitochondrial cardiomyopathies

    Directory of Open Access Journals (Sweden)

    Ayman W. El-Hattab

    2016-07-01

    Full Text Available Mitochondria are found in all nucleated human cells and perform a variety of essential functions, including the generation of cellular energy. Mitochondria are under dual genome control. Only a small fraction of their proteins are encoded by mitochondrial DNA (mtDNA while more than 99% of them are encoded by nuclear DNA (nDNA. Mutations in mtDNA or mitochondria-related nDNA genes result in mitochondrial dysfunction leading to insufficient energy production required to meet the needs of various organs, particularly those with high energy requirements, including the central nervous system, skeletal and cardiac muscles, kidneys, liver, and endocrine system. Because cardiac muscles are one of the high energy demanding tissues, cardiac involvement occurs in mitochondrial diseases with cardiomyopathies being one of the most frequent cardiac manifestations found in these disorders. Cardiomyopathy is estimated to occur in 20-40% of children with mitochondrial diseases. Mitochondrial cardiomyopathies can vary in severity from asymptomatic status to severe manifestations including heart failure, arrhythmias, and sudden cardiac death. Hypertrophic cardiomyopathy is the most common type; however, mitochondrial cardiomyopathies might also present as dilated, restrictive, left ventricular noncompaction, and histiocytoid cardiomyopathies. Cardiomyopathies are frequent manifestations of mitochondrial diseases associated with defects in electron transport chain (ETC complexes subunits and their assembly factors, mitochondrial tRNAs, rRNAs, ribosomal proteins, and translation factors, mtDNA maintenance, and coenzyme Q10 synthesis. Other mitochondrial diseases with cardiomyopathies include Barth syndrome, Sengers syndrome, TMEM70-related mitochondrial complex V deficiency, and Friedreich ataxia.

  14. Neonatal arrhythmias.

    Science.gov (United States)

    Poddar, Banani; Basu, Srikanta; Parmar, Veena R

    2006-02-01

    Neonatal arrhythmias are not uncommon; however, they rarely cause hemodynamic compromise. This paper aims to study the etiology, spectrum and outcome of neonates with arrhythmias who presented to a pediatric department. All neonates, either inborn or brought to the pediatric emergency with rhythm disorders, between August 1999 to August 2002, were included prospectively. Evaluation including a search for secondary causes of rhythm disorder and a chest X-ray, standard 12-lead electrocardiography and echocardiography in all. The management required in each and the outcomes were noted. Nine neonates were identified, of which 4 were inborn. Tachycardia was seen in 8 neonates and bradycardia in only one. Three neonates had an antenatal onset of arrhythmias; in the rest it was postnatal in onset. Five neonates had a secondary rhythm disorder, secondary to metabolic derangements in 4 and a cardiac mass in 1. Five had ventricular arrhythmias and 5 had hemodynamic compromise due to the arrhythmia. The outcome was poor in 4 and was related to the underlying illness. Tachyarrhythmia is more common than bradyarrhythmia in the neonate. Arrhythmias secondary to various metabolic causes are more common than primary rhythm disorders.

  15. Tuberculosis neonatal

    OpenAIRE

    Pastor Durán, Xavier

    1986-01-01

    PROTOCOLOS TERAPEUTICOS. TUBERCULOSIS NEONATAL 1. CONCEPTO La tuberculosis neonatal es la infección del recién nacido producida por el bacilo de Koch. Es una situación rara pero grave que requiere un diagnóstico precoz y un tratamiento enérgico..

  16. Mitochondrial energy metabolism in very premature neonates

    Czech Academy of Sciences Publication Activity Database

    Wenchich, L.; Zeman, J.; Hansíková, H.; Plavka, R.; Sperl, W.; Houštěk, Josef

    2002-01-01

    Roč. 81, č. 4 (2002), s. 229-235 ISSN 0006-3126 R&D Projects: GA MŠk LN00A079; GA MŠk LN00A079; GA MZd NE6555; GA ČR GA302/99/0648; GA MŠk ME 226 Institutional research plan: CEZ:AV0Z5011922 Keywords : mitochondria * oxidative phosphorylation * glucose Subject RIV: FB - Endocrinology, Diabetology, Metabolism , Nutrition Impact factor: 1.287, year: 2002

  17. Fatal colchicine intoxication

    Directory of Open Access Journals (Sweden)

    Smael Labib

    2014-01-01

    Full Text Available Colchicine is an alkaloid extracted from autumnal Colchicum plant which is used primarily for its anti-inflammatory therapy effect. Acute intoxication with colchicine is uncommon but often severe and results in multiple visceral organ dysfunctions. The intoxication severity and mortality are directly depending on the ingested dose. The treatment is manly symptomatic. However, the development of specific anti-colchicine immunotherapy would offer a new therapeutic perspective. Authors report a case of a young patient that ingested 40 tablets colchicine, which caused a multiple organ failure and with fatal outcome.

  18. Neonatal hypertension.

    Science.gov (United States)

    Sharma, Deepak; Farahbakhsh, Nazanin; Shastri, Sweta; Sharma, Pradeep

    2017-03-01

    Neonatal hypertension (HT) is a frequently under reported condition and is seen uncommonly in the intensive care unit. Neonatal HT has defined arbitrarily as blood pressure more than 2 standard deviations above the base as per the age or defined as systolic BP more than 95% for infants of similar size, gestational age and postnatal age. It has been diagnosed long back but still is the least studied field in neonatology. There is still lack of universally accepted normotensive data for neonates as per gestational age, weight and post-natal age. Neonatal HT is an important morbidity that needs timely detection and appropriate management, as it can lead to devastating short-term effect on various organs and also poor long-term adverse outcomes. There is no consensus yet about the treatment guidelines and majority of treatment protocols are based on the expert opinion. Neonate with HT should be evaluated in detail starting from antenatal, perinatal, post-natal history, and drug intake by neonate and mother. This review article covers multiple aspects of neonatal hypertension like definition, normotensive data, various etiologies and methods of BP measurement, clinical features, diagnosis and management.

  19. Fatal crocodile attack.

    Science.gov (United States)

    Chattopadhyay, Saurabh; Shee, Biplab; Sukul, Biswajit

    2013-11-01

    Attacks on human beings by various animals leading to varied types of injuries and even death in some cases are not uncommon. Crocodile attacks on humans have been reported from a number of countries across the globe. Deaths in such attacks are mostly due to mechanical injuries or drowning. Bites by the crocodiles often cause the limbs to be separated from the body. The present case refers to an incident of a fatal attack by a crocodile on a 35 years old female where only the mutilated head of the female was recovered. Multiple lacerated wounds over the face and scalp along with fracture of the cranial bones was detected on autopsy. Two distinct bite marks in the form of punched in holes were noted over the parietal and frontal bones. Injuries on the head with its traumatic amputation from the body were sufficient to cause death. However, the presence of other fatal injuries on the unrecovered body parts could not be ruled out. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  20. Neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program in provincial hospitals in Laos.

    Science.gov (United States)

    Schmidt, S; Bounnack, S; Hoehn, T

    2018-01-01

    Aim of this study was to analyze neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program to examine a possible impact on neonatal outcomes. This study is a retrospective data analysis of all neonatal patients treated in five provincial hospitals in Laos after implementation of a neonatal teaching program. A simulation-based teaching program aims to have positive impact on the theoretical and practical skill of hospital staff in the field of newborn care. A comparison between pre-implementation and post-implementation data of newborns admitted to provincial hospitals in Laos was used to quantify the effect of repetitive teaching on neonatal outcomes. Neonatal mortality and morbidity as well as case fatality rates of infections and asphyxia decreased in the post-implementation period. In contrast, neonatal mortality rate as well as case fatality rate of prematurity increased. The total neonatal mortality rate increased in the post-implementation period. The pre-implementation and post-implementation data enable longitudinal comparisons between hospitals and highlight the differences between hospitals concerning neonatal mortality and morbidity in provincial hospitals in Laos. These data can serve as a basis for an individual adaption of the teaching program to the unique requirements of each single hospital. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  1. Tirosinemia neonatal Neonatal tyrosinemia

    Directory of Open Access Journals (Sweden)

    Rafael J. Manotas Cabarcas

    1995-04-01

    Full Text Available Mediante la técnica de Udenfriend y Cooper, se midieron los niveles de tirosina en la sangre del cordón de 26 prematuros y 31 niños de término, con el fin de comparar las concentraciones según la edad gestacional y detectar la presencia de la tirosinemia neonatal. Se encontró un caso de esta entidad en un niño de 31 semanas de edad gestacional, lo cual correspondió al 3.8% de los prematuros y al 1.8% del grupo total. La concentración de tirosina en el paciente fue de 53 JJ.M. El promedio de las concentraciones en los prematuros menores de 32 semanas fue de 16.8 :t 6.3 JJ.M; el de los niños entre 33 y 36 semanas fue de 19.3 :t 7.6 JJ.M y el de los niños de término, de 17.2 :t 9.4 JJ.M. Las pruebas estadísticas no mostraron tendencias ni diferencias significativas entre estas concentraciones. El promedio ponderado para el grupo total fue 17.7 :t 7.3 JJ.M. Se recomienda establecer programas de tamizaje para detectar este problema porque puede presentar repercusiones neurológicas posteriores.

    By means of the Udenfriend-Cooper technique, levels of tyrosine were measured in the cord blood of 26 preterm and 31 term Infants; the objective was to compare tyrosine concentrations according to gestational age and to detect the presence of neonatal tyrosinemia. A case of this disease was found In an Infant with 31 weeks of gestational age; this case represented 3.8% of preterm Infants and 1.8% of the total group. Average tyrosine concentration according to age was as follows: 16.8: ± 6.3  µM in Infants under 32 weeks of gestational age; 19.3: ±: 7.6 µM In those between 33 and 36 weeks and 17.2 : ±: 9.4 µM In the term Infants

  2. Neonatal retinoblastoma

    Directory of Open Access Journals (Sweden)

    Tero T Kivelä

    2017-01-01

    Full Text Available From 7% to 10% of all retinoblastomas and from 44% to 71% of familial retinoblastomas in developed countries are diagnosed in the neonatal period, usually through pre- or post-natal screening prompted by a positive family history and sometimes serendipitously during screening for retinopathy of prematurity or other reasons. In developing countries, neonatal diagnosis of retinoblastoma has been less common. Neonatal retinoblastoma generally develops from a germline mutation of RB1, the retinoblastoma gene, even when the family history is negative and is thus usually hereditary. At least one-half of infants with neonatal retinoblastoma have unilateral tumors when the diagnosis is made, typically the International Intraocular Retinoblastoma Classification (Murphree Group B or higher, but most germline mutation carriers will progress to bilateral involvement, typically Group A in the fellow eye. Neonatal leukokoria usually leads to the diagnosis in children without a family history of retinoblastoma, and a Group C tumor or higher is typical in the more advanced involved eye. Almost all infants with neonatal retinoblastoma have at least one eye with a tumor in proximity to the foveola, but the macula of the fellow eye is frequently spared. Consequently, loss of reading vision from both eyes is exceptional. A primary ectopic intracranial neuroblastic tumor known as trilateral retinoblastoma is no more common after neonatal than other retinoblastoma. For many reasons, neonatal retinoblastoma may be a challenge to eradicate, and the early age at diagnosis and relatively small tumors do not guarantee the preservation of both eyes of every involved child. Oncology nurses can be instrumental in contributing to better outcomes by ensuring that hereditary retinoblastoma survivors receive genetic counseling, by referring families of survivors to early screening programs when they are planning for a baby, and by providing psychological and practical support

  3. Neonatal Retinoblastoma

    Science.gov (United States)

    Kivelä, Tero T.; Hadjistilianou, Theodora

    2017-01-01

    From 7% to 10% of all retinoblastomas and from 44% to 71% of familial retinoblastomas in developed countries are diagnosed in the neonatal period, usually through pre- or post-natal screening prompted by a positive family history and sometimes serendipitously during screening for retinopathy of prematurity or other reasons. In developing countries, neonatal diagnosis of retinoblastoma has been less common. Neonatal retinoblastoma generally develops from a germline mutation of RB1, the retinoblastoma gene, even when the family history is negative and is thus usually hereditary. At least one-half of infants with neonatal retinoblastoma have unilateral tumors when the diagnosis is made, typically the International Intraocular Retinoblastoma Classification (Murphree) Group B or higher, but most germline mutation carriers will progress to bilateral involvement, typically Group A in the fellow eye. Neonatal leukokoria usually leads to the diagnosis in children without a family history of retinoblastoma, and a Group C tumor or higher is typical in the more advanced involved eye. Almost all infants with neonatal retinoblastoma have at least one eye with a tumor in proximity to the foveola, but the macula of the fellow eye is frequently spared. Consequently, loss of reading vision from both eyes is exceptional. A primary ectopic intracranial neuroblastic tumor known as trilateral retinoblastoma is no more common after neonatal than other retinoblastoma. For many reasons, neonatal retinoblastoma may be a challenge to eradicate, and the early age at diagnosis and relatively small tumors do not guarantee the preservation of both eyes of every involved child. Oncology nurses can be instrumental in contributing to better outcomes by ensuring that hereditary retinoblastoma survivors receive genetic counseling, by referring families of survivors to early screening programs when they are planning for a baby, and by providing psychological and practical support for parents when

  4. Mitochondrial DNA.

    Science.gov (United States)

    Wright, Russell G.; Bottino, Paul J.

    1986-01-01

    Provides background information for teachers on mitochondrial DNA, pointing out that it may have once been a free-living organism. Includes a ready-to-duplicate exercise titled "Using Microchondrial DNA to Measure Evolutionary Distance." (JN)

  5. Mitochondrial Myopathy

    Science.gov (United States)

    ... fact, many cases of mitochondrial disease are sporadic, meaning that they occur without any family history. To ... temporary vision loss, difficulty speaking, or difficulty understanding speech) and lead to progressive brain injury. The cause ...

  6. Neonatal Nursing

    OpenAIRE

    Crawford, Doreen; Morris, Maryke

    1994-01-01

    "Neonatal Nursing" offers a systematic approach to the nursing care of the sick newborn baby. Nursing actions and responsibilities are the focus of the text with relevant research findings, clinical applications, anatomy, physiology and pathology provided where necessary. This comprehensive text covers all areas of neonatal nursing including ethics, continuing care in the community, intranatal care, statistics and pharmokinetics so that holistic care of the infant is described. This book shou...

  7. Paraquat: A fatal poison

    Directory of Open Access Journals (Sweden)

    J Shashibhushan

    2015-01-01

    Full Text Available Paraquat (1, 1′-dimethyl-4, 4′-dipyridylium is a bipyridilium herbicide used widely in our country and is a highly toxic compound. This compound is very notorious to cause rapid development of renal, liver, and respiratory failure with very high mortality due to lack of specific antidote and dearth of high-quality evidence-based treatment. Respiratory system involvement is the most common cause of death in these people. We hereby report a fatal case of a 30-year-old male with a history of paraquat consumption. The patient developed oliguric renal failure, deterioration of liver function, and acute respiratory distress syndrome over next few days. Different treatment modalities were tried to manage patient′s condition. In this case, none of the strategies worked well, and death ensued due to multi-organ dysfunction syndrome.

  8. Fatalism as a Metaphysical Thesis

    Directory of Open Access Journals (Sweden)

    Ulrich Meyer

    Full Text Available ABSTRACT Even though fatalism has been an intermittent topic of philosophy since Greek antiquity, this paper argues that fate ought to be of little concern to metaphysicians. Fatalism is neither an interesting metaphysical thesis in its own right, nor can it be identified with theses that are, such as realism about the future or determinism.

  9. Mitochondrial hepatopathies in the newborn period.

    Science.gov (United States)

    Fellman, Vineta; Kotarsky, Heike

    2011-08-01

    Mitochondrial disorders recognized in the neonatal period usually present as a metabolic crisis combined with one or several organ manifestations. Liver disorder in association with a respiratory chain deficiency may be overlooked since liver dysfunction is common in severely sick newborn infants. Lactacidosis, hypoglycemia, elevated serum transaminases and conjugated bilirubin are common signs of mitochondrial hepatopathy. Hepatosplenomegaly may occur in severe cases. A clinical picture with fetal growth restriction, postnatal lactacidosis, hypoglycemia, coagulopathy, and cholestasis, especially in combination with neurological symptoms or renal tubulopathy, should alert the neonatologist to direct investigations on mitochondrial disorder. A normal lactate level does not exclude respiratory chain defects. The most common liver manifestation caused by mutated mitochondrial DNA (deletion) is Pearson syndrome. Recently, mutations in several nuclear DNA genes have been identified that lead to mitochondrial hepatopathy, e.g. mitochondrial depletion syndrome caused by DGUOK, MPV17, SUCLG1, POLG1, or C10ORF2 mutations. A combination of lactacidosis, liver involvement, and Fanconi type renal tubulopathy is common when the complex III assembly factor BCS1L harbors mutations, the most severe disease with consistent genotype-phenotype correlation being the GRACILE syndrome. Mutations in nuclear translation factor genes (TRMU, EFG1, and EFTu) of the respiratory chain enzyme complexes have recently been identified. Diagnostic work-up of neonatal liver disorder should include assessment of function and structure of the complexes as well as mutation screening for known genes. So far, treatment is mainly symptomatic. Copyright © 2011. Published by Elsevier Ltd.

  10. Clinical Features of Fatal Asthma

    Directory of Open Access Journals (Sweden)

    Chiung-Zuei Chen

    2006-05-01

    Full Text Available To characterize the clinical features of fatal asthma, we retrospectively analyzed the clinical characteristics of patients who died of an acute asthma attack in our hospital during a 15-year period from 1989 to 2003. Twelve patients had fatal asthma during this period, including eight who were dead on arrival in the emergency room (ER and three who died within 1 hour of admission to the ER. Patients were categorized into three groups according to the clinical presentations during the fatal attack: (1 rapid (< 3 hours decompensation in four patients; (2 gradual development of respiratory failure over several days in two patients; and (3 acute deterioration after unstable asthma lasting several days in six patients. All patients in groups 1 and 2 had reported previous near-fatal attacks. The proportion of young patients was highest in group 3, with half of them (3/6 younger than 35 years of age. Only one patient in group 3 had had a previous near-fatal attack. Five of the seven patients, with previous near-fatal attacks, had a pattern of decompensation during their fatal attack that was similar to their previous attacks. In conclusion, nearly all patients with fatal asthma in this study died outside of the hospital or within 1 hour after admission to the ER. Patients had patterns of decompensation during the fatal attack that were similar to those of their previous attacks. Early detection of warning signs, early admission to the ER, adequate treatment, and extremely close observation of patients, especially within 1 hour after ER arrival, may prevent or decrease the incidence of fatal asthmatic attack.

  11. Neonatal neurosonography

    Energy Technology Data Exchange (ETDEWEB)

    Riccabona, Michael, E-mail: michael.riccabona@klinikum-graz.at

    2014-09-15

    Paediatric and particularly neonatal neurosonography still remains a mainstay of imaging the neonatal brain. It can be performed at the bedside without any need for sedation or specific monitoring. There are a number of neurologic conditions that significantly influence morbidity and mortality in neonates and infants related to the brain and the spinal cord; most of them can be addressed by ultrasonography (US). However, with the introduction of first CT and then MRI, neonatal neurosonography is increasingly considered just a basic first line technique that offers only orienting information and does not deliver much relevant information. This is partially caused by inferior US performance – either by restricted availability of modern equipment or by lack of specialized expertise in performing and reading neurosonographic scans. This essay tries to highlight the value and potential of US in the neonatal brain and briefly touching also on the spinal cord imaging. The common pathologies and their US appearance as well as typical indication and applications of neurosonography are listed. The review aims at encouraging paediatric radiologists to reorient there imaging algorithms and skills towards the potential of modern neurosonography, particularly in the view of efficacy, considering growing economic pressure, and the low invasiveness as well as the good availability of US that can easily be repeated any time at the bedside.

  12. Neonatal pain

    Science.gov (United States)

    Walker, Suellen M

    2014-01-01

    Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback. PMID:24330444

  13. Fatal diquat intoxication

    Directory of Open Access Journals (Sweden)

    Jović-Stošić Jasmina

    2009-01-01

    Full Text Available Background. Since the introduction of diquat in agriculture practice in 1960's, about 40 cases of poisoning have been described in detail in medical literature. Case report. We presented two cases. A case one, a 35-year-old, previously healthy, woman ingested 14% diquat solution. The poisoning had fulminant course, consisted of severe stomachache, vomiting, cardiocirculatory shock, respiratory failure and cardiac arrest 20 hours post-ingestion. Autopsy revealed myocardial infarction, bronchopneumonia and incipient renal damage. A case two, a 64-year-old man developed severe gastroenteritis, corrosive lesions of mucosal surfaces, acute renal injury, arrhythmias, brain stem infarction and bronchopneumonia. The diagnosis of diquat poisoning was made retrospectively upon the clinical picture and identification of pesticides he had been exposed to. The patient died 18 days post-exposure. The most prominent findings on autopsy were pontine hemorrhage and infarction, bronchopneumonia, left ventricle papillary muscle infarction and renal tubular damage. Conclusion. Cardiocirculatory disturbances led to fatal complications, the heart and brain infarction. We pointed out the heart as one of the most severely affected organs in diquat poisoning.

  14. Fatal Drownings in Fiji.

    Science.gov (United States)

    Murray, Kathryn; Carter, Peter

    2017-01-01

    Drowning is a newly comprehended public health concern in Fiji. Defined as "the process of experiencing respiratory impairment from submersions or immersion in liquid," drowning has been identified as one of Fiji's 5 leading causes of death for those aged 1 to 29 years. The aim of this article was to develop the most parsimonious model that can be used to explain the number of monthly fatal drowning cases in Fiji. Based on a cross-section of 187 drowning incidents from January 2012 to April 2015, this observational study found the number of monthly drownings in Fiji was significantly affected by monthly rainfall ( P = .008, 95% confidence interval = 0.10-0.62) and the number of days comprising public holidays/weekends ( P = .018, 95% confidence interval = 0.06-0.60). Furthermore, the multiple coefficient of determination ( r 2 = .4976) indicated that almost half the variation in drownings was explained by rainfall and public holidays/weekend periods. Inadequate supervision, an inability to identify or carry out safe rescue techniques, and limited water-safety knowledge were identified as common risk factors. To overcome this preventable cause of death, technically guided interventions need to be actively embedded into a range of government policies and community health promotions, disaster management, and education programs.

  15. Global earthquake fatalities and population

    Science.gov (United States)

    Holzer, Thomas L.; Savage, James C.

    2013-01-01

    Modern global earthquake fatalities can be separated into two components: (1) fatalities from an approximately constant annual background rate that is independent of world population growth and (2) fatalities caused by earthquakes with large human death tolls, the frequency of which is dependent on world population. Earthquakes with death tolls greater than 100,000 (and 50,000) have increased with world population and obey a nonstationary Poisson distribution with rate proportional to population. We predict that the number of earthquakes with death tolls greater than 100,000 (50,000) will increase in the 21st century to 8.7±3.3 (20.5±4.3) from 4 (7) observed in the 20th century if world population reaches 10.1 billion in 2100. Combining fatalities caused by the background rate with fatalities caused by catastrophic earthquakes (>100,000 fatalities) indicates global fatalities in the 21st century will be 2.57±0.64 million if the average post-1900 death toll for catastrophic earthquakes (193,000) is assumed.

  16. Fatalism in systematic aspect and fatalism in its functional context

    Directory of Open Access Journals (Sweden)

    Gustav Henningsen

    1967-02-01

    Full Text Available In this paper, the author explores ideas of how to approach the subject of fate and fatalism. Fate, when equated with a man's life, can be raised to an infinite number of powers—as illustrated in the well-known story of the philosopher who began to wonder whether he were awake or dreaming himself awake. It would be fertile for the study of Fatalism to devote itself to analyses of situations with a view to ascertaining in which situations Fatalism is used. It would be very interesting then to examine whether the typical situations of Fatalism are not such as exclude the application of religious, magical, or rational behaviour.

  17. Allegheny County Fatal Accidental Overdoses

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Fatal accidental overdose incidents in Allegheny County, denoting age, gender, race, drugs present, zip code of incident and zip code of residence. Zip code of...

  18. Neonatal Kraniefraktur

    DEFF Research Database (Denmark)

    Johannesen, Katrine Marie Harries; Stantchev, Hristo

    2015-01-01

    During the latest decades the incidence of birth traumas has decreased significantly. Even so the traumas still contribute to an increased mortality and morbidity. We present a case of spontaneous neonatal skull fracture following a normal vaginal delivery. Abnormal facial structure was seen...

  19. Neonatal Jaundice

    DEFF Research Database (Denmark)

    Maimburg, Rikke Damkjær; Væth, Michael; Schendel, Diana

    2008-01-01

    In a previous study, we found that infants transferred to a neonatal ward after delivery had an almost twofold increased risk of being diagnosed with infantile autism later in childhood in spite of extensive controlling of obstetric risk factors. We therefore decided to investigate other reasons ...

  20. Aetiology of neonatal sepsis at QECH, Blantyre: 1996-2001 | Phiri ...

    African Journals Online (AJOL)

    Neonatal sepsis is common and often fatal in Malawi. The aim of this retrospective study was to report causes, antibiotic resistance and outcome of sepsis in Malawian neonates. We reviewed all blood and cerebrospinal fluid isolates collected between January, 1996, and December, 2001, from inpatients aged 0-30 days ...

  1. Mitochondrial Reactive Oxygen Species in Lipotoxic Hearts Induce Post-Translational Modifications of AKAP121, DRP1, and OPA1 That Promote Mitochondrial Fission.

    Science.gov (United States)

    Tsushima, Kensuke; Bugger, Heiko; Wende, Adam R; Soto, Jamie; Jenson, Gregory A; Tor, Austin R; McGlauflin, Rose; Kenny, Helena C; Zhang, Yuan; Souvenir, Rhonda; Hu, Xiao X; Sloan, Crystal L; Pereira, Renata O; Lira, Vitor A; Spitzer, Kenneth W; Sharp, Terry L; Shoghi, Kooresh I; Sparagna, Genevieve C; Rog-Zielinska, Eva A; Kohl, Peter; Khalimonchuk, Oleh; Schaffer, Jean E; Abel, E Dale

    2018-01-05

    Cardiac lipotoxicity, characterized by increased uptake, oxidation, and accumulation of lipid intermediates, contributes to cardiac dysfunction in obesity and diabetes mellitus. However, mechanisms linking lipid overload and mitochondrial dysfunction are incompletely understood. To elucidate the mechanisms for mitochondrial adaptations to lipid overload in postnatal hearts in vivo. Using a transgenic mouse model of cardiac lipotoxicity overexpressing ACSL1 (long-chain acyl-CoA synthetase 1) in cardiomyocytes, we show that modestly increased myocardial fatty acid uptake leads to mitochondrial structural remodeling with significant reduction in minimum diameter. This is associated with increased palmitoyl-carnitine oxidation and increased reactive oxygen species (ROS) generation in isolated mitochondria. Mitochondrial morphological changes and elevated ROS generation are also observed in palmitate-treated neonatal rat ventricular cardiomyocytes. Palmitate exposure to neonatal rat ventricular cardiomyocytes initially activates mitochondrial respiration, coupled with increased mitochondrial polarization and ATP synthesis. However, long-term exposure to palmitate (>8 hours) enhances ROS generation, which is accompanied by loss of the mitochondrial reticulum and a pattern suggesting increased mitochondrial fission. Mechanistically, lipid-induced changes in mitochondrial redox status increased mitochondrial fission by increased ubiquitination of AKAP121 (A-kinase anchor protein 121) leading to reduced phosphorylation of DRP1 (dynamin-related protein 1) at Ser637 and altered proteolytic processing of OPA1 (optic atrophy 1). Scavenging mitochondrial ROS restored mitochondrial morphology in vivo and in vitro. Our results reveal a molecular mechanism by which lipid overload-induced mitochondrial ROS generation causes mitochondrial dysfunction by inducing post-translational modifications of mitochondrial proteins that regulate mitochondrial dynamics. These findings provide a

  2. Loss of mitochondrial exo/endonuclease EXOG affects mitochondrial respiration and induces ROS-mediated cardiomyocyte hypertrophy.

    Science.gov (United States)

    Tigchelaar, Wardit; Yu, Hongjuan; de Jong, Anne Margreet; van Gilst, Wiek H; van der Harst, Pim; Westenbrink, B Daan; de Boer, Rudolf A; Silljé, Herman H W

    2015-01-15

    Recently, a locus at the mitochondrial exo/endonuclease EXOG gene, which has been implicated in mitochondrial DNA repair, was associated with cardiac function. The function of EXOG in cardiomyocytes is still elusive. Here we investigated the role of EXOG in mitochondrial function and hypertrophy in cardiomyocytes. Depletion of EXOG in primary neonatal rat ventricular cardiomyocytes (NRVCs) induced a marked increase in cardiomyocyte hypertrophy. Depletion of EXOG, however, did not result in loss of mitochondrial DNA integrity. Although EXOG depletion did not induce fetal gene expression and common hypertrophy pathways were not activated, a clear increase in ribosomal S6 phosphorylation was observed, which readily explains increased protein synthesis. With the use of a Seahorse flux analyzer, it was shown that the mitochondrial oxidative consumption rate (OCR) was increased 2.4-fold in EXOG-depleted NRVCs. Moreover, ATP-linked OCR was 5.2-fold higher. This increase was not explained by mitochondrial biogenesis or alterations in mitochondrial membrane potential. Western blotting confirmed normal levels of the oxidative phosphorylation (OXPHOS) complexes. The increased OCR was accompanied by a 5.4-fold increase in mitochondrial ROS levels. These increased ROS levels could be normalized with specific mitochondrial ROS scavengers (MitoTEMPO, mnSOD). Remarkably, scavenging of excess ROS strongly attenuated the hypertrophic response. In conclusion, loss of EXOG affects normal mitochondrial function resulting in increased mitochondrial respiration, excess ROS production, and cardiomyocyte hypertrophy. Copyright © 2015 the American Physiological Society.

  3. [Neonatal cholestasis

    Science.gov (United States)

    Roquete, M L

    2000-07-01

    OBJECTIVE: To warn pediatricians about the early recognition of cholestasis in newborns and infants. METHODS: A bibliographic research about cholestasis was performed using Medline, and emphasizing the most relevant publications of the last 30 years. RESULTS: The concept of cholestasis and the causes of cholestatic tendency in newborns and infants are described. Several causes of intra and extrahepatic cholestasis are reported as well. In this review, only the diseases with diagnostic, therapeutic or prognostic peculiarities are commented, including extrahepatic biliary atresia, idiopathic neonatal hepatitis, galactosemia, and Alagille s syndrome. Furthermore, several resources are discussed for the diagnosis of cholestasis. CONCLUSIONS: The establishment of the diagnosis of cholestasis through the detection of hyperbilirubinemia in newborns who present jaundice after 14 days of life is a goal that could change the prognosis of several diseases responsible for neonatal cholestasis.

  4. Neonatal Kraniefraktur

    DEFF Research Database (Denmark)

    Johannesen, Katrine Marie Harries; Stantchev, Hristo

    2015-01-01

    During the latest decades the incidence of birth traumas has decreased significantly. Even so the traumas still contribute to an increased mortality and morbidity. We present a case of spontaneous neonatal skull fracture following a normal vaginal delivery. Abnormal facial structure was seen......, and the fracture was identified with an MRI. The fractures healed without neurosurgical intervention. Case reports show that even in uncomplicated vaginal deliveries skull fractures can be seen and should be suspected in children with facial abnormalities....

  5. Neonatal Listeriosis

    Directory of Open Access Journals (Sweden)

    Shih-Yu Chen

    2007-01-01

    Full Text Available In Western developed countries, Listeria monocytogenes is not an uncommon pathogen in neonates. However, neonatal listeriosis has rarely been reported in Taiwan. We describe two cases collected from a single medical institute between 1990 and 2005. Case 1 was a male premature baby weighing 1558 g with a gestational age of 31 weeks whose mother had fever with chills 3 days prior to delivery. Generalized maculopapular rash was found after delivery and subtle seizure developed. Both blood and cerebrospinal fluid culture collected on the 1st day yielded L. monocytogenes. In addition, he had ventriculitis complicated with hydrocephalus. Neurologic development was normal over 1 year of follow-up after ventriculoperitoneal shunt operation. Case 2 was a 28-weeks' gestation male premature baby weighing 1180 g. Endotracheal intubation and ventilator support were provided after delivery due to respiratory distress. Blood culture yielded L. monocyto-genes. Cerebrospinal fluid showed pleocytosis but the culture was negative. Brain ultrasonography showed ventriculitis. Sudden deterioration with cyanosis and bradycardia developed on the 8th day and he died on the same day. Neonatal listeriosis is uncommon in Taiwan, but has significant mortality and morbidity. Early diagnosis of perinatal infection relies on high index of suspicion in perinatal health care professionals. [J Formos Med Assoc 2007;106(2:161-164

  6. What Is Mitochondrial DNA?

    Science.gov (United States)

    ... DNA What is mitochondrial DNA? What is mitochondrial DNA? Although most DNA is packaged in chromosomes within ... proteins. For more information about mitochondria and mitochondrial DNA: Molecular Expressions, a web site from the Florida ...

  7. Aetiology of neonatal sepsis in Blantyre, Malawi: 1996-2001

    NARCIS (Netherlands)

    Milledge, J.; Calis, J. C. J.; Graham, S. M.; Phiri, A.; Wilson, L. K.; Soko, D.; Mbvwinji, M.; Walsh, A. L.; Rogerson, S. R.; Molyneux, M. E.; Molyneux, E. M.

    2005-01-01

    The aim of this retrospective study was to report causes, antibiotic resistance and outcome of neonatal sepsis (often fatal in developing countries) in Malawi. All blood and cerebrospinal fluid isolates collected between January 1996 and December 2001 from inpatients aged 0-30 days with suspected

  8. Osteoarthritis in the neonate

    International Nuclear Information System (INIS)

    Weigel, W.; Hayek, W.H.; Bens, G.

    1979-01-01

    A fatally ending index case of sepsis osteoarthritis that was diagnosed retrospectively initiated this report. This patient had severe, asymmetrically distributed metaphyseal growthdisturbances, many long bones. In order to determine the features of early radiologic diagnosis we report the findings of 7 further patients with neonatal septic osteoarthritis with clinical and radiological follow-up. The most important observation for early radiologic diagnosis of osteoarthritis is the displacement of fat layers along the metaphysis. Other findings of the soft tissues have the same diagnostic value as bone destruction and subperiosteal new bone formation found one to three weeks later on roentgenfilms. Detecting early signs of osteoarthritis helps in localizing the focus for bacteriologic diagnosis, which is to be more successful than blood cultures. Diagnosing a joint empyema initiates surgical intervention for pressure relief in order to avoid necrosis of the epiphysis as seen in the femoral bone in septic arthritis of the hip joint. Early diagnosis and treatment to destruction of growing cartilage is necessary to avoid gross disturbances and length discrepancies of long bones. In cases of sepsis called 'babygram' and a repeat examination 10 to 14 days later is mandatory. (orig.) [de

  9. Myocardial perfusion at fatal infarction

    DEFF Research Database (Denmark)

    Hvid-Jacobsen, K; Møller, J T; Kjøller, E

    1992-01-01

    In a consecutive study of myocardial scintigraphy in acute ischemic syndrome, four patients had 99mTc-hexamibi injected intravenously before they developed fatal cardiogenic shock. Planar scintigraphy was performed after death. Slices of the hearts after autopsy were analyzed for scintigraphic...

  10. Clinical case of Mitochondrial DNA Depletion

    Directory of Open Access Journals (Sweden)

    A. V. Degtyareva

    2017-01-01

    Full Text Available The article reports clinical case of early neonatal manifestation of a rare genetic disease – mitochondrial DNA depletion syndrome, confirmed in laboratory in Russia. Mutations of FBXL4, which encodes an orphan mitochondrial F-box protein, involved in the maintenance of mitochondrial DNA (mtDNA, ultimately leading to disruption of mtDNA replication and decreased activity of mitochondrial respiratory chain complexes. It’s a reason of abnormalities in clinically affected tissues, most of all the muscular system and the brain. In our case hydronephrosis on the right, subependimal cysts of the brain, partial intestinal obstruction accompanied by polyhydramnios were diagnosed antenatal. Baby’s condition at birth was satisfactory and worsened dramatically towards the end of the first day of life. Clinical presentation includes sepsis-like symptom complex, neonatal depression, muscular hypotonia, persistent decompensated lactic acidosis, increase in the concentration of mitochondrial markers in blood plasma and urine, and changes in the basal ganglia of the brain. Imaging of the brain by magnetic resonance imaging (MRI demonstrated global volume loss particularly the subcortical and periventricular white matter with significant abnormal signal in bilateral basal ganglia and brainstem with associated delayed myelination. Differential diagnosis was carried out with hereditary diseases that occur as a «sepsis-like» symptom complex, accompanied by lactic acidosis: a group of metabolic disorders of amino acids, organic acids, β-oxidation defects of fatty acids, respiratory mitochondrial chain disorders and glycogen storage disease. The diagnosis was confirmed after sequencing analysis of 62 mytochondrial genes by NGS (Next Generation Sequencing. Reported disease has an unfavorable prognosis, however, accurate diagnosis is very important for genetic counseling and helps prevent the re-birth of a sick child in the family.

  11. Infantile Encephalopathy and Defective Mitochondrial DNA Translation in Patients with Mutations of Mitochondrial Elongation Factors EFG1 and EFTu

    Science.gov (United States)

    Valente, Lucia; Tiranti, Valeria; Marsano, René Massimiliano; Malfatti, Edoardo; Fernandez-Vizarra, Erika; Donnini, Claudia; Mereghetti, Paolo; De Gioia, Luca; Burlina, Alberto; Castellan, Claudio; Comi, Giacomo P.; Savasta, Salvatore; Ferrero, Iliana; Zeviani, Massimo

    2007-01-01

    Mitochondrial protein translation is a complex process performed within mitochondria by an apparatus composed of mitochondrial DNA (mtDNA)–encoded RNAs and nuclear DNA–encoded proteins. Although the latter by far outnumber the former, the vast majority of mitochondrial translation defects in humans have been associated with mutations in RNA-encoding mtDNA genes, whereas mutations in protein-encoding nuclear genes have been identified in a handful of cases. Genetic investigation involving patients with defective mitochondrial translation led us to the discovery of novel mutations in the mitochondrial elongation factor G1 (EFG1) in one affected baby and, for the first time, in the mitochondrial elongation factor Tu (EFTu) in another one. Both patients were affected by severe lactic acidosis and rapidly progressive, fatal encephalopathy. The EFG1-mutant patient had early-onset Leigh syndrome, whereas the EFTu-mutant patient had severe infantile macrocystic leukodystrophy with micropolygyria. Structural modeling enabled us to make predictions about the effects of the mutations at the molecular level. Yeast and mammalian cell systems proved the pathogenic role of the mutant alleles by functional complementation in vivo. Nuclear-gene abnormalities causing mitochondrial translation defects represent a new, potentially broad field of mitochondrial medicine. Investigation of these defects is important to expand the molecular characterization of mitochondrial disorders and also may contribute to the elucidation of the complex control mechanisms, which regulate this fundamental pathway of mtDNA homeostasis. PMID:17160893

  12. Age trajectories of stroke case fatality

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Andersen, Zorana Jovanovic; Andersen, Klaus Kaae

    2011-01-01

    Mortality rates level off at older ages. Age trajectories of stroke case-fatality rates were studied with the aim of investigating prevalence of this phenomenon, specifically in case-fatality rates at older ages....

  13. Factors involved in fatal vehicle crashes

    Science.gov (United States)

    2010-09-01

    This report examines factors that contribute to fatal crashes involving a motor vehicle (e.g., car, truck, or bus). Accident level data was obtained from the National Highway Traffic Safety Administrations (NHTSAs) Fatality Analysis Reporting S...

  14. Increased intrinsic mitochondrial function in humans with mitochondrial haplogroup H

    DEFF Research Database (Denmark)

    Larsen, Steen; Díez-Sánchez, Carmen; Rabøl, Rasmus

    2014-01-01

    and determined their mitochondrial haplogroup, mitochondrial oxidative phosphorylation capacity (OXPHOS), mitochondrial content (citrate synthase (CS)) and VO2max. Intrinsic mitochondrial function is calculated as mitochondrial OXPHOS capacity divided by mitochondrial content (CS). Haplogroup H showed a 30......% higher intrinsic mitochondrial function compared with the other haplo group U. There was no relationship between haplogroups and VO2max. In skeletal muscle from men with mitochondrial haplogroup H, an increased intrinsic mitochondrial function is present....

  15. Neonatal sepsis

    Directory of Open Access Journals (Sweden)

    Angelica Dessì

    2014-06-01

    Full Text Available In this paper on neonatal sepsis, after a short presentation of etiopathogenesis and physiopathology, we will briefly present the clinical picture, the diagnosis and the therapy. Concerning diagnosis, we will focus our attention on procalcitonin (PCT, serum amyloid A (SAA, presepsin (sCD14 and metabolomics. Three practical tables complete the review. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  16. Neonatal cardiac mitochondria and ischemia/reperfusion injury

    Czech Academy of Sciences Publication Activity Database

    Milerová, Marie; Charvátová, Zuzana; Škárka, Libor; Ošťádalová, Ivana; Drahota, Zdeněk; Fialová, Martina; Ošťádal, Bohuslav

    2010-01-01

    Roč. 335, 1-2 (2010), s. 147-153 ISSN 0300-8177 R&D Projects: GA MŠk(CZ) 1M0510 Institutional research plan: CEZ:AV0Z50110509 Keywords : neonatal rat heart * tolerance to ischemia * mitochondrial permeability transition pore Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 2.168, year: 2010

  17. Fatal motorcycle accidents and alcohol

    DEFF Research Database (Denmark)

    Larsen, C F; Hardt-Madsen, M

    1987-01-01

    ); 59% above 0.08%. In all cases where a pillion passenger was killed, the operator of the motorcycle had a BAC greater than 0.08%. Of the killed counterparts 2 were non-intoxicated, 2 had a BAC greater than 0.08%, and 4 were not tested. The results advocate that the law should restrict alcohol......A series of fatal motorcycle accidents from a 7-year period (1977-1983) has been analyzed. Of the fatalities 30 were operators of the motorcycle, 11 pillion passengers and 8 counterparts. Of 41 operators 37% were sober at the time of accident, 66% had measurable blood alcohol concentration (BAC...... consumption by pillion passengers as well as by the motorcycle operator. Suggestions made to extend the data base needed for developing appropriate alcohol countermeasures by collecting sociodemographic data on drivers killed or seriously injured should be supported....

  18. Mitragynine concentrations in two fatalities.

    Science.gov (United States)

    Domingo, Olwen; Roider, Gabriele; Stöver, Andreas; Graw, Matthias; Musshoff, Frank; Sachs, Hans; Bicker, Wolfgang

    2017-02-01

    Two cases of fatalities are reported of which the recreational use of Mitragyna speciosa ("kratom") could be confirmed. One of these cases presents with one of the highest postmortem mitragynine concentrations published to date. Our results show that even extremely high mitragynine blood concentrations following the consumption of kratom do not necessarily have to be the direct cause of death in such fatalities as a result of an acute overdose. The two cases are compared with regard to the differences in mitragynine concentrations detected and the role of mitragynine in the death of the subjects. Irrespective of the big differences in mitragynine concentrations in the postmortem blood samples, mitragynine was not the primary cause of death in either of the two cases reported here. Additionally, by rough estimation, a significant difference in ratio of mitragynine to its diastereomers in the blood and urine samples between the two cases could be seen. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Fatal motorcycle accidents and alcohol

    DEFF Research Database (Denmark)

    Larsen, C F; Hardt-Madsen, M

    1987-01-01

    A series of fatal motorcycle accidents from a 7-year period (1977-1983) has been analyzed. Of the fatalities 30 were operators of the motorcycle, 11 pillion passengers and 8 counterparts. Of 41 operators 37% were sober at the time of accident, 66% had measurable blood alcohol concentration (BAC......); 59% above 0.08%. In all cases where a pillion passenger was killed, the operator of the motorcycle had a BAC greater than 0.08%. Of the killed counterparts 2 were non-intoxicated, 2 had a BAC greater than 0.08%, and 4 were not tested. The results advocate that the law should restrict alcohol...... consumption by pillion passengers as well as by the motorcycle operator. Suggestions made to extend the data base needed for developing appropriate alcohol countermeasures by collecting sociodemographic data on drivers killed or seriously injured should be supported....

  20. Chernobyl Accident Fatalities and Causes

    Science.gov (United States)

    1990-06-01

    death of the movie director and the hospi- nobyl. Chronicle of Difficult Days." which talization of two cameramen. Dr. Baraba- wvas filmed in May 1986... disease occurred only as a result of eight fatalities were caused by combina- severe damage, which was incompatible tions of various syndrornes without...transplant complications Iemophilia 1 Thermal burns/internal contamination 2 Radiation induced vascular damage I 10 In Moscow. 56 of the 115 ARS patients

  1. Acute renal failure in asphyxiated term neonates

    Directory of Open Access Journals (Sweden)

    Pejović Biljana

    2002-01-01

    fatal. CONCLUSION We conclude that in tgerm neonates with severe perinatal asphyxia oliguric ARF was the predominant type of ARF. There is a good prediction of the severity of oliguric ARF according to the degree of perinatal asphvxia determined by Apgar score at 1 min.

  2. Characteristics of pediatric firearm fatalities.

    Science.gov (United States)

    Beaver, B L; Moore, V L; Peclet, M; Haller, J A; Smialek, J; Hill, J L

    1990-01-01

    An increase in the awareness of the problem of gunshot fatalities in children has occurred nationwide over the last year. Unintentional firearm deaths are more common among children and young adults. These deaths may be addressed by preventive measures beyond those available for pediatric firearm suicide and homicide. This study focuses on the incidence of fatal gunshot injuries in children under 16 years of age during the years 1979 through 1987 in our state. Over the past 9 years 132 children (0 to 16 years) were shot and killed as a result of firearm injuries (M:F ratio, 3:1). No difference in absolute number in racial distribution existed. Deaths were classified as homicide, 61 (46%); accidental, 33 (25%); suicide, 29 (22%); undetermined, 7 (5%); and other, 2 (1.5%). Over 70% of these fatal injuries occurred in the home environment. Types of weapons involved included handguns (48%), shotguns (22%), rifles (17%), unspecified weapon (12%), and air rifle (1%). In a large number of cases, guns were found in the home unsecured. The perpetrator was known by the victim in 64 instances, while unknown in 27. Thirty-nine self-inflicted wounds and two shotgun blasts in the line of fire accounted for the remaining deaths. The most common anatomical injury and ultimate cause of death was cranial central nervous system (CNS) (62%), followed by chest/mediastinum (20%), abdomen (10%), and other (8%). A child who has sustained a firearm injury is more likely to know the perpetrator, be killed in the home by a readily available unsecured firearm, and die from severe head injury.

  3. [Fatal poisoning due to Indigofera].

    Science.gov (United States)

    Labib, S; Berdai, M-A; Bendadi, A; Achour, S; Harandou, M

    2012-01-01

    Indigo, also known in Morocco as Nila, is a dye widely used in the coloring of Moroccan handicrafts. It is obtained from fermentation reactions on the leaves and branches of true indigo, Indigofera tinctoria, which is a widespread plant in tropical Africa and Asia. We report a case of fatal poisoning in a 3-year-old child after administration of indigo for therapeutic purposes. Death resulted from multiple organ failure. The toxicity of this compound is little known in the literature and deserves to be explored through toxicokinetic and toxicodynamic studies, in order to better determine the toxic constituents of the dye. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  4. Preventing Mitochondrial Disease: A Path Forward.

    Science.gov (United States)

    Adashi, Eli Y; Cohen, I Glenn

    2018-03-01

    In a possible first, the heritable transmission of a fatal mitochondrial DNA disease (Leigh syndrome) may have been prevented by replacing the mutation-bearing mitochondria of oocytes with donated mutation-free counterparts. The procedure, carried out by a U.S.-led team, took place in Mexico in circumvention of a statutory U.S. moratorium on mitochondrial replacement. This development calls into question the regulatory utility of a national moratorium in a globalized world wherein cross-border care is increasingly prevalent. This development also calls to account the moral defensibility of a moratorium that acquiesces in the birth of gravely ill children whose afflictions could have been prevented. In this Current Commentary, we outline a potential path forward by analyzing the dual imprint of the moratorium, examining its legislative shortcomings, exploring its motivational roots, considering its national effect, and proposing its unlinking from the related yet distinct ban on editing the genome of the human embryo.

  5. The neonatal brain

    International Nuclear Information System (INIS)

    Flodmark, O.

    1987-01-01

    The clinical examination of the CNS in the neonate is often difficult in cases of complex pathology. Diagnostic imaging of the neonatal brain has become extremely useful and in the last decade has developed in two main directions: CT and US. MR imaging has been used recently with varying success in the diagnosis of pathology in the neonatal brain. Despite technical difficulties, this imaging method is likely to become increasingly important in the neonate. The paper examines the normal neonatal brain anatomy as seen with the different modalities, followed by pathologic conditions. Attention is directed to the common pathology, in asphyxiated newborns, the patholphysiology of intraventicular hemorrhage and periventricular leukomalacia in the preterm neonate, and hypoxic-ischemic brain injury in the term neonate. Pitfalls, artifacts, and problems in image interpretation are illustrated. Finally, the subsequent appearance of neonatal pathology later in infancy and childhood is discussed

  6. Fatal accidental hypothermia and alcohol.

    Science.gov (United States)

    Albiin, N; Eriksson, A

    1984-01-01

    A series of 51 fatal cases of accidental hypothermia in northern Sweden has been reviewed. The cases conform well to previous investigations with respect to the mean age of the victims (48 years) and a predominance of males. The cases occurred mainly during the winter months and on Saturdays. Most cases succumbed at temperatures below -10 degrees C. The most frequent necropsy findings were areas of frostbite with purple discoloration of the skin, reddish lividity and superficial erosions of the gastric mucosa. Paradoxical undressing was present in more than half of the cases. About two thirds of the cases were under the influence of alcohol with a mean blood alcohol concentration of 1.6 g/l. Furthermore, at least half of the cases could be considered habitual drunkards. In conclusion, the present series shows two main groups of fatal hypothermia victims: one group of elderly persons, mostly chronic abusers and under the influence of alcohol (approximately two-thirds of the series), and another of younger and sober persons, performing recognised sporting activities (approximately one-fourth of the series).

  7. Losing sleep over mitochondria: a new player in the pathophysiology of fatal familial insomnia.

    Science.gov (United States)

    Glatzel, Markus; Sepulveda-Falla, Diego

    2017-01-01

    This commentary highlights the study by Frau-Mendez and coworkers in this issue of Brain Pathology (xxx) in which the authors show evidence for involvement of mitochondria in the pathophysiology of fatal familial insomnia (FFI). Using genetic, biochemical and morphological means, they provide a comprehensive picture of the degree of mitochondrial damage in FFI and show that this leads to increased oxidative stress. This adds FFI to the growing list of dementias with mitochondrial involvement. Future studies will have to address the causality dilemma of which came first, mitochondrial damage and subsequent neurodegeneration or vice versa. Either way, these data provide the basis to devise novel therapeutic strategies for FFI. © 2016 International Society of Neuropathology.

  8. Mitochondrial function is altered in horse atypical myopathy.

    Science.gov (United States)

    Lemieux, Hélène; Boemer, François; van Galen, Gaby; Serteyn, Didier; Amory, Hélène; Baise, Etienne; Cassart, Dominique; van Loon, Gunther; Marcillaud-Pitel, Christel; Votion, Dominique-M

    2016-09-01

    Equine atypical myopathy in Europe is a fatal rhabdomyolysis syndrome that results from the ingestion of hypoglycin A contained in seeds and seedlings of Acer pseudoplatanus (sycamore maple). Acylcarnitine concentrations in serum and muscle OXPHOS capacity were determined in 15 atypical myopathy cases. All but one acylcarnitine were out of reference range and mitochondrial respiratory capacity was severely decreased up to 49% as compared to 10 healthy controls. The hallmark of atypical myopathy thus consists of a severe alteration in the energy metabolism including a severe impairment in muscle mitochondrial respiration that could contribute to its high death rate. Copyright © 2016 Elsevier B.V. and Mitochondria Research Society. All rights reserved.

  9. [Biochemical diagnostics of fatal opium intoxication].

    Science.gov (United States)

    Papyshev, I P; Astashkina, O G; Tuchik, E S; Nikolaev, B S; Cherniaev, A L

    2013-01-01

    Biochemical diagnostics of fatal opium intoxication remains a topical problem in forensic medical science and practice. We investigated materials obtained in the course of forensic medical expertise of the cases of fatal opium intoxication. The study revealed significant differences between myoglobin levels in blood, urine, myocardium, and skeletal muscles. The proposed approach to biochemical diagnostics of fatal opium intoxication enhances the accuracy and the level of evidence of expert conclusions.

  10. Cancer fatalism: the state of the science.

    Science.gov (United States)

    Powe, Barbara D; Finnie, Ramona

    2003-12-01

    Cancer fatalism--the belief that death is inevitable when cancer is present--has been identified as a barrier to participation in cancer screening, detection, and treatment. Yet this literature has not been reviewed in a comprehensive and systematic manner. Therefore, this literature review addressed (1) philosophical and theoretical underpinnings of cancer fatalism; (2) relationships among demographic factors, cancer fatalism, and cancer screening; (3) the role of cancer fatalism for patients diagnosed with cancer; and (4) intervention strategies. Most of the reviewed studies were descriptive or correlational, did not have an explicit theoretical framework, had varied definitions of fatalism, and reported screening as "intent to screen" or as "past screening behaviors." Review of the studies suggests that cancer fatalism develops over time and is most frequently reported among medically underserved persons and those with limited knowledge of cancer. Cancer fatalism may be modified through culturally relevant interventions that incorporate spirituality. Emphasis must be placed on recognizing the role of cancer fatalism when planning health promotion activities. Future studies should focus on the consistent measurement of cancer fatalism and testing intervention strategies.

  11. Pearson's marrow-pancreas syndrome. A multisystem mitochondrial disorder in infancy.

    OpenAIRE

    Rötig, A; Cormier, V; Blanche, S; Bonnefont, J P; Ledeist, F; Romero, N; Schmitz, J; Rustin, P; Fischer, A; Saudubray, J M

    1990-01-01

    Pearson's marrow-pancreas syndrome (McKusick No. 26056) is a fatal disorder of hitherto unknown etiology involving the hematopoietic system, exocrine pancreas, liver, and kidneys. The observation of high lactate/pyruvate molar ratios in plasma and abnormal oxidative phosphorylation in lymphocytes led us to postulate that Pearson's syndrome belongs to the group of mitochondrial cytopathies. Since rearrangements of the mitochondrial genome between direct DNA repeats were consistently found in a...

  12. CRISPR/Cas9 and mitochondrial gene replacement therapy: promising techniques and ethical considerations

    OpenAIRE

    Fogleman, Sarah; Santana, Casey; Bishop, Casey; Miller, Alyssa; Capco, David G

    2016-01-01

    Thousands of mothers are at risk of transmitting mitochondrial diseases to their offspring each year, with the most severe form of these diseases being fatal [1]. With no cure, transmission prevention is the only current hope for decreasing the disease incidence. Current methods of prevention rely on low mutant maternal mitochondrial DNA levels, while those with levels close to or above threshold (>60%) are still at a very high risk of transmission [2]. Two novel approaches may offer hope for...

  13. Dataset on psychosocial risk factors in cases of fatal and near-fatal physical child abuse

    Directory of Open Access Journals (Sweden)

    Mary Clyde Pierce

    2017-10-01

    Full Text Available This article presents the psychosocial risk factors identified in the cases of 20 children less than four years of age who were victims of fatal or near-fatal physical abuse during a 12 month period in the Commonwealth of Kentucky. These data are related to the article “History, injury, and psychosocial risk factor commonalities among cases of fatal and near-fatal physical child abuse” (Pierce et al., 2017 [1].

  14. Drug involvement in fatal overdoses

    Directory of Open Access Journals (Sweden)

    Christopher J. Ruhm

    2017-12-01

    Full Text Available Death certificate data from the Multiple Cause of Death (MCOD files were analyzed to better understand the drug categories most responsible for the increase in fatal overdoses occurring between 1999 and 2014. Statistical adjustment methods were used to account for the understatement in reported drug involvement occurring because death certificates frequently do not specify which drugs were involved in the deaths. The frequency of combination drug use introduced additional uncertainty and so a distinction was made between any versus exclusive drug involvement. Many results were sensitive to the starting and ending years chosen for examination. Opioid analgesics played a major role in the increased drug deaths for analysis windows starting in 1999 but other drugs, particularly heroin, became more significant for recent time periods. Combination drug use was important for all time periods and needs to be accounted for when designing policies to slow or reverse the increase in overdose deaths.

  15. Fatality in a wine vat.

    Science.gov (United States)

    La Harpe, Romano; Shiferaw, Kebede; Mangin, Patrice; Burkhardt, Sandra

    2013-06-01

    Intoxication with carbon dioxide (CO2), a nonexplosive, colorless, and odorless gas does not cause any clinical symptoms or signs, with the occasional exception of sudation. Carbon dioxide is principally used in the food industry (70% of CO2 production), in particular to preserve foods and to carbonate beverages. Most fatalities resulting from CO2 intoxication are accidental and occur either in closed spaces or when dry ice is used in the food industry. In this case report, a 42-year-old male winemaker engineer was found dead, his head inside a wine vat that had been filled with grapes on the previous day and supplemented with dry ice to improve the taste of wine.

  16. Molecular Mechanisms of Neonatal Brain Injury

    Directory of Open Access Journals (Sweden)

    Claire Thornton

    2012-01-01

    Full Text Available Fetal/neonatal brain injury is an important cause of neurological disability. Hypoxia-ischemia and excitotoxicity are considered important insults, and, in spite of their acute nature, brain injury develops over a protracted time period during the primary, secondary, and tertiary phases. The concept that most of the injury develops with a delay after the insult makes it possible to provide effective neuroprotective treatment after the insult. Indeed, hypothermia applied within 6 hours after birth in neonatal encephalopathy reduces neurological disability in clinical trials. In order to develop the next generation of treatment, we need to know more about the pathophysiological mechanism during the secondary and tertiary phases of injury. We review some of the critical molecular events related to mitochondrial dysfunction and apoptosis during the secondary phase and report some recent evidence that intervention may be feasible also days-weeks after the insult.

  17. [Neonatal Pearson syndrome. two case studies].

    Science.gov (United States)

    Collin-Ducasse, H; Maillotte, A-M; Monpoux, F; Boutté, P; Ferrero-Vacher, C; Paquis, V

    2010-01-01

    Among the etiologies of anemia in the newborn, those related to mitochondrial cytopathies are rare. Pearson syndrome is mostly diagnosed during infancy and characterized by refractory sideroblastic anemia with vacuolization of marrow progenitor cells and exocrine pancreatic dysfunction. We describe two diagnosed cases of Pearson syndrome in the early neonatal period caused by severe macrocytic aregenerative anemia. Bone marrow aspiration revealed sideroblastic anemia and vacuolization of erythroblastic precursors. The diagnosis was confirmed by genetic analysis revealing a deletion in the mitochondrial DNA. These two newborns received monthly transfusions. Five other newborns suffering from Pearson syndrome with various clinical symptoms were found in literature. Pearson syndrome, rarely diagnosed in newborns, should be suspected in the presence of macrocytic aregenerative anemia and requires a bone marrow aspirate followed by a genetic analysis from a blood sample. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  18. HEPATIC DIALYSIS IN NEONATES WITH ACUTE LIVER FAILURE

    OpenAIRE

    Stancu, Samantha Mc Kenzie; Cirstoveanu, Catalin Gabriel

    2016-01-01

    Hepatic dialysis is an artificial extracorporeal liver support device designed to filter out toxins accumulated in patients with acute liver failure. Although it is a rare entity encountered in neonates, acute liver failure is a highly fatal condition, with seventy percent resulting in mortality without liver transplantation. Scientific data on extracorporeal liver support concerning the pediatric population is scarce in literature. Artificial extracorporeal liver support devices in the form ...

  19. The mitochondrial ROMK channel is a molecular component of Mitokatp

    Science.gov (United States)

    Foster, D. Brian; Ho, Alice S.; Rucker, Jasma; Garlid, Anders O.; Chen, Ling; Sidor, Agnieszka; Garlid, Keith D.; O’Rourke, Brian

    2013-01-01

    Rationale Activation of the mitochondrial ATP-sensitive potassium channel (mitoKATP) has been implicated in the mechanism of cardiac ischemic preconditioning, yet its molecular composition is unknown. Objective To use an unbiased proteomic analysis of the mitochondrial inner membrane to identify the mitochondrial K+ channel underlying mitoKATP. Methods and Results Mass spectrometric analysis was used to identify KCNJ1(ROMK) in purified bovine heart mitochondrial inner membrane and confirmed that ROMK mRNA is present in neonatal rat ventricular myocytes and adult hearts. ROMK2, a short form of the channel, is shown to contain an N-terminal mitochondrial targeting signal and a full length epitope-tagged ROMK2 colocalizes with mitochondrial ATP synthase β. The high-affinity ROMK toxin, tertiapin Q, inhibits mitoKATP activity in isolated mitochondria and in digitonin-permeabilized cells. Moreover, shRNA-mediated knockdown of ROMK inhibits the ATP-sensitive, diazoxide activated, component of mitochondrial thallium uptake. Finally, the heart-derived cell line, H9C2, is protected from cell death stimuli by stable ROMK2 overexpression, while knockdown of the native ROMK exacerbates cell death. Conclusions The findings support ROMK as the pore-forming subunit of the cytoprotective mitoKATP channel. PMID:22811560

  20. Buses involved in fatal accidents codebook 2007.

    Science.gov (United States)

    2009-12-01

    This report provides documentation for UMTRIs file of Buses Involved in Fatal Accidents (BIFA), 2007, : including distributions of the code values for each variable in the file. The 2007 BIFA file is a census of all : buses involved in a fatal acc...

  1. Buses involved in fatal accidents codebook 2008.

    Science.gov (United States)

    2011-03-01

    This report provides documentation for UMTRIs file of Buses Involved in Fatal Accidents (BIFA), 2008, : including distributions of the code values for each variable in the file. The 2008 BIFA file is a census of all : buses involved in a fatal acc...

  2. Fatalism and Type of Information Sensitivity.

    Science.gov (United States)

    Nielsen, Richard P.; Nielsen, Angela B.

    Fatalism as measured by Rotter's internal-external locus of control scale is the degree to which a person generally believes that events affecting his life are largely determined by other forces rather than by his own efforts. The purpose of this paper is to examine behavioral science theory concerning fatalism, and develop and test which types of…

  3. NAD+-Dependent Activation of Sirt1 Corrects the Phenotype in a Mouse Model of Mitochondrial Disease

    Science.gov (United States)

    Cerutti, Raffaele; Pirinen, Eija; Lamperti, Costanza; Marchet, Silvia; Sauve, Anthony A.; Li, Wei; Leoni, Valerio; Schon, Eric A.; Dantzer, Françoise; Auwerx, Johan; Viscomi, Carlo; Zeviani, Massimo

    2014-01-01

    Summary Mitochondrial disorders are highly heterogeneous conditions characterized by defects of the mitochondrial respiratory chain. Pharmacological activation of mitochondrial biogenesis has been proposed as an effective means to correct the biochemical defects and ameliorate the clinical phenotype in these severely disabling, often fatal, disorders. Pathways related to mitochondrial biogenesis are targets of Sirtuin1, a NAD+-dependent protein deacetylase. As NAD+ boosts the activity of Sirtuin1 and other sirtuins, intracellular levels of NAD+ play a key role in the homeostatic control of mitochondrial function by the metabolic status of the cell. We show here that supplementation with nicotinamide riboside, a natural NAD+ precursor, or reduction of NAD+ consumption by inhibiting the poly(ADP-ribose) polymerases, leads to marked improvement of the respiratory chain defect and exercise intolerance of the Sco2 knockout/knockin mouse, a mitochondrial disease model characterized by impaired cytochrome c oxidase biogenesis. This strategy is potentially translatable into therapy of mitochondrial disorders in humans. PMID:24814483

  4. EVALUATION OF CARDIAC MURMURS IN NEONATES

    Directory of Open Access Journals (Sweden)

    Chakravathy

    2015-10-01

    Full Text Available BACKGROUND: Cardio vascular malformations are the most common congenital malformations. Early recognition of congenital heart disease is important in the neonatal period, as many of them may be fatal if undiagnosed. AIM : To study the epidemiology of neonatal cardiac murmurs. To identify clinical characteristics which differentiates pathological murmur from functional murmurs to assess the reliability of clinical evaluation in diagnosing congenital heart diseas e? METHODS : The study population included all neonates admitted in a Hospital in Visakhapatnam to the NICU, postnatal ward, attending pediatric OPD and were detected to have cardiac murmurs. It was a cross sectional study over a period of 16 months. A clinical diagnosis was made based on history and clinical examination. Then Chest X ray and ECG were done in symptomatic infants. Echo cardiography was done in all neonates for confirmation of diagnosis, the neonates were again examined daily till they were in hospital and during the follow up visit at 6 weeks. RESULTS : A total of 61 neonates were included and was conducted over a period of 16 months . T he incidence of cardiac murmurs among intramural neonates was 13.5 for 1000 live births. Most frequent symptom was fast breathing in 10[16.4%] cases. VSD was the most common diagnosis clinically in 19[31.47%] babies. The most frequent diagnosis was acyanotic complex congenital heart disease, Only intra mural neonates were considered for the incidence of murmurs and the incidence of cardiac murmurs among them babies was 13.5 for 1000 live in 23[37.7%] cases followed by 10[16.4%] cases each of VSD and ASD respectively. Overall in our study 73.77% [45 cases] of the murmurs were diagnosed correctly and confirmed by Echocardiography. INTERPRETATIONS & CONCLUSIONS: 1. It is possible to make clinical diagnosis in many cases of congenital heart diseases. 2. The functional murmurs could be differentiated from those arising from structural heart

  5. Rain-related Fatal Crashes in Texas

    Science.gov (United States)

    Sharif, Hatim; Jackson, Terrance

    2013-04-01

    Weather has a direct impact on traffic safety. This study focuses on fatal crashes in the presence of rain. We reviewed information related to the events that lead to rain- related crashes in the Texas since 1982. Analysis of the data reveals that 12.4% of crashes in Texas were rain-related. Most rain-related crashes are located in Texas "Flash Flood Alley" which includes major urban centers. Fatal crash data and GIS are used to explore and identify the spatio-temporal distribution of the crashes. Spatial statistical techniques are used to identify significant patterns of rain-related fatal crashes. Logistic and nonlinear regression is used to identify and rank all environmental and non-environmental factors that contribute to fatal crashes. Focus will be on factors that amplify the rain effect. Identifying the variables contributing to these fatal crash types is necessary for the implementation of effective countermeasures for road weather safety purposes.

  6. The mitochondrial contact site complex, a determinant of mitochondrial architecture

    OpenAIRE

    Harner, Max; Körner, Christian; Walther, Dirk; Mokranjac, Dejana; Kaesmacher, Johannes; Welsch, Ulrich; Griffith, Janice; Mann, Matthias; Reggiori, Fulvio; Neupert, Walter

    2011-01-01

    The outer and inner mitochondrial membranes are physically linked. Quantitative high resolution mass spectrometry now identifies the molecular nature of the Mitochondrial Contact Site complex (MICOS). MICOS is required for crista junctions formation, respiration and mitochondrial DNA inheritance.

  7. Congenital and neonatal pneumonia.

    Science.gov (United States)

    Nissen, Michael D

    2007-09-01

    The greatest risk of death from pneumonia in childhood is in the neonatal period. It is estimated that pneumonia contributes to between 750000-1.2 million neonatal deaths annually, accounting for 10% of global child mortality. Congenital and neonatal pneumonias are often a difficult disease to identify and treat, with clinical manifestations often being non-specific. Many of the normal lung defences are compromised in the fetus and neonate, leading to an increased susceptibility to infection. The aetiology and epidemiology of congenital and neonatal pneumonias will depend on the clinical setting and population that the baby belongs to, the stage in the perinatal period, the gestational age of the baby and the definition of pneumonia. Diagnosis, treatment and prevention strategies are therefore also dependent on these factors, and will differ depending on the clinical setting. This review summarizes the current knowledge concerning congenital and neonatal pneumonia worldwide and discusses future directions in the prevention of the disease.

  8. Fatal Necrotizing Fasciitis following Episiotomy

    Directory of Open Access Journals (Sweden)

    Faris Almarzouqi

    2015-01-01

    Full Text Available Introduction. Necrotizing fasciitis is an uncommon condition in general practice but one that provokes serious morbidity. It is characterized by widespread fascial necrosis with relative sparing of skin and underlying muscle. Herein, we report a fatal case of necrotizing fasciitis in a young healthy woman after episiotomy. Case Report. A 17-year-old primigravida underwent a vaginal delivery with mediolateral episiotomy. Necrotizing fasciitis was diagnosed on the 5th postpartum day, when the patient was referred to our tertiary care medical center. Surgical debridement was initiated together with antibiotics and followed by hyperbaric oxygen therapy. The patient died due to septic shock after 16 hours from the referral. Conclusion. Delay of diagnosis and consequently the surgical debridement were most likely the reasons for maternal death. In puerperal period, a physician must consider necrotizing fasciitis as a possible diagnosis in any local sings of infection especially when accompanied by fever and/or tenderness. Early diagnosis is the key for low mortality and morbidity.

  9. 78 FR 38096 - Fatality Analysis Reporting System Information Collection

    Science.gov (United States)

    2013-06-25

    ... Number NHTSA-2012-0168] Fatality Analysis Reporting System Information Collection AGENCY: National... comments on the following proposed collections of information: (1) Title: Fatal Analysis Reporting System... system that acquires national fatality information directly from existing State files and documents...

  10. Fatal falls among older construction workers.

    Science.gov (United States)

    Dong, Xiuwen Sue; Wang, Xuanwen; Daw, Christina

    2012-06-01

    This study examines recent trends and patterns in fall fatalities in the U.S. construction industry to determine whether fatal falls among older workers are different from younger workers in this industry. Falls are the leading cause of fatalities in the U.S. construction industry. Given the increasingly aging workforce in construction, it is important to assess the risk of falls among older construction workers. Fatality data were obtained from the Census of Fatal Occupational Injuries for the years 1992 through 2008. Denominators for death rates were estimated from the Current Population Survey. Stratified and multivariate analyses were performed to examine whether there are differences in fatal falls between older workers (> or = 55 years) and younger workers (16-54 years). Fatal falls in nonconstruction industries were excluded from this study. Older workers had higher rates of fatal falls than younger workers; results were significant in 11 of 14 construction occupations. Regression analysis indicated that older decedents had a higher likelihood that work-related death was caused by a fall, after controlling for major demographic and employment factors (odds ratio = 1.50, confidence interval [1.30, 1.72]). Falls from roofs accounted for one third of construction fatal falls, but falls from ladders caused a larger proportion of deadly falls in older decedents than in younger decedents. Older workers have a higher likelihood of dying from a fall. Roofs and ladders are particularly risky for older construction workers. As the construction workforce ages, there is an urgent need to enhance fall prevention efforts, provide work accommodations, and match work capabilities to job duties.

  11. Fatalism and cancer screening in Appalachian Kentucky.

    Science.gov (United States)

    Royse, David; Dignan, Mark

    2011-01-01

    Fatalism may play a role in Appalachians' views about cancer screening and contribute to high rates of cancer incidence and mortality, but few studies have explored this issue. A probability telephone survey was conducted of 696 adults living in 51 Appalachian Kentucky counties inquiring about intentions to obtain cancer screening. The Life Orientation Test-Revised as a surrogate measure for fatalism and logistic regression was used to predict screening activity. Insurance coverage was the best overall predictor variable. Fatalism was significant in one model possibly reflecting an appreciation of the costs and barriers associated with obtaining screening in rural counties.

  12. Reporting Fatal Neglect in Child Death Review.

    Science.gov (United States)

    Scott, Debbie

    2018-01-01

    Child death reviews are conducted with the aim of preventing child deaths however, definitions, inclusion criteria for the review of child deaths and reporting practices vary across Child Death Review Teams (CDRTs). This article aims to identify a common context and understanding of fatal neglect reporting by reviewing definitional issues of fatal neglect and comparing reporting practice across a number of CDRTs. Providing a consistent context for identifying and reporting neglect-related deaths may improve the understanding of the impact of fatal neglect and the risk factors associated with it and therefore, improve the potential of CDRT review to inform prevention programs, policies, and procedures.

  13. States with low non-fatal injury rates have high fatality rates and vice-versa.

    Science.gov (United States)

    Mendeloff, John; Burns, Rachel

    2013-05-01

    State-level injury rates or fatality rates are sometimes used in studies of the impact of various safety programs or other state policies. How much does the metric used affect the view of relative occupational risks among U.S. states? This paper uses a measure of severe injuries (fatalities) and of less severe injuries (non-fatal injuries with days away from work, restricted work, or job transfer-DART) to examine that issue. We looked at the correlation between the average DART injury rate (from the BLS Survey of Occupational Injuries and Illnesses) and an adjusted average fatality rate (from the BLS Census of Fatal Occupational Injuries) in the construction sector for states for 2003-2005 and for 2006-2008. The RAND Human Subjects Protection Committee determined that this study was exempt from review. The correlations between the fatal and non-fatal injury rates were between -0.30 and -0.70 for all construction and for the subsector of special trade contractors. The negative correlation was much smaller between the rate of fatal falls from heights and the rate of non-fatal falls from heights. Adjusting for differences in the industry composition of the construction sector across states had minor effects on these results. Although some have suggested that fatal and non-fatal injury rates should not necessarily be positively correlated, no one has suggested that the correlation is negative, which is what we find. We know that reported non-fatal rates are influenced by workers' compensation benefits and other factors. Fatality rates appear to be a more valid measure of risk. Efforts to explain the variations that we find should be undertaken. Copyright © 2012 Wiley Periodicals, Inc.

  14. Drug involvement of fatally injured drivers

    Science.gov (United States)

    2010-11-01

    While data focusing on the danger of driving under the influence : of alcohol is readily available and often cited, less is : known or discussed about drivers under the influence of : other drugs. The Fatality Analysis Reporting System (FARS), : a ce...

  15. Fatal accidents among Danes with multiple sclerosis

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik; Hansen, Thomas; Koch-Henriksen, Nils

    2006-01-01

    for death from accidents among persons with MS was 37% higher than that of the general population (SMR = 1.37). We found no significant excess risk for fatal road accidents (SMR = 0.80). The risk for falls was elevated (SMR = 1.29) but not statistically significantly so. The risks were particularly high......-1996. The end of follow-up was 1 January 1999. We calculated standardized mortality ratios (SMRs) for various types of fatal accidents. A total of 76 persons (48 men and 28 women) died from accidents, whereas the expected number of fatalities from such causes was 55.7 (31.4 men and 24.3 women). Thus, the risk...... for deaths from burns (SMR = 8.90) and suffocation (SMR = 5.57). We conclude that persons with MS are more prone to fatal accidents than the general population. The excess risk is due not to traffic accidents but to burns and suffocation....

  16. A fatal case of creosote poisoning.

    Science.gov (United States)

    Bowman, C. E.; Muhleman, M. F.; Walters, E.

    1984-01-01

    A case of fatal creosote poisoning is described. On presentation, extensive oropharyngeal ulceration was noted and gastric lavage withheld. Post-mortem examination showed an intact oesophagus and stomach. PMID:6463007

  17. A fatal case of creosote poisoning.

    OpenAIRE

    Bowman, C. E.; Muhleman, M. F.; Walters, E.

    1984-01-01

    A case of fatal creosote poisoning is described. On presentation, extensive oropharyngeal ulceration was noted and gastric lavage withheld. Post-mortem examination showed an intact oesophagus and stomach.

  18. In situ immune response and mechanisms of cell damage in central nervous system of fatal cases microcephaly by Zika virus.

    Science.gov (United States)

    Azevedo, Raimunda S S; de Sousa, Jorge R; Araujo, Marialva T F; Martins Filho, Arnaldo J; de Alcantara, Bianca N; Araujo, Fernanda M C; Queiroz, Maria G L; Cruz, Ana C R; Vasconcelos, Beatriz H Baldez; Chiang, Jannifer O; Martins, Lívia C; Casseb, Livia M N; da Silva, Eliana V; Carvalho, Valéria L; Vasconcelos, Barbara C Baldez; Rodrigues, Sueli G; Oliveira, Consuelo S; Quaresma, Juarez A S; Vasconcelos, Pedro F C

    2018-01-08

    Zika virus (ZIKV) has recently caused a pandemic disease, and many cases of ZIKV infection in pregnant women resulted in abortion, stillbirth, deaths and congenital defects including microcephaly, which now has been proposed as ZIKV congenital syndrome. This study aimed to investigate the in situ immune response profile and mechanisms of neuronal cell damage in fatal Zika microcephaly cases. Brain tissue samples were collected from 15 cases, including 10 microcephalic ZIKV-positive neonates with fatal outcome and five neonatal control flavivirus-negative neonates that died due to other causes, but with preserved central nervous system (CNS) architecture. In microcephaly cases, the histopathological features of the tissue samples were characterized in three CNS areas (meninges, perivascular space, and parenchyma). The changes found were mainly calcification, necrosis, neuronophagy, gliosis, microglial nodules, and inflammatory infiltration of mononuclear cells. The in situ immune response against ZIKV in the CNS of newborns is complex. Despite the predominant expression of Th2 cytokines, other cytokines such as Th1, Th17, Treg, Th9, and Th22 are involved to a lesser extent, but are still likely to participate in the immunopathogenic mechanisms of neural disease in fatal cases of microcephaly caused by ZIKV.

  19. Neonatal Arrhythmias: Atrial Flutter

    Directory of Open Access Journals (Sweden)

    M.O. Gonchar

    2014-10-01

    Full Text Available The paper presents the current data on the diagnosis of neonatal arrhythmias, covers the prevalence, mechanisms of formation, diagnosis and treatment of one type of cardiac arrhythmias — atrial flutter. Clinical observation in terms of the diagnosis and treatment of atrial flutter in a newborn in the early neonatal period is given.

  20. Neonatal cardiac emergencies

    African Journals Online (AJOL)

    Neonatal cardiac emergencies. The neonatal period is one that fills many generalists with fear – this article will help to dispel these concerns. George A Comitis, MB ChB, DCH (SA), DA (SA), FCPaed (SA), Cert Cardiology (SA) Paed. Consultant, Paediatric Cardiology Service of the Western Cape, Red Cross War Memorial ...

  1. Fatalism and risk of adolescent depression.

    Science.gov (United States)

    Roberts, R E; Roberts, C R; Chen, I G

    2000-01-01

    This research examined fatalism, the belief in external control over life chances, as a risk factor for adolescent depression. Data were analyzed from a large (N = 5,423) sample of adolescents attending middle school in an ethnically diverse community in the southwest. It was hypothesized that adolescents who demonstrated greater fatalism would have a higher risk for depression. Bivariate associations between fatalism and depression were substantial, with an odds ratio (OR) of nearly 25 for depression with impairment and nearly 13 for depression without impairment. Adjustment for the effects of 10 covariates drawn from three domains (status attributes, stressors, and personal/social resources) essentially eliminated the association between fatalism and depression with impairment. However, the OR was still 2.6. The significant association between fatalism and depression without impairment (OR = 2.7) remained after adjustment for covariates. The results provide further support for models of depression which emphasize the role of psychosocial deficits. In this case, we found depression was associated not only with greater fatalism but also greater pessimism, lower self-esteem, more passive coping, and less social support.

  2. Defects of mitochondrial DNA replication.

    Science.gov (United States)

    Copeland, William C

    2014-09-01

    Mitochondrial DNA is replicated by DNA polymerase γ in concert with accessory proteins such as the mitochondrial DNA helicase, single-stranded DNA binding protein, topoisomerase, and initiating factors. Defects in mitochondrial DNA replication or nucleotide metabolism can cause mitochondrial genetic diseases due to mitochondrial DNA deletions, point mutations, or depletion, which ultimately cause loss of oxidative phosphorylation. These genetic diseases include mitochondrial DNA depletion syndromes such as Alpers or early infantile hepatocerebral syndromes, and mitochondrial DNA deletion disorders, such as progressive external ophthalmoplegia, ataxia-neuropathy, or mitochondrial neurogastrointestinal encephalomyopathy. This review focuses on our current knowledge of genetic defects of mitochondrial DNA replication (POLG, POLG2, C10orf2, and MGME1) that cause instability of mitochondrial DNA and mitochondrial disease. © The Author(s) 2014.

  3. Value of CT in the Discrimination of Fatal from Non-Fatal Stercoral Colitis

    International Nuclear Information System (INIS)

    Wu, Cheng Hsien; Huang, Chen Chin; Wang, Li Jen; Wong, Yon Cheng; Wang, Chao Jan; Lo, Wang Chak; Lin, Being Chuan; Wan, Yung Liang; Haueh, Chuen

    2012-01-01

    Clinical presentation and physical signs may be unreliable in the diagnosis of stercoral colitis (SC). This study evaluates the value of computed tomography (CT) in distinguishing fatal from non-fatal SC. Ten patients diagnosed as SC were obtained from inter-specialist conferences. Additional 13 patients with suspected SC were identified via the Radiology Information System (RIS). These patients were divided into two groups; fatal and non-fatal SCs. Their CT images are reviewed by two board-certified radiologists blinded to the clinical data and radiographic reports. SC occurred in older patients and displayed no gender predisposition. There was significant correlation between fatal SC and CT findings of dense mucosa (p 0.017), perfusion defects (p = 0.026), ascites (p = 0.023), or abnormal gas (p = 0.033). The sensitivity, specificity, and accuracy of dense mucosa were 71%, 86%, and 81%, respectively. These figures were 75%, 79%, and 77% for perfusion defects; 75%, 80%, and 78% for ascites; and 50%, 93%, and 78% for abnormal gas, respectively. Each CT sign of mucosal sloughing and pericolonic abscess displayed high specificity of 100% and 93% for diagnosing fatal SC, respectively. However, this did not reach statistical significance in diagnosing fatal SC. CT appears to be valuable in discriminating fatal from non-fatal SC.

  4. Value of CT in the Discrimination of Fatal from Non-Fatal Stercoral Colitis

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Cheng Hsien; Huang, Chen Chin; Wang, Li Jen; Wong, Yon Cheng; Wang, Chao Jan; Lo, Wang Chak; Lin, Being Chuan; Wan, Yung Liang; Haueh, Chuen [Chang Gung Memorial Hospital, Chang Gung University, Taoyuan (China)

    2012-06-15

    Clinical presentation and physical signs may be unreliable in the diagnosis of stercoral colitis (SC). This study evaluates the value of computed tomography (CT) in distinguishing fatal from non-fatal SC. Ten patients diagnosed as SC were obtained from inter-specialist conferences. Additional 13 patients with suspected SC were identified via the Radiology Information System (RIS). These patients were divided into two groups; fatal and non-fatal SCs. Their CT images are reviewed by two board-certified radiologists blinded to the clinical data and radiographic reports. SC occurred in older patients and displayed no gender predisposition. There was significant correlation between fatal SC and CT findings of dense mucosa (p 0.017), perfusion defects (p = 0.026), ascites (p = 0.023), or abnormal gas (p = 0.033). The sensitivity, specificity, and accuracy of dense mucosa were 71%, 86%, and 81%, respectively. These figures were 75%, 79%, and 77% for perfusion defects; 75%, 80%, and 78% for ascites; and 50%, 93%, and 78% for abnormal gas, respectively. Each CT sign of mucosal sloughing and pericolonic abscess displayed high specificity of 100% and 93% for diagnosing fatal SC, respectively. However, this did not reach statistical significance in diagnosing fatal SC. CT appears to be valuable in discriminating fatal from non-fatal SC.

  5. Predictors of early neonatal mortality at a neonatal intensive care ...

    African Journals Online (AJOL)

    admin

    Predictors of early neonatal mortality at a neonatal intensive care unit of a specialized referral teaching hospital in. Ethiopia. Bogale Worku1, Assaye Kassie2, Amha Mekasha1, Birkneh Tilahun1, Alemayehu Worku3. Abstract. Background: The larger fraction of infant mortality is that of neonatal; and early neonatal death is ...

  6. Key Impact Factors on Dam Break Fatalities

    Science.gov (United States)

    Huang, D.; Yu, Z.; Song, Y.; Han, D.; Li, Y.

    2016-12-01

    Dam failures can lead to catastrophes on human society. However, there is a lack of research about dam break fatalities, especially on the key factors that affect fatalities. Based on the analysis of historical dam break cases, most studies have used the regression analysis to explore the correlation between those factors and fatalities, but without implementing optimization to find the dominating factors. In order to understand and reduce the risk of fatalities, this study has proposed a new method to select the impact factors on the fatality. It employs an improved ANN (Artificial Neural Network) combined with LOOCV (Leave-one-out cross-validation) and SFS (Stepwise Forward Selection) approach to explore the nonlinear relationship between impact factors and life losses. It not only considers the factors that have been widely used in the literature but also introduces new factors closely involved with fatalities. Dam break cases occurred in China from 1954 to 2013 are summarized, within which twenty-five cases are selected with a comprehensive coverage of geographic position and temporal variation. Twelve impact factors are taken into account as the inputs, i.e., severity of dam break flood (SF), population at risk (PR), public understanding of dam break (UB), warning time (TW), evacuation condition (EC), weather condition during dam break (WB), dam break mode (MB), water storage (SW), building vulnerability (VB), dam break time (TB), average distance from the affected area to the dam (DD) and preventive measures by government (PG).From those, three key factors of SF, MB and TB are chosen. The proposed method is able to extract the key factors, and the derived fatality model performs well in various types of dam break conditions.

  7. Disease fatality and bias in survival cohorts.

    Science.gov (United States)

    Barry, Vaughn; Klein, Mitchel; Winquist, Andrea; Darrow, Lyndsey A; Steenland, Kyle

    2015-07-01

    Simulate how the effect of exposure on disease occurrence and fatality influences the presence and magnitude of bias in survivor cohorts, motivated by an actual survivor cohort under study. We simulated a cohort of 50,000 subjects exposed to a disease-causing exposure over time and followed forty years, where disease incidence was the outcome of interest. We simulated this 'inception' cohort under different assumptions about the effect of exposure on disease occurrence and fatality after disease occurrence. We then created a corresponding 'survivor' (or 'cross-sectional') cohort, where cohort enrollment took place at a specific date after exposure began in the inception cohort; subjects dying prior to that enrollment date were excluded. The disease of interest caused all deaths in our simulations, but was not always fatal. In the survivor cohort, person-time at risk began before enrollment for all subjects who did not die prior to enrollment. We compared exposure-disease associations in each inception cohort to those in corresponding survivor cohorts to determine how different assumptions impacted bias in the survivor cohorts. All subjects in both inception and survivor cohorts were considered equally susceptible to the effect of exposure in causing disease. We used Cox proportional hazards regression to calculate effect measures. There was no bias in survivor cohort estimates when case fatality among diseased subjects was independent of exposure. This was true even when the disease was highly fatal and more highly exposed subjects were more likely to develop disease and die. Assuming a positive exposure-response in the inception cohort, survivor cohort rate ratios were biased downwards when case fatality was greater with higher exposure. Survivor cohort effect estimates for fatal outcomes are not always biased, although precision can decrease. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Vaccines for women for preventing neonatal tetanus.

    Science.gov (United States)

    Demicheli, Vittorio; Barale, Antonella; Rivetti, Alessandro

    2015-07-06

    Tetanus is an acute, often fatal, disease caused by an exotoxin produced by Clostridium tetani. It occurs in newborn infants born to mothers who do not have sufficient circulating antibodies to protect the infant passively, by transplacental transfer. Prevention may be possible by the vaccination of pregnant or non-pregnant women, or both, with tetanus toxoid, and the provision of clean delivery services. Tetanus toxoid consists of a formaldehyde-treated toxin that stimulates the production of antitoxin. To assess the effectiveness of tetanus toxoid, administered to women of reproductive age or pregnant women, to prevent cases of, and deaths from, neonatal tetanus. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2015), CENTRAL (The Cochrane Library 2015, Issue 1), PubMed (1966 to 28 January 2015), EMBASE (1974 to 28 January 2015) and reference lists of retrieved studies. Randomised or quasi-randomised trials evaluating the effects of tetanus toxoid in pregnant women or women of reproductive age on numbers of neonatal tetanus cases and deaths. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Two effectiveness trials (9823 infants) and one safety trial (48 mothers) were included. The main outcomes were measured on infants born to a subset of those randomised women who became pregnant during the course of the studies. For our primary outcomes, there was no high-quality evidence according to GRADE assessments.One study (1182 infants) assessed the effectiveness of tetanus toxoid in comparison with influenza vaccine in preventing neonatal tetanus deaths. A single dose did not provide significant protection against neonatal tetanus deaths, (risk ratio (RR) 0.57, 95% confidence interval (CI) 0.26 to 1.24; 494 infants; GRADE: low-quality evidence). However, a two- or three-dose course did provide protection against neonatal deaths, (RR 0.02, 95% CI 0.00 to 0

  9. Drugs taken in fatal and non-fatal self-poisoning : A study in South London

    NARCIS (Netherlands)

    Neeleman, J; Wessely, S

    This study compared the number and type of substances taken in deliberate self-poisoning with fatal (n=127) and non-fatal (n=521) outcome. The aims were (i) to describe substances typically involved in self-poisoning in England and Wales, (ii) to examine the role of drug 'cocktails' and (iii) to

  10. Neonatal Tele-Homecare

    DEFF Research Database (Denmark)

    Holm, Kristina Garne

    Neonatal homecare (NH) implies that parents manage tube feeding and care of their preterm infant at home supported by home visits from neonatal nurses, to monitor infant growth and the well-being of the family. Home visits are costly and time consuming in rural areas. The overall aim of this study...... was to develop a telehealth service for NH without home visits - neonatal tele-homecare (NTH) and test it in an observational study. Participatory design (PD) methods were conducted to facilitate involvement of the end-users (parent of preterm infants and clinicians) in the development of the telehealth service...

  11. The neonatal chest

    Energy Technology Data Exchange (ETDEWEB)

    Lobo, Luisa [Servico de Imagiologia Geral do Hospital de Santa Maria, Av. Prof. Egas Moniz, 1649-035 Lisbon (Portugal)]. E-mail: mluisalobo@gmail.com

    2006-11-15

    Lung diseases represent one of the most life threatening conditions in the newborn. Important progresses in modern perinatal care has resulted in a significantly improved survival and decreased morbidity, in both term and preterm infants. Most of these improvements are directly related to the better management of neonatal lung conditions, and infants of very low gestational ages are now surviving. This article reviews the common spectrum of diseases of the neonatal lung, including medical and surgical conditions, with emphasis to the radiological contribution in the evaluation and management of these infants. Imaging evaluation of the neonatal chest, including the assessment of catheters, lines and tubes are presented.

  12. Mitochondrial biogenesis: pharmacological approaches.

    Science.gov (United States)

    Valero, Teresa

    2014-01-01

    Organelle biogenesis is concomitant to organelle inheritance during cell division. It is necessary that organelles double their size and divide to give rise to two identical daughter cells. Mitochondrial biogenesis occurs by growth and division of pre-existing organelles and is temporally coordinated with cell cycle events [1]. However, mitochondrial biogenesis is not only produced in association with cell division. It can be produced in response to an oxidative stimulus, to an increase in the energy requirements of the cells, to exercise training, to electrical stimulation, to hormones, during development, in certain mitochondrial diseases, etc. [2]. Mitochondrial biogenesis is therefore defined as the process via which cells increase their individual mitochondrial mass [3]. Recent discoveries have raised attention to mitochondrial biogenesis as a potential target to treat diseases which up to date do not have an efficient cure. Mitochondria, as the major ROS producer and the major antioxidant producer exert a crucial role within the cell mediating processes such as apoptosis, detoxification, Ca2+ buffering, etc. This pivotal role makes mitochondria a potential target to treat a great variety of diseases. Mitochondrial biogenesis can be pharmacologically manipulated. This issue tries to cover a number of approaches to treat several diseases through triggering mitochondrial biogenesis. It contains recent discoveries in this novel field, focusing on advanced mitochondrial therapies to chronic and degenerative diseases, mitochondrial diseases, lifespan extension, mitohormesis, intracellular signaling, new pharmacological targets and natural therapies. It contributes to the field by covering and gathering the scarcely reported pharmacological approaches in the novel and promising field of mitochondrial biogenesis. There are several diseases that have a mitochondrial origin such as chronic progressive external ophthalmoplegia (CPEO) and the Kearns- Sayre syndrome (KSS

  13. Epilepsy and Mitochondrial Dysfunction

    Directory of Open Access Journals (Sweden)

    Russell P. Saneto DO, PhD

    2017-10-01

    Full Text Available Epilepsy is a common manifestation of mitochondrial disease. In a large cohort of children and adolescents with mitochondrial disease (n = 180, over 48% of patients developed seizures. The majority (68% of patients were younger than 3 years and medically intractable (90%. The electroencephalographic pattern of multiregional epileptiform discharges over the left and right hemisphere with background slowing occurred in 62%. The epilepsy syndrome, infantile spasms, was seen in 17%. Polymerase γ mutations were the most common genetic etiology of seizures, representing Alpers-Huttenlocher syndrome (14%. The severity of disease in those patients with epilepsy was significant, as 13% of patients experienced early death. Simply the loss of energy production cannot explain the development of seizures or all patients with mitochondrial dysfunction would have epilepsy. Until the various aspects of mitochondrial physiology that are involved in proper brain development are understood, epilepsy and its treatment will remain unsatisfactory.

  14. The plant mitochondrial proteome

    DEFF Research Database (Denmark)

    Millar, A.H.; Heazlewood, J.L.; Kristensen, B.K.

    2005-01-01

    The plant mitochondrial proteome might contain as many as 2000-3000 different gene products, each of which might undergo post-translational modification. Recent studies using analytical methods, such as one-, two- and three-dimensional gel electrophoresis and one- and two-dimensional liquid...... context to be defined for them. There are indications that some of these proteins add novel activities to mitochondrial protein complexes in plants....

  15. MITOCHONDRIAL DNA- REVOLUTIONARY EVOLUTION

    Directory of Open Access Journals (Sweden)

    Vaidhehi Narayan Nayak

    2017-07-01

    Full Text Available BACKGROUND Mitochondrion, the sausage-shaped organelle residing in the cytoplasm of all eukaryotic cells, apart from being the power house, represents endosymbiotic evolution of a free living organism to intracellular structure. Anthropologically, mitochondrial DNA is the fossilised source to trace the human ancestry particularly of maternal lineage. This article attempts to highlight the various biological functions of mitochondrial DNA (mtDNA with a note on its forensic application.

  16. Mitochondrial DNA with a large-scale deletion causes two distinct mitochondrial disease phenotypes in mice.

    Science.gov (United States)

    Katada, Shun; Mito, Takayuki; Ogasawara, Emi; Hayashi, Jun-Ichi; Nakada, Kazuto

    2013-09-04

    Studies in patients have suggested that the clinical phenotypes of some mitochondrial diseases might transit from one disease to another (e.g., Pearson syndrome [PS] to Kearns-Sayre syndrome) in single individuals carrying mitochondrial (mt) DNA with a common deletion (ΔmtDNA), but there is no direct experimental evidence for this. To determine whether ΔmtDNA has the pathologic potential to induce multiple mitochondrial disease phenotypes, we used trans-mitochondrial mice with a heteroplasmic state of wild-type mtDNA and ΔmtDNA (mito-miceΔ). Late-stage embryos carrying ≥50% ΔmtDNA showed abnormal hematopoiesis and iron metabolism in livers that were partly similar to PS (PS-like phenotypes), although they did not express sideroblastic anemia that is a typical symptom of PS. More than half of the neonates with PS-like phenotypes died by 1 month after birth, whereas the rest showed a decrease of ΔmtDNA load in the affected tissues, peripheral blood and liver, and they recovered from PS-like phenotypes. The proportion of ΔmtDNA in various tissues of the surviving mito-miceΔ increased with time, and Kearns-Sayre syndrome-like phenotypes were expressed when the proportion of mtDNA in various tissues reached >70-80%. Our model mouse study clearly showed that a single ΔmtDNA was responsible for at least two distinct disease phenotypes at different ages and suggested that the level and dynamics of mtDNA load in affected tissues would be important for the onset and transition of mitochondrial disease phenotypes in mice.

  17. Sonomammography in Neonatal Mastauxe

    Directory of Open Access Journals (Sweden)

    Sushil Ghanshyam Kachewar

    2015-03-01

    Full Text Available Prominence or even enlargement of one or both breasts is known in neonates. It is believed to be a physiological response to falling levels of maternal estrogen towards last trimester of pregnancy. This input stimulates prolactin release from the newborn's pituitary leading to transient neonatal breast enlargement. This phenomenon is independent of the gender of the neonate. It presents in the first few weeks of life and resolves subsequently. Often fluid discharge is noted from the prominent or swollen breast that resolves without treatment in subsequent weeks. Manual breast manipulation for discharge removal may lead to undesirable effects like local irritation, enhanced enlargement, prolonged tissue hypertropy or even mastitis. A case of such 7-days female neonate is presented here backed with imaging evaluation for confirmation of diagnosis. Typical sonomammographic findings are described. [Cukurova Med J 2015; 40(Suppl 1: 22-24

  18. Neonatal Cerebral Sinovenous Thrombosis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-04-01

    Full Text Available The presentation, treatment, and outcome of neonatal cerebral sinovenous thrombosis (SVT were studied in 42 children, using neurology clinic records (1986-2005 at Indiana University School of Medicine.

  19. Neonatal mortality in Utah.

    Science.gov (United States)

    Woolley, F R; Schuman, K L; Lyon, J L

    1982-09-01

    A cohort study of neonatal mortality (N = 106) in white singleton births (N = 14,486) in Utah for January-June 1975 was conducted. Using membership and activity in the Church of Jesus Christ of Latter-day Saints (LDS or Mormon) as a proxy for parental health practices, i.e., tobacco and alcohol abstinence, differential neonatal mortality rates were calculated. The influence of potential confounding factors was evaluated. Low activity LDS members were found to have an excess risk of neonatal death five times greater than high activity LDS, with an upper bound of a two-sided 95% confidence interval of 7.9. The data consistently indicate a lower neonatal mortality rate for active LDS members. Non-LDS were found to have a lower rate than either medium or low activity LDS.

  20. Neonatal pain management

    Directory of Open Access Journals (Sweden)

    Tarun Bhalla

    2014-01-01

    Full Text Available The past 2-3 decades have seen dramatic changes in the approach to pain management in the neonate. These practices started with refuting previously held misconceptions regarding nociception in preterm infants. Although neonates were initially thought to have limited response to painful stimuli, it was demonstrated that the developmental immaturity of the central nervous system makes the neonate more likely to feel pain. It was further demonstrated that untreated pain can have long-lasting physiologic and neurodevelopmental consequences. These concerns have resulted in a significant emphasis on improving and optimizing the techniques of analgesia for neonates and infants. The following article will review techniques for pain assessment, prevention, and treatment in this population with a specific focus on acute pain related to medical and surgical conditions.

  1. Neonatal herpes simplex pneumonia.

    OpenAIRE

    Lissauer, T J; Shaw, P J; Underhill, G

    1984-01-01

    A neonate with herpes simplex pneumonia is described. Herpes simplex infection should be considered in the differential diagnosis of pneumonia in newborn infants, even in the absence of clinically apparent herpes in the mother.

  2. Hiperbilirrubinemia neonatal agravada Aggravated neonatal hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    Ana Campo González

    2010-09-01

    Full Text Available INTRODUCCIÓN. La mayoría de las veces la ictericia en el recién nacido es un hecho fisiológico, causado por una hiperbilirrubinemia de predominio indirecto, secundario a inmadurez hepática e hiperproducción de bilirrubina. El objetivo de este estudio fue determinar el comportamiento de la hiperbilirrubinemia neonatal en el Hospital Docente Ginecoobstétrico de Guanabacoa en los años 2007 a 2009. MÉTODOS. Se realizó un estudio descriptivo y retrospectivo de 173 recién nacidos que ingresaron al Departamento de Neonatología con diagnóstico de hiperbilirrubinemia agravada. RESULTADOS. La incidencia de hiperbilirrubinemia neonatal agravada fue del 3,67 % y predominó en hermanos con antecedentes de ictericia (56,65 %. El tiempo de aparición fue de 48 a 72 h (76,87 % y entre los factores agravantes se hallaron el nacimiento pretérmino y el bajo peso al nacer. La mayoría de los pacientes fueron tratados con luminoterapia (90,17 %. CONCLUSIÓN. La hiperbilirrubinemia neonatal agravada constituye un problema de salud. Los factores agravantes son la prematuridad y el bajo peso al nacer. La luminoterapia es una medida terapéutica eficaz para su tratamiento.INTRODUCTION. Most of times jaundice in newborn is a physiological fact due to hyperbilirubinemia of indirect predominance, secondary to liver immaturity and to bilirubin hyperproduction. The aim of present of present study was to determine the behavior of neonatal hyperbilirubinemia in the Gynecology and Obstetrics Teaching Hospital of Guanabacoa municipality from 2007 to 2009. METHODS. A retrospective and descriptive study was conducted in 173 newborn patients admitted in the Neonatology Department diagnosed with severe hyperbilirubinemia. RESULTS. The incidence of severe neonatal hyperbilirubinemia was of 3,67% with predominance in brothers with a history of jaundice (56,65%. The time of appearance was of 48 to 72 hrs (76,87% and among the aggravating factors were the preterm birth and

  3. Neonatal orbital abscess

    Directory of Open Access Journals (Sweden)

    Khalil M Al-Salem

    2014-01-01

    Full Text Available Orbital complications due to ethmoiditis are rare in neonates. A case of orbital abscess due to acute ethmoiditis in a 28-day-old girl is presented. A Successful outcome was achieved following antimicrobial therapy alone; spontaneous drainage of the abscess occurred from the lower lid without the need for surgery. From this case report, we intend to emphasize on eyelid retraction as a sign of neonatal orbital abscess, and to review all the available literature of similar cases.

  4. [Neonatal asphyxia: neurologic outcome].

    Science.gov (United States)

    Allemand, A; Stanca, M; Sposato, M; Santoro, F; Danti, F R; Dosi, C; Allemand, F

    2013-08-01

    The neonatal asphyxia is recognized as an important cause of morbidity and mortality during the pediatric age. The objective of this study was to evaluate the correlation between some neonatal variables and neurological outcome at two years of life in infants with asphyxia, in order to produce a correct prognosis and to grant a rapid and targeted therapy. We have recruited 63 patients whose history and neuroimages suggested a neonatal asphyxia, and we have analysed their clinical- instrumental parameters every three months until two years of life. A correlation study was carried out in order to find a statistical significance indicated by p-value Neonatal seizures are not related to an increased risk to develop epilepsy. Epilepsy alone is a rare event and it usually complicates CP picture. Most subject with both epilepsy and CP are term infants with adequate weight. Preterm VLBW infants have a greater risk to develop a psychomotor delay. Clinical conditions at birth are related to CP severity (several neonatal neurological signs are the greater risk factors). Severely pathological neonatal EEG (background activity) is related to CP severity and an early symptomatic epilepsy onset is related with both epilepsy and CP severity.

  5. Critical Role of the Neonatal Fc Receptor (FcRn) in the Pathogenic Action of Antimitochondrial Autoantibodies Synergizing with Anti-desmoglein Autoantibodies in Pemphigus Vulgaris.

    Science.gov (United States)

    Chen, Yumay; Chernyavsky, Alex; Webber, Robert J; Grando, Sergei A; Wang, Ping H

    2015-09-25

    Pemphigus vulgaris (PV) is a life-long, potentially fatal IgG autoantibody-mediated blistering disease targeting mucocutaneous keratinocytes (KCs). PV patients develop pathogenic anti-desmoglein (Dsg) 3 ± 1 and antimitochondrial antibodies (AMA), but it remained unknown whether and how AMA enter KCs and why other cell types are not affected in PV. Therefore, we sought to elucidate mechanisms of cell entry, trafficking, and pathogenic action of AMA in PV. We found that PVIgGs associated with neonatal Fc receptor (FcRn) on the cell membrane, and the PVIgG-FcRn complexes entered KCs and reached mitochondria where they dissociated. The liberated AMA altered mitochondrial membrane potential, respiration, and ATP production and induced cytochrome c release, although the lack or inactivation of FcRn abolished the ability of PVIgG to reach and damage mitochondria and to cause detachment of KCs. The assays of mitochondrial functions and keratinocyte adhesion demonstrated that although the pathobiological effects of AMA on KCs are reversible, they become irreversible, leading to epidermal blistering (acantholysis), when AMA synergize with anti-Dsg antibodies. Thus, it appears that AMA enter a keratinocyte in a complex with FcRn, become liberated from the endosome in the cytosol, and are trafficked to the mitochondria, wherein they trigger pro-apoptotic events leading to shrinkage of basal KCs uniquely expressing FcRn in epidermis. During recovery, KCs extend their cytoplasmic aprons toward neighboring cells, but anti-Dsg antibodies prevent assembly of nascent desmosomes due to steric hindrance, thus rendering acantholysis irreversible. In conclusion, FcRn is a common acceptor protein for internalization of AMA and, perhaps, for PV autoantibodies to other intracellular antigens, and PV is a novel disease paradigm for investigating and elucidating the role of FcRn in this autoimmune disease and possibly other autoimmune diseases. © 2015 by The American Society for

  6. CRISPR/Cas9 and mitochondrial gene replacement therapy: promising techniques and ethical considerations.

    Science.gov (United States)

    Fogleman, Sarah; Santana, Casey; Bishop, Casey; Miller, Alyssa; Capco, David G

    2016-01-01

    Thousands of mothers are at risk of transmitting mitochondrial diseases to their offspring each year, with the most severe form of these diseases being fatal [1]. With no cure, transmission prevention is the only current hope for decreasing the disease incidence. Current methods of prevention rely on low mutant maternal mitochondrial DNA levels, while those with levels close to or above threshold (>60%) are still at a very high risk of transmission [2]. Two novel approaches may offer hope for preventing and treating mitochondrial disease: mitochondrial replacement therapy, and CRISPR/Cas9. Mitochondrial replacement therapy has emerged as a promising tool that has the potential to prevent transmission in patients with higher mutant mitochondrial loads. This method is the subject of many ethical concerns due its use of a donor embryo to transplant the patient's nuclear DNA; however, it has ultimately been approved for use in the United Kingdom and was recently declared ethically permissible by the FDA. The leading-edge CRISPR/Cas9 technology exploits the principles of bacterial immune function to target and remove specific sequences of mutated DNA. This may have potential in treating individuals with disease caused by mutant mitochondrial DNA. As the technology progresses, it is important that the ethical considerations herein emerge and become more established. The purpose of this review is to discuss current research surrounding the procedure and efficacy of the techniques, compare the ethical concerns of each approach, and look into the future of mitochondrial gene replacement therapy.

  7. Anticipating Early Fatality: Friends', Schoolmates' and Individual Perceptions of Fatality on Adolescent Risk Behaviors

    Science.gov (United States)

    Soller, Brian; Williams, Kristi

    2015-01-01

    Past research indicates that anticipating adverse outcomes, such as early death (fatalism), is associated positively with adolescents' likelihood of engaging in risky behaviors. Health researchers and criminologists have argued that fatalism influences present risk taking in part by informing individuals' motivation for delaying gratification for the promise of future benefits. While past findings highlight the association between the anticipation of early death and a number of developmental outcomes, no known research has assessed the impact of location in a context characterized by high perceptions of fatality. Using data from Add Health and a sample of 9,584 adolescents (51 % female and 71 % white) nested in 113 schools, our study builds upon prior research by examining the association between friends', school mates', and individual perceptions of early fatality and adolescent risk behaviors. We test whether friends' anticipation of being killed prior to age 21 or location in a school where a high proportion of the student body subscribes to attitudes of high fatality, is associated with risky behaviors. Results indicate that friends' fatalism is positively associated with engaging in violent delinquency, non-violent delinquency, and drug use after controlling for individual covariates and prior individual risk-taking. Although friends' delinquency accounts for much of the effect of friends' fatalism on violence, none of the potential intervening variables fully explain the effect of friends' fatalism on youth involvement in nonviolent delinquency and drug use. Our results underscore the importance of friendship contextual effects in shaping adolescent risk-taking behavior and the very serious consequences perceptions of fatality have for adolescents' involvement in delinquency and drug use. PMID:23828725

  8. Fatal dengue hemorrhagic fever in adults: emphasizing the evolutionary pre-fatal clinical and laboratory manifestations.

    Directory of Open Access Journals (Sweden)

    Ing-Kit Lee

    Full Text Available BACKGROUND: A better description of the clinical and laboratory manifestations of fatal patients with dengue hemorrhagic fever (DHF is important in alerting clinicians of severe dengue and improving management. METHODS AND FINDINGS: Of 309 adults with DHF, 10 fatal patients and 299 survivors (controls were retrospectively analyzed. Regarding causes of fatality, massive gastrointestinal (GI bleeding was found in 4 patients, dengue shock syndrome (DSS alone in 2; DSS/subarachnoid hemorrhage, Klebsiella pneumoniae meningitis/bacteremia, ventilator associated pneumonia, and massive GI bleeding/Enterococcus faecalis bacteremia each in one. Fatal patients were found to have significantly higher frequencies of early altered consciousness (≤24 h after hospitalization, hypothermia, GI bleeding/massive GI bleeding, DSS, concurrent bacteremia with/without shock, pulmonary edema, renal/hepatic failure, and subarachnoid hemorrhage. Among those experienced early altered consciousness, massive GI bleeding alone/with uremia/with E. faecalis bacteremia, and K. pneumoniae meningitis/bacteremia were each found in one patient. Significantly higher proportion of bandemia from initial (arrival laboratory data in fatal patients as compared to controls, and higher proportion of pre-fatal leukocytosis and lower pre-fatal platelet count as compared to initial laboratory data of fatal patients were found. Massive GI bleeding (33.3% and bacteremia (25% were the major causes of pre-fatal leukocytosis in the deceased patients; 33.3% of the patients with pre-fatal profound thrombocytopenia (<20,000/µL, and 50% of the patients with pre-fatal prothrombin time (PT prolongation experienced massive GI bleeding. CONCLUSIONS: Our report highlights causes of fatality other than DSS in patients with severe dengue, and suggested hypothermia, leukocytosis and bandemia may be warning signs of severe dengue. Clinicians should be alert to the potential development of massive GI bleeding

  9. Estimating cost ratio distribution between fatal and non-fatal road accidents in Malaysia

    Science.gov (United States)

    Hamdan, Nurhidayah; Daud, Noorizam

    2014-07-01

    Road traffic crashes are a global major problem, and should be treated as a shared responsibility. In Malaysia, road accident tragedies kill 6,917 people and injure or disable 17,522 people in year 2012, and government spent about RM9.3 billion in 2009 which cost the nation approximately 1 to 2 percent loss of gross domestic product (GDP) reported annually. The current cost ratio for fatal and non-fatal accident used by Ministry of Works Malaysia simply based on arbitrary value of 6:4 or equivalent 1.5:1 depends on the fact that there are six factors involved in the calculation accident cost for fatal accident while four factors for non-fatal accident. The simple indication used by the authority to calculate the cost ratio is doubted since there is lack of mathematical and conceptual evidence to explain how this ratio is determined. The main aim of this study is to determine the new accident cost ratio for fatal and non-fatal accident in Malaysia based on quantitative statistical approach. The cost ratio distributions will be estimated based on Weibull distribution. Due to the unavailability of official accident cost data, insurance claim data both for fatal and non-fatal accident have been used as proxy information for the actual accident cost. There are two types of parameter estimates used in this study, which are maximum likelihood (MLE) and robust estimation. The findings of this study reveal that accident cost ratio for fatal and non-fatal claim when using MLE is 1.33, while, for robust estimates, the cost ratio is slightly higher which is 1.51. This study will help the authority to determine a more accurate cost ratio between fatal and non-fatal accident as compared to the official ratio set by the government, since cost ratio is an important element to be used as a weightage in modeling road accident related data. Therefore, this study provides some guidance tips to revise the insurance claim set by the Malaysia road authority, hence the appropriate method

  10. Gastrointestinal manifestations of mitochondrial disease.

    Science.gov (United States)

    Gillis, Lynette A; Sokol, Ronald J

    2003-09-01

    Although non-specific gastrointestinal and hepatic symptoms are commonly found in most mitochondrial disorders, they are among the cardinal manifestations of several primary mitochondrial diseases, such as: mitochondrial neurogastrointestinal encephalomyopathy; mitochondrial DNA depletion syndrome; Alpers syndrome; and Pearson syndrome. Management of these heterogeneous disorders includes the empiric supplementation with various "mitochondrial cocktails," supportive therapies, and avoidance of drugs and conditions known to have a detrimental effect on the respiratory chain. There is a great need for improved methods of treatment and controlled clinical trials of existing therapies. Liver transplantation is successful in acquired cases; however neuromuscular involvement in primary mitochondrial disorders should be a contraindication for liver transplantation.

  11. A fatal pulmonary infection by Nocardia brasiliensis.

    Science.gov (United States)

    Wadhwa, V; Rai, S; Kharbanda, P; Kabra, S; Gur, R; Sharma, V K

    2006-01-01

    The reported case is of primary pulmonary nocardiosis, caused by Nocardia brasiliensis, in a immunocompromised patient, which ended fatally despite appropriate treatment. The partially acid fast filamentous bacterium was predominant on direct examination of the sputum. It was cultured on blood agar, MacConkey agar and by paraffin baiting technique. The bacterium was resistant to cotrimoxazole, the drug of choice for nocardiosis.

  12. 2015 ROW Fatality & Trespass Prevention Workshop

    Science.gov (United States)

    2015-12-01

    Trespassing along railroad rights-of-way (ROW) is the leading cause of rail-related deaths. More than 500 preventable trespass fatalities and nearly as many injuries occur each year in the United States, and most of these incidents involve pedestrian...

  13. 2012 ROW fatality & trespass prevention workshop

    Science.gov (United States)

    2012-08-31

    Trespassing along railroad and transit rights-of-way (ROW) is the leading cause of rail-related deaths in America. Nationally, more than 550 trespass fatalities and nearly as many injuries occur each year. The vast majority of these incidents are pre...

  14. Fatal cerebral oedema in adult diabetic ketoacidosis.

    NARCIS (Netherlands)

    Haringhuizen, A.; Tjan, D.H.; Grool, A.; Vugt, R. van; Zante, A.R. van

    2010-01-01

    In this report, a case of adult onset fatal cerebral oedema as a rare complication of diabetic ketoacidosis (DKA) is described and confirmed at post-mortem pathological examination. The pathogenesis of cerebral oedema due to DKA is still unknown. Potential mechanisms include the administration of

  15. Can We Reduce Workplace Fatalities by Half?

    Directory of Open Access Journals (Sweden)

    David Soo Quee Koh

    2012-06-01

    Full Text Available Singapore, an island republic of over 5 million inhabitants, has 3.1 million workers. Most are employed in the service, finance and tourist/transport industry. Significant numbers work in manufacturing, construction and heavy industry. Following a series of construction and shipyard accidents with multiple deaths in 2004, the government announced its intention to reduce workplace fatalities from 4.9 to 2.5 per 100,000 by 2015. There was strong political will to achieve this target. The strategic approaches were to build workplace safety and health (WSH capabilities; implement legislative changes with enforcement; promote benefits of WSH and recognize best practices, and enhance partnership with stakeholders. The anticipated outcomes were to reduce workplace fatality and injury rates; have WSH as an integral part of business; and establish a progressive and pervasive WSH culture. With these measures, the workplace fatality rate declined from 4.9/100,000 in 2004, to 2.2/100,000 in 2010. However, other confounding factors could also account for this decline, and have to be considered. The next target, announced by Singapore’s Prime Minister in 2008, is to further reduce the workplace fatality rate to 1.8/100,000 by 2018, and to have “one of the best workplace safety records in the world”.

  16. Can we reduce workplace fatalities by half?

    Science.gov (United States)

    Koh, David Soo Quee

    2012-06-01

    Singapore, an island republic of over 5 million inhabitants, has 3.1 million workers. Most are employed in the service, finance and tourist/transport industry. Significant numbers work in manufacturing, construction and heavy industry. Following a series of construction and shipyard accidents with multiple deaths in 2004, the government announced its intention to reduce workplace fatalities from 4.9 to 2.5 per 100,000 by 2015. There was strong political will to achieve this target. The strategic approaches were to build workplace safety and health (WSH) capabilities; implement legislative changes with enforcement; promote benefits of WSH and recognize best practices, and enhance partnership with stakeholders. The anticipated outcomes were to reduce workplace fatality and injury rates; have WSH as an integral part of business; and establish a progressive and pervasive WSH culture. With these measures, the workplace fatality rate declined from 4.9/100,000 in 2004, to 2.2/100,000 in 2010. However, other confounding factors could also account for this decline, and have to be considered. The next target, announced by Singapore's Prime Minister in 2008, is to further reduce the workplace fatality rate to 1.8/100,000 by 2018, and to have "one of the best workplace safety records in the world".

  17. Meeste suurim meistriteos - femme fatale / Marianne Kõrver

    Index Scriptorium Estoniae

    Kõrver, Marianne, 1980-

    2006-01-01

    15.-21. maini on kinos Sõprus Manifesti filminädal, mis pühendatud prantsuse mängufilmidele, kus keskne karakter on femme fatale - saatuslik naine, meeste hukutaja. Ajalooline lühiülevaade selle naisetüübi kujutamisest religioonist kinokunstini

  18. Fatal anaphylactoid reaction following ioversol administration

    NARCIS (Netherlands)

    Jansman, Frank G. A.; Kieft, Hans; Harting, Johannes W.

    2007-01-01

    We report a fatal intravenous ioversol administration in a 60-year old male patient. Although the introduction of new low-osmolar non-ionogenic contrast media with a more favourable efficacy-toxicity balance has diminished the side-effects significantly, everyone involved in radiodiagnostic

  19. Fatal Disseminated Infection with Fusarium petroliphilum

    NARCIS (Netherlands)

    Ersal, Tuba; Al-Hatmi, Abdullah S M; Dalyan Cilo, Burcu; Curfs-Breuker, Ilse; Meis, Jacques F; Ozkalemkaş, Fahir; Ener, Beyza; van Diepeningen, Anne D

    2014-01-01

    Members of the Fusarium solani species complex (FSSC) are causing the majority of the fusariosis in humans. Disseminated fusariosis has a high mortality and is predominantly observed in patients with leukemia. Here, we present the case of a fatal infection by a Fusarium strain with a degenerated

  20. Potentially fatal tricuspid valve aspergilloma detected after ...

    African Journals Online (AJOL)

    Establishing a definitive and timely diagnosis remains difficult and there are many reports of undetected aspergillomas leading to fatalities in the perioperative period. We present a case report of preoperatively undiagnosed large mobile tricuspid valve aspergilloma obstructing the right ventricular inlet, diagnosed ...

  1. A Fatal Complication of Dermatomyositis: Spontaneous Pneumomediastinum

    Directory of Open Access Journals (Sweden)

    Ezgi Demirdöğen Çetinoğlu

    2016-04-01

    Full Text Available Interstitial lung disease (ILD is a negative prognostic factor associated with increased morbidity and mortality in patients with dermatomyositis (DM. Spontaneous pneumomediastinum is a rare complication of DM and it can be fatal. We present a 48-year-old woman with DM and ILD complicated by pneumomediastinum without pneumothorax and subcutaneous emphysema.

  2. Role of Mitochondria in Neonatal Hypoxic-Ischemic Brain Injury.

    Science.gov (United States)

    Lu, Yujiao; Tucker, Donovan; Dong, Yan; Zhao, Ningjun; Zhuo, Xiaoying; Zhang, Quanguang

    Hypoxic-ischemia (HI) causes severe brain injury in neonates. It's one of the leading causes to neonatal death and pediatric disability, resulting in devastating consequences, emotionally and economically, to their families. A series of events happens in this process, e.g. excitatory transmitter release, extracelluar Ca 2+ influxing, mitochondrial dysfunction, energy failure, and neuron death. There are two forms of neuron death after HI insult: necrosis and apoptosis, apoptosis being the more prevalent form. Mitochondria handle a series of oxidative reactions, and yield energy for various cellular activities including the maintainance of membrane potential and preservation of intracellular ionic homeostasis. Therefore mitochondria play a critical role in neonatal neurodegeneration following HI, and mitochondrial dysfunction is the key point in neurodegenerative evolution. Because of this, exploring effective mitochondria-based clinical strategies is crucial. Today the only efficacious clinic treatment is hypothermia. However, due to its complex management, clinical complication and autoimmune decrease, its clinical application is limited. So far, many mitochondria-based strategies have been reported neuroprotective in animal models, which offers promise on neonatal therapy. However, since their clinical effectiveness are still unclear, plenty of studies need to be continued in the future. According to recent reports, two novel strategies have been proposed: methylene blue (MB) and melatonin. Although they are still in primary stage, the underlying mechanisms indicate promising clinical applications. Every neurological therapeutic strategy has its intrinsic deficit and limited efficacy, therefore in the long run, the perfect clinical therapy for hypoxic-ischemic neonatal brain injury will be based on the combination of multiple strategies.

  3. Oxygen glucose deprivation in rat hippocampal slice cultures results in alterations in carnitine homeostasis and mitochondrial dysfunction.

    Directory of Open Access Journals (Sweden)

    Thomas F Rau

    Full Text Available Mitochondrial dysfunction characterized by depolarization of mitochondrial membranes and the initiation of mitochondrial-mediated apoptosis are pathological responses to hypoxia-ischemia (HI in the neonatal brain. Carnitine metabolism directly supports mitochondrial metabolism by shuttling long chain fatty acids across the inner mitochondrial membrane for beta-oxidation. Our previous studies have shown that HI disrupts carnitine homeostasis in neonatal rats and that L-carnitine can be neuroprotective. Thus, this study was undertaken to elucidate the molecular mechanisms by which HI alters carnitine metabolism and to begin to elucidate the mechanism underlying the neuroprotective effect of L-carnitine (LCAR supplementation. Utilizing neonatal rat hippocampal slice cultures we found that oxygen glucose deprivation (OGD decreased the levels of free carnitines (FC and increased the acylcarnitine (AC: FC ratio. These changes in carnitine homeostasis correlated with decreases in the protein levels of carnitine palmitoyl transferase (CPT 1 and 2. LCAR supplementation prevented the decrease in CPT1 and CPT2, enhanced both FC and the AC∶FC ratio and increased slice culture metabolic viability, the mitochondrial membrane potential prior to OGD and prevented the subsequent loss of neurons during later stages of reperfusion through a reduction in apoptotic cell death. Finally, we found that LCAR supplementation preserved the structural integrity and synaptic transmission within the hippocampus after OGD. Thus, we conclude that LCAR supplementation preserves the key enzymes responsible for maintaining carnitine homeostasis and preserves both cell viability and synaptic transmission after OGD.

  4. Mitochondrial dysfunction in obesity.

    Science.gov (United States)

    de Mello, Aline Haas; Costa, Ana Beatriz; Engel, Jéssica Della Giustina; Rezin, Gislaine Tezza

    2018-01-01

    Obesity leads to various changes in the body. Among them, the existing inflammatory process may lead to an increase in the production of reactive oxygen species (ROS) and cause oxidative stress. Oxidative stress, in turn, can trigger mitochondrial changes, which is called mitochondrial dysfunction. Moreover, excess nutrients supply (as it commonly is the case with obesity) can overwhelm the Krebs cycle and the mitochondrial respiratory chain, causing a mitochondrial dysfunction, and lead to a higher ROS formation. This increase in ROS production by the respiratory chain may also cause oxidative stress, which may exacerbate the inflammatory process in obesity. All these intracellular changes can lead to cellular apoptosis. These processes have been described in obesity as occurring mainly in peripheral tissues. However, some studies have already shown that obesity is also associated with changes in the central nervous system (CNS), with alterations in the blood-brain barrier (BBB) and in cerebral structures such as hypothalamus and hippocampus. In this sense, this review presents a general view about mitochondrial dysfunction in obesity, including related alterations, such as inflammation, oxidative stress, and apoptosis, and focusing on the whole organism, covering alterations in peripheral tissues, BBB, and CNS. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Neonatal Infections: a 5-Year Analysis in a Neonatal Care Unit in North East of Iran

    Directory of Open Access Journals (Sweden)

    Hassan Boskabadi

    2016-12-01

    Full Text Available Background: Neonatal infections are one of the major causes of death in Iran. Since identifying the risk factors, types, site, bacterial causes, and case fatality rate of an infection can be effective in selecting preventive and therapeutic methods, and appropriate supportive measures, this study aimed to investigate the aforementioned factors in the neonatal intensive care unit (NICU of Ghaem Hospital in Mashhad- Iran during a 5-year period.Materials and Methods: This cross-sectional study was conducted from Jan 2010 to Jun 2016 on 221 infants diagnosed with infections (positive blood, cerebrospinal fluid, or urine cultures, and radiographic evidence of lung infection as well as laboratory and clinical evidence of infection. Data collection tools consisted of a researcher-made questionnaire including maternal and neonatal characteristics and clinical and laboratory evaluation. Moreover, the infants were followed up until hospital discharge or death. Data were analyzed using SPSS-16.Results: The incidence of neonatal infection was 11.6%. About 70% of the infants were born preterm and 52% of the infected infants were born by cesarean. The most common pathogens of sepsis were gram-negative bacteria (55%, coagulase-negative staphylococci (35% and other gram-positive bacteria (10%. There were three main causes of infection of central nervous system (CNS: Klebsiella (66%, Escherichia coli (17%, and Acinetobacter (17%. Infant mortality rate due to infection was 28.1%. The causes of death included meningitis (60%, sepsis (27%, and UTI (16%.Conclusion: According to our study, the prevalence of infection and mortality rate in our ward is higher compared to developed countries. The most common cause of infections was gram-negative bacteria, but coagulase-negative staphylococci become more prevalent and needs more attention.

  6. Neonatal nonimmune hemolytic anemia.

    Science.gov (United States)

    Yaish, Hassan M; Christensen, Robert D; Lemons, Richard S

    2017-02-01

    As in adults and older children, anemia in newborn infants can be the result of erythropoietic failure, hemorrhage, or hemolysis. When hemolysis is the prime consideration, it can be challenging for physicians caring for neonates to choose from the wide variety of available diagnostic tests. This review describes the authors' opinions regarding rational, consistent, and cost-effective means of making an exact diagnosis of a neonatal hemolytic condition. Two recent advances in the diagnosis of neonatal nonimmune hemolytic disorders are highlighted in this review: introduction of flow cytometry-based Eosin-5-maleimide (EMA) uptake as a screening test to identify RBC membrane defects and next-generation sequencing (NGS)-based panels to uncover exact mutations causing hemolysis. The availability of newer tools such as EMA and NGS to diagnose specific hemolytic conditions, which might otherwise remain unknown, enables neonatal practitioners not only to identify the exact cause of hemolysis but also to discover novel mutations that can be implicated in the cause of neonatal hemolytic processes.

  7. Congenital Complete Tracheal Ring in a Neonate: A Case Report

    Directory of Open Access Journals (Sweden)

    Esra ARUN ÖZER

    2017-09-01

    Full Text Available Abnormalities of the upper airway tract lead to congenital high airway obstruction and may complicate neonatal airway management in the delivery room. Congenital complete tracheal rings are a rare and unusual tracheal anomaly, usually presenting in the neonate or infant as respiratory distress. The clinical presentation can vary from almost asymptomatic patients to near-fatal airway obstruction. It may exist as an isolated entity, or in association with other congenital malformations, in particular, cardiac anomalies along with vascular rings and pulmonary slings. Other associated anomalies have also been reported, for example, chromosomal anomalies, malformation of other parts of the respiratory tract, esophagus and skeletal systems. Here, we report an extreme case of VACTERL/TACRD association presented with congenital complete tracheal ring, encephalocele, bilateral radial agenesis with absent thumbs, equinovalgus deformity on right foot, low-set ears and micrognathia.

  8. Transient neonatal diabetes or neonatal hyperglycaemia: A case ...

    African Journals Online (AJOL)

    Transient neonatal diabetes and neonatal hyperglycaemia both present in the neonatal period with features of hyperglycaemia, dehydration and weight loss. Differentiating these conditions clinically is difficult. We describe the case of a 13 day old female whom we managed recently who could have had either condition.

  9. The value of neonatal autopsy.

    LENUS (Irish Health Repository)

    Hickey, Leah

    2012-01-01

    Neonatal autopsy rates were in decline internationally at the end of the last century. Our objective was to assess the current value of neonatal autopsy in providing additional information to families and healthcare professionals.

  10. Cancer: Mitochondrial Origins.

    Science.gov (United States)

    Stefano, George B; Kream, Richard M

    2015-12-01

    The primacy of glucose derived from photosynthesis as an existential source of chemical energy across plant and animal phyla is universally accepted as a core principle in the biological sciences. In mammalian cells, initial processing of glucose to triose phosphate intermediates takes place within the cytosolic glycolytic pathway and terminates with temporal transport of reducing equivalents derived from pyruvate metabolism by membrane-associated respiratory complexes in the mitochondrial matrix. The intra-mitochondrial availability of molecular oxygen as the ultimate electron acceptor drives the evolutionary fashioned chemiosmotic production of ATP as a high-efficiency biological process. The mechanistic bases of carcinogenesis have demonstrated profound alteration of normative mitochondrial function, notably dysregulated respiratory processes. Accordingly, the classic Warburg effect functionally links aerobic glycolysis, aberrant production and release of lactate, and metabolic down-regulation of mitochondrial oxidative processes with the carcinogenetic phenotype. We surmise, however, that aerobic fermentation by cancer cells may also represent a developmental re-emergence of an evolutionarily conserved early phenotype, which was "sidelined" with the emergence of mitochondrial oxidative phosphorylation as a primary mechanism for ATP production in normal cells. Regardless of state-dependent physiological status in mixed populations of cancer cells, it has been established that mitochondria are functionally linked to the initiation of cancer and its progression. Biochemical, molecular, and physiological differences in cancer cell mitochondria, notably mtDNA heteroplasmy and allele-specific expression of selected nuclear genes, may represent major focal points for novel targeting and elimination of cancer cells in metastatic disease afflicting human populations. To date, and despite considerable research efforts, the practical realization of advanced mitochondrial

  11. Road traffic crashes with fatal and non-fatal injuries in Arkhangelsk, Russia in 2005-2010.

    Science.gov (United States)

    Kudryavtsev, Alexander V; Nilssen, Odd; Lund, Johan; Grjibovski, Andrej M; Ytterstad, Børge

    2013-01-01

    The study investigated trends in traffic crashes with fatal and non-fatal injuries in Arkhangelsk, Russia in 2005-2010. Data were obtained from the road police. Negative binomial regression with time regressor was used to investigate trends in monthly incidence rates (IRs) of crashes, fatalities, and non-fatal injuries. During the six-year period, the police registered 4955 crashes with fatal and non-fatal injuries, which resulted in 217 fatalities and 5964 non-fatal injury cases. The IR of crashes with fatal and non-fatal injuries per total population showed no evident change, while the IR per increasing total number of motor vehicles decreased on average by 0.6% per month. Pedestrian crashes constituted 51.8% of studied crashes, and pedestrians constituted 54.6% of fatalities and 44.5% of non-fatal injuries. The IRs of pedestrian crashes and non-fatal pedestrian injuries per total population decreased on average by 0.3% per month, and these were the major trends in the data.

  12. Comparison of US metropolitan region pedestrian and bicyclist fatality rates.

    Science.gov (United States)

    Schneider, Robert J; Vargo, Jason; Sanatizadeh, Aida

    2017-09-01

    Annual US pedestrian and bicyclist fatalities involving motor vehicles have each increased by 30% in just six years, reaching their highest levels in two decades. To provide information to reverse this trend, we quantified pedestrian and bicyclist fatality rates in 46 of the largest US metropolitan statistical areas (MSAs) during two five-year time periods: 1999-2003 and 2007-2011. We divided the annual average number of pedestrian and bicyclist fatalities during 1999-2003 from the Fatality Analysis Reporting System by the annual estimates of pedestrian and bicycle trips, kilometers traveled, and minutes traveled from the 2001 National Household Travel Survey (NHTS) and the annual average number of fatalities from 2007 to 2011 by similar estimates from the 2009 NHTS. The five most dangerous regions for walking during 2007-2011 averaged 262 pedestrian fatalities per billion trips while the five safest averaged 49 pedestrian fatalities per billion trips. The five most dangerous regions for bicycling averaged 458 bicyclist fatalities per billion trips while the five safest averaged 75 bicyclist fatalities per billion trips. Random-effects meta-analysis identified eight metropolitan regions as outliers with low pedestrian fatality rates, six with high pedestrian fatality rates, one with a low bicyclist fatality rate, and five with high bicyclist fatality rates. MSAs with low pedestrian and bicycle fatality rates tended to have central cities recognized as Walk Friendly Communities and Bicycle Friendly Communities for investing in pedestrian and bicycle projects and programs. Random-effects meta-regression showed that certain socioeconomic characteristics and high pedestrian and bicyclist mode shares were associated with lower MSA fatality rates. Results suggest that pedestrian and bicycle infrastructure and safety programs should be complemented with strategies to increase walking and bicycling. In particular, safety initiatives should be honed to reduce pedestrian and

  13. NEONATES (BIRTH – 1 MONTH)

    African Journals Online (AJOL)

    Chantel

    western Johannesburg and also at the. Donald Gordon Medical Centre. Neonatal skin, like the respiratory system, bears the brunt of the extreme change in external environment that characterises birth. NEONATES. 488 CME September 2004 Vol.22 No.9. NEONATES (BIRTH – 1 MONTH). Fig. 1. Café-au-lait macule. Fig. 2.

  14. Neonatal Malaria in the Gambia

    African Journals Online (AJOL)

    Uche

    Conclusions: These data show that neonatal malaria is not uncommon in The Gambia and that the clinical features are akin to those of neonatal septicaemia. Key words: Malaria; septicaemia; neonate: ... mechanisms such as the milk diet of the infant being deficient in p-amino-benzoic acid,. 9 haematological factors such as ...

  15. Bone marrow features in Pearson syndrome with neonatal onset: A case report and review of the literature.

    Science.gov (United States)

    Tadiotto, Elisa; Maines, Evelina; Degani, Daniela; Balter, Rita; Bordugo, Andrea; Cesaro, Simone

    2018-04-01

    Pearson syndrome (PS) is a rare mitochondrial disorder that usually presents with transfusion-dependent macrocytic anemia, exocrine pancreatic dysfunction, and lactic acidosis. Typical bone marrow (BM) features are vacuolization in hematopoietic progenitors, hypocellularity, and ringed sideroblasts. At the neonatal age, PS may have a variable clinical onset. Moreover, there is little information about BM features at this age and the timing of their presentation. We report a neonatal case of PS that presented with refractory anemia and atypical BM features. We reviewed the BM findings in neonatal-onset PS cases to stress the importance and limitations of BM evaluation at this age. © 2017 Wiley Periodicals, Inc.

  16. Rings in the neonate.

    LENUS (Irish Health Repository)

    Hackett, C B

    2011-02-01

    Neonatal lupus erythematosus (NLE) is an uncommon disease of the neonate. It is believed to be caused by the transplacental passage of maternal autoantibodies to the ribonucleoproteins (Ro\\/SSA, La\\/SSB or rarely U RNP) as these are almost invariably present in NLE sera. The most common clinical manifestations include cutaneous lupus lesions and congenital complete heart block. Hepatobiliary and haematologic abnormalities are reported less frequently. We describe a patient with cutaneous NLE to illustrate and raise awareness of the characteristic annular eruption of this condition. We also emphasize the need for thorough investigation for concomitant organ involvement and for maternal education regarding risk in future pregnancies.

  17. Ultrasonography of Neonatal Cholestasis

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung Eun [Seoul National University Hospital, Seoul (Korea, Republic of)

    2012-06-15

    Ultrasonography (US) is as an important tool for differentiation of obstructive and non-obstructive causes of jaundice in infants and children. Beyond two weeks of age, extrahepatic biliary atresia and neonatal hepatitis are the two most common causes of persistent neonatal jaundice: differentiation of extrahepatic biliary atresia, which requires early surgical intervention, is very important. Meticulous analysis should focus on size and configuration of the gallbladder and anatomical changes of the portahepatis. In order to narrow the differential diagnosis, combined approaches using hepatic scintigraphy, MR cholangiography, and, at times, percutaneous liver biopsy are necessary. US is useful for demonstrating choledochal cyst, bile plug syndrome, and spontaneous perforation of the extrahepatic bile duct

  18. Work zone fatal crashes involving large trucks, 2012 : [analysis brief].

    Science.gov (United States)

    2014-11-01

    In 2012, 30,800 fatal crashes took place on our Nations roadways, with 11.2 percent (3,464) involving at least 1 large truck. While the majority of all fatal crashes (98.2 percent) took place outside of a work zone in 2012, 547 fatal crashes (1.8 ...

  19. Diminished exercise capacity and mitochondrial bc1 complex deficiency in tafazzin-knockdown mice.

    Directory of Open Access Journals (Sweden)

    Corey ePowers

    2013-04-01

    Full Text Available The phospholipid, cardiolipin, is essential for maintaining mitochondrial structure and optimal function. Cardiolipin-deficiency in humans, Barth syndrome, is characterized by exercise intolerance, dilated cardiomyopathy, neutropenia and 3-methyl-glutaconic aciduria. The causative gene is the mitochondrial acyl-transferase, tafazzin that is essential for remodeling acyl chains of cardiolipin. We sought to determine metabolic rates in tafazzin-deficient mice during resting and exercise, and investigate the impact of cardiolipin deficiency on mitochondrial respiratory chain activities. Tafazzin knockdown in mice markedly impaired oxygen consumption rates during an exercise, without any significant effect on resting metabolic rates. CL-deficiency resulted in significant reduction of mitochondrial respiratory reserve capacity in neonatal cardiomyocytes that is likely to be caused by diminished activity of complex-III, which requires CL for its assembly and optimal activity. Our results may provide mechanistic insights of Barth syndrome pathogenesis.

  20. Neonatal seizures in a rural Kenyan District Hospital: aetiology, Incidence and outcome of hospitalization

    Directory of Open Access Journals (Sweden)

    Newton Charles RJC

    2010-03-01

    Full Text Available Abstract Background Acute seizures are common among children admitted to hospitals in resource poor countries. However, there is little data on the burden, causes and outcome of neonatal seizures in sub-Saharan Africa. We determined the minimum incidence, aetiology and immediate outcome of seizures among neonates admitted to a rural district hospital in Kenya. Methods From 1st January 2003 to 31st December 2007, we assessed for seizures all neonates (age 0-28 days admitted to the Kilifi District Hospital, who were resident in a defined, regularly enumerated study area. The population denominator, the number of live births in the community on 1 July 2005 (the study midpoint was modelled from the census data. Results Seizures were reported in 142/1572 (9.0% of neonatal admissions. The incidence was 39.5 [95% confidence interval (CI 26.4-56.7] per 1000 live-births and incidence increased with birth weight. The main diagnoses in neonates with seizures were sepsis in 85 (60%, neonatal encephalopathy in 30 (21% and meningitis in 21 (15%, but only neonatal encephalopathy and bacterial meningitis were independently associated with seizures. Neonates with seizures had a longer hospitalization [median period 7 days - interquartile range (IQR 4 to10] -compared to 5 days [IQR 3 to 8] for those without seizures, P = 0.02. Overall, there was no difference in inpatient case fatality between neonates with and without seizures but, when this outcome was stratified by birth weight, it was significantly higher in neonates ≥ 2.5 kg compared to low birth weight neonates [odds ratio 1.59 (95%CI 1.02 to 2.46, P = 0.037]. Up to 13% of the surviving newborn with seizures had neurological abnormalities at discharge. Conclusion There is a high incidence of neonatal seizures in this area of Kenya and the most important causes are neonatal encephalopathy and meningitis. The high incidence of neonatal seizures may be a reflection of the quality of the perinatal and

  1. Cannabis, alcohol and fatal road accidents.

    Science.gov (United States)

    Martin, Jean-Louis; Gadegbeku, Blandine; Wu, Dan; Viallon, Vivian; Laumon, Bernard

    2017-01-01

    This research aims to estimate the relative risks of responsibility for a fatal accident linked to driving under the influence of cannabis or alcohol, the prevalence of these influences among drivers and the corresponding attributable risk ratios. A secondary goal is to estimate the same items for three other groups of illicit drugs (amphetamines, cocaine and opiates), and to compare the results to a similar study carried out in France between 2001 and 2003. Police procedures for fatal accidents in Metropolitan France during 2011 were analyzed and 300 characteristics encoded to provide a database of 4,059 drivers. Information on alcohol and four groups of illicit drugs derived from tests for positivity and potential confirmation through blood analysis. The study compares drivers responsible for causing the accident, that is to say having directly contributed to its occurrence, to drivers involved in an accident for which they were not responsible, and who can be assimilated to drivers in general. The proportion of persons driving under the influence of alcohol is estimated at 2.1% (95% CI: 1.4-2.8) and under the influence of cannabis at 3.4% (2.9%-3.9%). Drivers under the influence of alcohol are 17.8 times (12.1-26.1) more likely to be responsible for a fatal accident, and the proportion of fatal accidents which would be prevented if no drivers ever exceeded the legal limit for alcohol is estimated at 27.7% (26.0%-29.4%). Drivers under the influence of cannabis multiply their risk of being responsible for causing a fatal accident by 1.65 (1.16-2.34), and the proportion of fatal accidents which would be prevented if no drivers ever drove under the influence of cannabis is estimated at 4.2% (3.7%-4.8%). An increased risk linked to opiate use has also been found to be significant, but with low prevalence, requiring caution in interpreting this finding. Other groups of narcotics have even lower prevalence, and the associated extra risks cannot be assessed. Almost a

  2. A Rare Fatal Complication of Llizarov Procedure.

    Science.gov (United States)

    Sikary, Asit Kumar; Kumar, Mahesh; Dhaka, Shivani; Subramanian, Arulselvi

    2018-03-01

    Ilizarov process is used for the management of multiple fractures, polytrauma conditions, cosmetic limb lengthening, and fracture malunion. Complications associated with the process are nerve palsy, joint contracture, premature or delayed osseous consolidation, a nonunion and permanent stiffness of the joint, pin tract infection, edema, and transient paresthesia, etc. In our case, there was a fatal complication. A 25-year-old African lady underwent the Ilizarov procedure for femur lengthening in a hospital in New Delhi, India. During her first distraction process, she suddenly collapsed at the hospital and could not be revived. At postmortem, a small hematoma was seen around the surgically fractured area. On histopathology of internal organs, fat globules were present in the vasculature of brain and lungs. Cause of death was opined as due to fat embolism. This is the first case reported of a fatal fat embolism following Ilizarov procedure for limb lengthening in a healthy adult. © 2018 American Academy of Forensic Sciences.

  3. Cannabis, alcohol and fatal road accidents.

    Directory of Open Access Journals (Sweden)

    Jean-Louis Martin

    Full Text Available This research aims to estimate the relative risks of responsibility for a fatal accident linked to driving under the influence of cannabis or alcohol, the prevalence of these influences among drivers and the corresponding attributable risk ratios. A secondary goal is to estimate the same items for three other groups of illicit drugs (amphetamines, cocaine and opiates, and to compare the results to a similar study carried out in France between 2001 and 2003.Police procedures for fatal accidents in Metropolitan France during 2011 were analyzed and 300 characteristics encoded to provide a database of 4,059 drivers. Information on alcohol and four groups of illicit drugs derived from tests for positivity and potential confirmation through blood analysis. The study compares drivers responsible for causing the accident, that is to say having directly contributed to its occurrence, to drivers involved in an accident for which they were not responsible, and who can be assimilated to drivers in general.The proportion of persons driving under the influence of alcohol is estimated at 2.1% (95% CI: 1.4-2.8 and under the influence of cannabis at 3.4% (2.9%-3.9%. Drivers under the influence of alcohol are 17.8 times (12.1-26.1 more likely to be responsible for a fatal accident, and the proportion of fatal accidents which would be prevented if no drivers ever exceeded the legal limit for alcohol is estimated at 27.7% (26.0%-29.4%. Drivers under the influence of cannabis multiply their risk of being responsible for causing a fatal accident by 1.65 (1.16-2.34, and the proportion of fatal accidents which would be prevented if no drivers ever drove under the influence of cannabis is estimated at 4.2% (3.7%-4.8%. An increased risk linked to opiate use has also been found to be significant, but with low prevalence, requiring caution in interpreting this finding. Other groups of narcotics have even lower prevalence, and the associated extra risks cannot be assessed

  4. Clash of Desires: Detective vs. Femme Fatale

    Directory of Open Access Journals (Sweden)

    Veronika Pituková

    2013-06-01

    Full Text Available This article discusses the theme of desire presented in American hard-boiled detective fiction and its subsequent transformation on the screen in form of films noir of the 1940’s. The works in focus are novels The Maltese Falcon by Dashiell Hammett, Farewell, My Lovely by Raymond Chandler and Build My Gallows High by Daniel Mainwaring and their film noir adaptations – The Maltese Falcon (1941, Murder, My Sweet (1944 and Out of the Past (1947. The proposed paper seeks to offer a contrastive analysis of the novels and the films and situate them in their respective social and cultural contexts. The central conflict of this article is presented by the clash between the femme fatale’s and detective’s desires. Hard-boiled novels present femme fatale as a dame with a past, a spider woman, and the detective as a hero with no future, caught in her web of intrigues. The only way out for the detective is to suppress the sexual desire for the woman and hold strong to his professional code. The femme fatale’s desire for more and for better is deadly and dangerous for those who succumb to her lure, but the detective’s desire for truth can be fatal for the dark lady too.  This clash presented in the novels is confronted with the 1940’s Hollywood production. When the detective frees himself from the sexual lure of the fatal woman he has a chance to live and even bring her to justice, but she can still escape or decide herself what to do with her destiny. Both, the dame and the hero are victims of their desires. The 1940’s films noir’s femme fatales have to pay for their crimes, no matter how crafty, seductive or manipulative they are.  Thus these films present the masculine dominance as strong and undefeated.

  5. A fatal pulmonary infection by Nocardia brasiliensis

    Directory of Open Access Journals (Sweden)

    Wadhwa V

    2006-01-01

    Full Text Available The reported case is of primary pulmonary nocardiosis, caused by Nocardia brasiliensis , in a immunocompromised patient, which ended fatally despite appropriate treatment. The partially acid fast filamentous bacterium was predominant on direct examination of the sputum. It was cultured on blood agar, MacConkey agar and by paraffin baiting technique. The bacterium was resistant to cotrimoxazole, the drug of choice for nocardiosis.

  6. Unusual cause of fatal anthrax meningitis.

    Science.gov (United States)

    Parlak, Emine; Parlak, Mehmet; Atli, Seval Bilgiç

    2015-03-01

    We report the case of fatal anthrax meningoencephalitis in the province of Muş located in eastern Anatolia, Turkey. The organism isolated from cerebrospinal fluid was identified as Bacillus anthracis. The patient was treated with crystallized penicillin G (24 MU/day IV) and ciprofloxacin (2 × 400/day IV), but died 5 days after hospitalization. Although it is a rare case, we consider that the patients who have skin, respiratory and neurological systems might also have hemorrhagic meningitis.

  7. Fatal lawn mower related projectile injury

    DEFF Research Database (Denmark)

    Colville-Ebeling, Bonnie; Lynnerup, Niels; Banner, Jytte

    2014-01-01

    Fatal lawn mower related injuries are a relatively rare occurrence. In a forensic setting, the primary aim is to reconstruct the injury mechanism and establish the cause of death. A relatively rare, but characteristic type of injury is a so-called projectile or missile injury. This occurs when...... mechanism has not previously been reported as a cause of death. This case illustrates the importance of postmortem radiological imaging and interdisciplinary cooperation when establishing manner and cause of death in unusual cases....

  8. Fatalism and Mammography in a Multicultural Population.

    Science.gov (United States)

    Baron-Epel, Orna; Friedman, Nurit; Lernau, Omri

    2009-05-01

    Purpose/Objectives: To assess levels of fatalistic beliefs and their association with mammography use in four population groups in Israel.Design: Telephone survey.Setting: Maccabi Healthcare Services in Israel.Sample: A random sample of 1,550 Arabic and Jewish women.Methods: A random telephone survey was performed during May and June 2007. Women's fatalistic beliefs were measured. Information from claims records regarding mammography use was obtained for each woman.Main Research Variables: Levels of fatalistic beliefs and mammography use.Findings: Fatalistic beliefs included general beliefs that God or fate (external force) was the cause of cancer and related to cancer survivorship. The higher-educated women reported less fatalistic beliefs. Arab women reported more fatalistic beliefs compared to the other women. Mammography use was associated with fatalistic beliefs that external forces were the cause of cancer among Arab and immigrant women but not among veteran Jewish and ultraorthodox women. Fatalistic beliefs about cancer survivorship were not associated with mammography in any of the population groups. Levels of fatalism and education may explain the difference in rates of mammography among Arab and Jewish women.Conclusions: High levels of fatalism may inhibit women from having a mammogram, particularly Arab and immigrant women in Israel. However, this is not a generalizable result for all population groups and all types of fatalism.Implications for Nursing: Interventions to decrease fatalism in Arabs and immigrants may increase compliance with mammography. Nurses may achieve this by developing tailored messages for women who believe that external forces are the cause of cancer.

  9. Cathelicidin Insufficiency in Patients with Fatal Leptospirosis.

    Directory of Open Access Journals (Sweden)

    Janet C Lindow

    2016-11-01

    Full Text Available Leptospirosis causes significant morbidity and mortality worldwide; however, the role of the host immune response in disease progression and high case fatality (>10-50% is poorly understood. We conducted a multi-parameter investigation of patients with acute leptospirosis to identify mechanisms associated with case fatality. Whole blood transcriptional profiling of 16 hospitalized Brazilian patients with acute leptospirosis (13 survivors, 3 deceased revealed fatal cases had lower expression of the antimicrobial peptide, cathelicidin, and chemokines, but more abundant pro-inflammatory cytokine receptors. In contrast, survivors generated strong adaptive immune signatures, including transcripts relevant to antigen presentation and immunoglobulin production. In an independent cohort (23 survivors, 22 deceased, fatal cases had higher bacterial loads (P = 0.0004 and lower anti-Leptospira antibody titers (P = 0.02 at the time of hospitalization, independent of the duration of illness. Low serum cathelicidin and RANTES levels during acute illness were independent risk factors for higher bacterial loads (P = 0.005 and death (P = 0.04, respectively. To investigate the mechanism of cathelicidin in patients surviving acute disease, we administered LL-37, the active peptide of cathelicidin, in a hamster model of lethal leptospirosis and found it significantly decreased bacterial loads and increased survival. Our findings indicate that the host immune response plays a central role in severe leptospirosis disease progression. While drawn from a limited study size, significant conclusions include that poor clinical outcomes are associated with high systemic bacterial loads, and a decreased antibody response. Furthermore, our data identified a key role for the antimicrobial peptide, cathelicidin, in mounting an effective bactericidal response against the pathogen, which represents a valuable new therapeutic approach for leptospirosis.

  10. [Anaerobiospirillum thomasii bacteremia with fatal outcome].

    Science.gov (United States)

    Streitenberger, Edgardo R; Chavez, Claudio M; Rizzo, Mabel S; Suarez, Ariel I

    2015-01-01

    Anaerobiospirillum thomasii has been reported as a causative agent of diarrhea in humans; however no bacteremia associated with this pathogen has been described so far. We present here the first case of fatal A. thomasii bacteremia in an alcoholic patient. Copyright © 2015 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Alcoholic beverages as determinants of traffic fatalities

    OpenAIRE

    Arranz Muñoz, José María; Gil, Ana Isabel

    2008-01-01

    The most important contribution of this research lies in considering the impact of wine, beer and liquors on the ratio of traffic fatalities because each kind of alcoholic beverage is characterized by different ethanol content. The data, drawn for case of Spain, validate our theoretical hypothesis. Our findings support the strategy of incrementing alcohol taxes in order to reduce the negative externalities of alcohol abuse. However, it is necessary to implement non-economic policies because o...

  12. Mitochondrial dysfunction in epilepsy

    Czech Academy of Sciences Publication Activity Database

    Folbergrová, Jaroslava; Kunz, W.S.

    2012-01-01

    Roč. 12, č. 1 (2012), s. 35-40 ISSN 1567-7249 R&D Projects: GA ČR(CZ) GA309/05/2015; GA ČR GA309/08/0292 Institutional research plan: CEZ:AV0Z50110509 Keywords : epilepsy * mitochondrial dysfunction * neurodegeneration Subject RIV: FH - Neurology Impact factor: 4.025, year: 2012

  13. Mitochondrial Dysfunction in Gliomas

    Czech Academy of Sciences Publication Activity Database

    Katsetos, C.D.; Anni, H.; Dráber, Pavel

    2013-01-01

    Roč. 20, č. 3 (2013), s. 216-227 ISSN 1071-9091 R&D Projects: GA MŠk LH12050 Institutional support: RVO:68378050 Keywords : gliomas * mitochondrial dysfunction * microtubule proteins Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.883, year: 2013

  14. Aluminum phosphide fatalities, new local experience.

    Science.gov (United States)

    Abder-Rahman, H A; Battah, A H; Ibraheem, Y M; Shomaf, M S; el-Batainch, N

    2000-04-01

    Aluminum phosphide (AlP) pesticide is a highly toxic, low cost, and easily accessible rodenticidal agent. Its toxicity results from the liberation of phosphine gas upon exposure to moisture, which leads to multisystem involvement, resulting in serious consequences. The highly toxic parathion insecticide was a common cause of mortality in pesticide fatalities, prior to its banning. Its toxicity was familiar to the public as well as to physicians. Recently, ten fatalities due to AlP were encountered within a three-month period during spring, when it was used as a rodenticide in the vicinity of grain stores. The victims' ages ranged from 1-34 years. The circumstances of death were accidental in six cases, suicidal in two and possibly homicidal in two cases. Retrospectively, the clinical manifestations, scene investigation, autopsy, histological and toxicological findings supported the diagnosis of AlP intoxication. Immediate recognition was difficult due to unfamiliarity of the agent to the physicians. The occurrence of these fatalities might suggest changes of pattern in pesticide poisoning. This should raise the attention of the physician to the problem of AlP poisoning and also necessitates the awareness of the public to the hazards of this poison. Education, proper handling, strict observation and abiding by the regulations controlling this material are good protective measures against AlP poisoning.

  15. Mechanisms of Mitochondrial Damage in Keratinocytes by Pemphigus Vulgaris Antibodies*

    Science.gov (United States)

    Kalantari-Dehaghi, Mina; Chen, Yumay; Deng, Wu; Chernyavsky, Alex; Marchenko, Steve; Wang, Ping H.; Grando, Sergei A.

    2013-01-01

    The development of nonhormonal treatment of pemphigus vulgaris (PV) has been hampered by a lack of clear understanding of the mechanisms leading to keratinocyte (KC) detachment and death in pemphigus. In this study, we sought to identify changes in the vital mitochondrial functions in KCs treated with the sera from PV patients and healthy donors. PV sera significantly increased proton leakage from KCs, suggesting that PV IgGs increase production of reactive oxygen species. Indeed, measurement of intracellular reactive oxygen species production showed a drastic increase of cell staining in response to treatment by PV sera, which was confirmed by FACS analysis. Exposure of KCs to PV sera also caused dramatic changes in the mitochondrial membrane potential detected with the JC-1 dye. These changes can trigger the mitochondria-mediated intrinsic apoptosis. Although sera from different PV patients elicited unique patterns of mitochondrial damage, the mitochondria-protecting drugs nicotinamide (also called niacinamide), minocycline, and cyclosporine A exhibited a uniform protective effect. Their therapeutic activity was validated in the passive transfer model of PV in neonatal BALB/c mice. The highest efficacy of mitochondrial protection of the combination of these drugs found in mitochondrial assay was consistent with the ability of the same drug combination to abolish acantholysis in mouse skin. These findings provide a theoretical background for clinical reports of the efficacy of mitochondria-protecting drugs in PV patients. Pharmacological protection of mitochondria and/or compensation of an altered mitochondrial function may therefore become a novel approach to development of personalized nonhormonal therapies of patients with this potentially lethal autoimmune blistering disease. PMID:23599429

  16. Neonatal nutrition and metabolism

    National Research Council Canada - National Science Library

    Thureen, Patti J; Hay, William W

    2006-01-01

    ..., the volume highlights the important longterm effects of fetal and neonatal growth on health in later life. In addition, there are very practical chapters on methods and techniques for assessing nutritional status, body composition, and evaluating metabolic function. Written by an authoritative, international team of cont...

  17. Fatalism Revisited: Further Psychometric Testing Across Two Studies.

    Science.gov (United States)

    Heiney, Sue P; Gullatte, Mary; Hayne, Pearman D; Powe, Barbara; Habing, Brian

    2016-08-01

    Cancer fatalism may impact outcomes, particularly for African American (AA) women with breast cancer (BrCa). We examined the psychometrics of the modified Powe Fatalism Inventory in sample of AA women with BrCa from two studies. Only the predetermination and God's will items satisfy the conditions to be classified as a strong subscale. Our analysis identified that five items had strong psychometric properties for measuring fatalism for AA women with BrCa. However, these items do not include all the defining attributes of fatalism. A strong measure of fatalism strengthens our understanding of how this concept influences AA patient outcomes.

  18. Religious fatalism and its association with health behaviors and outcomes.

    Science.gov (United States)

    Franklin, Monica D; Schlundt, David G; McClellan, Linda H; Kinebrew, Tunu; Sheats, Jylana; Belue, Rhonda; Brown, Anne; Smikes, Dorlisa; Patel, Kushal; Hargreaves, Margaret

    2007-01-01

    To examine the association between religious fatalism and health care utilization, health behaviors, and chronic illness. As part of Nashville's REACH 2010 project, residents (n=1273) participated in a random telephone survey that included health variables and the helpless inevitability subscale of the Religious Health Fatalism Questionnaire. Religious health fatalism was higher among African Americans and older participants. Some hypotheses about the association between fatalism and health outcomes were confirmed. Religious fatalism is only partially predictive of health behaviors and outcomes and may be a response to chronic illness rather than a contributor to unhealthy behaviors.

  19. Tetanus toxoid vaccine: elimination of neonatal tetanus in selected states of India.

    Science.gov (United States)

    Verma, Ramesh; Khanna, Pardeep

    2012-10-01

    Tetanus is caused by a neurotoxin produced by Clostridium tetani (C. tetani), a spore-forming bacterium. Infection begins when tetanus spores are introduced into damaged tissue. Tetanus is characterized by muscle rigidity and painful muscle spasms caused by tetanus toxin's blockade of inhibitory neurons that normally oppose and modulate the action of excitatory motor neurons. Maternal and neonatal tetanus (MNT) are caused by unhygienic methods of delivery, abortion, or umbilical-cord care. Maternal and neonatal tetanus are both forms of generalized tetanus and have similar clinical courses. About 90% of neonates with tetanus develop symptoms in the first 3-14 d of life, mostly on days 6-8, distinguishing neonatal tetanus from other causes of neonatal mortality which typically occur during the first two days of life. Overall case fatality rates for patients admitted to the hospital with neonatal tetanus in developing countries are 8-50%, while the fatality rate can be as high as 100% without hospital care. Tetanus toxoid (TT) vaccination of pregnant women to prevent neonatal tetanus was included in WHO's Expanded Program on Immunization (EPI) a few years after its inception in 1974. In 2000, WHO, UNICEF, and UNFPA formed a partnership to relaunch efforts toward this goal, adding the elimination of maternal tetanus as a program objective, and setting a new target date of 2005. By February 2007, 40 countries had implemented tetanus vaccination campaigns in high-risk areas, targeting more than 94 million women, and protecting more than 70 million subjects with at least two doses of TT. In 2011, 653 NT cases were reported in India compared with 9313 in 1990. As of February 2012, 25 countries and 15 States and Union Territories of India, all of Ethiopia except Somaliland, and almost 29 of 34 provinces in Indonesia have been validated to have eliminated MNT.

  20. [Recommendations for neonatal transport].

    Science.gov (United States)

    Moreno Hernando, J; Thió Lluch, M; Salguero García, E; Rite Gracia, S; Fernández Lorenzo, J R; Echaniz Urcelay, I; Botet Mussons, F; Herranz Carrillo, G; Sánchez Luna, M

    2013-08-01

    During pregnancy, it is not always possible to identify maternal or foetal risk factors. Infants requiring specialised medical care are not always born in centres providing intensive care and will need to be transferred to a referral centre where intensive care can be provided. Therefore Neonatal Transport needs to be considered as part of the organisation of perinatal health care. The aim of Neonatal Transport is to transfer a newborn infant requiring intensive care to a centre where specialised resources and experience can be provided for the appropriate assessment and continuing treatment of a sick newborn infant. Intrauterine transfer is the ideal mode of transport when the birth of an infant with risk factors is diagnosed. Unfortunately, not all problems can be detected in advance with enough time to safely transfer a pregnant woman. Around 30- 50% of risk factors will be diagnosed during labour or soon after birth. Therefore, it is important to have the knowledge and resources to resuscitate and stabilise a newborn infant, as well as a specialised neonatal transport system. With this specialised transport it is possible to transfer newly born infants with the same level of care that they would receive if they had been born in a referral hospital, without increasing their risks or affecting the wellbeing of the newborn. The Standards Committee of the Spanish Society of Neonatology reviewed and updated recommendations for intrauterine transport and indications for neonatal transfer. They also reviewed organisational and logistic factors involved with performing neonatal transport. The Committee review included the type of personnel who should be involved; communication between referral and receiving hospitals; documentation; mode of transport; equipment to stabilise newly born infants; management during transfer, and admission at the referral hospital. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  1. Neonatal liver failure due to deoxyguanosine kinase deficiency

    Science.gov (United States)

    Nobre, Susana; Grazina, Manuela; Silva, Francisco; Pinto, Carla; Gonçalves, Isabel; Diogo, Luísa

    2012-01-01

    Deoxyguanosine kinase (dGK) deficiency, a rare severe cause of mitochondrial DNA (mtDNA) depletion, has two forms of presentation: hepatocerebral syndrome and isolated hepatic disease. The authors report three cases with neonatal liver failure due to dGK deficiency. Consanguinity was present in all patients. One patient had a brother who died with a probable diagnosis of neonatal haemochromatosis. All patients had progressive cholestatic liver failure, hypoglycaemia, hyperlactacidaemia, elevated ferritin levels and nystagmus, since first day of life. Liver tissue study revealed: cholestasis, iron deposits, microvesicular steatosis and fibrosis/cirrhosis. Only one patient was submitted to liver transplantation. The other two died, at 2 and 5 months of age. mtDNA quantification and DGUOK gene study should be considered in infants/neonates with acute liver failure and systematically performed in patients with hepatocerebral presentation. Differential diagnosis with neonatal haemochromatosis is needed. Liver transplantation might be a therapeutic option. Early diagnosis is important for genetic counselling. PMID:22602837

  2. Abnormal mitochondrial bioenergetics and heart rate dysfunction in mice lacking very-long-chain acyl-CoA dehydrogenase

    NARCIS (Netherlands)

    Exil, VJ; Gardner, CD; Rottman, JN; Sims, H; Bartelds, B; Khuchua, Z; Sindhal, R; Ni, GM; Strauss, AW

    Mitochondrial very-long-chain acyl-CoA dehydrogenase ( VLCAD) deficiency is associated with severe hypoglycemia, cardiac dysfunction, and sudden death in neonates and children. Sudden death is common, but the underlying mechanisms are not fully understood. We report on a mouse model of VLCAD

  3. Ruptured Tricuspid Valve Papillary Muscle in a Neonate with Intractable Persistent Fetal Circulation

    OpenAIRE

    Yoon, Ja Kyoung; Kim, Hye Rim; Kwon, Hye Won; Kwon, Bo Sang; Kim, Gi Beom; Bae, Eun Jung; Noh, Chung Il; Kim, Woong Han

    2015-01-01

    Unguarded tricuspid regurgitation (TR) due to a flail tricuspid leaflet is a rare condition of newborn cyanosis. A high perinatal mortality has been associated with this fatal condition. But, there are feasible surgical repairs to improve survival. We report the case of a male full-term neonate with intractable hypoxia. He had profound tricuspid insufficiency and leaflet prolapse caused by a ruptured papillary muscle supporting the anterior leaflet of the tricuspid valve. He presented with se...

  4. Detection of Echinococcus multilocularis in Carnivores in Razavi Khorasan Province, Iran Using Mitochondrial DNA

    OpenAIRE

    Beiromvand, Molouk; Akhlaghi, Lame; Fattahi Massom, Seyed Hossein; Mobedi, Iraj; Meamar, Ahmad Reza; Oormazdi, Hormozd; Motevalian, Abbas; Razmjou, Elham

    2011-01-01

    BACKGROUND: Echinococcus multilocularis is the source of alveolar echinococcosis, a potentially fatal zoonotic disease. This investigation assessed the presence of E. multilocularis infection in definitive hosts in the Chenaran region of Razavi Khorasan Province, northeastern Iran. METHODOLOGY/PRINCIPAL FINDINGS: Fecal samples from 77 domestic and stray dogs and 14 wild carnivores were examined using the flotation/sieving method followed by multiplex PCR of mitochondrial genes. The intestinal...

  5. [Fatal neonatal listeriosis after maternal infection acquired with ingestion of fresh home-made cheese].

    Science.gov (United States)

    Negri, F; Massone, M L; Cingolani, M; Morando, A; Somenzi, M; Barretta, M A; Savioli, C

    1994-09-01

    The authors report on a newborn admitted to the Intensive Care Unit of Gaslini Institute for serious respiratory insufficiency who died on the third day of life because of a sepsis due to Listeria monocytogenes. The authors focus on the patient's history and clinical picture and on the histological evaluation of the lesions observed. The importance of infection in pregnancy and the possible severe consequences of listeriosis on the foetus are underlined, stressing the need for early diagnosis and adequate treatment.

  6. Mitochondrial ROMK channel is a molecular component of mitoK(ATP).

    Science.gov (United States)

    Foster, D Brian; Ho, Alice S; Rucker, Jasma; Garlid, Anders O; Chen, Ling; Sidor, Agnieszka; Garlid, Keith D; O'Rourke, Brian

    2012-08-03

    Activation of the mitochondrial ATP-sensitive potassium channel (mitoK(ATP)) has been implicated in the mechanism of cardiac ischemic preconditioning, yet its molecular composition is unknown. To use an unbiased proteomic analysis of the mitochondrial inner membrane to identify the mitochondrial K(+) channel underlying mitoK(ATP). Mass spectrometric analysis was used to identify KCNJ1(ROMK) in purified bovine heart mitochondrial inner membrane and ROMK mRNA was confirmed to be present in neonatal rat ventricular myocytes and adult hearts. ROMK2, a short form of the channel, is shown to contain an N-terminal mitochondrial targeting signal, and a full-length epitope-tagged ROMK2 colocalizes with mitochondrial ATP synthase β. The high-affinity ROMK toxin, tertiapin Q, inhibits mitoK(ATP) activity in isolated mitochondria and in digitonin-permeabilized cells. Moreover, short hairpin RNA-mediated knockdown of ROMK inhibits the ATP-sensitive, diazoxide-activated component of mitochondrial thallium uptake. Finally, the heart-derived cell line, H9C2, is protected from cell death stimuli by stable ROMK2 overexpression, whereas knockdown of the native ROMK exacerbates cell death. The findings support ROMK as the pore-forming subunit of the cytoprotective mitoK(ATP) channel.

  7. Pearson syndrome: unique endocrine manifestations including neonatal diabetes and adrenal insufficiency.

    Science.gov (United States)

    Williams, T B; Daniels, M; Puthenveetil, G; Chang, R; Wang, R Y; Abdenur, J E

    2012-05-01

    Pearson syndrome is a very rare metabolic disorder that is usually present in infancy with transfusion dependent macrocytic anemia and multiorgan involvement including exocrine pancreas, liver and renal tubular defects. The disease is secondary to a mitochondrial DNA deletion that is variable in size and location. Endocrine abnormalities can develop, but are usually not part of the initial presentation. We report two patients who presented with unusual endocrine manifestations, neonatal diabetes and adrenal insufficiency, who were both later diagnosed with Pearson syndrome. Medical records were reviewed. Confirmatory testing included: mitochondrial DNA deletion testing and sequencing of the breakpoints, muscle biopsy, and bone marrow studies. Case 1 presented with hyperglycemia requiring insulin at birth. She had several episodes of ketoacidosis triggered by stress and labile blood glucose control. Workup for genetic causes of neonatal diabetes was negative. She had transfusion dependent anemia and died at 24 months due to multisystem organ failure. Case 2 presented with adrenal insufficiency and anemia during inturcurrent illness, requiring steroid replacement since 37 months of age. He is currently 4 years old and has mild anemia. Mitochondrial DNA studies confirmed a 4.9 kb deletion in patient 1 and a 5.1 kb deletion in patient 2. The patients reported highlight the importance of considering mitochondrial DNA disorders in patients with early onset endocrine dysfunction, and expand the knowledge about this rare mitochondrial disease. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Mitochondrial disease and endocrine dysfunction.

    Science.gov (United States)

    Chow, Jasmine; Rahman, Joyeeta; Achermann, John C; Dattani, Mehul T; Rahman, Shamima

    2017-02-01

    Mitochondria are critical organelles for endocrine health; steroid hormone biosynthesis occurs in these organelles and they provide energy in the form of ATP for hormone production and trafficking. Mitochondrial diseases are multisystem disorders that feature defective oxidative phosphorylation, and are characterized by enormous clinical, biochemical and genetic heterogeneity. To date, mitochondrial diseases have been found to result from >250 monogenic defects encoded across two genomes: the nuclear genome and the ancient circular mitochondrial genome located within mitochondria themselves. Endocrine dysfunction is often observed in genetic mitochondrial diseases and reflects decreased intracellular production or extracellular secretion of hormones. Diabetes mellitus is the most frequently described endocrine disturbance in patients with inherited mitochondrial diseases, but other endocrine manifestations in these patients can include growth hormone deficiency, hypogonadism, adrenal dysfunction, hypoparathyroidism and thyroid disease. Although mitochondrial endocrine dysfunction frequently occurs in the context of multisystem disease, some mitochondrial disorders are characterized by isolated endocrine involvement. Furthermore, additional monogenic mitochondrial endocrine diseases are anticipated to be revealed by the application of genome-wide next-generation sequencing approaches in the future. Understanding the mitochondrial basis of endocrine disturbance is key to developing innovative therapies for patients with mitochondrial diseases.

  9. Mitochondrial nucleoid interacting proteins support mitochondrial protein synthesis.

    Science.gov (United States)

    He, J; Cooper, H M; Reyes, A; Di Re, M; Sembongi, H; Litwin, T R; Gao, J; Neuman, K C; Fearnley, I M; Spinazzola, A; Walker, J E; Holt, I J

    2012-07-01

    Mitochondrial ribosomes and translation factors co-purify with mitochondrial nucleoids of human cells, based on affinity protein purification of tagged mitochondrial DNA binding proteins. Among the most frequently identified proteins were ATAD3 and prohibitin, which have been identified previously as nucleoid components, using a variety of methods. Both proteins are demonstrated to be required for mitochondrial protein synthesis in human cultured cells, and the major binding partner of ATAD3 is the mitochondrial ribosome. Altered ATAD3 expression also perturbs mtDNA maintenance and replication. These findings suggest an intimate association between nucleoids and the machinery of protein synthesis in mitochondria. ATAD3 and prohibitin are tightly associated with the mitochondrial membranes and so we propose that they support nucleic acid complexes at the inner membrane of the mitochondrion.

  10. Powering Up Mitochondrial Functions to Treat Mitochondrial Disease

    Science.gov (United States)

    2017-10-01

    Philadelphia, PA. “Listen to your heart” *05/2017 Keystone Symposia—Mitochondria, Metabolism and Heart. Santa Fe, NM. “A heart-derived hormone that...ND6P25L combination was associated with impaired mitochondrial complex I activity, altered mitochondrial morphology, increased reactive oxygen species ...oxygen species production, sensitization of the mitochondrial permeability transition pore, increased somatic mtDNA mutation levels, and shortened

  11. Cancer: Mitochondrial Origins

    OpenAIRE

    Stefano, George B.; Kream, Richard M.

    2015-01-01

    The primacy of glucose derived from photosynthesis as an existential source of chemical energy across plant and animal phyla is universally accepted as a core principle in the biological sciences. In mammalian cells, initial processing of glucose to triose phosphate intermediates takes place within the cytosolic glycolytic pathway and terminates with temporal transport of reducing equivalents derived from pyruvate metabolism by membrane-associated respiratory complexes in the mitochondrial ma...

  12. Analyzing temozolomide medication errors: potentially fatal.

    Science.gov (United States)

    Letarte, Nathalie; Gabay, Michael P; Bressler, Linda R; Long, Katie E; Stachnik, Joan M; Villano, J Lee

    2014-10-01

    The EORTC-NCIC regimen for glioblastoma requires different dosing of temozolomide (TMZ) during radiation and maintenance therapy. This complexity is exacerbated by the availability of multiple TMZ capsule strengths. TMZ is an alkylating agent and the major toxicity of this class is dose-related myelosuppression. Inadvertent overdose can be fatal. The websites of the Institute for Safe Medication Practices (ISMP), and the Food and Drug Administration (FDA) MedWatch database were reviewed. We searched the MedWatch database for adverse events associated with TMZ and obtained all reports including hematologic toxicity submitted from 1st November 1997 to 30th May 2012. The ISMP describes errors with TMZ resulting from the positioning of information on the label of the commercial product. The strength and quantity of capsules on the label were in close proximity to each other, and this has been changed by the manufacturer. MedWatch identified 45 medication errors. Patient errors were the most common, accounting for 21 or 47% of errors, followed by dispensing errors, which accounted for 13 or 29%. Seven reports or 16% were errors in the prescribing of TMZ. Reported outcomes ranged from reversible hematological adverse events (13%), to hospitalization for other adverse events (13%) or death (18%). Four error reports lacked detail and could not be categorized. Although the FDA issued a warning in 2003 regarding fatal medication errors and the product label warns of overdosing, errors in TMZ dosing occur for various reasons and involve both healthcare professionals and patients. Overdosing errors can be fatal.

  13. MITOCHONDRIAL BKCa CHANNEL

    Directory of Open Access Journals (Sweden)

    Enrique eBalderas

    2015-03-01

    Full Text Available Since its discovery in a glioma cell line 15 years ago, mitochondrial BKCa channel (mitoBKCa has been studied in brain cells and cardiomyocytes sharing general biophysical properties such as high K+ conductance (~300 pS, voltage-dependency and Ca2+-sensitivity. Main advances in deciphering the molecular composition of mitoBKCa have included establishing that it is encoded by the Kcnma1 gene, that a C-terminal splice insert confers mitoBKCa ability to be targeted to cardiac mitochondria, and evidence for its potential coassembly with β subunits. Notoriously, β1 subunit directly interacts with cytochrome c oxidase and mitoBKCa can be modulated by substrates of the respiratory chain. mitoBKCa channel has a central role in protecting the heart from ischemia, where pharmacological activation of the channel impacts the generation of reactive oxygen species and mitochondrial Ca2+ preventing cell death likely by impeding uncontrolled opening of the mitochondrial transition pore. Supporting this view, inhibition of mitoBKCa with Iberiotoxin, enhances cytochrome c release from glioma mitochondria. Many tantalizing questions remain. Some of them are: how is mitoBKCa coupled to the respiratory chain? Does mitoBKCa play non-conduction roles in mitochondria physiology? Which are the functional partners of mitoBKCa? What are the roles of mitoBKCa in other cell types? Answers to these questions are essential to define the impact of mitoBKCa channel in mitochondria biology and disease.

  14. Human Mitochondrial DNA Replication

    Science.gov (United States)

    Holt, Ian J.; Reyes, Aurelio

    2012-01-01

    Elucidation of the process of DNA replication in mitochondria is in its infancy. For many years, maintenance of the mitochondrial genome was regarded as greatly simplified compared to the nucleus. Mammalian mitochondria were reported to lack all DNA repair systems, to eschew DNA recombination, and to possess but a single DNA polymerase, polymerase γ. Polγ was said to replicate mitochondrial DNA exclusively via one mechanism, involving only two priming events and a handful of proteins. In this “strand-displacement model,” leading strand DNA synthesis begins at a specific site and advances approximately two-thirds of the way around the molecule before DNA synthesis is initiated on the “lagging” strand. Although the displaced strand was long-held to be coated with protein, RNA has more recently been proposed in its place. Furthermore, mitochondrial DNA molecules with all the features of products of conventional bidirectional replication have been documented, suggesting that the process and regulation of replication in mitochondria is complex, as befits a genome that is a core factor in human health and longevity. PMID:23143808

  15. Replicating animal mitochondrial DNA

    Directory of Open Access Journals (Sweden)

    Emily A. McKinney

    2013-01-01

    Full Text Available The field of mitochondrial DNA (mtDNA replication has been experiencing incredible progress in recent years, and yet little is certain about the mechanism(s used by animal cells to replicate this plasmid-like genome. The long-standing strand-displacement model of mammalian mtDNA replication (for which single-stranded DNA intermediates are a hallmark has been intensively challenged by a new set of data, which suggests that replication proceeds via coupled leading-and lagging-strand synthesis (resembling bacterial genome replication and/or via long stretches of RNA intermediates laid on the mtDNA lagging-strand (the so called RITOLS. The set of proteins required for mtDNA replication is small and includes the catalytic and accessory subunits of DNA polymerase y, the mtDNA helicase Twinkle, the mitochondrial single-stranded DNA-binding protein, and the mitochondrial RNA polymerase (which most likely functions as the mtDNA primase. Mutations in the genes coding for the first three proteins are associated with human diseases and premature aging, justifying the research interest in the genetic, biochemical and structural properties of the mtDNA replication machinery. Here we summarize these properties and discuss the current models of mtDNA replication in animal cells.

  16. Fatal poisoning among patients with drug addiction

    DEFF Research Database (Denmark)

    Simonsen, K. W.; Christoffersen, D. J.; Banner, J.

    2015-01-01

    in 2012 were included in the study. Results: A total of 188 fatal intoxications were recorded. The median age increased from 37.5 in 2007 to 41.5 in 2012. The majority were men (77%). Methadone (59%) was the main intoxicant. The decrease in the frequency of heroin/morphine deaths since 1997 (71......%) continued, declining to 44% in 2002, 33% in 2007 and finally to 27% in 2012. Few deaths from central stimulants (amphetamine and cocaine) occurred. Multiple drug use was common and consisted mainly of opioids, cocaine, amphetamine, cannabis, benzodiazepines and alcohol. Heroin/morphine use was most frequent...

  17. Fatal poisoning among patients with drug addiction

    DEFF Research Database (Denmark)

    Simonsen, Kirsten Wiese; Christoffersen, Dorte J; Banner, Jytte

    2015-01-01

    in 2012 were included in the study. RESULTS: A total of 188 fatal intoxications were recorded. The median age increased from 37.5 in 2007 to 41.5 in 2012. The majority were men (77%). Methadone (59%) was the main intoxicant. The decrease in the frequency of heroin/morphine deaths since 1997 (71......%) continued, declining to 44% in 2002, 33% in 2007 and finally to 27% in 2012. Few deaths from central stimulants (amphetamine and cocaine) occurred. Multiple drug use was common and consisted mainly of opioids, cocaine, amphetamine, cannabis, benzodiazepines and alcohol. Heroin/morphine use was most frequent...

  18. Fatality as a Feature of Medical Care

    Directory of Open Access Journals (Sweden)

    Ruiz-Sada Pablo

    2016-12-01

    Full Text Available Taking advantage of an interesting clinical scenario, we want to introduce a discussion about fatality in our daily practice and the need to accept that. An 80 year-old man with non-traumatic spontaneous bleeding tendency came to the clinics. Although being on warfarin as a consequence of primary thrombotic prophylaxis due to an atrial fibrillation, full assessment was performed. Not only the rare entity found on him, but also the severe complication that happened afterwards challenged clinicians and led them to risky treatment options.

  19. [Fatal outcome after overdosage with antidepressants].

    Science.gov (United States)

    Gude, Martin Faurholdt; Jensen, Lisbet Tokkesdal; Bjerre-Kristensen, Lars

    2014-02-10

    Serotonin syndrome (SS) is a complication after overdosage with antidepressants. SS increases the level of circulating serotonin. Fatal outcome of SS is most often seen in cases where there has been an overdosage with selective serotonin reuptake inhibitors (SSRI)/selective noradrenaline reuptake inhibitors (SNRI) in combination with other serotonin increasing drugs. This case report describes the rapid development of symptoms in a 54-year-old man who ingested a total amount of 6.5 g of SSRI and SNRI drugs as the only drug types. It proves the importance of being aware of the symptoms of SS when the patient is first seen in the emergency department.

  20. [Fatal female genital mutilation in a 10-year-old girl].

    Science.gov (United States)

    Sow, A; Diagne, G; Keita, Y; Sow, O; Ndiath, A; Ouattara, A; Sarr, M-L; Sylla, A; Moreira, C

    2017-10-01

    Female genital mutilation (FGM) comprises all procedures involving partial or total removal of the external genitalia and/or any other procedures affecting the female genitalia, for cultural or religious reasons or for nontherapeutic purposes in general. FGM is responsible for a number of short-, medium-, and long-term complications that can engage the vital and functional prognosis, especially in African countries. We report on a case in a 10-year-old girl who underwent genital mutilation, a traditional type of total excision during the neonatal period. She was followed for urethral meatus stenosis, which then was complicated by obstructive chronic kidney failure and urinary sepsis, whose progression was fatal. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  1. Mitochondrial functionality in female reproduction

    Directory of Open Access Journals (Sweden)

    Łukasz Gąsior

    2017-01-01

    Full Text Available In most animal species female germ cells are the source of mitochondrial genome for the whole body of individuals. As a source of mitochondrial DNA for future generations the mitochondria in the female germ line undergo dynamic quantitative and qualitative changes. In addition to maintaining the intact template of mitochondrial genome from one generation to another, mitochondrial role in oocytes is much more complex and pleiotropic. The quality of mitochondria determines the ability of meiotic divisions, fertilization ability, and activation after fertilization or sustaining development of a new embryo. The presence of normal number of functional mitochondria is also crucial for proper implantation and pregnancy maintaining. This article addresses issues of mitochondrial role and function in mammalian oocyte and presents new approaches in studies of mitochondrial function in female germ cells.

  2. Molecular basis for mitochondrial signaling

    CERN Document Server

    2017-01-01

    This book covers recent advances in the study of structure, function, and regulation of metabolite, protein and ion translocating channels, and transporters in mitochondria. A wide array of cutting-edge methods are covered, ranging from electrophysiology and cell biology to bioinformatics, as well as structural, systems, and computational biology. At last, the molecular identity of two important channels in the mitochondrial inner membrane, the mitochondrial calcium uniporter and the mitochondrial permeability transition pore have been established. After years of work on the physiology and structure of VDAC channels in the mitochondrial outer membrane, there have been multiple discoveries on VDAC permeation and regulation by cytosolic proteins. Recent breakthroughs in structural studies of the mitochondrial cholesterol translocator reveal a set of novel unexpected features and provide essential clues for defining therapeutic strategies. Molecular Basis for Mitochondrial Signaling covers these and many more re...

  3. Diffuse neonatal gastric infarction

    International Nuclear Information System (INIS)

    Johnson, J.F.; Woisard, K.K.; Cooper, G.L.

    1988-01-01

    Diffuse neonatal gastric infarction can be a devastating complication of invasion of the gastric wall and vessels by fungi colonizing the gastric mucosa. Even in the presence of extensive transmural necrosis, however, the radiographs do not necessarily show evidence of gastric mucosal abnormality. Instead, plain films and positive contrast studies may erroneously suggest a mechanical gastric outlet obstruction. Ancillary evidence of a devitalized viscus in a baby who appears to have complete gastric outlet obstruction should suggest the diagnosis of gastric infarction. (orig.)

  4. Diffuse neonatal gastric infarction

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, J.F.; Woisard, K.K.; Cooper, G.L.

    1988-02-01

    Diffuse neonatal gastric infarction can be a devastating complication of invasion of the gastric wall and vessels by fungi colonizing the gastric mucosa. Even in the presence of extensive transmural necrosis, however, the radiographs do not necessarily show evidence of gastric mucosal abnormality. Instead, plain films and positive contrast studies may erroneously suggest a mechanical gastric outlet obstruction. Ancillary evidence of a devitalized viscus in a baby who appears to have complete gastric outlet obstruction should suggest the diagnosis of gastric infarction.

  5. Vaccines for women to prevent neonatal tetanus.

    Science.gov (United States)

    Demicheli, Vittorio; Barale, Antonella; Rivetti, Alessandro

    2013-05-31

    Tetanus is an acute, often fatal, disease caused by an exotoxin produced by Clostridium tetani. It occurs in newborn infants born to mothers who do not have sufficient circulating antibodies to protect the infant passively, by transplacental transfer. Prevention may be possible by the vaccination of pregnant or non-pregnant women, or both, with tetanus toxoid, and the provision of clean delivery services. Tetanus toxoid consists of a formaldehyde-treated toxin which stimulates the production of antitoxin. To assess the effectiveness of tetanus toxoid, administered to women of childbearing age or pregnant women, to prevent cases of, and deaths from, neonatal tetanus. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2012), The Cochrane Library (2012, Issue 10), PubMed (1966 to 31 October 2012), EMBASE (1974 to 31 October 2012). We also used the results from handsearching and consultations with manufacturers and authors. Randomised or quasi-randomised trials evaluating the effects of tetanus toxoid in pregnant women or women of childbearing age on numbers of neonatal tetanus cases and deaths. Three review authors independently assessed trials for inclusion and trial quality, and extracted data. Two trials (10,560 infants) were included. It should be noted that these trials are very old,1966 and 1980 respectively, and one trial randomised exclusively non-pregnant women. The main outcomes were measured on infants born to a subset of those randomised women who became pregnant during the course of the studies. One study (1919 infants) assessed the effectiveness of tetanus toxoid in comparison with influenza vaccine in preventing neonatal tetanus deaths. After a single dose, the risk ratio (RR) was 0.57 (95% confidence interval (CI) 0.26 to 1.24), and the vaccine effectiveness was 43%. With a two- or three-dose course, the RR was 0.02 (95% CI 0.00 to 0.30); vaccine effectiveness was 98%. No effect was detected on causes of death other

  6. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

    Holm, Kristina Garne; Brødsgaard, Anne; Zachariassen, Gitte

    2016-01-01

    BACKGROUND: For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home...... visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. OBJECTIVE: To identify parental needs when wanting to provide neonatal home care supported by telemedicine. METHODS: The study used...... participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care...

  7. Mitochondrial Genetics and Cancer

    Directory of Open Access Journals (Sweden)

    Safarina G. Malik

    2017-02-01

    Full Text Available The first modern human, the Mitochondrial Eve, was traced back to Africa about 200,000 years ago, based on the variation in the mitochondrial DNA (mtDNA. An eruption of a super volcano, Mount Toba, in Sumatra 70,000 years ago may have led to a 'nuclear winter', followed by a 1,000-year ice age. This cold snap would have made life difficult; genetic evidence indicated a sharp reduction in population size around this time, reaching approximately 10,000 individuals. Once the climate started to improve, our ancestors recovered from this near-extinction event. The population expanded, and some courageous explorers ventured beyond Africa. Around 50,000 years ago some of these brave ancestors had successfully crossed the globe to South East Asia and Australia. Some of them settled in the Indonesian archipelago, forming the first settlement of prehistoric Indonesia. The second migration happened around 10,000 years ago, where a group of hunter-gatherers followed the now-submerged river systems that once ran from mainland Asia between the modern islands of Sumatera, Java, and Borneo. Then, around 4,000 years ago the third group of ancestors arrived. This agricultural community brought along their culture of pottery, plant cultivation, and animal domestication, co-inciding with the vast spread of Austronesian languages. Therefore, it is likely that the Indonesian archipelago hosts a wide range of linguistic, ethnic and genetic diversity.1 Nowadays, the modern Indonesia is home to around 700 ethnic populations, each with distinct cultural and linguistic characteristics, representing vast genome diversity. Our ancestors’ decision to embark on a sea travel and take on its related lifestyle has influenced the development of susceptibility and resistance to various diseases observed today. During the prolonged travel, our ancestors were subjected to changes in global climate and geographic dynamic, which strongly influenced and shaped the genetic background

  8. Fatal rhabdomyolysis after torture by reverse hanging.

    Science.gov (United States)

    Pollanen, Michael S

    2016-06-01

    Reverse hanging (also known as Palestinian hanging) is a form of positional torture where the victim is suspended for a prolonged period of time by the wrists, after the wrists are bound at the back. We report the first autopsy case of reverse hanging. We have discovered that fatal myoglobinuric renal failure due to rhabdomyolysis can be a complication of Palestinian hanging. An adult detainee, who underwent interrogation by authorities, was admitted to hospital from a prison and died in hospital after a few days. Death was due to myoglobinuric renal failure. An autopsy was performed. At autopsy, the body showed anasarca due to renal failure. There were healing ligature marks on the wrist and forearm, but no blunt impact injury to the shoulders or arms. There was extensive necrosis of the pectoralis major, biceps, and deltoid muscles, organizing hemoarthrosis of the right glenohumeral joint and hemorrhage into the joint capsule of the both glenohumeral joints. The kidneys showed evidence of myoglobin deposition grossly. The overstretching of the major muscles of the shoulder, in response to the prolonged Palestinian hanging, gave rise to the muscle necrosis. This case underscores the importance of conducting autopsies on people who die in custody, particularly if detained at times of political instability when torture may be practiced by state actors and others. This case also reveals that fatal rhabdomyolysis can occur by positional torture in a stress position, despite the absence of direct trauma due to blunt impacts.

  9. Novelty helmet use and motorcycle rider fatality.

    Science.gov (United States)

    Rice, Thomas M; Troszak, Lara; Erhardt, Taryn; Trent, Roger B; Zhu, Motao

    2017-06-01

    To compare the risk of fatal injury across helmet types among collision-involved motorcyclists. We used data from a cohort of motorcyclists involved in police-reported traffic collisions. Eighty-four law enforcement agencies in California collected detailed information on helmet and rider characteristics during collision investigations in June 2012 through July 2013. Multiply-adjusted risk ratios were estimated with log-binomial regression. The adjusted fatal injury risk ratio for novelty helmets was 1.95 (95% CI 1.11-3.40, p 0.019), comparing novelty helmets with full-face helmets. The risk ratios for modular, open-face, and half-helmets, compared with full-face helmets, were not significant. A more complete understanding of the inadequacy of novelty helmets can be used in educational and law enforcement countermeasures to improve helmet use among motorcycling populations in California and other US states. Law enforcement approaches to mitigating novelty helmet use would seem attractive given that novelty helmets can be visually identified by law enforcement officers with sufficient training. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Fatal hydrogen sulphide poisoning in unconfined spaces.

    Science.gov (United States)

    Nogué, S; Pou, R; Fernández, J; Sanz-Gallén, P

    2011-05-01

    Fatal hydrogen sulphide poisoning usually occurs in confined spaces. We report two fatal accidents in unconfined spaces. The first accident caused the death of three workers who entered an unconfined room in a silo of sludge at the same time that a truck dumped several tons of sludge from water purification stations. The hydrogen sulphide that had accumulated inside the silo spilled out into the interior of the room due to a 'splashing effect' caused by the impact of the dumped sludge. The second accident occurred when the foreman of a wastewater treatment plant entered one of the substations to perform routine checks and suddenly lost consciousness. Although he was rapidly transferred to an intensive care unit, death occurred a few hours later. Hydrogen sulphide production was, in this case, due to an 'embolism effect' produced by the displacement of wastewater when the substation pumps were activated. We suggest ways in which accidents such as these caused by sudden release of hydrogen sulphide can be prevented.

  11. Deletions of the mitochondrial genome.

    Science.gov (United States)

    Harding, A E; Hammans, S R

    1992-01-01

    Single large deletions of mitochondrial DNA are found in the muscle of about 40% of patients with mitochondrial myopathies, and are detectable in both blood and muscle in Pearson syndrome. In mitochondrial myopathies, there is a close association between the presence of deletions and involvement of extra-ocular muscles, together with other features of the Kearns-Sayre syndrome. Deletions appear to arise as fresh mutations in the vast majority of patients and are often flanked by direct repeats up to 13 nucleotides in length. They should affect translation of all mitochondrially encoded components of the respiratory chain, but there is evidence to suggest that intramitochondrial complementation occurs in some cases.

  12. Neonatal severe bacterial infection impairment estimates in South Asia, sub-Saharan Africa, and Latin America for 2010.

    Science.gov (United States)

    Seale, Anna C; Blencowe, Hannah; Zaidi, Anita; Ganatra, Hammad; Syed, Sana; Engmann, Cyril; Newton, Charles R; Vergnano, Stefania; Stoll, Barbara J; Cousens, Simon N; Lawn, Joy E

    2013-12-01

    Survivors of neonatal infections are at risk of neurodevelopmental impairment (NDI), a burden not previously systematically quantified and yet important for program priority setting. Systematic reviews and meta-analyses were undertaken and applied in a three-step compartmental model to estimate NDI cases after severe neonatal bacterial infection in South Asia, sub-Saharan Africa, and Latin America in neonates of >32 wk gestation (or >1,500 g). We estimated cases of sepsis, meningitis, pneumonia, or no severe bacterial infection from among estimated cases of possible severe bacterial infection ((pSBI) step 1). We applied respective case fatality risks ((CFRs) step 2) and the NDI risk among survivors (step 3). For neonatal tetanus, incidence estimates were based on the estimated deaths, CFRs, and risk of subsequent NDI. For 2010, we estimated 1.7 million (uncertainty range: 1.1-2.4 million) cases of neonatal sepsis, 200,000 (21,000-350,000) cases of meningitis, 510,000 cases (150,000-930,000) of pneumonia, and 79,000 cases (70,000-930,000) of tetanus in neonates >32 wk gestation (or >1,500 g). Among the survivors, we estimated moderate to severe NDI after neonatal meningitis in 23% (95% confidence interval: 19-26%) of survivors, 18,000 (2,700-35,000) cases, and after neonatal tetanus in 16% (6-27%), 4,700 cases (1,700-8,900). Data are lacking for impairment after neonatal sepsis and pneumonia, especially among those of >32 wk gestation. Improved recognition and treatment of pSBI will reduce neonatal mortality. Lack of follow-up data for survivors of severe bacterial infections, particularly sepsis, was striking. Given the high incidence of sepsis, even minor NDI would be of major public health importance. Prevention of neonatal infection, improved case management, and support for children with NDI are all important strategies, currently receiving limited policy attention.

  13. Neonatal cystic fibrosis screening test

    Science.gov (United States)

    Cystic fibrosis screening - neonatal; Immunoreactive trypsinogen; IRT test; CF - screening ... Cystic fibrosis is a disease passed down through families. CF causes thick, sticky mucus to build up in ...

  14. Clinical practice: neonatal resuscitation. A Dutch consensus

    NARCIS (Netherlands)

    van den Dungen, F.A.M.; van Veenendaal, M.B.; Mulder, A.L.M.

    2010-01-01

    The updated Dutch guidelines on Neonatal Resuscitation assimilate the latest evidence in neonatal resuscitation. Important changes with regard to the 2004 guidelines and controversial issues concerning neonatal resuscitation are reviewed, and recommendations for daily practice are provided and

  15. Liberal diagnosis and treatment of intrauterine infection reduces early-onset neonatal group B streptococcal infection but not sepsis by other pathogens

    NARCIS (Netherlands)

    Wolf, H.; Schaap, A. H.; Smit, B. J.; Spanjaard, L.; Adriaanse, A. H.

    2000-01-01

    OBJECTIVE: Comparison of the incidence and case fatality of early-onset group B streptococcus sepsis and sepsis caused by other pathogens in neonates after change of management of intrauterine infection. METHODS: All infants delivered from 1988 through 1997 at a gestational age > or = 24 weeks with

  16. Pearson syndrome and mitochondrial encephalomyopathy in a patient with a deletion of mtDNA.

    OpenAIRE

    McShane, M A; Hammans, S R; Sweeney, M; Holt, I J; Beattie, T J; Brett, E M; Harding, A E

    1991-01-01

    A patient is described who has features of Pearson syndrome and who presented in the neonatal period with a hypoplastic anemia. He later developed hepatic, renal, and exocrine pancreatic dysfunction. At the age of 5 years he developed visual impairment, tremor, ataxia, proximal muscle weakness, external ophthalmoplegia, and a pigmentary retinopathy (Kearns-Sayre syndrome). Muscle biopsy confirmed the diagnosis of mitochondrial myopathy. Analysis of mtDNA from leukocytes and muscle showed mtDN...

  17. Biochemical, clinical and molecular findings in LCHAD and general mitochondrial trifunctional protein deficiency

    DEFF Research Database (Denmark)

    Olpin, S E; Clark, S; Andresen, B S

    2005-01-01

    General mitochondrial trifunctional protein (TFP) deficiency leads to a wide clinical spectrum of disease ranging from severe neonatal/infantile cardiomyopathy and early death to mild chronic progressive sensorimotor poly-neuropathy with episodic rhabdomyolysis. Isolated long-chain 3-hydroxyacyl...... major presenting feature but usually later accompanied by episodic rhabdomyolysis, is a manifestation of mild TFP protein deficiency. The mild clinical presentation and relative difficulty in diagnosis suggest that this form of TFP is probably underdiagnosed....

  18. An analysis of 332 fatalities infected with pandemic 2009 influenza A (H1N1 in Argentina.

    Directory of Open Access Journals (Sweden)

    Ana M Balanzat

    Full Text Available The apparent high number of deaths in Argentina during the 2009 pandemic led to concern that the influenza A H1N1pdm disease was different there. We report the characteristics and risk factors for influenza A H1N1pdm fatalities.We identified laboratory-confirmed influenza A H1N1pdm fatalities occurring during June-July 2009. Physicians abstracted data on age, sex, time of onset of illness, medical history, clinical presentation at admission, laboratory, treatment, and outcomes using standardize questionnaires. We explored the characteristics of fatalities according to their age and risk group.Of 332 influenza A H1N1pdm fatalities, 226 (68% were among persons aged <50 years. Acute respiratory failure was the leading cause of death. Of all cases, 249 (75% had at least one comorbidity as defined by Advisory Committee on Immunization Practices. Obesity was reported in 32% with data and chronic pulmonary disease in 28%. Among the 40 deaths in children aged <5 years, chronic pulmonary disease (42% and neonatal pathologies (35% were the most common co-morbidities. Twenty (6% fatalities were among pregnant or postpartum women of which only 47% had diagnosed co-morbidities. Only 13% of patients received antiviral treatment within 48 hours of symptom onset. None of children aged <5 years or the pregnant women received antivirals within 48 h of symptom onset. As the pandemic progressed, the time from symptom-onset to medical care and to antiviral treatment decreased significantly among case-patients who subsequently died (p<0.001.Persons with co-morbidities, pregnant and who received antivirals late were over-represented among influenza A H1N1pdm deaths in Argentina, though timeliness of antiviral treatment improved during the pandemic.

  19. 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.

  20. Neonatal respiratory distress in a reference neonatal unit in ...

    African Journals Online (AJOL)

    Acute fetal distress, elective caesarean delivery, APGAR score < 7 at the 1st minute, prematurity, male gender and macrosomia were independent predictors of NRD. The main etiologies were neonatal infections (31%) and transient tachypnea of the newborn (25%). Its neonatal mortality rate was 24.5%, mainly associated ...

  1. Inheritance of the yeast mitochondrial genome

    DEFF Research Database (Denmark)

    Piskur, Jure

    1994-01-01

    Mitochondrion, extrachromosomal genetics, intergenic sequences, genome size, mitochondrial DNA, petite mutation, yeast......Mitochondrion, extrachromosomal genetics, intergenic sequences, genome size, mitochondrial DNA, petite mutation, yeast...

  2. Phenotypic expression of mitochondrial genotypes in cultured skin fibroblasts and in Epstein-Barr virus-transformed lymphocytes in Pearson syndrome.

    Science.gov (United States)

    Rötig, A; Bourgeron, T; Rustin, P; Munnich, A

    1995-01-01

    Pearson syndrome is a fatal disorder involving the hematopoietic system and exocrine pancreas. Mitochondrial respiratory chain deficiencies and/or rearrangements of the mitochondrial DNA were consistently observed in all patients. We report here on the variant phenotypic expression of mitochondrial genotypes in cultured cells from a patient with Pearson syndrome. Skin fibroblasts and lymphocytes harbored, respectively, 60% and 80% of deleted mtDNA molecules initially and displayed defective respiratory chain activities. In both cases, there was a progressive recovery of respiratory chain activities during in vitro cell proliferation due to the loss of deleted mtDNA molecules in cultured skin fibroblasts and to an increase in the mtRNA translation efficiency in Epstein-Barr virus-transformed lymphocytes. The present study suggests that various cellular responses to abnormal mitochondrial genotypes might contribute to the tissue-specific expression of mitochondrial disorders in vivo.

  3. Biochemical diagnosis of mitochondrial disorders

    NARCIS (Netherlands)

    Rodenburg, R.J.T.

    2011-01-01

    Establishing a diagnosis in patients with a suspected mitochondrial disorder is often a challenge. Both knowledge of the clinical spectrum of mitochondrial disorders and the number of identified disease-causing molecular genetic defects are continuously expanding. The diagnostic examination of

  4. Muscle regeneration in mitochondrial myopathies

    DEFF Research Database (Denmark)

    Krag, T O; Hauerslev, S; Jeppesen, T D

    2013-01-01

    myopathies. We investigated regeneration in muscle biopsies from 61 genetically well-defined patients affected by mitochondrial myopathy. Our results show that the perturbed energy metabolism in mitochondrial myopathies causes ongoing muscle regeneration in a majority of patients, and some were even affected...

  5. [An autopsy case of fatal nicotine poisoning].

    Science.gov (United States)

    Takayasu, T; Ohshima, T; Lin, Z; Nishigami, J; Nakaya, T; Maeda, H; Tanaka, N

    1992-10-01

    A fatal case of nicotine poisoning is reported in which a 44-year-old female committed suicide in a short time by taking orally the eluate from tobacco. External examination showed no abnormal findings except for markedly dark red-purple postmortem lividity, and internal examination demonstrated no pathological changes but the signs of sudden death. Through the toxicological investigation by GC and GC-MS, however, nicotine was detected in the solution which she had taken orally and in the blood, urine and the contents of the stomach and small intestine. The nicotine concentrations of the blood, urine and contents of stomach and small intestine were 6.3 micrograms/ml, 1.5 micrograms/ml, 30 micrograms/ml and 71 micrograms/g respectively, and enough to be lethal.

  6. When attempts at robbing prey turn fatal

    Science.gov (United States)

    Dejean, Alain; Corbara, Bruno; Azémar, Frédéric; Carpenter, James M.

    2012-07-01

    Because group-hunting arboreal ants spread-eagle insect prey for a long time before retrieving them, these prey can be coveted by predatory flying insects. Yet, attempting to rob these prey is risky if the ant species is also an effective predator. Here, we show that trying to rob prey from Azteca andreae workers is a fatal error as 268 out of 276 potential cleptobionts (97.1 %) were captured in turn. The ant workers hunt in a group and use the "Velcro®" principle to cling firmly to the leaves of their host tree, permitting them to capture very large prey. Exceptions were one social wasp, plus some Trigona spp. workers and flies that landed directly on the prey and were able to take off immediately when attacked. We conclude that in this situation, previously captured prey attract potential cleptobionts that are captured in turn in most of the cases.

  7. Fatal primary meningoencephalitis caused by Naegleria fowleri.

    Science.gov (United States)

    Shariq, Ali; Afridi, Faisal Iqbal; Farooqi, Badar Jahan; Ahmed, Sumaira; Hussain, Arif

    2014-07-01

    Naegleria fowleri is a free living parasite which habitats in fresh water reservoirs. It causes a fatal nervous system infection known as primary amoebic meningoencephalitis by invading through cribriform plate of nose and gaining entry into brain. We report a case of primary amoebic meningoencephalitis caused by Naegleria fowleri in Karachi, Pakistan, in a 42 years old male poultry farm worker having no history of swimming. Clinical course was fulminant and death occurred within one week of hospital admission. Naegleria fowleri was detected by wet mount technique in the sample of cerebrospinal fluid collected by lumbar puncture of patient. This is a serious problem and requires immediate steps to prevent general population to get affected by this lethal neurological infection.

  8. Shopping cart injuries, entrapment, and childhood fatality.

    Science.gov (United States)

    Jensen, Lisbeth; Charlwood, Cheryl; Byard, Roger W

    2008-09-01

    Shopping carts may be associated with a variety of injuries, particularly in toddlers and young children. These usually relate to falls from carts or to tip-overs. Injuries that are sustained include hematomas/contusions, abrasions, lacerations, fractures, and fingertip amputations. Fatal episodes are uncommon and are usually due to blunt craniocerebral trauma from falls. A case involving a 19-month-old girl is reported who became entrapped when she inserted her head through the side frame of a cart that had been removed from a supermarket and left at her home address. Death was caused by neck compression. Although rare, the potential for lethal entrapment during unsupervised play means that the presence of stray shopping carts at private residences and in public places, including playgrounds and parks, is of concern. Strategies, such as coin deposits, should be encouraged to assist in the return of such carts to supermarkets.

  9. Fatal exit the automotive black box debate

    CERN Document Server

    Kowalick, Tom

    2005-01-01

    "Fatal Exit: The Automotive Black Box Debate cuts through thirty years of political wrangling and institutional biases to provide an argument for the Motor Vehicle Event Data Recorder (MVEDR). This automotive equivalent of an airplane's flight recorder or black box is intended to solve the mysteries of car crashes and improve the safety of our roads. The reader is taken inside the automotive industry and the government highway safety establishment to foster an understanding of the politics and the positions on all sides of this safety debate. The author takes an unbiased approach, chronologically presenting each argument and uncovering the agendas and mandates of each of the stakeholders." "This publication is essential reading for all consumers who need to have their voices heard on this critical issue, as well as for attorneys, public safety advocates, public policy administrators, engineers, automotive professionals, journalists, and insurance executives."--Jacket.

  10. The metabolic effects of fatal cyanide poisoning.

    Science.gov (United States)

    Singh, B. M.; Coles, N.; Lewis, P.; Braithwaite, R. A.; Nattrass, M.; FitzGerald, M. G.

    1989-01-01

    Metabolic and toxicological data were obtained during the first 24 hours following severe and eventually fatal cyanide poisoning. Initial blood cyanide concentrations were 804 mumol/l but fell rapidly over 24 hours following cobalt edetate therapy to 15 mumol/l. However, plasma thiocyanate concentrations rose over 24 hours (147-267 mumol/l) suggesting continued tissue detoxification. The major metabolic abnormality was lactic acidosis (initial pH 7.21, blood lactate 17.5 mmol/l) which corrected over 12 hours. Despite high circulating insulin concentrations the responses of blood glucose, plasma non-esterified fatty acid, blood glycerol and 3-hydroxybutyrate suggested marked insulin resistance. PMID:2616434

  11. Chronic fatal pneumocystosis in nude mice.

    Science.gov (United States)

    Ueda, K; Goto, Y; Yamazaki, S; Fujiwara, K

    1977-12-01

    A chronic pulmonary disease was encountered in nude mice of a barrier sustained colony, and Pneumocystis carinii was identified as the causative agent histopathologically as well as on impression smear preparations in the affected lungs. Fatal infection was seen only in old nude mice aged more than 6 months, while focal pulmonary lesions were developed without clinical signs in young adult nudes 2 to 3 months of age. The lesions produced in aged nude mice were characterized by propagation of mononuclear cells with the presence of foamy masses of P. carinii. Heterozygous littermates were much less susceptible to the infection but pneumocystic lesions could be produced readily by multiple treatment with immunosuppressants. The infection could be transmitted without immunosuppressant to non-infected nudes but not to heterozygous littermates after intranasal inoculation of affected tissue emulsion or by cage mating with severely affected nudes.

  12. Two fatal tiger attacks in zoos.

    Science.gov (United States)

    Tantius, Britta; Wittschieber, Daniel; Schmidt, Sven; Rothschild, Markus A; Banaschak, Sibylle

    2016-01-01

    Two captive tiger attacks are presented that took place in Cologne and Münster zoos. Both attacks occurred when the handlers, intent on cleaning the enclosures, entered whilst the tigers accidently retained access to the location, and thus defended their territory against the perceived intruders. Both victims suffered fatal neck injuries from the bites. At Münster, colleagues managed to lure the tiger away from its victim to enable treatment, whilst the Cologne zoo tiger had to be shot in order to allow access to be gained. Whilst it was judged that human error led to the deaths of the experienced zookeepers, the investigation in Münster was closed as no third party was found to be at fault, whereas the Cologne zoo director was initially charged with being negligent. These charges were subsequently dismissed as safety regulations were found to be up to date.

  13. Fatal Colloid Cysts: A Systematic Review.

    Science.gov (United States)

    Lagman, Carlito; Rai, Kanwaldeep; Chung, Lawrance K; Nagasawa, Daniel T; Beckett, Joel S; Tucker, Alexander M; Yang, Isaac

    2017-11-01

    To accurately describe patient characteristics and the clinical presentation of fatal colloid cysts. A systematic literature search of 3 popular databases was performed. Inclusion criteria were individuals with sudden-onset death and colloid cysts identified on imaging and/or autopsy. The cause of death must have been ascribed to the colloid cyst to be eligible for data extraction. Deaths precipitated by lumbar puncture were excluded. Clinical data were extracted and descriptive statistics were ascertained. Subgroup analyses were performed to compare adults with pediatric patients. A total of 107 patients were included in the quantitative synthesis. The mean age was 28.5 years (standard deviation 13.3, range 6-79 years). Male and female patients were affected equally. Headache was the most frequent symptom (n = 86, 80%). There were 6 patients (5 adults and 1 child) who reported positional headaches. The mean duration of signs and symptoms was shorter in adults versus pediatric patients (2.1 days vs. 6.5 days, P = 0.02), and more adults presented with signs and symptoms for less than 24 hours than did pediatric patients (38% vs. 6%, P = 0.01). Colloid cyst mean diameter was 2.0 cm (standard deviation 1.1, range 0.5-7.9 cm) and 96% measured 1 cm or larger. Our data suggests that the prodrome preceding sudden death in the setting of a colloid cyst may be shorter in adults. Also, most fatal colloid cysts measured 1 cm or larger. Copyright © 2017. Published by Elsevier Inc.

  14. Feeding premature neonate

    DEFF Research Database (Denmark)

    Dam, Mie S.; Juhl, Sandra M.; Sangild, Per T.

    2017-01-01

    a novel milk diet (bovine colostrum) to model the effects of this new diet in premature infants. Our ethnographic fieldwork in an experimental pig laboratory and a neonatal intensive care unit (NICU) in 2013–2014 shows that regardless of biogenetics, daily practices of feeding, housing, and clinical care...... parents may perceive the animality of bovine colostrum, and the background information obtained in piglets, as a threat to the infants' connection to their biological parents as well as the larger human collective. Our study argues that the ‘species flexibility’ of premature beings profoundly shapes...

  15. Fetal and Neonatal Arrhythmias.

    Science.gov (United States)

    Jaeggi, Edgar; Öhman, Annika

    2016-03-01

    Cardiac arrhythmias are an important aspect of fetal and neonatal medicine. Premature complexes of atrial or ventricular origin are the main cause of an irregular heart rhythm. The finding is typically unrelated to an identifiable cause and no treatment is required. Tachyarrhythmia most commonly relates to supraventricular reentrant tachycardia, atrial flutter, and sinus tachycardia. Several antiarrhythmic agents are available for the perinatal treatment of tachyarrhythmias. Enduring bradycardia may result from sinus node dysfunction, complete heart block and nonconducted atrial bigeminy as the main arrhythmia mechanisms. The management and outcome of bradycardia depend on the underlying mechanism. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Cost of neonatal care.

    OpenAIRE

    Ryan, S; Sics, A; Congdon, P

    1988-01-01

    A six month evaluation of the costs of a regional neonatal medical and surgical unit was carried out. The total cost for six months was pounds 970,000 and this covered 4349 inpatient days and 282 admissions. For medical cases the cost ranged from pounds 132 to pounds 27,600 and the mean daily cost for different weight groups ranged from pounds 159 to pounds 274. The average daily cost for regional patients at pounds 258 was greater than for district patients who cost pounds 199. Altogether 23...

  17. Neonatal opioid withdrawal syndrome.

    Science.gov (United States)

    Sutter, Mary Beth; Leeman, Lawrence; Hsi, Andrew

    2014-06-01

    Neonatal opioid withdrawal syndrome is common due to the current opioid addiction epidemic. Infants born to women covertly abusing prescription opioids may not be identified as at risk until withdrawal signs present. Buprenorphine is a newer treatment for maternal opioid addiction and appears to result in a milder withdrawal syndrome than methadone. Initial treatment is with nonpharmacological measures including decreasing stimuli, however pharmacological treatment is commonly required. Opioid monotherapy is preferred, with phenobarbital or clonidine uncommonly needed as adjunctive therapy. Rooming-in and breastfeeding may decease the severity of withdrawal. Limited evidence is available regarding long-term effects of perinatal opioid exposure. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Fatal work injuries involving natural disasters, 1992-2006.

    Science.gov (United States)

    Fayard, Gregory M

    2009-12-01

    Although a goal of disaster preparedness is to protect vulnerable populations from hazards, little research has explored the types of risks that workers face in their encounters with natural disasters. This study examines how workers are fatally injured in severe natural events. A classification structure was created that identified the physical component of the disaster that led to the death and the pursuit of the worker as it relates to the disaster. Data on natural disasters from the Census of Fatal Occupational Injuries for the years 1992 through 2006 were analyzed. A total of 307 natural disaster deaths to workers were identified in 1992-2006. Most fatal occupational injuries were related to wildfires (80 fatalities), hurricanes (72 fatalities), and floods (62 fatalities). Compared with fatal occupational injuries in general, natural disaster fatalities involved more workers who were white and more workers who were working for the government. Most wildfire fatalities stemmed directly from exposure to fire and gases and occurred to those engaged in firefighting, whereas hurricane fatalities tended to occur more independently of disaster-produced hazards and to workers engaged in cleanup and reconstruction. Those deaths related to the 2005 hurricanes occurred a median of 36.5 days after landfall of the associated storm. Nearly half of the flood deaths occurred to passengers in motor vehicles. Other disasters included tornadoes (33 fatalities), landslides (17), avalanches (16), ice storms (14), and blizzards (9). Despite an increasing social emphasis on disaster preparation and response, there has been little increase in expert knowledge about how people actually perish in these large-scale events. Using a 2-way classification structure, this study identifies areas of emphasis in preventing occupational deaths from various natural disasters.

  19. Intraoperative fluid therapy in neonates

    African Journals Online (AJOL)

    The evidence base for the administration of intraoperative fluids in neonates is poor and extrapolated from adults and children. Differences from adults and children in physiology and anatomy of neonates inform our practice. Keywords: fluid ..... compromise lung function and wound healing. The EGL develops early in ...

  20. Neonatal Tetanus: A Continuing Menace

    African Journals Online (AJOL)

    Alasia Datonye

    WHO/EPI/GEN/86/7 REVE 1 (ENGLISH). 27. UNICEF. Neonatal tetanus: protecting mothers and children. The State of World's Children 1994: 10. 28. WHO. EPI: Disease incidence and immunization coverage (Saudi Arabia). Weekly Epidem. Record. 1986;. 61(7): 45-46. 29. WHO. EPI. Neonatal tetanus mortality surveys.

  1. Colorful story of phototherapy for neonatal jaundice

    Science.gov (United States)

    Agati, Giovanni; Fusi, Franco; Pratesi, Riccardo; Pratesi, Simone; Donzelli, Gian Paolo

    1996-12-01

    Colors have always attracted our fantasy and imagination. Medicine, like many other human activities, did not escape their attraction, sometimes with fatal consequences. The scientific literature, magazines, etc. are full of reports on the beneficial, miraculous effects of colors. Even nowadays, where photobiology and photomedicine have been put on very firm bases, chromopaths are still at work. The evolution of light therapy from chromotherapy to photomedicine is presented in brief, with the aim of contributing to the action against the unscientific behavior of researchers and clinicians who support biological and/or clinical results without serious and well documented work. Colors have played an important role in the phototherapy of neonatal jaundice. It is an interesting example of how even a rigorous scientific search for the optimal color has progressed in part by change, due to the lack of an action spectrum, too hurried extrapolations of animal results to man, unsuspected dynamical behavior of bilirubin molecules, etc. The story of its evolution up to present knowledge is reported in this paper.

  2. Endocrine disorders in mitochondrial disease.

    Science.gov (United States)

    Schaefer, Andrew M; Walker, Mark; Turnbull, Douglass M; Taylor, Robert W

    2013-10-15

    Endocrine dysfunction in mitochondrial disease is commonplace, but predominantly restricted to disease of the endocrine pancreas resulting in diabetes mellitus. Other endocrine manifestations occur, but are relatively rare by comparison. In mitochondrial disease, neuromuscular symptoms often dominate the clinical phenotype, but it is of paramount importance to appreciate the multi-system nature of the disease, of which endocrine dysfunction may be a part. The numerous phenotypes attributable to pathogenic mutations in both the mitochondrial (mtDNA) and nuclear DNA creates a complex and heterogeneous catalogue of disease which can be difficult to navigate for novices and experts alike. In this article we provide an overview of the endocrine disorders associated with mitochondrial disease, the way in which the underlying mitochondrial disorder influences the clinical presentation, and how these factors influence subsequent management. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  3. Animal Mitochondrial DNA Replication

    Science.gov (United States)

    Ciesielski, Grzegorz L.; Oliveira, Marcos T.; Kaguni, Laurie S.

    2016-01-01

    Recent advances in the field of mitochondrial DNA (mtDNA) replication highlight the diversity of both the mechanisms utilized and the structural and functional organization of the proteins at mtDNA replication fork, despite the simplicity of the animal mtDNA genome. DNA polymerase γ, mtDNA helicase and mitochondrial single-stranded DNA-binding protein- the key replisome proteins, have evolved distinct structural features and biochemical properties. These appear to be correlated with mtDNA genomic features in different metazoan taxa and with their modes of DNA replication, although a substantial integrative research is warranted to establish firmly these links. To date, several modes of mtDNA replication have been described for animals: rolling circle, theta, strand-displacement, and RITOLS/bootlace. Resolution of a continuing controversy relevant to mtDNA replication in mammals/vertebrates will have a direct impact on the mechanistic interpretation of mtDNA-related human diseases. Here we review these subjects, integrating earlier and recent data to provide a perspective on the major challenges for future research. PMID:27241933

  4. Interpretation of neonatal chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye Kyung [Dept. of Radiology, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2016-05-15

    Plain radiographs for infants in the neonatal intensive care unit are obtained using the portable X-ray equipment in order to evaluate the neonatal lungs and also to check the position of the tubes and catheters used for monitoring critically-ill neonates. Neonatal respiratory distress is caused by a variety of medical or surgical disease conditions. Clinical information about the gestational week, respiratory symptoms, and any events during delivery is essential for interpretation of the neonatal chest radiographs. Awareness of common chest abnormality in the prematurely born or term babies is also very important for chest evaluation in the newborn. Furthermore, knowledge about complications such as air leaks and bronchopulmonary dysplasia following treatment are required to accurately inform the clinicians. The purpose of this article was to briefly review radiographic findings of chest diseases in newborns that are relatively common in daily practice.

  5. Interpretation of neonatal chest radiography

    International Nuclear Information System (INIS)

    Yoon, Hye Kyung

    2016-01-01

    Plain radiographs for infants in the neonatal intensive care unit are obtained using the portable X-ray equipment in order to evaluate the neonatal lungs and also to check the position of the tubes and catheters used for monitoring critically-ill neonates. Neonatal respiratory distress is caused by a variety of medical or surgical disease conditions. Clinical information about the gestational week, respiratory symptoms, and any events during delivery is essential for interpretation of the neonatal chest radiographs. Awareness of common chest abnormality in the prematurely born or term babies is also very important for chest evaluation in the newborn. Furthermore, knowledge about complications such as air leaks and bronchopulmonary dysplasia following treatment are required to accurately inform the clinicians. The purpose of this article was to briefly review radiographic findings of chest diseases in newborns that are relatively common in daily practice

  6. Fluorescence assay for mitochondrial permeability transition in cardiomyocytes cultured in a microtiter plate

    DEFF Research Database (Denmark)

    Christensen, Marie Louise Muff; Braunstein, Thomas Hartig; Treiman, Marek

    2008-01-01

    Mitochondrial permeability transition pore (MPTP) is a voltage-dependent, large-conductance channel of the inner mitochondrial membrane with an important role in a range of pathophysiological conditions. To facilitate studies of pharmacological pore modulation, we describe an assay in a model using...... neonatal cardiomyocytes in a 96-well microtiter plate format. In the presence of mitochondrial membrane potential Delta Psi m, accumulation of rhodamine-123 in mitochondria (40,000 cells/well, 2.6 microM rhodamine-123) caused fluorescence signal quenching. Following substitution of dye-free buffer......, dequenching occurred on the distribution of rhodamine-123 into the extracellular volume. The addition of a small buffer volume containing digitonin (final concentration 10 microg/ml) and Ca(2+) (final concentrations up to 100 microM free Ca(2+)) caused dequenching (Delta F) due to Delta Psi m dissipation...

  7. Melatonin: A Mitochondrial Targeting Molecule Involving Mitochondrial Protection and Dynamics

    Science.gov (United States)

    Tan, Dun-Xian; Manchester, Lucien C.; Qin, Lilan; Reiter, Russel J.

    2016-01-01

    Melatonin has been speculated to be mainly synthesized by mitochondria. This speculation is supported by the recent discovery that aralkylamine N-acetyltransferase/serotonin N-acetyltransferase (AANAT/SNAT) is localized in mitochondria of oocytes and the isolated mitochondria generate melatonin. We have also speculated that melatonin is a mitochondria-targeted antioxidant. It accumulates in mitochondria with high concentration against a concentration gradient. This is probably achieved by an active transportation via mitochondrial melatonin transporter(s). Melatonin protects mitochondria by scavenging reactive oxygen species (ROS), inhibiting the mitochondrial permeability transition pore (MPTP), and activating uncoupling proteins (UCPs). Thus, melatonin maintains the optimal mitochondrial membrane potential and preserves mitochondrial functions. In addition, mitochondrial biogenesis and dynamics is also regulated by melatonin. In most cases, melatonin reduces mitochondrial fission and elevates their fusion. Mitochondrial dynamics exhibit an oscillatory pattern which matches the melatonin circadian secretory rhythm in pinealeocytes and probably in other cells. Recently, melatonin has been found to promote mitophagy and improve homeostasis of mitochondria. PMID:27999288

  8. Heavy vehicle driver fatalities: learning's from fatal road crash investigations in Victoria.

    Science.gov (United States)

    Brodie, Lisa; Lyndal, Bugeja; Elias, Ibrahim Joseph

    2009-05-01

    This study describes the nature and extent of fatal heavy vehicle driver crashes in Victoria between 1999 and 2007 and the factors associated with the crash. A descriptive study was conducted comprising the population of heavy vehicle drivers killed in a road transport crash while operating a vehicle of > or =4.5 tonne Gross Vehicle Mass (GVM) for the purposes of work. Information about the nature of crash, environmental, driver, vehicle and occupational factors were collected from the coroner's death investigation file. Of the 91 deaths identified 61 were eligible for review. All 61 cases were male, solo drivers with a mean age of 44.7 years. Most vehicles were articulated in configuration. One-third of crash scenarios involved a single vehicle leaving the roadway on a straight road. One in every six fatally injured drivers was detected with the presence of stimulants or cannabis. Twenty-two drivers were travelling at excessive or inappropriate speeds for the circumstances. Seatbelt wearing status was documented for only 25 of 61 drivers. This study is the first to comprehensively examine a population of fatally injured heavy vehicle drivers using coroner's investigation files and these findings are consistent with previous, less detailed, Australian research. Information about potential associations between occupational factors and crash risk was limited. Improving driver safety requires incorporation of occupational factors into a standardised approach to heavy vehicle crash investigations.

  9. Has the great recession and its aftermath reduced traffic fatalities?

    Science.gov (United States)

    Noland, Robert B; Zhou, Yuhan

    2017-01-01

    An analysis of state-level data from 1984 to 2014 provides evidence on the relationship between economic recessions and US traffic fatalities. While there are large reductions associated with decreases in household median income, other policy variables tend to have additional and in some cases, larger effects. An increase in the inequality of the income distribution, measured by the Gini index, has reduced traffic fatalities. Graduated licensing policies, cell phone laws, and motorcycle helmet requirements are all associated with reductions in fatalities. Other factors include a proxy for medical technology, and access to emergency medical services (based on the percent of vehicle miles traveled in rural areas); reductions in the latter accounted for a substantial reduction in fatalities and is likely another indicator of reduced economic activity. Changes in the road network, mainly increases in the percent of collector roads has increased fatalities. Population growth is associated with increased traffic fatalities and changes in age cohorts has a small negative effect. Overall, results suggest that there has been a beneficial impact on traffic fatalities from reduced economic activity, but various policies adopted by the states have also reduced traffic fatalities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. A fatal case of Babesia divergens infection in Northwestern Spain.

    Science.gov (United States)

    Asensi, Víctor; González, Luis Miguel; Fernández-Suárez, Jonathan; Sevilla, Elena; Navascués, Rafael Álvarez; Suárez, María Luisa; Lauret, María Eugenia; Bernardo, Angel; Carton, José Antonio; Montero, Estrella

    2018-02-21

    We describe a fatal case caused by the intra-erythrocytic Babesia divergens parasite in an elderly woman. This is the third case of fatal babesiosis reported in the last 15 years in Europe, and the only one in a patient with an intact spleen. Copyright © 2018 Elsevier GmbH. All rights reserved.

  11. Danish diving-related fatalities 1999-2012

    DEFF Research Database (Denmark)

    Vinkel, Julie; Bak, Peter; Hyldegaard, Ole

    2016-01-01

    AIM: The purpose was to explore causative tendencies among diving fatalities to prevent similar injuries in the future. METHODS: We report 33 fatal diving injuries that occurred among Danish divers during the period 1999-2012 in Scandinavian waters. The study was performed as a retrospective...

  12. Influence of Appalachian Fatalism on Adolescent Identity Processes

    Science.gov (United States)

    Phillips, Tommy M.

    2007-01-01

    The influences of the fatalism frequently associated with Appalachian culture on adolescent identity processes were explored. The sample consisted of 91 Appalachian adolescents and 87 non-Appalachian adolescents. Participants completed measures of fatalism (operationalized in terms of higher hopelessness and lower optimism/efficacy scores) and…

  13. Bordetella bronchiseptica and fatal pneumonia of dogs and cats

    Science.gov (United States)

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

  14. Fatal Child Maltreatment in England, 2005-2009

    Science.gov (United States)

    Sidebotham, Peter; Bailey, Sue; Belderson, Pippa; Brandon, Marian

    2011-01-01

    Objective: This paper presents comprehensive and up-to-date data covering 4 years of Serious Case Reviews into fatal child maltreatment in England. Methods: Information on all notified cases of fatal maltreatment between April 2005 and March 2009 was examined to obtain case characteristics related to a systemic classification of 5 broad groups of…

  15. A population based study of unintentional firearm fatalities

    OpenAIRE

    Cherry, D; Runyan, C; Butts, J

    2001-01-01

    Objectives—To describe the circumstances of fatal unintentional firearm injuries in a statewide population in a region of the United States with high firearm fatality rates and to compare to similar data from an earlier period in the same state.

  16. A high burden of late-onset sepsis among newborns admitted to the largest neonatal unit in central Vietnam.

    Science.gov (United States)

    Tran, H T; Doyle, L W; Lee, K J; Dang, N M; Graham, S M

    2015-10-01

    The objective of this study is to determine the prevalence, causes and outcome of sepsis in hospitalized neonates in the largest neonatal unit in central Vietnam. A 1-year prospective cohort study of newborns admitted to the neonatal unit in Da Nang. A sepsis work-up including blood culture was undertaken before commencing antibiotics for neonates with suspected sepsis. Of 2555 neonatal admissions, 616 neonates had 729 episodes of suspected invasive sepsis. A pathogen was isolated from blood in 115 (16%) episodes in 106 neonates. The prevalence of early-onset sepsis (EOS) was 8 (95% confidence interval (CI): 4 to 11) per 1000 admissions, and of late-onset sepsis (LOS) was 34 (95% CI: 27 to 41) per 1000 admissions. Of 86 neonates with LOS, 69 (80%) also fulfilled the criteria for nosocomial sepsis. The commonest bacterial causes of EOS were coagulase-negative Staphylococcus (CoNS) and Staphylococcus aureus, and of LOS were Acinetobacter, CoNS and Klebsiella pneumoniae. Fungal sepsis occurred in 35 neonates of which most were nosocomial sepsis. In vitro resistance to multiple antibiotics was common among Gram-negative bacteria. Antibiotics were prescribed and given to 68% of all admissions, and 14% of all admissions received four or more different antibiotics. The case fatality rate for confirmed sepsis was 46%. Late-onset, nosocomial sepsis was common and associated with a high mortality in hospitalized newborns in the largest neonatal unit in central Vietnam. These findings highlighted the need for improved infection control measures and antibiotic stewardship, which have since been implemented.

  17. Neonatal gastrointestinal imaging

    International Nuclear Information System (INIS)

    Rao, Padma

    2006-01-01

    Radiological imaging is an important part of the evaluation and management of neonates with suspected anomalies of the gastrointestinal tract. Clinical presentation is often non-specific, commonly with abdominal distension and vomiting for which the underlying cause may or may not be clinically apparent. In a proportion of patients, the clinical assessment alone may suffice in providing the diagnosis and no further imaging is necessary. The reader must have an understanding of the normal radiographic appearances of the gastrointestinal tract in neonates and appreciate normal variants and differences to adults. In certain cases, the abdominal radiograph alone is diagnostic. In others, sonography and contrast studies are useful adjunct investigations and the indications for CT and MRI are few, but specific. Appropriate radiological investigation will help to establish the diagnosis and guide surgical intervention whilst also avoiding unnecessary radiation. Some of the conditions require transfer to specialist paediatric institutions for care. Thus, in some circumstances it is appropriate for imaging to be delayed and performed at the specialist centre with early referral often essential for the continued well being of the child

  18. Neonatal status of twins

    Directory of Open Access Journals (Sweden)

    Božinović Dragica

    2012-01-01

    Full Text Available Multiple pregnancy is a pregnancy where more than one fetus develops simultaneously in the womb, as a result of the ovulation and fertilization of more than one egg. It is relatively rare in humans and represents the rest of the phylogenetic stages. The most common are twins and they indicate the development of two fetuses in the womb. The frequency of twin pregnancies is about 1%. Multiple pregnancies belong to a group of high-risk pregnancies because of the many complications that occur during the pregnancy: higher number of premature deliveries, bleeding, early neonatal complications and higher perinatal morbidity and mortality. Such pregnancies and infants require greater supervision and monitoring. The aim of this study was to determine the percentage of baby twins born at the maternity ward of the General Hospital in Prokuplje and their morbidity and mortality. Data on the total number of deliveries, number of twins, parity and maternal age, gestational age, body weight of twins, method of delivery, Apgar score and perinatal mortality were collected and statistically analyzed by means of retrospective analysis of operative birth and neonatal protocol for 6 years (2005 of 2010. Out of 4527 mothers who gave birth 43 were pairs of twins, or 0.95% of women gave birth to twins. These babies are more likely born by Caesarean section, but delivered with slightly lower birth weight.

  19. Fatal poisonings in Oslo: a one-year observational study

    Directory of Open Access Journals (Sweden)

    Heyerdahl Fridtjof

    2010-06-01

    Full Text Available Abstract Background Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Methods Fatal and non-fatal acute poisonings in subjects aged ≥16 years in Oslo (428 198 inhabitants were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic, and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. Results In Oslo, during the one-year period studied, 103 subjects aged ≥16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years. In 92 cases (89%, death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases, followed by ethanol (9%, tricyclic anti-depressants (TCAs (4%, benzodiazepines (4%, and zopiclone (4%. Seventy-one (69% were evaluated as accidental deaths and 32 (31% as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04. Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91, 14% (95% C.I., 0.04-0.33, and 10% (95% C.I., 0.02-0.27, respectively. Conclusions Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental

  20. Fatal poisonings in Oslo: a one-year observational study.

    Science.gov (United States)

    Bjornaas, Mari A; Teige, Brita; Hovda, Knut E; Ekeberg, Oivind; Heyerdahl, Fridtjof; Jacobsen, Dag

    2010-06-06

    Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Fatal and non-fatal acute poisonings in subjects aged > or =16 years in Oslo (428 198 inhabitants) were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic), and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. In Oslo, during the one-year period studied, 103 subjects aged > or =16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years). In 92 cases (89%), death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases), followed by ethanol (9%), tricyclic anti-depressants (TCAs) (4%), benzodiazepines (4%), and zopiclone (4%). Seventy-one (69%) were evaluated as accidental deaths and 32 (31%) as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04). Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91), 14% (95% C.I., 0.04-0.33), and 10% (95% C.I., 0.02-0.27), respectively. Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental deaths. Although case fatality rates were

  1. Fatal occupational accidents in Danish fishing vessels 1989-2005

    DEFF Research Database (Denmark)

    Laursen, Lise Hedegaard; Hansen, Henrik L; Jensen, Olaf

    2008-01-01

    The purpose of the study was to study the circumstances and incidence rates of fatal accidents in inspection obligated and non-inspection obligated Danish fishing vessels to identify areas for prevention. Information about the fatalities came from maritime authority reports, including vessel...... disaster reports, post mortem reports, maritime inquiries and police reports. The person- and vessel years at risk came from the Danish Directorate of Fisheries. During the period 1989-2005, 114 fatalities occurred. Sixty-one of the fatalities occurred in 36 vessel disasters mainly caused by foundering...... in foreign ports and alcohol intoxication. In the period 1995-2005, the overall incidence rate was 10 per 10,000 fishermen per year with no down-going trend during that period. The fatal accident rates are still too high, despite the efforts to reduce the risk. Increased focus on regular and repeated safety...

  2. NAD(+)-dependent activation of Sirt1 corrects the phenotype in a mouse model of mitochondrial disease.

    Science.gov (United States)

    Cerutti, Raffaele; Pirinen, Eija; Lamperti, Costanza; Marchet, Silvia; Sauve, Anthony A; Li, Wei; Leoni, Valerio; Schon, Eric A; Dantzer, Françoise; Auwerx, Johan; Viscomi, Carlo; Zeviani, Massimo

    2014-06-03

    Mitochondrial disorders are highly heterogeneous conditions characterized by defects of the mitochondrial respiratory chain. Pharmacological activation of mitochondrial biogenesis has been proposed as an effective means to correct the biochemical defects and ameliorate the clinical phenotype in these severely disabling, often fatal, disorders. Pathways related to mitochondrial biogenesis are targets of Sirtuin1, a NAD(+)-dependent protein deacetylase. As NAD(+) boosts the activity of Sirtuin1 and other sirtuins, intracellular levels of NAD(+) play a key role in the homeostatic control of mitochondrial function by the metabolic status of the cell. We show here that supplementation with nicotinamide riboside, a natural NAD(+) precursor, or reduction of NAD(+) consumption by inhibiting the poly(ADP-ribose) polymerases, leads to marked improvement of the respiratory chain defect and exercise intolerance of the Sco2 knockout/knockin mouse, a mitochondrial disease model characterized by impaired cytochrome c oxidase biogenesis. This strategy is potentially translatable into therapy of mitochondrial disorders in humans. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Fatal train accidents on Europe's railways: 1980-2009.

    Science.gov (United States)

    Evans, Andrew W

    2011-01-01

    This paper presents an analysis of fatal train accident rates and trends on Europe's main line railways from 1980 to 2009. The paper uses a new set of data for the European Union together with Norway and Switzerland, assembled partly under the auspices of the European Railway Agency and partly on the author's own account. The estimated overall trend in the number of fatal train collisions and derailments per train-kilometre is -6.3% per year from 1990 to 2009, with a 95% confidence interval of -8.7% to -3.9%. The estimated accident rate in 2009 is 1.35 fatal collisions or derailments per billion train-kilometres, giving an estimated mean number of fatal accidents in 2009 of 6.0. The overall number of fatalities per fatal accident in 1990-2009 is 4.10, with no apparent long term change over time, giving an estimated mean of 24.6 fatalities per year in train collisions and derailments in 2009. There are statistically significant differences in the fatal train accident rates and trends between the different European countries, although the estimates of the rates and trends for many individual countries have wide confidence limits. The distribution of broad causes of accidents appears to have remained unchanged over the long term, so that safety improvements appear to have been across the board, and not focused on any specific cause. The most frequent cause of fatal train collisions and derailments is signals passed at danger. In contrast to fatal train collisions and derailments, the rate per train-kilometre of serious accidents at level crossings remained unchanged in 1990-2009. The immediate causes of most of the serious level crossing accidents are errors or violations by road users. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. Desmin common mutation is associated with multi-systemic disease manifestations and depletion of mitochondria and mitochondrial DNA

    Directory of Open Access Journals (Sweden)

    Elizabeth eMcCormick

    2015-06-01

    Full Text Available Desmin (DES is a major muscle scaffolding protein that also functions to anchor mitochondria. Pathogenic DES mutations, however, have not previously been recognized as a cause of multi-systemic mitochondrial disease. Here, we describe a 45-year-old man who presented to The Children’s Hospital of Philadelphia Mitochondrial-Genetics Diagnostic Clinic for evaluation of progressive cardiac, neuromuscular, gastrointestinal, and mood disorders. Muscle biopsy at age 45 was remarkable for cytoplasmic bodies, as well as ragged red fibers and SDH positive/COX negative fibers that were suggestive of a mitochondrial myopathy. Muscle also showed significant reductions in mitochondrial content (16% of control mean for citrate synthase activity and mitochondrial DNA (35% of control mean. His family history was significant for cardiac conduction defects and myopathy in multiple maternal relatives. Multiple single gene and panel-based sequencing studies were unrevealing. Whole exome sequencing identified a known pathogenic p.S13F mutation in DES that had previously been associated with desmin-related myopathy. Desmin-related myopathy is an autosomal dominant disorder characterized by right ventricular hypertrophic cardiomyopathy, myopathy, and arrhythmias. However, neuropathy, gastrointestinal dysfunction, and depletion of both mitochondria and mitochondrial DNA have not previously been widely recognized in this disorder. Recognition that mitochondrial dysfunction occurs in desmin-related myopathy clarifies the basis for the multi-systemic manifestations, as are typical of primary mitochondrial disorders. Understanding the mitochondrial pathophysiology of desmin-related myopathy highlights the possibility of new therapies for the otherwise untreatable and often fatal class of disease. We postulate that drug treatments aimed at improving mitochondrial biogenesis or reducing oxidative stress may be effective therapies to ameliorate the effects of desmin

  5. Neonatal Mortality of Inborns in the Neonatal Unit of a Tertiary ...

    African Journals Online (AJOL)

    The neonatal deaths comprised of 120 early neonatal deaths and 39 late neonatal deaths. The yearly neonatal mortality rate showed a steady decline except for 1999 during which there was a slight rise. The incidence of neonatal deaths decreased with age, weight at birth and maturity. Low birth weight and birth asphyxia ...

  6. Lophotrochozoan mitochondrial genomes

    Energy Technology Data Exchange (ETDEWEB)

    Valles, Yvonne; Boore, Jeffrey L.

    2005-10-01

    Progress in both molecular techniques and phylogeneticmethods has challenged many of the interpretations of traditionaltaxonomy. One example is in the recognition of the animal superphylumLophotrochozoa (annelids, mollusks, echiurans, platyhelminthes,brachiopods, and other phyla), although the relationships within thisgroup and the inclusion of some phyla remain uncertain. While much ofthis progress in phylogenetic reconstruction has been based on comparingsingle gene sequences, we are beginning to see the potential of comparinglarge-scale features of genomes, such as the relative order of genes.Even though tremendous progress is being made on the sequencedetermination of whole nuclear genomes, the dataset of choice forgenome-level characters for many animals across a broad taxonomic rangeremains mitochondrial genomes. We review here what is known aboutmitochondrial genomes of the lophotrochozoans and discuss the promisethat this dataset will enable insight into theirrelationships.

  7. Nitric oxide and mitochondrial respiration.

    Science.gov (United States)

    Brown, G C

    1999-05-05

    Nitric oxide (NO) and its derivative peroxynitrite (ONOO-) inhibit mitochondrial respiration by distinct mechanisms. Low (nanomolar) concentrations of NO specifically inhibit cytochrome oxidase in competition with oxygen, and this inhibition is fully reversible when NO is removed. Higher concentrations of NO can inhibit the other respiratory chain complexes, probably by nitrosylating or oxidising protein thiols and removing iron from the iron-sulphur centres. Peroxynitrite causes irreversible inhibition of mitochondrial respiration and damage to a variety of mitochondrial components via oxidising reactions. Thus peroxynitrite inhibits or damages mitochondrial complexes I, II, IV and V, aconitase, creatine kinase, the mitochondrial membrane, mitochondrial DNA, superoxide dismutase, and induces mitochondrial swelling, depolarisation, calcium release and permeability transition. The NO inhibition of cytochrome oxidase may be involved in the physiological regulation of respiration rate, as indicated by the finding that isolated cells producing NO can regulate cellular respiration by this means, and the finding that inhibition of NO synthase in vivo causes a stimulation of tissue and whole body oxygen consumption. The recent finding that mitochondria may contain a NO synthase and can produce significant amounts of NO to regulate their own respiration also suggests this regulation may be important for physiological regulation of energy metabolism. However, definitive evidence that NO regulation of mitochondrial respiration occurs in vivo is still missing, and interpretation is complicated by the fact that NO appears to affect tissue respiration by cGMP-dependent mechanisms. The NO inhibition of cytochrome oxidase may also be involved in the cytotoxicity of NO, and may cause increased oxygen radical production by mitochondria, which may in turn lead to the generation of peroxynitrite. Mitochondrial damage by peroxynitrite may mediate the cytotoxicity of NO, and may be

  8. Two Fatal Intoxications Involving Butyryl Fentanyl

    Science.gov (United States)

    Poklis, Justin; Poklis, Alphonse; Wolf, Carl; Hathaway, Cindie; Arbefeville, Elise; Chrostowski, Leszek; Devers, Kelly; Hair, Laura; Mainland, Mary; Merves, Michele; Pearson, Julia

    2016-01-01

    We present the case histories, autopsy findings and toxicology findings of two fatal intoxications involving the designer drug, butyryl fentanyl. The quantitative analysis of butyryl fentanyl in postmortem fluids and tissues was performed by an ultrahigh-performance liquid chromatography tandem mass spectrometry method. In the first case, butyryl fentanyl was the only drug detected with concentrations of 99 ng/mL in peripheral blood, 220 ng/mL in heart blood, 32 ng/mL in vitreous humor, 590 ng/mL in gastric contents, 93 ng/g in brain, 41 ng/g in liver, 260 ng/mL in bile and 64 ng/mL in urine. The cause of death was ruled fatal intoxication by butyryl fentanyl. In the second case, butyryl fentanyl was detected along with acetyl fentanyl, alprazolam and ethanol. The butyryl fentanyl concentrations were 3.7 ng/mL in peripheral blood, 9.2 ng/mL in heart blood, 9.8 ng/mL in vitreous humor, 4,000 ng/mL in gastric contents, 63 ng/g in brain, 39 ng/g in liver, 49 ng/mL in bile and 2 ng/mL in urine. The acetyl fentanyl concentrations were 21 ng/mL in peripheral blood, 95 ng/mL in heart blood, 68 ng/mL in vitreous humor, 28,000 ng/mL in gastric contents, 200 ng/g in brain, 160 ng/g in liver, 330 ng/mL in bile and 8 ng/mL in urine. In addition, the alprazolam concentration was 40 ng/mL and the ethanol concentration was 0.11 g/dL, both measured in peripheral blood. The cause of death in the second case was ruled a mixed drug intoxication. In both cases, the manner of death was accident. PMID:27339481

  9. Fatal toxic epidermal necrolysis associated with minoxidil.

    Science.gov (United States)

    Karaoui, Lamis R; Chahine-Chakhtoura, Corinne

    2009-04-01

    Minoxidil is a direct-acting peripheral vasodilator for the treatment of symptomatic hypertension, or refractory hypertension associated with target organ damage, that is not manageable with a diuretic and two other antihypertensive drugs. The most frequent adverse events associated with minoxidil include hypertrichosis and cardiovascular events related to its powerful antihypertensive effect, and less frequently, rashes, bullous eruptions, and Stevens-Johnson syndrome (SJS). Evidence suggests that SJS and toxic epidermal necrolysis (TEN) are variants of a single disease with common causes and mechanisms, but differing severities. Epidermal detachment is mild in SJS, moderate in overlap SJS-TEN, and severe (> 30% of body surface area) in TEN. We describe a case of minoxidil-associated SJS that evolved into fatal TEN. A 69-year-old African-American woman with a history of chronic kidney disease was admitted to the hospital for a cerebrovascular accident and uncontrolled hypertension. On hospital day 12, oral minoxidil was added to her drug regimen. On day 23, she developed a maculopapular rash on her face that gradually diffused to her chest and back. Vesicles and papular lesions extended to her extremities and mucosal membranes; results of a skin biopsy revealed SJS. A positive Nikolsky's sign (blisters spread on application of pressure) was detected. On days 27-31, diffuse bullae developed with rash exacerbation. Skin detachment exceeded 30% and was consistent with TEN. The patient died on day 39. An evaluation of the causality and time course suggested that minoxidil was the most likely culpable drug, with a Naranjo adverse drug reaction probability scale score indicating that the likelihood of the association was possible (score of 3). The mechanism of this reaction has not been well elucidated. It may be related to an impaired clearance of the minoxidil metabolite, or an immune stimulation resulting in apoptosis and epidermis destruction. To our knowledge, this

  10. Fatalities in high school and college football players.

    Science.gov (United States)

    Boden, Barry P; Breit, Ilan; Beachler, Jason A; Williams, Aaron; Mueller, Frederick O

    2013-05-01

    Fatalities in football are rare but tragic events. The purpose was to describe the causes of fatalities in high school and college football players and potentially provide preventive strategies. Descriptive epidemiology study. We reviewed the 243 football fatalities reported to the National Center for Catastrophic Sports Injury Research from July 1990 through June 2010. Football fatalities averaged 12.2 per year, or 1 per 100,000 participants. There were 164 indirect (systemic) fatalities (average, 8.2 annually [or 0.7 per 100,000 participants]) and 79 direct (traumatic) fatalities (average, 4.0 annually [or 0.3 per 100,000 participants]). Indirect fatalities were 2.1 times more common than direct fatalities. The risk of a fatality in college compared with high school football players was 2.8 (95% CI, 0.7-8.2) times higher for all fatalities, 3.6 (95% CI, 2.5-5.3) times higher for indirect events, 1.4 (95% CI, 0.6-3.0) times higher for direct injuries, 3.8 (95% CI, 1.8-8.3) times higher for heat illness, and 66 (95% CI, 14.4-308) times higher for sickle cell trait (SCT) fatalities. Most indirect events occurred in practice sessions; preseason practices and intense conditioning sessions were vulnerable periods for athletes to develop heat illness or SCT fatalities, respectively. In contrast, most brain fatalities occurred during games. The odds of a fatality during the second decade, compared with the first decade of the study, were 9.7 (95% CI, 1.2-75.9) for SCT, 1.5 (95% CI, 0.8-2.9) for heat illness, 1.1 (95% CI, 0.8-1.7) for cardiac fatalities, and 0.7 (95% CI, 0.4-1.2) for brain fatalities. The most common causes of fatalities were cardiac failure (n = 100, 41.2%), brain injury (n = 62, 25.5%), heat illness (n = 38, 15.6%), SCT (n = 11, 4.5%), asthma and commotio cordis (n = 7 each, 2.9% each), embolism/blood clot (n = 5, 2.1%), cervical fracture (n = 4, 1.7%), and intra-abdominal injury, infection, and lightning (n = 3, 1.2% each). High school and college

  11. Neonate brain disorders

    International Nuclear Information System (INIS)

    Xydis, V.

    2012-01-01

    Full text: Hypoxic-Ischemic insults in the brain of neonates constitute major cause of morbidity and mortality. A wide range of motor, sensory, and cognitive disabilities are observed in this population spanning from slight motor deficits, school difficulties and behavioral problems up to cerebral palsy and mental retardation. Pathologically involved areas characterized by high metabolic demands and therefore with enhanced vulnerability to any reduction or cessation of energy and oxygen supply. Watershed areas of the brain (vascular end zones and vascular border zones) are predominately affected in any adverse event. Radiologic and pathologic appearance of these lesions depends both on the severity of the insult and the maturity of the brain. The dominant pathology observed in preterm neonates is white matter lesions. There are three basic patterns of brain destruction in this population. Periventricular leukomalacia (PVL focal fPVL, diffuse dPVL), germinal matrix haemorrhage (GMH) associated with intraventricular haemorrhage (IVH), and parenchymal haemorrhage (PH). fPVL is characterized by focal necrosis of all cellular elements in the periventricular white matter, resulting in the formation of cysts, and dPVL is characterized by diffuse destruction of the premyelinating oligodendrocytes (pre-OLs) the precursors of mature oligodendroglia cells responsible for the formation of myelin in a later stage. GMH is located beneath germinal matrix layer surrounding the lateral ventricles and can extend into the ventricular system resulting thus to IVH. Finally, PH is located within the parenchyma adjacent to the ventricles and is believed to represent haemorrhagic infarcts following venous drainage compromise. In term or near-term neonates, the top-ographic pattern of injuries involves mainly gray matter structures. Most frequent predilection sites include the cerebral cortex (paracentral lobule, Rolandic area, visual cortex and hippocampus), basal ganglia, thalamus, and

  12. Surfactant treatment for neonatal respiratory disorders other than respiratory distress syndrome.

    Science.gov (United States)

    Alkan, Senem; Ozer, Esra Arun; Ilhan, Ozkan; Sutcuoglu, Sumer; Tatli, Mansur

    2015-01-01

    It is suggested that there may be expanded use of surfactant replacement for the neonatal diseases such as meconium aspiration syndrome (MAS), pneumonia and possibly bronchopulmonary dysplasia (BPD). To evaluate the characteristics and short-term outcome of the neonates given exogenous surfactant because of the diseases other than respiratory disease syndrome (RDS). This retrospective study included 35 neonates admitted to the neonatal intensive care unit from January 2012 to December 2012 for an expanded use of surfactant. Data related to gestational age, birth weight, gender and perinatal risk factors were obtained from the patients' records. The short-term prognosis was also noted. The diagnosis was sepsis in 16 patients, eight MAS, seven transient tachypnea of the newborns (TTN) and four BPD. Mean gestational age was 35.6 ± 4.5 weeks and mean birth weight was 2661 ± 981 g. Of overall cases, 65% were boys and 35% girls. The mortality rate was 17%. Of six fatal cases, three was with BPD, two with sepsis and one with MAS. We think that surfactant replacement may be life saver in the neonatal diseases other than RDS such as BPD, MAS and sepsis by rapidly improving oxygenation. Further investigation is necessary to validate the significance of expanded use of surfactant.

  13. Mitochondrial DNA and primary mitochondrial dysfunction in Parkinson's disease.

    Science.gov (United States)

    Giannoccaro, Maria Pia; La Morgia, Chiara; Rizzo, Giovanni; Carelli, Valerio

    2017-03-01

    In 1979, it was observed that parkinsonism could be induced by a toxin inhibiting mitochondrial respiratory complex I. This initiated the long-standing hypothesis that mitochondrial dysfunction may play a key role in the pathogenesis of Parkinson's disease (PD). This hypothesis evolved, with accumulating evidence pointing to complex I dysfunction, which could be caused by environmental or genetic factors. Attention was focused on the mitochondrial DNA, considering the occurrence of mutations, polymorphic haplogroup-specific variants, and defective mitochondrial DNA maintenance with the accumulation of multiple deletions and a reduction of copy number. Genetically determined diseases of mitochondrial DNA maintenance frequently manifest with parkinsonism, but the age-related accumulation of somatic mitochondrial DNA errors also represents a major driving mechanism for PD. Recently, the discovery of the genetic cause of rare inherited forms of PD highlighted an extremely complex homeostatic control over mitochondria, involving their dynamic fission/fusion cycle, the balancing of mitobiogenesis and mitophagy, and consequently the quality control surveillance that corrects faulty mitochondrial DNA maintenance. Many genes came into play, including the PINK1/parkin axis, but also OPA1, as pieces of the same puzzle, together with mitochondrial DNA damage, complex I deficiency and increased oxidative stress. The search for answers will drive future research to reach the understanding necessary to provide therapeutic options directed not only at limiting the clinical evolution of symptoms but also finally addressing the pathogenic mechanisms of neurodegeneration in PD. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  14. Fatalities from black powder percussion handguns.

    Science.gov (United States)

    Karger, B; Teige, K

    1998-12-21

    Three suicides and one homicide from black powder muzzle loading handguns are reported and the muzzle velocities of two weapons are recorded. The fatal head shots caused wide wound tracts traversing the brains and intracerebral haemorrhages remote from the tract were present in every case. The skulls showed considerable fractures which were pronounced in the cases of contact shots but were also present when the range of fire was 5 m. These extensive injuries from soft lead spheres with muzzle velocities of only approximately 200 m/s are attributed to the expansion of the spheres. The regularly occurring deformation resulted in 13-16 mm calibre missiles in the cases of .44 spheres. The special features of black powder such as incomplete and slow combustion resulted in intense soot deposits in the vicinity of the entrance wound and in long ranges the gunshot residues travelled. In contact shots, large pocket-like underminings even in deeper tissue layers, abundant soot along the trajectory and skin burns were observed.

  15. Retrospective study of fatal pneumonia in racehorses.

    Science.gov (United States)

    Carvallo, Francisco R; Uzal, Francisco A; Diab, Santiago S; Hill, Ashley E; Arthur, Rick M

    2017-07-01

    Respiratory diseases have a major impact on racehorses in training and are often cited as the second most common reason of horses failing to perform. Cases were submitted by the California Horse Racing Board to the California Animal Health and Food Safety laboratory for postmortem examination between January 1, 2005 and December 31, 2014. We determined the demographics of racehorses with fatal pneumonia, characterized the pathologic findings in animals with a postmortem diagnosis of respiratory infection, and determined the most significant pathogens associated with lower respiratory tract disease. We analyzed autopsy reports from 83 horses with a diagnosis of pneumonia, bronchopneumonia, and/or pleuropneumonia. The most common presentation was pleuropneumonia (71% of cases), with extensive areas of lytic necrosis and abscesses of the pulmonary parenchyma. Streptococcus equi ssp. zooepidemicus, a normal mucosal commensal of the upper respiratory tract of healthy horses, was the most commonly isolated organism (72% of cases), either in pure culture or accompanied by other aerobic or anaerobic bacteria. Its presence in the pulmonary parenchyma is associated with severe and extensive damage to the lung. Furthermore, this agent has zoonotic potential, which stresses the importance of early detection and proper management of cases of pneumonia in racehorses.

  16. Fatal toxoplasmosis in sand cats (Felis margarita).

    Science.gov (United States)

    Pas, An; Dubey, J P

    2008-09-01

    The sand cat (Felis margarita) is a small-sized felid occurring in the United Arab Emirates (UAE). The sand cat captive-breeding program at the Breeding Centre for Endangered Arabian Wildlife in Sharjah, UAE, has until recently been severely compromised by very high newborn mortality rates. Two different pairs of sand cats gave birth, respectively, to one and two litters (with a total of eight kittens) between 1999 and 2006. Seven out of eight kittens died between the third and 21st wk of life. Toxoplasmosis was confirmed as the cause of death in these two litters. Adult cats had high antibody titers to Toxoplasma gondii before pregnancy, suggesting that maternal immunity did not protect the kittens against infection with T. gondii and that maternal immunity might not have prevented transplacental transmission of the parasite. This observation contrasts with what is seen in domestic cats. To date, this is the first report on confirmed fatal toxoplasmosis and prevalence of T. gondii in sand cats.

  17. Consideraciones en tomo a "La fatal arrogancia"

    Directory of Open Access Journals (Sweden)

    Javier Fernández Aguado

    2013-11-01

    Full Text Available The author makes here an analysis of Friedrick A. Hayek's The Fatal Conceit. This thinker considers that the best political-economical system for human civilization is capitalism, which has arised in an spontaneous, evolutive and adaptative way without any intention or plan thanks to a deus ex machina. Hayek shows himself as an advocate of capitalism and as an enemy of socialism; he despises solidarity and supports egoism as the motor of economy, for, according to him, without it society would not be where it is now. Hayek imports Darwin's evolutionary theory in order to justify economy's blind and fortuitous development, which in turn explains that capitalism is reached through a series of unforeseen and spontaneous events which are overcomed thanks to adaptation. Hayek draws historicist arguments at some poins, in an invalid way, rejecting everything that looks like socialism, and he makes mistakes where philosophical concepts are dealed with. Hayek's continuous reject towards Aristotle and his political-economical thesis obeys to the fact that the author rejects the Catholic Church, which, according to him, gathered the Aristotelian thesis through saint Thomas Aquinas. Hayek proposes a selfish and capitalist moral which one ought to accept if one does not wish for hunger and poverty.

  18. [Recurrent postpartum pyoderma gangrenosum and fatal cardiomyopathy].

    Science.gov (United States)

    Naciri, I; Meziane, M; Benzekri, L; Ghaouti, M; Senouci, K; Hassam, B

    2017-12-06

    We report a case of recurrent post-partum pyoderma gangrenosum (PG) complicated by post-partum cardiomyopathy (PPCM). A 23-year-old woman presented with a previous medical history of aseptic abscess of the left breast in her fourth pregnancy, which developed after surgical drainage of an inflammatory ulceration treated by atraumatic topical care. During her fifth pregnancy, the patient presented a large and painful ulceration in relation to the scar of the Caesarean section, despite the introduction of broad-spectrum antibiotic therapy. Bacteriological samples were negative. Histological examination militated in favor of PG. One week after initiation of corticosteroid therapy, the patient suddenly showed signs of heart failure. Based on trans-thoracic echocardiography PPCM was diagnosed, and the outcome was fatal. This observation raises the question of the relationship between PG and pregnancy and describes the association of PG and PPCM. PG occurs rarely during pregnancy and it may be induced by the rise in G-CSF levels found in pregnant women. The association with PPCM seen in our patient could have been due to the development of an anti-angiogenic climate at the end of pregnancy, together with inflammatory myocardial aggression linked to the PG. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Fatal cocaine intoxication in a body packer

    Directory of Open Access Journals (Sweden)

    Brajković Gordana

    2016-01-01

    Full Text Available Introduction. ‘Body packer’ syndrome with severe intoxication or sudden death may happen in persons who smuggle drugs in their body cavities. In case of lethal outcome when carrying cocaine, it is important, but sometimes difficult to determine whether death was due to intoxication or due to other causes. Therefore, it is necessary not only to quantify cocaine and its metabolites in biological material, but also based on their distribution in body fluids and tissues to conclude whether it is acute intoxication. We described a well-documented case of fatal poisoning in a body packer and post mortem distribution of the drug in biological samples. Case report. A 26-year-old man was brought to hospital with no vital signs. Resuscitation measures started at once, but with no success. Autopsy revealed 66 packets of cocaine in his digestive tract, one of which was ruptured. Hyperemia of the most of all internal organs and pulmonary and brain edema were found. High concentrations of cocaine, its metabolites benzoylecgonine and ecgonine methyl ester, as well as cocaine adulteration levamisole were proven in the post mortem blood and tissues by liquid chromatography-mass spectrometry (LC-MC method with selective-ion monitoring. Conclusion. The ratio of cocaine and its metabolites concentrations in the brain and blood obtained by LC-MS method can be used for forensic confirmation of acute intoxication with cocaine.

  20. The neonate in distress

    International Nuclear Information System (INIS)

    Ball, T.I. Jr.

    1987-01-01

    Respiratory distress is a very common and yet non-specific symptom in neonates and young infants. It may be manifested clinically in many ways, including tachypnea, apnea, periodic respiratory, grunting, retractions, nasal flaring, and cyanosis. In many instances, the chest radiograph is diagnostic or at least suggestive of the diagnosis. This fact is important in determining surgical or medical conditions that require emergency therapy. Even if the chest film is normal, valuable information can be gained. This initial normal radiograph can be used as a baseline film in the face of further developing symptoms which, likewise, may have developing radiographic findings. In any event, the chest radiograph gives the clinician ''direction'' in his or her search for the cause of the patient's respiratory distress

  1. Neonatal Pulmonary Hemosiderosis

    Directory of Open Access Journals (Sweden)

    Boris Limme

    2014-01-01

    Full Text Available Idiopathic pulmonary hemosiderosis (IPH is a rare complex entity characterized clinically by acute or recurrent episodes of hemoptysis secondary to diffuse alveolar hemorrhage. The radiographic features are variable, including diffuse alveolar-type infiltrates, and interstitial reticular and micronodular patterns. We describe a 3-week-old infant presenting with hemoptysis and moderate respiratory distress. Idiopathic pulmonary hemosiderosis was the first working diagnosis at the Emergency Department and was confirmed, 2 weeks later, by histological studies (bronchoalveolar lavage. The immunosuppressive therapy by 1 mg/kg/d prednisone was immediately started, the baby returned home on steroid therapy at a dose of 0,5 mg/kg/d. The diagnosis of idiopathic pulmonary hemosiderosis should be evocated at any age, even in the neonate, when the clinical presentation (hemoptysis and abnormal radiological chest images is strongly suggestive.

  2. Neonatal Pulmonary Hemosiderosis

    Science.gov (United States)

    Limme, Boris; Nicolescu, Ramona; Misson, Jean-Paul

    2014-01-01

    Idiopathic pulmonary hemosiderosis (IPH) is a rare complex entity characterized clinically by acute or recurrent episodes of hemoptysis secondary to diffuse alveolar hemorrhage. The radiographic features are variable, including diffuse alveolar-type infiltrates, and interstitial reticular and micronodular patterns. We describe a 3-week-old infant presenting with hemoptysis and moderate respiratory distress. Idiopathic pulmonary hemosiderosis was the first working diagnosis at the Emergency Department and was confirmed, 2 weeks later, by histological studies (bronchoalveolar lavage). The immunosuppressive therapy by 1 mg/kg/d prednisone was immediately started, the baby returned home on steroid therapy at a dose of 0,5 mg/kg/d. The diagnosis of idiopathic pulmonary hemosiderosis should be evocated at any age, even in the neonate, when the clinical presentation (hemoptysis and abnormal radiological chest images) is strongly suggestive. PMID:25389504

  3. Community Poverty and Child Abuse Fatalities in the United States.

    Science.gov (United States)

    Farrell, Caitlin A; Fleegler, Eric W; Monuteaux, Michael C; Wilson, Celeste R; Christian, Cindy W; Lee, Lois K

    2017-05-01

    Child maltreatment remains a problem in the United States, and individual poverty is a recognized risk factor for abuse. Children in impoverished communities are at risk for negative health outcomes, but the relationship of community poverty to child abuse fatalities is not known. Our objective was to evaluate the association between county poverty concentration and rates of fatal child abuse. This was a retrospective, cross-sectional analysis of child abuse fatalities in US children 0 to 4 years of age from 1999 to 2014 by using the Centers for Disease Control and Prevention Compressed Mortality Files. Population and poverty statistics were obtained from US Census data. National child abuse fatality rates were calculated for each category of community poverty concentration. Multivariate negative binomial regression modeling assessed the relationship between county poverty concentration and child abuse fatalities. From 1999 to 2014, 11 149 children 0 to 4 years old died of child abuse; 45% (5053) were poverty concentration had >3 times the rate of child abuse fatalities compared with counties with the lowest poverty concentration (adjusted incidence rate ratio, 3.03; 95% confidence interval, 2.4-3.79). Higher county poverty concentration is associated with increased rates of child abuse fatalities. This finding should inform public health officials in targeting high-risk areas for interventions and resources. Copyright © 2017 by the American Academy of Pediatrics.

  4. Australian quad bike fatalities: what is the economic cost?

    Science.gov (United States)

    Lower, Tony; Pollock, Kirrily; Herde, Emily

    2013-04-01

    To determine the economic costs associated with all quad bike-related fatalities in Australia, 2001 to 2010. A human capital approach to establish the economic costs of quad bike related fatalities to the Australian economy. The model included estimates on loss of earnings due to premature death and direct costs based on coronial records for ambulance, police, hospital, premature funeral, coronial and work safety authority investigation, and death compensation costs. All costs were calculated to 2010 dollars. The estimated total economic cost associated with quad bike fatalities over this period was $288.1 million, with an average cost for each fatality of $2.3 million. When assessing the average cost of incidents between age cohorts, those aged 25-34 years had the lowest number of fatalities but had the highest average cost ($4.2 million). Quad bike fatalities have a significant economic impact on Australian society that is increasing. Implications : Given the high cost to society, interventions to address quad bike fatalities have the potential to be highly cost-effective. Such interventions should focus on design approaches to improve the safety of quad bikes in terms of stability and protection in the event of a rollover. Additionally, relevant policy (e.g. no children under 16 years riding quads, no passengers) and intervention approaches (e.g. training and use of helmets) must also support the design modifications. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

  5. Cancer fatalism: deterring early presentation and increasing social inequalities?

    Science.gov (United States)

    Beeken, Rebecca J; Simon, Alice E; von Wagner, Christian; Whitaker, Katriina L; Wardle, Jane

    2011-10-01

    Fatalistic beliefs about cancer have been implicated in low uptake of screening and delay in presentation particularly in low socioeconomic status (SES) groups, but no studies have systematically evaluated interrelationships between SES, fatalism, and early detection behaviors. We explored whether (i) fatalism is associated with negative attitudes toward early detection, (ii) lower SES groups are more fatalistic, and (iii) SES differences in fatalism partly explain SES differences in attitudes toward early detection. In a population-representative sample of adults in Britain using computer-based interviews in the home setting, respondents (N = 2,018) answered two questions to index fatalism (expectations of cancer survival and cure) and two items on early detection attitudes (the perceived value of early detection and fear of symptom reporting). SES was indexed with a social grade classification. Fatalism was associated with being less positive about early detection (β = -0.40, P fatalism might explain SES differences in attitudes about early detection. In this population sample, SES differences in fatalism partly explained SES differences in the perceived value of early detection and fear of symptom presentation. Fatalistic beliefs about cancer should be targeted to promote early presentation of cancer and this may be particularly important for lower SES groups. ©2011 AACR

  6. Pathological Significance of Mitochondrial Glycation

    Directory of Open Access Journals (Sweden)

    Pamela Boon Li Pun

    2012-01-01

    Full Text Available Glycation, the nonenzymatic glycosylation of biomolecules, is commonly observed in diabetes and ageing. Reactive dicarbonyl species such as methylglyoxal and glyoxal are thought to be major physiological precursors of glycation. Because these dicarbonyls tend to be formed intracellularly, the levels of advanced glycation end products on cellular proteins are higher than on extracellular ones. The formation of glycation adducts within cells can have severe functional consequences such as inhibition of protein activity and promotion of DNA mutations. Although several lines of evidence suggest that there are specific mitochondrial targets of glycation, and mitochondrial dysfunction itself has been implicated in disease and ageing, it is unclear if glycation of biomolecules specifically within mitochondria induces dysfunction and contributes to disease pathology. We discuss here the possibility that mitochondrial glycation contributes to disease, focussing on diabetes, ageing, cancer, and neurodegeneration, and highlight the current limitations in our understanding of the pathological significance of mitochondrial glycation.

  7. Control of plant mitochondrial respiration.

    NARCIS (Netherlands)

    Affourtit, C.; Krab, K.; Moore, A.L.

    2001-01-01

    Plant mitochondria are characterised by the presence of both phosphorylating (cytochrome) and non-phosphorylating (alternative) respiratory pathways, the relative activities of which directly affect the efficiency of mitochondrial energy conservation. Different approaches to study the regulation of

  8. Mitochondrial contribution to lipofuscin formation

    Directory of Open Access Journals (Sweden)

    Jeannette König

    2017-04-01

    Moreover, we observed that Lon protease downregulation is linked to a higher lipofuscinogenesis whereas the application of the mitochondrial-targeted antioxidant mitoTEMPO is able to prevent the accumulation of this protein aggregate.

  9. Nordic ski jumping fatalities in the United States: a 50-year summary.

    Science.gov (United States)

    Wright, J R

    1988-06-01

    Nordic ski-jumping fatalities are rare events. Six jumping fatalities have occurred in the United States during the past 50 years. The fatality rate for nordic ski jumping, estimated to be roughly 12 fatalities/100,000 participants annually, appears to be within the range of fatality rates for other "risky" outdoor sports. Cervical fractures appear to be the most frequent fatal ski-jumping injury.

  10. Mitochondrial Metabolism in Aging Heart

    OpenAIRE

    Lesnefsky, Edward J.; Chen, Qun; Hoppel, Charles L.

    2016-01-01

    Altered mitochondrial metabolism is the underlying basis for the increased sensitivity in the aged heart to stress. The aged heart exhibits impaired metabolic flexibility, with a decreased capacity to oxidize fatty acids and enhanced dependence on glucose metabolism. Aging impairs mitochondrial oxidative phosphorylation, with a greater role played by the mitochondria located between the myofibrils, the interfibrillar mitochondria. With aging, there is a decrease in activity of complexes III a...

  11. Mitochondrial dysfunction and organophosphorus compounds

    International Nuclear Information System (INIS)

    Karami-Mohajeri, Somayyeh; Abdollahi, Mohammad

    2013-01-01

    Organophosphorous (OPs) pesticides are the most widely used pesticides in the agriculture and home. However, many acute or chronic poisoning reports about OPs have been published in the recent years. Mitochondria as a site of cellular oxygen consumption and energy production can be a target for OPs poisoning as a non-cholinergic mechanism of toxicity of OPs. In the present review, we have reviewed and criticized all the evidences about the mitochondrial dysfunctions as a mechanism of toxicity of OPs. For this purpose, all biochemical, molecular, and morphological data were retrieved from various studies. Some toxicities of OPs are arisen from dysfunction of mitochondrial oxidative phosphorylation through alteration of complexes I, II, III, IV and V activities and disruption of mitochondrial membrane. Reductions of adenosine triphosphate (ATP) synthesis or induction of its hydrolysis can impair the cellular energy. The OPs disrupt cellular and mitochondrial antioxidant defense, reactive oxygen species generation, and calcium uptake and promote oxidative and genotoxic damage triggering cell death via cytochrome C released from mitochondria and consequent activation of caspases. The mitochondrial dysfunction induced by OPs can be restored by use of antioxidants such as vitamin E and C, alpha-tocopherol, electron donors, and through increasing the cytosolic ATP level. However, to elucidate many aspect of mitochondrial toxicity of Ops, further studies should be performed. - Highlights: • As a non-cholinergic mechanism of toxicity, mitochondria is a target for OPs. • OPs affect action of complexes I, II, III, IV and V in the mitochondria. • OPs reduce mitochondrial ATP. • OPs promote oxidative and genotoxic damage via release of cytochrome C from mitochondria. • OP-induced mitochondrial dysfunction can be restored by increasing the cytosolic ATP

  12. Mitochondrial dysfunction and organophosphorus compounds

    Energy Technology Data Exchange (ETDEWEB)

    Karami-Mohajeri, Somayyeh [Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Kerman University of Medical Sciences, Kerman (Iran, Islamic Republic of); Abdollahi, Mohammad, E-mail: Mohammad.Abdollahi@UToronto.Ca [Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of)

    2013-07-01

    Organophosphorous (OPs) pesticides are the most widely used pesticides in the agriculture and home. However, many acute or chronic poisoning reports about OPs have been published in the recent years. Mitochondria as a site of cellular oxygen consumption and energy production can be a target for OPs poisoning as a non-cholinergic mechanism of toxicity of OPs. In the present review, we have reviewed and criticized all the evidences about the mitochondrial dysfunctions as a mechanism of toxicity of OPs. For this purpose, all biochemical, molecular, and morphological data were retrieved from various studies. Some toxicities of OPs are arisen from dysfunction of mitochondrial oxidative phosphorylation through alteration of complexes I, II, III, IV and V activities and disruption of mitochondrial membrane. Reductions of adenosine triphosphate (ATP) synthesis or induction of its hydrolysis can impair the cellular energy. The OPs disrupt cellular and mitochondrial antioxidant defense, reactive oxygen species generation, and calcium uptake and promote oxidative and genotoxic damage triggering cell death via cytochrome C released from mitochondria and consequent activation of caspases. The mitochondrial dysfunction induced by OPs can be restored by use of antioxidants such as vitamin E and C, alpha-tocopherol, electron donors, and through increasing the cytosolic ATP level. However, to elucidate many aspect of mitochondrial toxicity of Ops, further studies should be performed. - Highlights: • As a non-cholinergic mechanism of toxicity, mitochondria is a target for OPs. • OPs affect action of complexes I, II, III, IV and V in the mitochondria. • OPs reduce mitochondrial ATP. • OPs promote oxidative and genotoxic damage via release of cytochrome C from mitochondria. • OP-induced mitochondrial dysfunction can be restored by increasing the cytosolic ATP.

  13. Mitochondrial PKA mediates sperm motility.

    Science.gov (United States)

    Mizrahi, Rashel; Breitbart, Haim

    2014-12-01

    Mitochondria are the major source of ATP to power sperm motility. Phosphorylation of mitochondrial proteins has been proposed as a major regulatory mechanism for mitochondrial bioenergetics. Sperm motility was measured by a computer-assisted analyzer, protein detection by western blotting, membrane potential by tetramethylrhodamine, cellular ATP by luciferase assay and localization of PKA by immuno-electron microscopy. Bicarbonate is essential for the creation of mitochondrial electro-chemical gradient, ATP synthesis and sperm motility. Bicarbonate stimulates PKA-dependent phosphorylation of two 60kDa proteins identified as Tektin and glucose-6-phosphate isomerase. This phosphorylation was inhibited by respiration inhibition and phosphorylation could be restored by glucose in the presence of bicarbonate. However, this effect of glucose cannot be seen when the mitochondrial ATP/ADP exchanger was inhibited indicating that glycolytic-produced ATP is transported into the mitochondria and allows PKA-dependent protein phosphorylation inside the mitochondria. Bicarbonate activates mitochondrial soluble adenylyl cyclase (sAC) which catalyzes cAMP production leading to the activation of mitochondrial PKA. Glucose can overcome the lack of ATP in the absence of bicarbonate but it cannot affect the mitochondrial sAC/PKA system, therefore the PKA-dependent phosphorylation of the 60kDa proteins does not occur in the absence of bicarbonate. Production of CO2 in Krebs cycle, which is converted to bicarbonate is essential for sAC/PKA activation leading to mitochondrial membrane potential creation and ATP synthesis. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Fatalism toward breast cancer among the women of Ghana.

    Science.gov (United States)

    Mayo, Rachel M; Hunter, Anita; Parker, Veronica G

    2003-08-01

    Personal beliefs about health and illness influence many people's decisions about seeking care. This research represents a study of beliefs about breast cancer held by African women in Ghana. In-person interviews based on the revised Powe fatalism inventory (rPFI) were held with 109 women. Correlational analysis and factor analysis were performed. There were negative, nonsignificant associations between fatalism and age (r = -.095, p = 0.33), and educational level (r = -.078, p = .422). Fatalism scores were relatively low, 3.78 on an 11 -point scale. Comparisons are made to responses by African American women in other studies.

  15. Radiologic findings of neonatal sepsis

    International Nuclear Information System (INIS)

    Kim, Sam Soo; Han, Dae Hee; Choi, Guk Myeong; Jung, Hye Won; Yoon, Hye Kyung; Han, Bokyung Kim; Lee, Nam Yong

    1997-01-01

    To review the simple radiographic and sonographic findings in infants with neonatal sepsis. We retrospectively analyzed simple chest and abdominal radiographs, and brain sonograms in 36 newborn infants (preterm : term=23 :13). With neonatal sepsis diagnosed by blood culture and clinical manifestations. Pulmonary parenchymal infiltrate excluding respiratory distress syndrome and pulmonary edema or atelectasis was found in 22 infants (61%). Paralytic ileus, hepatosplenomegaly, and necrotizing enterocolitis were present in 18(50%), 9(25%), and 1(3%) infants, respectively, while skeletal changes suggesting osteomyelitis were found in three. Brain sonography was performed in 29 infants and in four, abnormalities were seen ; these comprised three germinal matrix hemorrhages and one intraparenchymal hemorrhage. In six patients(17%) radiologic examinations revealed no abnormality. In patients with neonatal sepsis, pulmonary infiltrates and paralytic ileus were common abnormalities. Although these were nonspecific, radiologic findings may be used to supplement clinical and laboratory findings in diagnosing neonatal sepsis and planning its treatment

  16. Radiologic findings of neonatal sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sam Soo; Han, Dae Hee; Choi, Guk Myeong; Jung, Hye Won [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Yoon, Hye Kyung; Han, Bokyung Kim; Lee, Nam Yong [Sansung Medical Center, Seoul (Korea, Republic of)

    1997-06-01

    To review the simple radiographic and sonographic findings in infants with neonatal sepsis. We retrospectively analyzed simple chest and abdominal radiographs, and brain sonograms in 36 newborn infants (preterm : term=23 :13). With neonatal sepsis diagnosed by blood culture and clinical manifestations. Pulmonary parenchymal infiltrate excluding respiratory distress syndrome and pulmonary edema or atelectasis was found in 22 infants (61%). Paralytic ileus, hepatosplenomegaly, and necrotizing enterocolitis were present in 18(50%), 9(25%), and 1(3%) infants, respectively, while skeletal changes suggesting osteomyelitis were found in three. Brain sonography was performed in 29 infants and in four, abnormalities were seen ; these comprised three germinal matrix hemorrhages and one intraparenchymal hemorrhage. In six patients(17%) radiologic examinations revealed no abnormality. In patients with neonatal sepsis, pulmonary infiltrates and paralytic ileus were common abnormalities. Although these were nonspecific, radiologic findings may be used to supplement clinical and laboratory findings in diagnosing neonatal sepsis and planning its treatment.

  17. Microbes causing severe neonatal septicemia in a tertiary neonatal intensive care unit

    OpenAIRE

    Khashana, Abdelmoneim

    2016-01-01

    Neonatal sepsis is the most challenging neonatal disease in developing countries despite the progress in the neonatal management. The aim of the study is to demonstrate the most common organisms causing severe neonatal sepsis in a tertiary neonatal intensive care unit. The study conducted in the neonatal intensive care unit (ICU) unit of pediatric department in Suez Canal University Hospital in the period from December 2013 to November 2014.Blood cultures showed the growth of Escherichia coli...

  18. Mitochondrial Metabolism in Aging Heart.

    Science.gov (United States)

    Lesnefsky, Edward J; Chen, Qun; Hoppel, Charles L

    2016-05-13

    Altered mitochondrial metabolism is the underlying basis for the increased sensitivity in the aged heart to stress. The aged heart exhibits impaired metabolic flexibility, with a decreased capacity to oxidize fatty acids and enhanced dependence on glucose metabolism. Aging impairs mitochondrial oxidative phosphorylation, with a greater role played by the mitochondria located between the myofibrils, the interfibrillar mitochondria. With aging, there is a decrease in activity of complexes III and IV, which account for the decrease in respiration. Furthermore, aging decreases mitochondrial content among the myofibrils. The end result is that in the interfibrillar area, there is ≈50% decrease in mitochondrial function, affecting all substrates. The defective mitochondria persist in the aged heart, leading to enhanced oxidant production and oxidative injury and the activation of oxidant signaling for cell death. Aging defects in mitochondria represent new therapeutic targets, whether by manipulation of the mitochondrial proteome, modulation of electron transport, activation of biogenesis or mitophagy, or the regulation of mitochondrial fission and fusion. These mechanisms provide new ways to attenuate cardiac disease in elders by preemptive treatment of age-related defects, in contrast to the treatment of disease-induced dysfunction. © 2016 American Heart Association, Inc.

  19. Melatonin and human mitochondrial diseases

    Directory of Open Access Journals (Sweden)

    Reza Sharafati-Chaleshtori

    2017-01-01

    Full Text Available Mitochondrial dysfunction is one of the main causative factors in a wide variety of complications such as neurodegenerative disorders, ischemia/reperfusion, aging process, and septic shock. Decrease in respiratory complex activity, increase in free radical production, increase in mitochondrial synthase activity, increase in nitric oxide production, and impair in electron transport system and/or mitochondrial permeability are considered as the main factors responsible for mitochondrial dysfunction. Melatonin, the pineal gland hormone, is selectively taken up by mitochondria and acts as a powerful antioxidant, regulating the mitochondrial bioenergetic function. Melatonin increases the permeability of membranes and is the stimulator of antioxidant enzymes including superoxide dismutase, glutathione peroxidase, glutathione reductase, and catalase. It also acts as an inhibitor of lipoxygenase. Melatonin can cause resistance to oxidation damage by fixing the microsomal membranes. Melatonin has been shown to retard aging and inhibit neurodegenerative disorders, ischemia/reperfusion, septic shock, diabetes, cancer, and other complications related to oxidative stress. The purpose of the current study, other than introducing melatonin, was to present the recent findings on clinical effects in diseases related to mitochondrial dysfunction including diabetes, cancer, gastrointestinal diseases, and diseases related to brain function.

  20. CFTR activity and mitochondrial function

    Directory of Open Access Journals (Sweden)

    Angel Gabriel Valdivieso

    2013-01-01

    Full Text Available Cystic Fibrosis (CF is a frequent and lethal autosomal recessive disease, caused by mutations in the gene encoding the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR. Before the discovery of the CFTR gene, several hypotheses attempted to explain the etiology of this disease, including the possible role of a chloride channel, diverse alterations in mitochondrial functions, the overexpression of the lysosomal enzyme α-glucosidase and a deficiency in the cytosolic enzyme glucose 6-phosphate dehydrogenase. Because of the diverse mitochondrial changes found, some authors proposed that the affected gene should codify for a mitochondrial protein. Later, the CFTR cloning and the demonstration of its chloride channel activity turned the mitochondrial, lysosomal and cytosolic hypotheses obsolete. However, in recent years, using new approaches, several investigators reported similar or new alterations of mitochondrial functions in Cystic Fibrosis, thus rediscovering a possible role of mitochondria in this disease. Here, we review these CFTR-driven mitochondrial defects, including differential gene expression, alterations in oxidative phosphorylation, calcium homeostasis, oxidative stress, apoptosis and innate immune response, which might explain some characteristics of the complex CF phenotype and reveals potential new targets for therapy.

  1. Mitochondrial Metabolism in Aging Heart

    Science.gov (United States)

    Lesnefsky, Edward J.; Chen, Qun; Hoppel, Charles L.

    2016-01-01

    Altered mitochondrial metabolism is the underlying basis for the increased sensitivity in the aged heart to stress. The aged heart exhibits impaired metabolic flexibility, with a decreased capacity to oxidize fatty acids and enhanced dependence on glucose metabolism. Aging impairs mitochondrial oxidative phosphorylation, with a greater role played by the mitochondria located between the myofibrils, the interfibrillar mitochondria. With aging, there is a decrease in activity of complexes III and IV, which account for the decrease in respiration. Furthermore, aging decreases mitochondrial content among the myofibrils. The end result is that in the interfibrillar area there is an approximate 50% decrease in mitochondrial function, affecting all substrates. The defective mitochondria persist in the aged heart, leading to enhanced oxidant production and oxidative injury and the activation of oxidant signaling for cell death. Aging defects in mitochondria represent new therapeutic targets, whether by manipulation of the mitochondrial proteome, modulation of electron transport, activation of biogenesis or mitophagy, or the regulation of mitochondrial fission and fusion. These mechanisms provide new ways to attenuate cardiac disease in elders by preemptive treatment of age-related defects, in contrast to the treatment of disease-induced dysfunction. PMID:27174952

  2. Atrial fibrillation is poorly tolerated by patients with hypertrophic concentric cardiomyopathy caused by mitochondrial tRNALeu (UUR mutations

    Directory of Open Access Journals (Sweden)

    Tiina M. Heliö

    2013-06-01

    Full Text Available Knowledge on the molecular background of mitochondrial disorders has accumulated during the past two decades, but clinical and molecular features of mitochondrial cardiomyopathies (CMPs are only starting to be characterized. We studied the detailed cardiologic phenotype of patients with adult-onset CMPs associated with mitochondrial DNA (mtDNA mutations and their relatives, from three families. We identified a pathogenic T3258C point mutation of mtDNA tRNALeu(UUR in an adult patient with mitochondrial myopathy and CMP, with acute manifestation of dyspnea and elevated plasma N-terminal pro-B-type natriuretic peptide concentration. Two other families with maternally segregated CMP, fatal in three patients, had the A3243G mutation in tRNALeu(UUR of mtDNA. Many of the mutation carriers, even if oligosymptomatic, had concentric, non-obstructive hypertrophic CMP with diastolic dysfunction or restrictive hemodynamics, or depression of systolic function especially at times when patients had lactic acidosis. Atrial fibrillation led to manifest heart failure in four patients, fatal in one. In conclusion, tRNALeu(UUR mutations in mtDNA may underlie mitochondrial non-obstructive, sometimes fatal, hypertrophic CMPs of adult age. Such CMPs are characterized by left ventricular hypertrophy and poor tolerance of atrial arrhythmias, often leading to rapidly deteriorating systolic function and heart failure. These patients benefit of rapid intervention of tachyarrhythmias. These patients may not have neurological symptoms, and may therefore remain underdiagnosed. Our observations emphasize that patients with tRNALeu(UUR mutations need cardiologic evaluation and follow- up. tRNALeu(UUR mutations should be screened of patients with hypertrophic CMP and metabolic acidosis, especially if atrial arrhythmia provoked cardiac decompensation.

  3. Transient pseudohypoparathyroidism and neonatal seizure.

    Science.gov (United States)

    Manzar, S

    2001-04-01

    The case of a neonate is presented who had late onset seizure associated with hypocalcemia, hyperphosphatemia, and raised parathyroid hormone. The infant did not have any stigmata of pseudohypoparathyroidism. The hypocalcemia was initially resistant to calcium therapy, but responded to vitamin D analog therapy. The diagnosis of 'transient neonatal pseudohypoparathyroidism' was entertained, as the infant remained stable and seizure-free with normal serum biochemistry during 8 months of follow-up.

  4. Experimental studies of mitochondrial function in CADASIL vascular smooth muscle cells

    Energy Technology Data Exchange (ETDEWEB)

    Viitanen, Matti [Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm (Sweden); Department of Geriatrics, Turku City Hospital and University of Turku, Turku (Finland); Sundström, Erik [Division of Neurodegeneration, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm (Sweden); Baumann, Marc [Protein Chemistry Unit, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki (Finland); Poyhonen, Minna [Department of Clinical Genetics, Helsinki University Hospital, HUSLAB, Helsinki (Finland); Tikka, Saara [Protein Chemistry Unit, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki (Finland); Behbahani, Homira, E-mail: homira.behbahani@ki.se [Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm (Sweden); Karolinska Institutet Alzheimer' s Disease Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm (Sweden)

    2013-02-01

    Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a familiar fatal progressive degenerative disorder characterized by cognitive decline, and recurrent stroke in young adults. Pathological features include a dramatic reduction of brain vascular smooth muscle cells and severe arteriopathy with the presence of granular osmophilic material in the arterial walls. Here we have investigated the cellular and mitochondrial function in vascular smooth muscle cell lines (VSMCs) established from CADASIL mutation carriers (R133C) and healthy controls. We found significantly lower proliferation rates in CADASIL VSMC as compared to VSMC from controls. Cultured CADASIL VSMCs were not more vulnerable than control cells to a number of toxic substances. Morphological studies showed reduced mitochondrial connectivity and increased number of mitochondria in CADASIL VSMCs. Transmission electron microscopy analysis demonstrated increased irregular and abnormal mitochondria in CADASIL VSMCs. Measurements of mitochondrial membrane potential (Δψ{sub m}) showed a lower percentage of fully functional mitochondria in CADASIL VSMCs. For a number of genes previously reported to be changed in CADASIL VSMCs, immunoblotting analysis demonstrated a significantly reduced SOD1 expression. These findings suggest that alteration of proliferation and mitochondrial function in CADASIL VSMCs might have an effect on vital cellular functions important for CADASIL pathology. -- Highlights: ► CADASIL is an inherited disease of cerebral vascular cells. ► Mitochondrial dysfunction has been implicated in the pathogenesis of CADASIL. ► Lower proliferation rates in CADASIL VSMC. ► Increased irregular and abnormal mitochondria and lower mitochondrial membrane potential in CADASIL VSMCs. ► Reduced mitochondrial connectivity and increased number of mitochondria in CADASIL VSMCs.

  5. Mitochondrial dynamics and bioenergetic dysfunction is associated with synaptic alterations in mutant SOD1 motor neurons

    Science.gov (United States)

    Magrané, Jordi; Sahawneh, Mary Anne; Przedborski, Serge; Estévez, Álvaro G.; Manfredi, Giovanni

    2012-01-01

    Mutations in Cu,Zn superoxide dismutase (SOD1) cause familial amyotrophic lateral sclerosis (FALS), a rapidly fatal motor neuron disease. Mutant SOD1 has pleiotropic toxic effects on motor neurons, among which mitochondrial dysfunction has been proposed as one of the contributing factors in motor neuron demise. Mitochondria are highly dynamic in neurons; they are constantly reshaped by fusion and move along neurites to localize at sites of high-energy utilization, such as synapses. The finding of abnormal mitochondria accumulation in neuromuscular junctions, where the SOD1-FALS degenerative process is though to initiate, suggests that impaired mitochondrial dynamics in motor neurons may be involved in pathogenesis. We addressed this hypothesis by live imaging microscopy of photo-switchable fluorescent mitoDendra in transgenic rat motor neurons expressing mutant or wild type human SOD1. We demonstrate that mutant SOD1 motor neurons have impaired mitochondrial fusion in axons and cell bodies. Mitochondria also display selective impairment of retrograde axonal transport, with reduced frequency and velocity of movements. Fusion and transport defects are associated with smaller mitochondrial size, decreased mitochondrial density, and defective mitochondrial membrane potential. Furthermore, mislocalization of mitochondria at synapses among motor neurons, in vitro, correlates with abnormal synaptic number, structure, and function. Dynamics abnormalities are specific to mutant SOD1 motor neuron mitochondria, since they are absent in wild type SOD1 motor neurons, they do not involve other organelles, and they are not found in cortical neurons. Taken together, these results suggest that impaired mitochondrial dynamics may contribute to the selective degeneration of motor neurons in SOD1-FALS. PMID:22219285

  6. Simvastatin impairs ADP-stimulated respiration and increases mitochondrial oxidative stress in primary human skeletal myotubes.

    Science.gov (United States)

    Kwak, Hyo-Bum; Thalacker-Mercer, Anna; Anderson, Ethan J; Lin, Chien-Te; Kane, Daniel A; Lee, Nam-Sihk; Cortright, Ronald N; Bamman, Marcas M; Neufer, P Darrell

    2012-01-01

    Statins, the widely prescribed cholesterol-lowering drugs for the treatment of cardiovascular disease, cause adverse skeletal muscle side effects ranging from fatigue to fatal rhabdomyolysis. The purpose of this study was to determine the effects of simvastatin on mitochondrial respiration, oxidative stress, and cell death in differentiated primary human skeletal muscle cells (i.e., myotubes). Simvastatin induced a dose-dependent decrease in viability of proliferating and differentiating primary human muscle precursor cells, and a similar dose-dependent effect was noted in differentiated myoblasts and myotubes. Additionally, there were decreases in myotube number and size following 48 h of simvastatin treatment (5 μM). In permeabilized myotubes, maximal ADP-stimulated oxygen consumption, supported by palmitoylcarnitine+malate (PCM, complex I and II substrates) and glutamate+malate (GM, complex I substrates), was 32-37% lower (Prespiration at complex I. Mitochondrial superoxide and hydrogen peroxide generation were significantly greater in the simvastatin-treated human skeletal myotube cultures compared to control. In addition, simvastatin markedly increased protein levels of Bax (proapoptotic, +53%) and Bcl-2 (antiapoptotic, +100%, P<0.05), mitochondrial PTP opening (+44%, P<0.05), and TUNEL-positive nuclei in human skeletal myotubes, demonstrating up-regulation of mitochondrial-mediated myonuclear apoptotic mechanisms. These data demonstrate that simvastatin induces myotube atrophy and cell loss associated with impaired ADP-stimulated maximal mitochondrial respiratory capacity, mitochondrial oxidative stress, and apoptosis in primary human skeletal myotubes, suggesting that mitochondrial dysfunction may underlie human statin-induced myopathy. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Experimental studies of mitochondrial function in CADASIL vascular smooth muscle cells

    International Nuclear Information System (INIS)

    Viitanen, Matti; Sundström, Erik; Baumann, Marc; Poyhonen, Minna; Tikka, Saara; Behbahani, Homira

    2013-01-01

    Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a familiar fatal progressive degenerative disorder characterized by cognitive decline, and recurrent stroke in young adults. Pathological features include a dramatic reduction of brain vascular smooth muscle cells and severe arteriopathy with the presence of granular osmophilic material in the arterial walls. Here we have investigated the cellular and mitochondrial function in vascular smooth muscle cell lines (VSMCs) established from CADASIL mutation carriers (R133C) and healthy controls. We found significantly lower proliferation rates in CADASIL VSMC as compared to VSMC from controls. Cultured CADASIL VSMCs were not more vulnerable than control cells to a number of toxic substances. Morphological studies showed reduced mitochondrial connectivity and increased number of mitochondria in CADASIL VSMCs. Transmission electron microscopy analysis demonstrated increased irregular and abnormal mitochondria in CADASIL VSMCs. Measurements of mitochondrial membrane potential (Δψ m ) showed a lower percentage of fully functional mitochondria in CADASIL VSMCs. For a number of genes previously reported to be changed in CADASIL VSMCs, immunoblotting analysis demonstrated a significantly reduced SOD1 expression. These findings suggest that alteration of proliferation and mitochondrial function in CADASIL VSMCs might have an effect on vital cellular functions important for CADASIL pathology. -- Highlights: ► CADASIL is an inherited disease of cerebral vascular cells. ► Mitochondrial dysfunction has been implicated in the pathogenesis of CADASIL. ► Lower proliferation rates in CADASIL VSMC. ► Increased irregular and abnormal mitochondria and lower mitochondrial membrane potential in CADASIL VSMCs. ► Reduced mitochondrial connectivity and increased number of mitochondria in CADASIL VSMCs.

  8. Fatal Fentanyl: One Pill Can Kill.

    Science.gov (United States)

    Sutter, Mark E; Gerona, Roy R; Davis, M Thais; Roche, Bailey M; Colby, Daniel K; Chenoweth, James A; Adams, Axel J; Owen, Kelly P; Ford, Jonathan B; Black, Hugh B; Albertson, Timothy E

    2017-01-01

    The current national opioid epidemic is a public health emergency. We have identified an outbreak of exaggerated opioid toxicity caused by fentanyl adulterated tablets purchased on the street as hydrocodone/acetaminophen. Over an 8-day period in late March 2016, a total of 18 patients presented to our institution with exaggerated opioid toxicity. The patients provided a similar history: ingesting their "normal dose" of hydrocodone/acetaminophen tablets but with more pronounced symptoms. Toxicology testing and analysis was performed on serum, urine, and surrendered pills. One of the 18 patients died in hospital. Five patients underwent cardiopulmonary resuscitation, one required extracorporeal life support, three required intubation, and two received bag-valve-mask ventilation. One patient had recurrence of toxicity after 8 hours after naloxone discontinuation. Seventeen of 18 patients required boluses of naloxone, and four required prolonged naloxone infusions (26-39 hours). All 18 patients tested positive for fentanyl in the serum. Quantitative assays conducted in 13 of the sera revealed fentanyl concentrations of 7.9 to 162 ng/mL (mean = 52.9 ng/mL). Pill analysis revealed fentanyl amounts of 600-6,900 μg/pill. The pills are virtually indistinguishable from authentic hydrocodone/acetaminophen tablets and are similar in weight. To date, our county has reported 56 cases of fentanyl opioid toxicity, with 15 fatalities. In our institution, the outbreak has stressed the capabilities and resources of the emergency department and intensive care units. A serious outbreak of exaggerated opioid toxicity caused by fentanyl-adulterated tablets purchased on the street as hydrocodone/acetaminophen is under way in California. These patients required higher dosing and prolonged infusions of naloxone. Additionally, observation periods off naloxone were extended due to delayed, recurrent toxicity. The outbreak has serious ramifications for public health and safety, law

  9. Pathologic features of fatal shark attacks.

    Science.gov (United States)

    Byard, R W; Gilbert, J D; Brown, K

    2000-09-01

    To examine the pattern of injuries in cases of fatal shark attack in South Australian waters, the authors examined the files of their institution for all cases of shark attack in which full autopsies had been performed over the past 25 years, from 1974 to 1998. Of the seven deaths attributed to shark attack during this period, full autopsies were performed in only two cases. In the remaining five cases, bodies either had not been found or were incomplete. Case 1 was a 27-year-old male surfer who had been attacked by a shark. At autopsy, the main areas of injury involved the right thigh, which displayed characteristic teeth marks, extensive soft tissue damage, and incision of the femoral artery. There were also incised wounds of the right wrist. Bony injury was minimal, and no shark teeth were recovered. Case 2 was a 26-year-old male diver who had been attacked by a shark. At autopsy, the main areas of injury involved the left thigh and lower leg, which displayed characteristic teeth marks, extensive soft tissue damage, and incised wounds of the femoral artery and vein. There was also soft tissue trauma to the left wrist, with transection of the radial artery and vein. Bony injury was minimal, and no shark teeth were recovered. In both cases, death resulted from exsanguination following a similar pattern of soft tissue and vascular damage to a leg and arm. This type of injury is in keeping with predator attack from underneath or behind, with the most severe injuries involving one leg. Less severe injuries to the arms may have occurred during the ensuing struggle. Reconstruction of the damaged limb in case 2 by sewing together skin, soft tissue, and muscle bundles not only revealed that no soft tissue was missing but also gave a clearer picture of the pattern of teeth marks, direction of the attack, and species of predator.

  10. Firearm fatalities in Dammam, Saudi Arabia.

    Science.gov (United States)

    Al Madni, Osama; Kharosha, Magdy Abdel Azim; Shotar, Ali M

    2008-07-01

    This paper provides a database representing injury mortality in Dammam, Saudi Arabia, with the aim of establishing a system which will record information about the incidence of such deaths, identify new trends and give priority to violence prevention. The retrospective study was carried out on 64 fatalities from gunfire injuries at the Forensic Medicine Centre in Dammam, Saudi Arabia during the period from January 2002 - December 2006. The deaths included 55 cases of homicide, seven cases of suicide and two accidental shootings. Twenty-six victims were aged between 16-30 years and 24 victims were between 31-45 years. Fifty-nine of the cases were male. A handgun was the weapon used in 49 cases. The most common sites for the firearm entrance wounds were the head (45 cases) and the chest (35 cases). In the majority of cases (56.3%) a single shot was fired while in 15.6% of cases there were two shots. In 51.5% of cases no bullet was recovered from the body while a single bullet was recovered in 31.5% and two bullets in 6.2% of the cases. Distant range fire was observed in 65.6% of cases. Exit wounds were found on the head in 36.7% and on the chest in 28.7% of cases. The majority of victims were young males living in urban areas. This result should help in forming a strategy to improve the livelihoods of this group. The low incidence of alcohol abuse (one case, 1.56%) and only three cases (4.68%) of amphetamine abuse is significant.

  11. Estimated total costs from non-fatal and fatal bicycle crashes in the USA: 1997-2013.

    Science.gov (United States)

    Gaither, Thomas W; Sanford, Thomas A; Awad, Mohannad A; Osterberg, E Charles; Murphy, Gregory P; Lawrence, Bruce A; Miller, Ted R; Breyer, Benjamin N

    2018-04-01

    Emergency department visits and hospital admissions resulting from adult bicycle trauma have increased dramatically. Annual medical costs and work losses of these incidents last were estimated for 2005 and quality-of-life losses for 2000. We estimated costs associated with adult bicycle injuries in the USA using 1997-2013 non-fatal incidence data from the National Electronic Injury Surveillance System with cost estimates from the Consumer Product Safety Commission's Injury Cost Model, and 1999-2013 fatal incidence data from the National Vital Statistics System costed by similar methods. Approximately 3.8 million non-fatal adult bicycle injuries were reported during the study period and 9839 deaths. In 2010 dollars, estimated adult bicycle injury costs totalled $24.4 billion in 2013. Estimated injury costs per mile bicycled fell from $2.85 in 2001 to $2.35 in 2009. From 1999 to 2013, total estimated costs were $209 billion due to non-fatal bicycle injuries and $28 billion due to fatal injuries. Inflation-free annual costs in the study period increased by 137% for non-fatal injuries and 23% for fatal injuries. The share of non-fatal costs associated with injuries to riders age 45 and older increased by 1.6% (95% CI 1.4% to 1.9%) annually. The proportion of costs due to incidents that occurred on a street or highway steadily increased by 0.8% (95% CI 0.4% to 1.3%) annually. Inflation-free costs per case associated with non-fatal bicycle injuries are increasing. The growth in costs is especially associated with rising ridership, riders 45 and older, and street/highway crashes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase: a control enzyme in ketogenesis.

    Science.gov (United States)

    Hegardt, F G

    1999-03-15

    Cytosolic and mitochondrial 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) synthases were first recognized as different chemical entities in 1975, when they were purified and characterized by Lane's group. Since then, the two enzymes have been studied extensively, one as a control site of the cholesterol biosynthetic pathway and the other as an important control site of ketogenesis. This review describes some key developments over the last 25 years that have led to our current understanding of the physiology of mitochondrial HMG-CoA synthase in the HMG-CoA pathway and in ketogenesis in the liver and small intestine of suckling animals. The enzyme is regulated by two systems: succinylation and desuccinylation in the short term, and transcriptional regulation in the long term. Both control mechanisms are influenced by nutritional and hormonal factors, which explains the incidence of ketogenesis in diabetes and starvation, during intense lipolysis, and in the foetal-neonatal and suckling-weaning transitions. The DNA-binding properties of the peroxisome-proliferator-activated receptor and other transcription factors on the nuclear-receptor-responsive element of the mitochondrial HMG-CoA synthase promoter have revealed how ketogenesis can be regulated by fatty acids. Finally, the expression of mitochondrial HMG-CoA synthase in the gonads and the correction of auxotrophy for mevalonate in cells deficient in cytosolic HMG-CoA synthase suggest that the mitochondrial enzyme may play a role in cholesterogenesis in gonadal and other tissues.

  13. Fatal and non-fatal injury outcomes: results from a purposively sampled census of seven rural subdistricts in Bangladesh.

    Science.gov (United States)

    Alonge, Olakunle; Agrawal, Priyanka; Talab, Abu; Rahman, Qazi S; Rahman, Akm Fazlur; Arifeen, Shams El; Hyder, Adnan A

    2017-08-01

    90% of the global burden of injuries is borne by low-income and middle-income countries (LMICs). However, details of the injury burden in LMICs are less clear because of the scarcity of data and population-based studies. The Saving of Lives from Drowning project, implemented in rural Bangladesh, did a census on 1·2 million people to fill this gap. This Article describes the epidemiology of fatal and non-fatal injuries from the study. In this study, we used data from the baseline census conducted as part of the Saving of Lives from Drowning (SoLiD) project. The census was implemented in 51 unions from seven purposively sampled rural subdistricts of Bangladesh between June and November, 2013. Sociodemographic, injury mortality, and morbidity information were collected for the whole population in the study area. We analysed the data for descriptive measures of fatal and non-fatal injury outcomes. Age and gender distribution, socioeconomic characteristics, and injury characteristics such as external cause, intent, location, and body part affected were reported for all injury outcomes. The census covered a population of 1 169 593 from 270 387 households and 451 villages. The overall injury mortality rate was 38 deaths per 100 000 population per year, and 104 703 people sustained major non-fatal injuries over a 6-month recall period. Drowning was the leading external cause of injury death for all ages, and falls caused the most number of non-fatal injuries. Fatal injury rates were highest in children aged 1-4 years. Non-fatal injury rates were also highest in children aged 1-4 years and those aged 65 years and older. Males had more fatal and non-fatal injuries than females across all external causes except for burns. Suicide was the leading cause of injury deaths in individuals aged 15-24 years, and more than 50% of the suicides occurred in females. The home environment was the most common location for most injuries. The burden of fatal and non-fatal injuries

  14. Children in Hot Cars Result in Fatal Consequences

    Medline Plus

    Full Text Available ... Health Tips » Holiday and Seasonal Children in Hot Cars Result in Fatal Consequences Emergency physicians are warning ... it bluntly, leaving your child in a hot car is like leaving your child in a lit ...

  15. Children in Hot Cars Result in Fatal Consequences

    Medline Plus

    Full Text Available ... Health Tips » Holiday and Seasonal Children in Hot Cars Result in Fatal Consequences Emergency physicians are warning ... with leaving anyone, especially children in hot, unventilated vehicles during the summer. Children throughout the country die ...

  16. Children in Hot Cars Result in Fatal Consequences

    Medline Plus

    Full Text Available ... Share this! Home » Health Tips » Holiday and Seasonal Children in Hot Cars Result in Fatal Consequences Emergency ... the overwhelming dangers associated with leaving anyone, especially children in hot, unventilated vehicles during the summer. Children ...

  17. Children in Hot Cars Result in Fatal Consequences

    Medline Plus

    Full Text Available ... Home » Health Tips » Holiday and Seasonal Children in Hot Cars Result in Fatal Consequences Emergency physicians are ... dangers associated with leaving anyone, especially children in hot, unventilated vehicles during the summer. Children throughout the ...

  18. Fatal poisoning in drug addicts in the Nordic countries

    DEFF Research Database (Denmark)

    Steentoft, Anni; Teige, Brita; Ceder, Gunnel

    2001-01-01

    . For all countries the distribution of deaths according to geographical regions showed a decreasing number of drug deaths in the metropolitan area and an increasing number in other cities. Heroin/ morphine dominated as the cause of death and was responsible for about 90% of the cases in Norway. In Sweden...... and Denmark, however, heroin/morphine caused only about 70% of the fatal poisonings. About 30% of the fatal poisonings in Denmark and Sweden were caused by other group I drugs, in Denmark mainly methadone and in Sweden mainly propoxyphene. Apart from two cases in Sweden methadone deaths were not seen...... in the other Nordic countries. In Finland heroin/morphine deaths have increased from about 10% in 1991 to about 40% in 1997. Forty-four percent of the fatal poisonings in Finland were caused by other group I drugs, mainly codeine and propoxyphene. The two fatal poisonings in Iceland were caused by carbon...

  19. Children in Hot Cars Result in Fatal Consequences

    Medline Plus

    Full Text Available ... Tips » Holiday and Seasonal Children in Hot Cars Result in Fatal Consequences Emergency physicians are warning the ... children play in an unattended vehicle. Make a habit of looking in the vehicle before you get ...

  20. Post-transplant withdrawal of lamivudine results in fatal hepatitis ...

    African Journals Online (AJOL)

    Post-transplant withdrawal of lamivudine results in fatal hepatitis flares in kidney transplant recipients, under immune suppression, with inactive hepatitis B infection. Bin Miao, Xiang-Ming Lao, Guo-Li Lin ...

  1. New Jersey motorcycle fatality rates : final report, December 2009.

    Science.gov (United States)

    2009-12-01

    Motorcycle crashes have been increasing in recent years, more than doubling since 1991. In 2007 there were 84 fatal motorcycle crashes in New Jersey. This report describes the methods and findings of an investigation of motorcycle crashes in New Jers...

  2. Children in Hot Cars Result in Fatal Consequences

    Medline Plus

    Full Text Available ... Tips Campaigns SUBSCRIBE Health Tips Share this! Home » Health Tips » Holiday and Seasonal Children in Hot Cars Result in Fatal Consequences Emergency physicians are warning the public about the overwhelming dangers associated with leaving anyone, ...

  3. Towards a Theory of Suicide: The Case for Modern Fatalism.

    Science.gov (United States)

    Peck, Dennis L.

    1980-01-01

    Explores the empirical relationship between fatalism and suicide in a population of youthful victims. Content analysis of case histories and suicide notes showed almost one-third experienced fatalistic thoughtways prior to their death. (Author)

  4. Dehydration Comes on Fast and Can Be Fatal

    Science.gov (United States)

    ... Share this! Home » Health Tips » Holiday and Seasonal Dehydration comes on fast and can be fatal During ... at a higher risk ofbecoming dehydrated. Causes of Dehydration: Excessive sweating (from heat and/or exercise) with ...

  5. Children in Hot Cars Result in Fatal Consequences

    Medline Plus

    Full Text Available ... as high as 106 degrees Fahrenheit in that time and it often is fatal. Specifically, these extreme ... get out. If your infant or young child travels in a rear-facing car seat or the ...

  6. Fatality analysis reporting system and roadway inventory correlation.

    Science.gov (United States)

    2013-01-01

    In this project, we developed an integrated database to provide new analysis capabilities : for discovering correlations between roadway characteristics and the occurrence of : fatality collisions. Specifically, the aim of this data analysis project ...

  7. Geo-demographic analysis of fatal motorcycle crashes

    Science.gov (United States)

    2001-01-01

    The objective of this study is to analyze the combined motor vehicle crash data from the Fatality Analysis Reporting System (FARS) with the Claritas geo-demographic database from the lifestyle perspective to determine the appropriate media to use in ...

  8. Mitochondrial DNA Damage and its Consequences for Mitochondrial Gene Expression

    Science.gov (United States)

    Cline, Susan D.

    2012-01-01

    How mitochondria process DNA damage and whether a change in the steady-state level of mitochondrial DNA damage (mtDNA) contributes to mitochondrial dysfunction are questions that fuel burgeoning areas of research into aging and disease pathogenesis. Over the past decade, researchers have identified and measured various forms of endogenous and environmental mtDNA damage and have elucidated mtDNA repair pathways. Interestingly, mitochondria do not appear to contain the full range of DNA repair mechanisms that operate in the nucleus, although mtDNA contains types of damage that are targets of each nuclear DNA repair pathway. The reduced repair capacity may, in part, explain the high mutation frequency of the mitochondrial chromosome. Since mtDNA replication is dependent on transcription, mtDNA damage may alter mitochondrial gene expression at three levels: by causing DNA polymerase γ nucleotide incorporation errors leading to mutations, by interfering with the priming of mtDNA replication by the mitochondrial RNA polymerase, or by inducing transcriptional mutagenesis or premature transcript termination. This review summarizes our current knowledge of mtDNA damage, its repair, and its effects on mtDNA integrity and gene expression. PMID:22728831

  9. Mitochondrial and Nuclear Genes of Mitochondrial Components in Cancer

    Science.gov (United States)

    Kirches, E

    2009-01-01

    Although the observation of aerobic glycolysis of tumor cells by Otto v. Warburg had demonstrated abnormalities of mitochondrial energy metabolism in cancer decades ago, there was no clear evidence for a functional role of mutant mitochondrial proteins in cancer development until the early years of the 21st century. In the year 2000, a major breakthrough was achieved by the observation, that several genes coding for subunits of the respiratory chain (ETC) complex II, succinate dehydrogenase (SDH) are tumor suppressor genes in heritable paragangliomas, fulfilling Knudson’s classical two-hit hypothesis. A functional inactivation of both alleles by germline mutations and chromosomal losses in the tumor tissue was found in the patients. Later, SDH mutations were also identified in sporadic paragangliomas and pheochromocytomas. Genes of the mitochondrial ATP-synthase and of mitochondrial iron homeostasis have been implicated in cancer development at the level of cell culture and mouse experiments. In contrast to the well established role of some nuclear SDH genes, a functional impact of the mitochondrial genome itself (mtDNA) in cancer development remains unclear. Nevertheless, the extremely high frequency of mtDNA mutations in solid tumors raises the question, whether this small circular genome might be applicable to early cancer detection. This is a meaningful approach, especially in cancers, which tend to spread tumor cells early into bodily fluids or faeces, which can be screened by non-invasive methods. PMID:19949549

  10. Fatal Candidemia in a Patient with Acute Lymphoblastic Leukemia

    Science.gov (United States)

    2018-02-16

    NOTES 14. ABSTRACT Fatal Candidcn1ia in a Patient \\\\ith Acute Lympboblastic Leukemia Brittany Lenz. MD. Arturo Dominguez.. MD. Adnan J’vlir. MD, PhD...Profoosionaf 7 ,0 Fatal Candidemia in a Patient with Acute Lymphoblastic Leukemia Brittany Lenz, MD, Arturo Dominguez, MD, Adnan Mir, MD, PhD Objectives...with pre-B cell acute lymphoblastic leukemia was admitted for presumed septic shock secondary to an unknown infectious etiology. The patient was

  11. A fatal case of streptococcal toxic shock syndrome.

    Science.gov (United States)

    Doganci, Levent; Tanyel, Esra; Basibuyuk, Hakki; Darka, Ozge

    2008-04-01

    In daily medical practice, streptococcal toxic shock syndrome is an infrequent clinical entity which carry a very high risk of fatality. Early recognition of this toxin mediated immunopathological disease is very important to apply necessary invasive procedures such as an prompt amputation of the effected areas to save the patient. Here, we report a 47 year-old male farmer with a fatal streptococcal toxic shock syndrome to highlight the importance of emergency care and aggresive surgical intervention in similar situations.

  12. Car mass and fatality risk: has the relationship changed?

    Science.gov (United States)

    Evans, L; Frick, M C

    1994-01-01

    The finding that the relative safety disadvantage of small compared with large cars is less for post-1980 cars than for pre-1980 cars has stimulated speculation that increasing fuel economy standards would increase fatalities less than previously expected. Fatal crashes between two cars of similar model year were examined to see whether this would be the case. Driver fatality risk in relation to car mass was examined with Fatal Accident Reporting System data for crashes between two cars of a specific model year. The relative risk for driver fatality in the lighter car compared with the other driver's risk in a car 50% heavier was as follows: for 1966 through 1979 cars, the risk was between 3.7 and 5.1; for 1984 cars, 2.6; and for 1990 cars, 4.1. The results suggest that the lesser mass effect observed for mid-1980s cars occurred because improved crashworthiness features appeared in small cars earlier than in large cars. As all cars are redesigned, the relationship between risk and mass can be expected to approach that observed earlier in pre-1980 cars. If so, future fatality increases from fuel economy increases will be greater than estimated on the basis of mid-1980 data.

  13. Hematologic features and clinical course of an infant with Pearson syndrome caused by a novel deletion of mitochondrial DNA.

    Science.gov (United States)

    Knerr, Ina; Metzler, Markus; Niemeyer, Charlotte Marie; Holter, Wolfgang; Gerecke, Anja; Baumann, Irith; Trollmann, Regina; Repp, Reinald

    2003-12-01

    Pearson bone marrow-pancreas syndrome (PS) is a rare, usually fatal mitochondrial disorder involving the hematopoietic system in early infancy. Due to the diversity of clinical symptoms, the diagnosis can be difficult. The authors describe a boy with severe hypoplastic anemia in whom extensive clinical, biochemical, and morphologic findings led to the diagnosis of PS, and molecular analysis revealed a novel deletion of mitochondrial DNA from nucleotide position 10.371 to 14.607. The patient is a 2-year-old boy who presented at age 5 months with hypoplastic macrocytic anemia. His first months of life and the family history were uneventful. Extensive pretransfusion evaluations did not reveal a metabolic, infectious, or hematologic-neoplastic etiology, and he had no evidence of exocrine pancreatic insufficiency. However, a second bone marrow aspirate at age 7 months showed a reduced cell number, vacuolated erythroblasts and myeloblasts, and ringed sideroblasts, so PS was suspected. Additional molecular analysis from the boy's blood leukocytes revealed a deletion of mitochondrial DNA from nucleotide position 10.371 to 14.607, which was absent in his mother's blood cells, consistent with a sporadic mutation as commonly seen in PS. The muscle histology and the respiratory chain enzymes were normal. Mitochondriopathies should be considered in children with persistent non-neuromuscular symptoms such as unexplained refractory anemia. Due to the often-fatal course of PS, the rapid detection of mitochondrial DNA deletions is imperative for diagnosis and family counseling.

  14. Formation and Regulation of Mitochondrial Membranes

    Directory of Open Access Journals (Sweden)

    Laila Cigana Schenkel

    2014-01-01

    Full Text Available Mitochondrial membrane phospholipids are essential for the mitochondrial architecture, the activity of respiratory proteins, and the transport of proteins into the mitochondria. The accumulation of phospholipids within mitochondria depends on a coordinate synthesis, degradation, and trafficking of phospholipids between the endoplasmic reticulum (ER and mitochondria as well as intramitochondrial lipid trafficking. Several studies highlight the contribution of dietary fatty acids to the remodeling of phospholipids and mitochondrial membrane homeostasis. Understanding the role of phospholipids in the mitochondrial membrane and their metabolism will shed light on the molecular mechanisms involved in the regulation of mitochondrial function and in the mitochondrial-related diseases.

  15. Porcine Neonatal Coccidiosis

    Science.gov (United States)

    Sanford, S. E.; Josephson, G. K. A.

    1981-01-01

    Coccidia were identified in intestinal sections from 82 piglets comprising 37 consignments from 34 farms, and represented a yearly increasing incidence in the three years 1978 to 1980. Piglets were primarily from medium to large farms with intensive, continuous-farrowing, confinement-rearing programs. Piglets, usually five days to 15 days old, had yellow, fluid diarrhea, became unthrifty and sometimes died. In six piglets from two farms, a green, adherent, fibrinonecrotic membrane was seen throughout most of the jejunum and ileum. Significant gross lesions were not observed in the other 76 piglets. Moderate to severe villous atrophy of jejunum and ileum was seen histologically. Various asexual and sexual stages of coccidia were seen within parasitophorous vacuoles of villar epithelial cells. Multifocal erosions with necrosis of villar tips and occasionally more diffuse mucosal necrosis with fibrinocellular exudate were seen. Isospora suis oocysts were identified in feces from several weaners from one farm. Amprolium and decoquinate mixed in the sow ration at 1 kg/tonne for three weeks prior to and postfarrowing was moderately successful in stopping outbreaks of neonatal diarrhea associated with coccidiosis. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6. PMID:7343074

  16. Severe acute respiratory syndrome: implications for perinatal and neonatal nurses.

    Science.gov (United States)

    Rebmann, Terri

    2005-01-01

    Severe acute respiratory syndrome (SARS) is an emerging infection that causes a potentially fatal respiratory disease. Although the SARS outbreak lasted less than 1 year, it resulted in significant morbidity and mortality and impacted nursing practices. A literature review was conducted. Only English language research articles in peer-reviewed journals, national organization publications, and book chapters were utilized. Data from 37 relevant articles were extracted, analyzed, and summarized. SARS' clinical description is presented, including its common signs/symptoms, diagnosis, and treatment. Recommended isolation practices for labor and delivery and proper procedures for donning, using, and doffing personal protective equipment are provided. Potential maternal outcomes include spontaneous miscarriage during the first trimester, preterm birth, emergency cesarean section, renal failure, secondary bacterial pneumonia, sepsis, adult respiratory distress syndrome, disseminated intravascular coagulation, surgical site infection, and maternal death. There have been no documented cases of vertical transmission; passive immunity is suspected on the basis of the presence of antibodies in some maternal body fluids. Potential neonatal outcomes include complications related to premature birth, intrauterine growth restriction, respiratory distress syndrome, and severe gastrointestinal manifestations. It is not known if or when SARS will reemerge, but perinatal and neonatal nurses should become familiar with its clinical description and proper infection control procedures to halt potential outbreaks.

  17. Advancing obstetric and neonatal care in a regional hospital in Ghana via continuous quality improvement.

    Science.gov (United States)

    Srofenyoh, Emmanuel; Ivester, Thomas; Engmann, Cyril; Olufolabi, Adeyemi; Bookman, Laurel; Owen, Medge

    2012-01-01

    To reduce maternal and neonatal death at a large regional hospital through the use of quality improvement methodologies. In 2007, Kybele and the Ghana Health Service formed a partnership to analyze systems and patient care processes at a regional hospital in Accra, Ghana. A model encompassing continuous assessment, implementation, advocacy, outputs, and outcomes was designed. Key areas for improvement were grouped into "bundles" based on personnel, systems management, and service quality. Primary outcomes included maternal and perinatal mortality, and case fatality rates for hemorrhage and hypertensive disorders. Implementation and outcomes were evaluated tri-annually between 2007 and 2009. During the study period, there was a 34% decrease in maternal mortality despite a 36% increase in patient admission. Case fatality rates for pre-eclampsia and hemorrhage decreased from 3.1% to 1.1% (Pcontinuous quality improvement were developed and employed. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

    Taha-Abdelaziz, Khaled; Bassel, Laura L; Harness, Melanie L; Clark, Mary Ellen; Register, Karen B; Caswell, Jeff L

    2016-07-01

    Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less recognized. Our study evaluated histologic identification of cilia-associated bacteria as a method for diagnosis of B. bronchiseptica pneumonia. Cases of fatal bronchopneumonia were studied retrospectively, excluding neonates and cases of aspiration pneumonia, minor lung lesions, or autolysis. The study population comprised 36 canine and 31 feline cases of bronchopneumonia. B. bronchiseptica was identified in 8 of 36 canine and 14 of 31 feline cases based on immunohistochemistry (IHC) using serum from a rabbit hyperimmunized with pertactin, PCR testing (Fla2/Fla12), and/or bacterial culture data when available. Of these, IHC was positive in 4 canine and 7 feline cases, PCR was positive in 8 canine and 14 feline cases, and B. bronchiseptica was isolated in 2 of 5 canine and 3 of 9 feline cases tested. Examination of histologic sections stained with hematoxylin and eosin revealed bronchial cilia-associated bacteria in 4 of 36 canine and 5 of 31 feline cases; these were all positive by IHC and PCR. The presence of cilia-associated bacteria had been noted in the pathology report for only 2 of these 9 cases. Thus, the presence of cilia-associated bacteria seems frequently overlooked by pathologists, but is a diagnostically significant feature of B. bronchiseptica pneumonia. A specific diagnosis of B. bronchiseptica pneumonia is important because it suggests primary or opportunistic bacterial pneumonia rather than aspiration pneumonia, and because of the risk of animal-to-animal transmission of B. bronchiseptica, the availability of vaccines for disease prevention, and the potential zoonotic risk to immunocompromised pet owners. © 2016 The Author(s).

  19. Using speeding detections and numbers of fatalities to estimate relative risk of a fatality for motorcyclists and car drivers.

    Science.gov (United States)

    Huggins, Richard

    2013-10-01

    Precise estimation of the relative risk of motorcyclists being involved in a fatal accident compared to car drivers is difficult. Simple estimates based on the proportions of licenced drivers or riders that are killed in a fatal accident are biased as they do not take into account the exposure to risk. However, exposure is difficult to quantify. Here we adapt the ideas behind the well known induced exposure methods and use available summary data on speeding detections and fatalities for motorcycle riders and car drivers to estimate the relative risk of a fatality for motorcyclists compared to car drivers under mild assumptions. The method is applied to data on motorcycle riders and car drivers in Victoria, Australia in 2010 and a small simulation study is conducted. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Neonatal respiratory extracorporeal membrane oxygenation (ECMO) referrals.

    LENUS (Irish Health Repository)

    El-Khuffash, A

    2011-03-01

    Extracorporeal membrane oxygenation (ECMO) is a complex technique for providing life support in neonatal respiratory failure. T UK Collaborative ECMO trial demonstrated cost-effectiveness and substantial improvements in neurological morbidity and mortality. Currently, infants requiring ECMO in Ireland are referred to one of various centres in the UK and Scandinavia. We aimed to review the number of infants referred from Ireland for respiratory ECMO. All infants with a non-cardiac condition referred from Ireland for ECMO were reviewed for diagnosis and outcomes. Eleven infants required ECMO between June 2006 and January 2009 and were referred to the Scandinavian team for ECMO transport although one infant improved and did not require ECMO following the arrival of the team. Four infants died: one infant died prior to arrival of the ECMO team, 3 infants had fatal diagnoses and one infant with congenital diaphragmatic hernia received pre-op ECMO. The median (inter-quartile range) gestational age was 39.7 (38.3-40.7) weeks and birth weight of 3.7 (3.2-4.0) kg. The median age at the decision to transfer for ECMO was 13h (4-123) and the team arrived at 23 h (12-132). All infants had a normal cranial ultrasound and echo prior to ECMO and 2 infants had an abnormal MRI post-ECMO. The time on ECMO was 9 days (3-17) and total length of hospital stay was 32 d (23-36). There were no pre-ECMO clinical or biochemical

  1. The mitochondrial contact site complex, a determinant of mitochondrial architecture.

    Science.gov (United States)

    Harner, Max; Körner, Christian; Walther, Dirk; Mokranjac, Dejana; Kaesmacher, Johannes; Welsch, Ulrich; Griffith, Janice; Mann, Matthias; Reggiori, Fulvio; Neupert, Walter

    2011-10-18

    Mitochondria are organelles with a complex architecture. They are bounded by an envelope consisting of the outer membrane and the inner boundary membrane (IBM). Narrow crista junctions (CJs) link the IBM to the cristae. OMs and IBMs are firmly connected by contact sites (CS). The molecular nature of the CS remained unknown. Using quantitative high-resolution mass spectrometry we identified a novel complex, the mitochondrial contact site (MICOS) complex, formed by a set of mitochondrial membrane proteins that is essential for the formation of CS. MICOS is preferentially located at the CJs. Upon loss of one of the MICOS subunits, CJs disappear completely or are impaired, showing that CJs require the presence of CS to form a superstructure that links the IBM to the cristae. Loss of MICOS subunits results in loss of respiratory competence and altered inheritance of mitochondrial DNA.

  2. Mitochondrial quality control pathways as determinants of metabolic health

    NARCIS (Netherlands)

    Held, Ntsiki M.; Houtkooper, Riekelt H.

    2015-01-01

    Mitochondrial function is key for maintaining cellular health, while mitochondrial failure is associated with various pathologies, including inherited metabolic disorders and age-related diseases. In order to maintain mitochondrial quality, several pathways of mitochondrial quality control have

  3. Neonatal cardiac tamponade and pleural effusion resolved with chest tube placement.

    Science.gov (United States)

    Alabsi, Samir

    2010-01-01

    Pericardial effusion and cardiac tamponade secondary to umbilical venous catheterization are rare complications but potentially fatal. This article reports a case of cardiac tamponade and right pleural effusion secondary to transudation of hyperosmolar fluid from an appropriately placed umbilical venous catheter. The infant survived as a result of early diagnosis by echocardiography and urgent chest tube placement that drained both pleural and pericardial effusions. Cardiac tamponade should be highly suspected in any neonate with a central venous catheter who develops sudden, unexplained clinical deterioration in cardiopulmonary status even when the line is properly placed, and urgent echocardiography or pericardiocentesis should be considered early in management of such patients. Umbilical venous catheterization should be considered only for a select group of sick neonates due to risks involved with these lines. When an umbilical venous catheter is placed, special precautions should be taken and maintenance guidelines followed.

  4. The efficacy of antenatal steroid therapy in preterm neonates in Shariati Hospital

    Directory of Open Access Journals (Sweden)

    Jamal A

    1996-07-01

    Full Text Available The newborn who is born before terms is a candidate for the development of idiopathic respiratory distress syndrome. The intense hypoxia and acidosis that ensue as the consequence of inadequate alveolar-capillary exchange of oxygen and carbon dioxid may prove fatal antenatal steroid therapy can affect RDS (Respiratory Distress Syndrom and its complications. The newborn before 34 weeks have a significantly lowered incidence of RDS and neonatal mortality from RDS with antenatal steroid therapy. In a retrospective study we compared 37 preterm infants whose mothers had received corticosteroids to 29 similar but untreated infants. The study showed that antenatal steroid therapy reduced neonatal mortality from RDS more than reducing the incidence of RDS and further it was concluded that this beneficial effect was more significant in female fetus than male fetus, but it was not significant statistically

  5. A large animal fatal extremity hemorrhage model and evaluation of a polymeric dressing (fatal extremity hemorrhage).

    Science.gov (United States)

    Walters, Thomas; Baer, David G; Kauvar, David S

    2006-11-01

    Extremity hemorrhage is a contributor to preventable battlefield mortality. The Army has liberalized tourniquet use guidelines in an attempt to prevent these deaths. To evaluate wound hemostatic agents that might allow for early tourniquet removal while maintaining hemorrhage control, a model of lethal extremity hemorrhage in the goat (Capra hircus) was developed and a polymeric dressing agent (BioFoam) tested. After administration of a spinal block, animals were placed in lateral recumbancy with a head-up tilt of 6 degrees, 500 mL crystalloid was injected and 600 u/Kg of heparin was administered. After tourniquet application to the thigh, a soft tissue and vascular injury was created by transecting muscles and the femoral artery. The polymeric wound dressing was applied and the tourniquet was released. In testing, the primary endpoint was mortality within the first hour after tourniquet release. None of the control animals survived the full hour. Two out of five (40%) of the treated animals survived. With survivors' survival time calculated as 60 minutes, survival time was found not to differ between treated (34 +/- 19 minutes) and untreated (29 +/- 18 minutes) animals (p = 0.77). The physical characteristics of tissue injury, need for anticoagulation, and manipulation of blood pressure are vital factors contributing to the lethality of a large animal fatal extremity hemorrhage model. BioFoam was successful in preventing fatal arterial extremity hemorrhage after the release of an effective tourniquet in some cases. An agent that can reliably allow for safe tourniquet removal and restoration of collateral circulation is a potential solution to tourniquet-associated morbidity in traumatic extremity injury. The model developed will serve as a rigorous test for such agents.

  6. Hypothyroidism in Filipino neonates

    International Nuclear Information System (INIS)

    Guevarra, R.; Torres, J.F.; Estrada, F.A.; San Luis, T.O.L.

    1988-01-01

    Thyroid hormone determination (T4, T3, rT3, TSH) in cord blood of 3,897 newborns was carried out in Metro Manila (non-endemic) and central, Northern and Southern Luzon (endemic for goiter). The objective is to detect congenital hypothyroidism and establish its incidence in new born Filipinos. This was done by radioimmunoassay, using commercial kits from Abbott Laboratories. The results obtained as mean values for non-endemic regions are: T4: 10.96 +- 2.25 ug/dl; T3: 60-64 +- 13.82 ng/dl; rT3: 250.4 +- 64.9 ng/dl; and TSH 5.89 +- 2.58 uU/ml, n=200. Mean values in endemic regions (n = 205) are T4: 9.46 +- 2.18 ug/dl; T3: 67.8 +- 12.05 ng/dl; rT3: 184.3 +- 32.7 ng/dl and TSH: 6.65 +- 3.13 uU/ml. From the above data, nomograms were drawn where the values obtained from each case were plotted. From non-endemic regions 28 positive cases were recalled and in the endemic regions 16 positive cases were also recalled for re-examination but most of them turned out to be false positive. As of now, four positive cases were found in Metro Manila, i.e. 4/2, 441 births and five in endemic regions out of 1,456 births so the incidence of neonatal hypothyroidism is 9/3,897 births. This is 9 times higher than most reports abroad which is about 1/4000 births. (Auth.). 36 refs; 10 tabs; 10 figs

  7. Fetal and neonatal thyrotoxicosis

    Directory of Open Access Journals (Sweden)

    Chandar Mohan Batra

    2013-01-01

    Full Text Available Fetal thyrotoxicosis is a rare disease occurring in 1 out of 70 pregnancies with Grave′s disease or in 1 out of 4000-50,000 deliveries. The mortality is 12-20%, usually from heart failure, but other complications are tracheal compression, infections and thrombocytopenia. It results from transfer of thyroid stimulating immunoglobulins from mother to fetus through the placenta. This transplacental transfer begins around 20 th week of pregnancy and reaches its maximum by 30 th week. These autoantibodies bind to the fetal thyroid stimulating hormone (TSH receptors and increase the secretion of the thyroid hormones. The mother has an active autoimmune thyroid disease or has been treated for it in the past. She may be absolutely euthyroid due to past treatment by drugs, surgery or radioiodine ablation, but still have active TSH receptor stimulating autoantibodies, which can cause fetal thyrotoxicosis. The other features of this disease are fetal tachycardia, fetal goiter and history of spontaneous abortions and findings of goiter, ascites, craniosyntosis, fetal growth retardation, maceration and hydrops at fetal autopsy. If untreated, this disease can result in intrauterine death. The treatment for this disease consists of giving carbimazole to the mother, which is transferred through the placenta to the fetus. The dose of carbimazole is titrated with the fetal heart rate. If the mother becomes hypothyroid due to carbimazole, thyroxine is added taking advantage of the fact that very little of thyroxine is transferred across the placenta. Neonatal thyrotoxicosis patients are very sick and require emergency treatment. The goal of the treatment is to normalize thyroid functions as quickly as possible, to avoid iatrogenic hypothyroidism while providing management and supportive therapy for the infant′s specific signs and symptoms.

  8. Pearson marrow-pancreas syndrome with worsening cardiac function caused by pleiotropic rearrangement of mitochondrial DNA.

    Science.gov (United States)

    Krauch, Gabriele; Wilichowski, Ekkehard; Schmidt, Klaus G; Mayatepek, Ertan

    2002-06-01

    Pearson marrow-pancreas syndrome is a usually fatal disorder that involves the hematopoietic system, exocrine pancreas, liver, kidneys, and often presents clinically with failure to thrive. We report a 5-year-old patient who developed, in addition to the typical features of Pearson syndrome, worsening cardiac function, mainly affecting the left ventricle. The latter finding is particularly interesting because cardiac involvement has not yet been regarded as a major feature of Pearson syndrome. The diagnosis was proved by the finding of so far undescribed pleioplasmatic rearrangement of mitochondrial (mt)DNA (loss of 5,630 bp, 70% deleted and duplicated mtDNA) in blood cells. Our report demonstrates that patients with Pearson syndrome may also have impaired cardiac function. Thus, Pearson syndrome should be considered in the differential diagnosis of patients with left ventricular dysfunction of unknown origin and other clinical findings suggestive of a mitochondrial disease. Copyright 2002 Wiley-Liss, Inc.

  9. Myopathology and a mitochondrial DNA deletion in the Pearson marrow and pancreas syndrome.

    Science.gov (United States)

    de Vries, D D; Buzing, C J; Ruitenbeek, W; van der Wouw, M P; Sperl, W; Sengers, R C; Trijbels, J M; van Oost, B A

    1992-01-01

    A patient with the Pearson marrow and pancreas syndrome is presented. She showed an anaemia with neutropenia and thrombopenia, failure to thrive, diarrhoea, disturbed glucose homeostasis and lactic acidosis. An exocrine pancreatic insufficiency was lacking. The disease followed a fatal course. Biochemical investigations of skeletal muscle revealed a disturbed mitochondrial energy metabolism, while many ultrastructural abnormal features were observed in the muscle tissue. Molecular genetic studies showed a de novo deletion in the mitochondrial DNA (mtDNA), different in size from the already published deletions and flanked by two 4 bp direct repeats, interspaced by 4-5 non-repeated nucleotides. mtDNA from 12 other tissues showed the same deletion in different percentages. No obvious relation between these percentages and tissue dysfunction was found. In spite of an open reading frame of 74 codons, only little transcription product of the genomic region resulting from the deletion was found.

  10. Mitochondrial DNA and Cancer Epidemiology Workshop

    Science.gov (United States)

    A workshop to review the state-of-the science in the mitochondrial DNA field and its use in cancer epidemiology, and to develop a concept for a research initiative on mitochondrial DNA and cancer epidemiology.

  11. Maternal hypotension and neonatal acidemia during Caeserean ...

    African Journals Online (AJOL)

    Objectives: To determine the incidence of neonatal acidaemia following delivery through caesarean section under spinal anaesthesia and determine the prevalence of maternal hypotension during Caesarean section under spinal anaesthesia and its correlation with neonatal acidaemia. Design: Prospective observational ...

  12. Buprenorphine During Pregnancy Reduces Neonate Distress

    Science.gov (United States)

    ... who received buprenorphine had milder symptoms of neonatal opioid withdrawal than those born to women who received methadone. ... with less neonatal distress. Buprenorphine, like methadone, reduces opioid craving and alleviates withdrawal symptoms without the safety and health risks related ...

  13. Clinical diagnosis versus autopsy findings in polytrauma fatalities

    Directory of Open Access Journals (Sweden)

    Fakler Johannes K

    2010-10-01

    Full Text Available Abstract Objectives The aim of the study was to determine if differences in clinical diagnosis versus autopsy findings concerning the cause of death in polytrauma fatalities would be detected in 19 cases of fatal polytrauma from a Level 1 trauma centre. Methods Clinical diagnoses determining the cause of death in 19 cases of fatal polytrauma (2007 - 2008 from a Level 1 trauma centre were correlated with autopsy findings. Results In 13 cases (68%, the clinical cause of death and the cause of death as determined by autopsy were congruent. Marginal differences occurred in three (16% patients while obvious differences in interpreting the cause of death were found in another three (16% cases. Five fatalities (three with obvious differences and two with marginal differences were remarked as early death (1-4 h after trauma and one fatality with marginal differences as late death (>1 week after trauma. Obvious and marginal discrepancies mostly occurred in the early phase of treatment, especially when severely injured patients were admitted to the emergency room undergoing continued cardiopulmonary resuscitation, i. e. limiting diagnostic procedures, and thus the clinical cause of death was essentially determined by basic emergency diagnostics. Conclusions Autopsy as golden standard to define the cause of death in fatal polytrauma varies from the clinical point of view, depending on the patient's pre-existing condition, mechanism of polytrauma, necessity of traumatic cardiopulmonary resuscitation, survival time, and thus the possibility to perform emergency diagnostics. An autopsy should be performed at least in cases of early fatal polytrauma to help establishing the definite cause of death. Moreover, autopsy data should be included in trauma registries as a quality assessment tool.

  14. The profile of wounding in civilian public mass shooting fatalities.

    Science.gov (United States)

    Smith, Edward Reed; Shapiro, Geoff; Sarani, Babak

    2016-07-01

    The incidence and severity of civilian public mass shootings (CPMS) continue to rise. Initiatives predicated on lessons learned from military woundings have placed strong emphasis on hemorrhage control, especially via use of tourniquets, as means to improve survival. We hypothesize that both the overall wounding pattern and the specific fatal wounds in CPMS events are different from those in military combat fatalities and thus may require a new management strategy. A retrospective study of autopsy reports for all victims involved in 12 CPMS events was performed. Civilian public mass shootings was defined using the FBI and the Congressional Research Service definition. The site of injury, probable site of fatal injury, and presence of potentially survivable injury (defined as survival if prehospital care is provided within 10 minutes and trauma center care within 60 minutes of injury) was determined independently by each author. A total 139 fatalities consisting of 371 wounds from 12 CPMS events were reviewed. All wounds were due to gunshots. Victims had an average of 2.7 gunshots. Relative to military reports, the case fatality rate was significantly higher, and incidence of potentially survivable injuries was significantly lower. Overall, 58% of victims had gunshots to the head and chest, and only 20% had extremity wounds. The probable site of fatal wounding was the head or chest in 77% of cases. Only 7% of victims had potentially survivable wounds. The most common site of potentially survivable injury was the chest (89%). No head injury was potentially survivable. There were no deaths due to exsanguination from an extremity. The overall and fatal wounding patterns following CPMS are different from those resulting from combat operations. Given that no deaths were due to extremity hemorrhage, a treatment strategy that goes beyond use of tourniquets is needed to rescue the few victims with potentially survivable injuries. Prognostic/epidemiologic study, level IV

  15. Polyglucosan Bodies in Placental Extravillious Trophoblast for the Diagnosis of Fatal Perinatal Neuromuscular Type Glycogen Storage Disease Type IV.

    Science.gov (United States)

    Yu, Weiming; Brundler, Marie-Anne; Wright, James R

    2017-01-01

    The fatal infantile neuromuscular type is the most severe form of glycogen storage disease type IV. We report a case of a 22-day-old female neonate born at 34 weeks gestation with polyhyramnios, fetal hydrops, and severe hypotonia. Placental examination revealed numerous periodic acid schiff (PAS)-positive diastase-resistant polyglucosan bodies in the cytoplasm of extravillous trophoblast predominantly in the placental basal plate. Muscle biopsy and autopsy findings supported a diagnosis of neuromuscular-type glycogen storage disease IV with extensive involvement of skeletal muscle, heart, and liver. The diagnosis was confirmed by molecular genetic testing. We could only find one prior report in the English literature that describes placental pathological changes. Our findings suggest that placental examination can be a useful adjunct for early diagnosis, as placentas are often received for pathological examination shortly after birth and usually before a diagnostic muscle biopsy can be performed. Pathologists need to be aware of characteristic placental features.

  16. A new method for continuous, long-term polysomnographic recording of neonatal rats.

    Science.gov (United States)

    Feng, P; Vogel, G W

    2000-02-01

    Many findings suggest that in altricial mammals neonatal REM sleep has developmental functions. However, investigations of these developmental functions has been hampered by technical limitations of the conventional polysomnographic (PSG) recording technique. One limitation is that continuous (24 hour/day), long-term (weeks) PSG recordings have not been achieved. A second limitation is that the metal screw electrodes and head plugs cemented to the skull cannot be removed to allow the neonate to mature into adulthood. As a result of these limitations, the relationship between neonatal sleep/wake variables and adult variables has not been studied. Also the effects of polysomnographically controlled neonatal REM sleep deprivation on adult variables have not been studied. The present work describes a new technique called the soft head plug (SH) method for continuous, long-term PSG recording. In the new technique, electrodes are thin, strong, Teflon wires that are led by a suturing needle through the soft skull to the epidural space, then with a U-turn exited from the skull and tied to the entry wire. Thus, in contrast to the conventional technique, the soft head plug technique does not use screws as electrodes and does not cement a hard, relatively large electrode plug to the skull, removal of which is fatal or very traumatic. The SH recording electrodes can be removed without damage to neonates. NA. NA. NA. In the present study sleep/wake results with the soft head plug technique were reliable (replicated) and, compared with results of the conventional method, valid. The results indicate that the soft head plug technique can be used to study relationships between neonatal sleep/wake variables and adult variables.

  17. Two Neonates with Congenital Hydrocolpos

    Directory of Open Access Journals (Sweden)

    Vydehi Murthy

    2013-01-01

    Full Text Available Introduction. Neonatal hydrocolpos is a rare condition. Hydrocolpos is cystic dilatation of the vagina with fluid accumulation due to a combination of stimulation of secretary glands of the reproductive tract and vaginal obstruction. The differential for a neonatal presentation of lower abdominal mass includes urogenital anomalies, Hirschsprung’s, disease or sacrococcygeal teratoma. Prenatal diagnosis and early newborn imaging studies leads to early detection and treatment of these cases. Case. We report here two cases of neonatal hydrocolpos with prenatal diagnosis of lower abdominal mass. Postnatally, ultrasound, MRI imaging, and cystoscopy confirmed large cystic mass as hydrocolpos with distal vaginal obstruction. Both patients had enlarged renal system secondary to mass effect. Conclusion. High index of suspicion for hydrocolpos in a newborn presenting with fetal diagnosis of infraumbilical abdominal mass will facilitate timely intervention and prevention of complications.

  18. Diagnostic imaging in neonatal stroke

    International Nuclear Information System (INIS)

    Kuhle, S.; Ipsiroglu, O.; Weninger, M.

    2000-01-01

    A cerebral artery infarction is an important differential diagnosis in the newborn with neurological abnormalities. Based on clinical data, its incidence is estimated to be 1 in 4000 newborns. Since the course is often subclinical, the true incidence is probably higher. Diagnosis: Cerebral ultrasound and Doppler sonography as readily available screening tools play a central role in the initial diagnosis of neonatal cerebral infarction. Definitive diagnosis is made by computed tomography or magnetic resonance imaging. Beside symptomatic anticonvulsive therapy, treatment aims at the prevention of secondary ischemic injury. Discussion: Three term infants with different clinical courses of neonatal stroke are presented to sensitize the clinician and the radiologist for this probably underdiagnosed entity. The role of imaging modalities in the diagnosis and follow-up of neonatal cerebral infarction is discussed. (orig.) [de

  19. Neonatal hemophilia: a rare presentation

    Directory of Open Access Journals (Sweden)

    Nuno Ferreira

    2015-12-01

    Full Text Available Hemophilia A is a X-linked hereditary condition that lead to decreased factor VIII activity, occurs mainly in males. Decreased factor VIII activity leads to increased risk of bleeding events. During neonatal period, diagnosis is made after post-partum bleeding complication or unexpected bleeding after medical procedures. Subgaleal hemorrhage during neonatal period is a rare, severe extracranial bleeding with high mortality and usually related to traumatic labor or coagulation disorders. Subgaleal hemorrhage complications result from massive bleeding. We present a neonate with unremarkable family history and uneventful pregnancy with a vaginal delivery with no instrumentation, presenting with severe subgaleal bleeding at 52 hours of life. Aggressive support measures were implemented and bleeding managed. The unexpected bleeding lead to a coagulation study and the diagnosis of severe hemophilia A. There were no known sequelae. This case shows a rare hemophilia presentation reflecting the importance of coagulation studies when faced with unexplained severe bleeding.

  20. GASTROINTESTINAL MANIFESTATIONS OF MITOCHONDRIAL DYSFUNCTION

    Directory of Open Access Journals (Sweden)

    A. A. Ziganshina

    2016-01-01

    Full Text Available Objective: to highlight the current concepts of gastrointestinal manifestations of mitochondrial dysfunction. The data available in Russian and foreign literature on the gastrointestinal manifestations of mitochondrial dysfunction were analyzed. Functional digestive diseases are common in pediatric practice; however, their etiopathogenesis has not been adequately explored today. According to the literature, impaired cellular energy metabolism may underlie gastrointestinal motility disorders in cyclic vomiting syndrome, gastroesophageal reflux, gastric stasis, chronic diarrhea, constipation, intestinal pseudoobstruction, malabsorption syndrome, irritable bowel syndrome, as well as diseases of the liver and pancreas.

  1. Mitochondrial myopathy and myoclonic epilepsy

    Directory of Open Access Journals (Sweden)

    Walter O. Arruda

    1990-03-01

    Full Text Available The authors describe a family (mother, son and two daughters with mitochondrial myopathy. The mother was asymptomatic. Two daughters had lactic acidosis and myoclonic epilepsy, mild dementia, ataxia, weakness and sensory neuropathy. The son suffered one acute hemiplegic episode due to an ischemic infarct in the right temporal region. All the patients studied had hypertension. EEG disclosed photomyoclonic response in the proband patient. Muscle biopsy disclosed ragged-red fibers and abnormal mitochondria by electron microscopy. Biochemical analysis showed a defect of cytochrome C oxidase in mitochondria isolated from skeletal muscle. Several clinical and genetic aspects of the mitochondrial encephalomyopathies are discussed.

  2. Antimicrobial therapy in neonatal intensive care unit

    OpenAIRE

    Tzialla, C.; Borghesi, A.; Serra, G.; Stronati, M.; Corsello, G.

    2015-01-01

    Severe infections represent the main cause of neonatal mortality accounting for more than one million neonatal deaths worldwide every year. Antibiotics are the most commonly prescribed medications in neonatal intensive care units (NICUs) and in industrialized countries about 1% of neonates are exposed to antibiotic therapy. Sepsis has often nonspecific signs and symptoms and empiric antimicrobial therapy is promptly initiated in high risk of sepsis or symptomatic infants. However continued us...

  3. Bupivacaine versus lidocaine analgesia for neonatal circumcision

    OpenAIRE

    Stolik-Dollberg, Orit C; Dollberg, Shaul

    2005-01-01

    Abstract Background Analgesia for neonatal circumcision was recently advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics. We compared the post-operative analgesic quality of bupivacaine to that of lidocaine for achieving dorsal penile nerve block (DPNB) when performing neonatal circumcision. Methods Data were obtained from 38 neonates following neonatal circumcision. The infants had received DPNB analgesia with either lidocaine or bupivac...

  4. Neonatal and infantile acne vulgaris: an update.

    Science.gov (United States)

    Serna-Tamayo, Cristian; Janniger, Camila K; Micali, Giuseppe; Schwartz, Robert A

    2014-07-01

    Acne may present in neonates, infants, and small children. Neonatal and infantile acne vulgaris are not considered to be rare. The presentation of acne in this patient population sometimes represents virilization and may portend later development of severe adolescent acne. Neonatal and infantile acne vulgaris must be distinguished from other cutaneous disorders seen in newborns and infants. Infantile acne tends to be more pleomorphic and inflammatory, thus requiring more vigorous therapy than neonatal acne.

  5. Loss-of-function mutations in ISCA2 disrupt 4Fe-4S cluster machinery and cause a fatal leukodystrophy with hyperglycinemia and mtDNA depletion.

    Science.gov (United States)

    Alaimo, Joseph T; Besse, Arnaud; Alston, Charlotte L; Pang, Ki; Appadurai, Vivek; Samanta, Monisha; Smpokou, Patroula; McFarland, Robert; Taylor, Robert W; Bonnen, Penelope E

    2018-04-01

    Iron-sulfur (Fe-S) clusters are essential cofactors for proteins that participate in fundamental cellular processes including metabolism, DNA replication and repair, transcriptional regulation, and the mitochondrial electron transport chain (ETC). ISCA2 plays a role in the biogenesis of Fe-S clusters and a recent report described subjects displaying infantile-onset leukodystrophy due to bi-allelic mutation of ISCA2. We present two additional unrelated cases, and provide a more complete clinical description that includes hyperglycinemia, leukodystrophy of the brainstem with longitudinally extensive spinal cord involvement, and mtDNA deficiency. Additionally, we characterize the role of ISCA2 in mitochondrial bioenergetics and Fe-S cluster assembly using subject cells and ISCA2 cellular knockdown models. Loss of ISCA2 diminished mitochondrial membrane potential, the mitochondrial network, basal and maximal respiration, ATP production, and activity of ETC complexes II and IV. We specifically tested the impact of loss of ISCA2 on 2Fe-2S proteins versus 4Fe-4S proteins and observed deficits in the functioning of 4Fe-4S but not 2Fe-2S proteins. Together these data indicate loss of ISCA2 impaired function of 4Fe-4S proteins resulting in a fatal encephalopathy accompanied by a relatively unusual combination of features including mtDNA depletion alongside complex II deficiency and hyperglycinemia that may facilitate diagnosis of ISCA2 deficiency patients. © 2018 The Authors. Human Mutation published by Wiley Periodicals, Inc.

  6. Left ventricular hypertrophy and risk of fatal and non-fatal stroke EUROSTROKE: a collaborative study among research centres in Europe

    NARCIS (Netherlands)

    M.L. Bots (Michiel); J. Tuomilehto; D.E. Grobbee (Diederick); P.J. Koudstaal (Peter Jan); Y. Nikitin; J.T. Salonen; P.C. Elwood; S. Malyutina; A. Freire de Concalves; J. Sivenius; A. di Carlo; P. Lagiou

    2002-01-01

    textabstractBACKGROUND: This study investigated the association between electrocardiographically assessed left ventricular hypertrophy (LVH) and fatal, non-fatal, haemorrhagic and ischaemic stroke in four European cohorts participating in EUROSTROKE. METHODS: EUROSTROKE is a

  7. ATAD3 gene cluster deletions cause cerebellar dysfunction associated with altered mitochondrial DNA and cholesterol metabolism.

    Science.gov (United States)

    Desai, Radha; Frazier, Ann E; Durigon, Romina; Patel, Harshil; Jones, Aleck W; Dalla Rosa, Ilaria; Lake, Nicole J; Compton, Alison G; Mountford, Hayley S; Tucker, Elena J; Mitchell, Alice L R; Jackson, Deborah; Sesay, Abdul; Di Re, Miriam; van den Heuvel, Lambert P; Burke, Derek; Francis, David; Lunke, Sebastian; McGillivray, George; Mandelstam, Simone; Mochel, Fanny; Keren, Boris; Jardel, Claude; Turner, Anne M; Ian Andrews, P; Smeitink, Jan; Spelbrink, Johannes N; Heales, Simon J; Kohda, Masakazu; Ohtake, Akira; Murayama, Kei; Okazaki, Yasushi; Lombès, Anne; Holt, Ian J; Thorburn, David R; Spinazzola, Antonella

    2017-06-01

    Although mitochondrial disorders are clinically heterogeneous, they frequently involve the central nervous system and are among the most common neurogenetic disorders. Identifying the causal genes has benefited enormously from advances in high-throughput sequencing technologies; however, once the defect is known, researchers face the challenge of deciphering the underlying disease mechanism. Here we characterize large biallelic deletions in the region encoding the ATAD3C, ATAD3B and ATAD3A genes. Although high homology complicates genomic analysis of the ATAD3 defects, they can be identified by targeted analysis of standard single nucleotide polymorphism array and whole exome sequencing data. We report deletions that generate chimeric ATAD3B/ATAD3A fusion genes in individuals from four unrelated families with fatal congenital pontocerebellar hypoplasia, whereas a case with genomic rearrangements affecting the ATAD3C/ATAD3B genes on one allele and ATAD3B/ATAD3A genes on the other displays later-onset encephalopathy with cerebellar atrophy, ataxia and dystonia. Fibroblasts from affected individuals display mitochondrial DNA abnormalities, associated with multiple indicators of altered cholesterol metabolism. Moreover, drug-induced perturbations of cholesterol homeostasis cause mitochondrial DNA disorganization in control cells, while mitochondrial DNA aggregation in the genetic cholesterol trafficking disorder Niemann-Pick type C disease further corroborates the interdependence of mitochondrial DNA organization and cholesterol. These data demonstrate the integration of mitochondria in cellular cholesterol homeostasis, in which ATAD3 plays a critical role. The dual problem of perturbed cholesterol metabolism and mitochondrial dysfunction could be widespread in neurological and neurodegenerative diseases. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain.

  8. Evidence Suggesting Absence of Mitochondrial DNA Methylation

    DEFF Research Database (Denmark)

    Mechta, Mie; Ingerslev, Lars R; Fabre, Odile

    2017-01-01

    Methylation of nuclear genes encoding mitochondrial proteins participates in the regulation of mitochondria function. The existence of cytosine methylation in the mitochondrial genome is debated. To investigate whether mitochondrial DNA (mtDNA) is methylated, we used both targeted- and whole mito...

  9. Neonatal lupus erythematosus in a Nigerian infant

    African Journals Online (AJOL)

    2017-06-15

    Jun 15, 2017 ... persisted unchanged after 14 days of antibiotics. A skin snip was taken for histology and a diagnosis of neonatal lupus erythematosus was made. Key words: neonatal lupsus erythematosus, infant .... anti-Rho (SSA) antibody which is present in 95% of cases of Neonatal lupus is fundamental.8,9 The signifi-.

  10. 21 CFR 880.5400 - Neonatal incubator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neonatal incubator. 880.5400 Section 880.5400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... § 880.5400 Neonatal incubator. (a) Identification. A neonatal incubator is a device consisting of a...

  11. Neonatal tetanus mortality in coastal Kenya

    DEFF Research Database (Denmark)

    Bjerregaard, P; Steinglass, R; Mutie, D M

    1993-01-01

    In a house-to-house survey in Kilifi District, Kenya, mothers of 2556 liveborn children were interviewed about neonatal mortality, especially from neonatal tetanus (NNT). The crude birth rate was 60.5 per 1000 population, the neonatal mortality rate 21.1 and the NNT mortality rate 3.1 per 1000...

  12. Neonatal arrhythmias: diagnosis, treatment, and clinical outcome

    OpenAIRE

    Ban, Ji-Eun

    2017-01-01

    Arrhythmias in the neonatal period are not uncommon, and may occur in neonates with a normal heart or in those with structural heart disease. Neonatal arrhythmias are classified as either benign or nonbenign. Benign arrhythmias include sinus arrhythmia, premature atrial contraction, premature ventricular contraction, and junctional rhythm; these arrhythmias have no clinical significance and do not need therapy. Supraventricular tachycardia, ventricular tachycardia, atrioventricular conduction...

  13. Malaria parasite positivity among febrile neonates | Enyuma ...

    African Journals Online (AJOL)

    Background: Malaria, earlier considered rare in neonates, has been reported with increasing frequency in the last decade. Neonatal malaria diagnosis is challenging because the clinical features are non-specific, variable and also overlap with bacterial infection. Aim: To determine the prevalence of neonatal malaria and ...

  14. Neonatal varicella: A case report

    Directory of Open Access Journals (Sweden)

    Bhardwaj AK

    2011-06-01

    Full Text Available Chicken pox is an infectious childhood disease. It is rare ininfants and newborns due to passive immunity receivedfrom the mother. The characteristic skin eruptions inchicken pox are vesicular with erythematous base andaccompanied with pruritus. The skin of the palms and solesis typically spared. We report a case of neonatal varicellawhere the mother was having skin eruptions at the time ofdelivery and the neonate contracted it during the perinatalperiod and developed clinical disease on the day five of life.Specific anti-viral therapy was given to the mother and thebaby and the recovery was uneventful.

  15. Pain Management Perceptions of the Neonatal Nurses in NICUs and Neonatal Units in Ardebil, Iran

    OpenAIRE

    Nasrin Mehrnoush; Tahereh Ashktorab; Mohammad heidarzadeh; Sirous momenzadeh; jafar khalafi

    2016-01-01

    Background: This study aimed to determine neonatal nurses’ perceptions of knowledge and practice in pain management in NICUs & neonatal units. Methods: A cross-sectional descriptive study design was used. A total of 120 neonatal nurses who working in NICUs & neonatal units in Ardebil province, Iran were selected using the convenience sampling technique. A questionnaire of Nurses’ Perceptions of Neonatal Pain (Cong, 2013), including 36 questions with Likert scale and 2 open ended questions, wa...

  16. Effect of case management on neonatal mortality due to sepsis and pneumonia

    Directory of Open Access Journals (Sweden)

    Black Robert

    2011-04-01

    Full Text Available Abstract Background Each year almost one million newborns die from infections, mostly in low-income countries. Timely case management would save many lives but the relative mortality effect of varying strategies is unknown. We have estimated the effect of providing oral, or injectable antibiotics at home or in first-level facilities, and of in-patient hospital care on neonatal mortality from pneumonia and sepsis for use in the Lives Saved Tool (LiST. Methods We conducted systematic searches of multiple databases to identify relevant studies with mortality data. Standardized abstraction tables were used and study quality assessed by adapted GRADE criteria. Meta-analyses were undertaken where appropriate. For interventions with biological plausibility but low quality evidence, a Delphi process was undertaken to estimate effectiveness. Results Searches of 2876 titles identified 7 studies. Among these, 4 evaluated oral antibiotics for neonatal pneumonia in non-randomised, concurrently controlled designs. Meta-analysis suggested reductions in all-cause neonatal mortality (RR 0.75 95% CI 0.64- 0.89; 4 studies and neonatal pneumonia-specific mortality (RR 0.58 95% CI 0.41- 0.82; 3 studies. Two studies (1 RCT, 1 observational study, evaluated community-based neonatal care packages including injectable antibiotics and reported mortality reductions of 44% (RR= 0.56, 95% CI 0.41-0.77 and 34% (RR =0.66, 95% CI 0.47-0.93, but the interpretation of these results is complicated by co-interventions. A third, clinic-based, study reported a case-fatality ratio of 3.3% among neonates treated with injectable antibiotics as outpatients. No studies were identified evaluating injectable antibiotics alone for neonatal pneumonia. Delphi consensus (median from 20 respondents effects on sepsis-specific mortality were 30% reduction for oral antibiotics, 65% for injectable antibiotics and 75% for injectable antibiotics on pneumonia-specific mortality. No trials were

  17. Effect of case management on neonatal mortality due to sepsis and pneumonia.

    Science.gov (United States)

    Zaidi, Anita K M; Ganatra, Hammad A; Syed, Sana; Cousens, Simon; Lee, Anne C C; Black, Robert; Bhutta, Zulfiqar A; Lawn, Joy E

    2011-04-13

    Each year almost one million newborns die from infections, mostly in low-income countries. Timely case management would save many lives but the relative mortality effect of varying strategies is unknown. We have estimated the effect of providing oral, or injectable antibiotics at home or in first-level facilities, and of in-patient hospital care on neonatal mortality from pneumonia and sepsis for use in the Lives Saved Tool (LiST). We conducted systematic searches of multiple databases to identify relevant studies with mortality data. Standardized abstraction tables were used and study quality assessed by adapted GRADE criteria. Meta-analyses were undertaken where appropriate. For interventions with biological plausibility but low quality evidence, a Delphi process was undertaken to estimate effectiveness. Searches of 2876 titles identified 7 studies. Among these, 4 evaluated oral antibiotics for neonatal pneumonia in non-randomised, concurrently controlled designs. Meta-analysis suggested reductions in all-cause neonatal mortality (RR 0.75 95% CI 0.64- 0.89; 4 studies) and neonatal pneumonia-specific mortality (RR 0.58 95% CI 0.41- 0.82; 3 studies). Two studies (1 RCT, 1 observational study), evaluated community-based neonatal care packages including injectable antibiotics and reported mortality reductions of 44% (RR = 0.56, 95% CI 0.41-0.77) and 34% (RR = 0.66, 95% CI 0.47-0.93), but the interpretation of these results is complicated by co-interventions. A third, clinic-based, study reported a case-fatality ratio of 3.3% among neonates treated with injectable antibiotics as outpatients. No studies were identified evaluating injectable antibiotics alone for neonatal pneumonia. Delphi consensus (median from 20 respondents) effects on sepsis-specific mortality were 30% reduction for oral antibiotics, 65% for injectable antibiotics and 75% for injectable antibiotics on pneumonia-specific mortality. No trials were identified assessing effect of hospital management for

  18. Characteristics of schools in which fatal shootings occur.

    Science.gov (United States)

    de Apodaca, Roberto Flores; Brighton, Lauren M; Perkins, Ashley N; Jackson, Kiana N; Steege, Jessica R

    2012-04-01

    School-based violence, and fatal school shootings in particular, have gained increased attention in the media and psychological literature. Most reports have focused on the characteristics of perpetrators, but there is a growing awareness that school-related factors may also influence the occurrence of fatal school shootings. The current study examined several key characteristics of all schools where random (38) and targeted (96) fatal shootings occurred in the United States between 1966 and 2009. These were compared with a group (138) of schools randomly selected to represent the population of all schools in the United States. The size of a school's enrollment, urban or suburban locale, public funding, and predominantly non-white enrollment were positively associated with fatal shootings. Universities and colleges were disproportionately associated with random shootings and high schools with targeted ones. It was proposed that characteristics of schools that allow feelings of anonymity or alienation among students may help create environmental conditions associated with fatal school shootings. Implications for future research and interventions are considered.

  19. Motor vehicle fatalities among oil and gas extraction workers.

    Science.gov (United States)

    Retzer, Kyla D; Hill, Ryan D; Pratt, Stephanie G

    2013-03-01

    Motor vehicle crashes are the leading cause of work-related fatality in the U.S. as well as in the oil and gas extraction industry. This study describes the characteristics of motor vehicle-related fatalities in the oil and gas extraction industry using data from the U.S. Bureau of Labor Statistics' Census of Fatal Occupational Injuries. It compares the risk of dying in a motor vehicle crash in this industry to other major industries and among different types and sizes of oil and gas extraction companies. There were 202 oil and gas extraction workers who died in a work-related motor vehicle crash from 2003 to 2009. The motor vehicle fatality rate for workers in this industry was 8.5 times that of all private wage and salary workers (7.6 vs. 0.9, poil and gas establishments (motor vehicle crash. Pick-up trucks were the most frequent type of vehicle occupied by the fatally injured worker (n=104, 51.5%). Safety belt non-use was identified in 38.1% (n=77) of the cases. Increased focus on motor vehicle safety in this industry is needed, in particular among small establishments. Extraction workers who drive light duty vehicles need to be a specific focus. Published by Elsevier Ltd.

  20. Evaluation of meteorological and epidemiological characteristics of fatal pulmonary embolism

    Science.gov (United States)

    Törő, Klára; Pongrácz, Rita; Bartholy, Judit; Váradi-T, Aletta; Marcsa, Boglárka; Szilágyi, Brigitta; Lovas, Attila; Dunay, György; Sótonyi, Péter

    2016-03-01

    The objective of the present study was to identify risk factors among epidemiological factors and meteorological conditions in connection with fatal pulmonary embolism. Information was collected from forensic autopsy records in sudden unexpected death cases where pulmonary embolism was the exact cause of death between 2001 and 2010 in Budapest. Meteorological parameters were detected during the investigated period. Gender, age, manner of death, cause of death, place of death, post-mortem pathomorphological changes and daily meteorological conditions (i.e. daily mean temperature and atmospheric pressure) were examined. We detected that the number of registered pulmonary embolism (No 467, 211 male) follows power law in time regardless of the manner of death. We first described that the number of registered fatal pulmonary embolism up to the nth day can be expressed as Y( n) = α ṡ n β where Y denotes the number of fatal pulmonary embolisms up to the nth day and α > 0 and β > 1 are model parameters. We found that there is a definite link between the cold temperature and the increasing incidence of fatal pulmonary embolism. Cold temperature and the change of air pressure appear to be predisposing factors for fatal pulmonary embolism. Meteorological parameters should have provided additional information about the predisposing factors of thromboembolism.

  1. Trends in occupational injuries and fatality in Turkey.

    Science.gov (United States)

    Turkkan, Alpaslan; Pala, Kayihan

    2016-12-01

    The aim of this study was to evaluate the trend of occupational injuries in Turkey using epidemiologic criteria such as incidence mortality and fatality/all injuries recorded - rates. Safety and health data were obtained from the Annual Statistic Books of the Social Insurance Institution (1988-2006) and Social Security Institution (2007-2011) of Turkey. The results from the official data showed that although total employment is increasing the number of occupational injuries and incidence and mortality rates are decreasing. The results also demonstrate that occupational fatality/all injuries recorded - rate is increasing. The fatality/all injuries recorded - rate per 1000 injuries increased to 25.5 in 2011 from 8.6 in 1988. Each work day an average of five people died because of occupational injuries. The fatality/all injuries recorded - rate (the number of fatal cases per 1000 occupational injuries) is an important indicator of the injury rate for a country. Systems of occupational injury and illness surveillance constitute a critical resource for the management and reduction of occupational injuries and illness.

  2. Hemodynamics and gas exchange during chest compressions in neonatal resuscitation.

    Directory of Open Access Journals (Sweden)

    Payam Vali

    Full Text Available Current knowledge about pulmonary/systemic hemodynamics and gas exchange during neonatal resuscitation in a model of transitioning fetal circulation with fetal shunts and fluid-filled alveoli is limited. Using a fetal lamb asphyxia model, we sought to determine whether hemodynamic or gas-exchange parameters predicted successful return of spontaneous circulation (ROSC.The umbilical cord was occluded in 22 lambs to induce asphyxial cardiac arrest. Following five minutes of asystole, resuscitation as per AHA-Neonatal Resuscitation Program guidelines was initiated. Hemodynamic parameters and serial arterial blood gases were assessed during resuscitation.ROSC occurred in 18 lambs (82% at a median (IQR time of 120 (105-180 seconds. There were no differences in hemodynamic parameters at baseline and at any given time point during resuscitation between the lambs that achieved ROSC and those that did not. Blood gases at arrest prior to resuscitation were comparable between groups. However, lambs that achieved ROSC had lower PaO2, higher PaCO2, and lower lactate during resuscitation. Increase in diastolic blood pressures induced by epinephrine in lambs that achieved ROSC (11 ±4 mmHg did not differ from those that were not resuscitated (10 ±6 mmHg. Low diastolic blood pressures were adequate to achieve ROSC.Hemodynamic parameters in a neonatal lamb asphyxia model with transitioning circulation did not predict success of ROSC. Lactic acidosis, higher PaO2 and lower PaCO2 observed in the lambs that did not achieve ROSC may represent a state of inadequate tissue perfusion and/or mitochondrial dysfunction.

  3. The contribution of respiratory pathogens to fatal and non-fatal respiratory hospitalizations: a pilot study of Taqman Array Cards (TAC) in Kenya.

    Science.gov (United States)

    Njuguna, Henry N; Chaves, Sandra S; Emukule, Gideon O; Nyawanda, Bryan; Omballa, Victor; Juma, Bonventure; Onyango, Clayton O; Mott, Joshua A; Fields, Barry

    2017-08-25

    Respiratory diseases cause substantial morbidity and mortality worldwide, with sub-Saharan Africa bearing the greatest burden. Identifying etiologies of respiratory disease is important to inform cost effective treatment, prevention and control strategies. Testing for all of the different pathogens that are potentially associated with respiratory illnesses is challenging. We piloted the use of a multi-pathogen respiratory Taqman Array Cards (TAC) to identify pathogens in respiratory samples collected from non-fatal and fatal cases and their matched asymptomatic controls. This is a case control study comparing viral and bacterial pathogens detected among non-fatal and fatal cases to those detected among age and time matched asymptomatic controls. We used McNemar's test to compare proportions of pathogens detected among cases (non-fatal and fatal) to their matched asymptomatic controls. We used Mann-Whitney test to compare the distribution of median Cycle threshold (Ct) values among non-fatal and fatal cases to their corresponding asymptomatic controls. There were 72 fatal and 72 non-fatal cases matched to 72 controls. We identified at least one pathogen in 109/144 (76%) cases and 59/72 (82%) controls. For most pathogens, the median Ct values were lower among cases (fatal and non-fatal) compared to asymptomatic controls. Similar rates of pathogen detection among cases and controls make interpretation of results challenging. Ct-values might be helpful in interpreting clinical relevance of detected pathogens using multi-pathogen diagnostic tools.

  4. The potato tuber mitochondrial proteome

    DEFF Research Database (Denmark)

    Møller, Ian Max; Salvato, Fernanda; Havelund, Jesper

    We are testing the hypothesis that oxidized peptides are released from stressed mitochondria and contribute to retrograde signalling (Møller IM & Sweetlove LJ 2010 Trends Plant Sci 15, 370-374). However, there is a large gap between the number of experimentally verified mitochondrial proteins (~450...

  5. Insulin Resistance and Mitochondrial Dysfunction.

    Science.gov (United States)

    Gonzalez-Franquesa, Alba; Patti, Mary-Elizabeth

    2017-01-01

    Insulin resistance precedes and predicts the onset of type 2 diabetes (T2D) in susceptible humans, underscoring its important role in the complex pathogenesis of this disease. Insulin resistance contributes to multiple tissue defects characteristic of T2D, including reduced insulin-stimulated glucose uptake in insulin-sensitive tissues, increased hepatic glucose production, increased lipolysis in adipose tissue, and altered insulin secretion. Studies of individuals with insulin resistance, both with established T2D and high-risk individuals, have consistently demonstrated a diverse array of defects in mitochondrial function (i.e., bioenergetics, biogenesis and dynamics). However, it remains uncertain whether mitochondrial dysfunction is primary (critical initiating defect) or secondary to the subtle derangements in glucose metabolism, insulin resistance, and defective insulin secretion present early in the course of disease development. In this chapter, we will present the evidence linking mitochondrial dysfunction and insulin resistance, and review the potential for mitochondrial targets as a therapeutic approach for T2D.

  6. Renal disease and mitochondrial genetics.

    Science.gov (United States)

    Rötig, Agnès

    2003-01-01

    Respiratory chain (RC) deficiencies have long been regarded as neuromuscular diseases mainly originating from mutations in the mitochondrial DNA. Oxidative phosphorylation, i.e. adenosine triphosphate (ATP) synthesis-coupled electron transfer from substrate to oxygen through the RC, does not occur only in the neuromuscular system. Therefore, a RC deficiency can theoretically give rise to any symptom, in any organ or tissue, at any age and with any mode of inheritance, owing to the dual genetic origin of RC enzymes (nuclear DNA and mitochondrial DNA). Mitochondrial diseases can give rise to various syndromes or association, namely, neurologic and neuromuscular diseases, cardiac, renal, hepatic, hematological and endocrin or dermatological presentations. The most frequent renal symptom is proximal tubular dysfunction with a more or less complete de Toni-Debre-Fanconi Syndrome. A few patients have been reported with tubular acidosis, Bartter Syndrome, chronic tubulointerstitial nephritis or nephrotic syndrome. The diagnosis of a RC deficiency is difficult when only renal symptoms are present, but should be easier when another, seemingly unrelated symptom is observed. Metabolic screening for abnormal oxidoreduction status in plasma, including lactate/pyruvate and ketone body molar ratios, can help to identify patients for further investigations. These include the measurement of oxygen consumption by mitochondria and the assessment of mitochondrial respiratory enzyme activities by spectrophotometric studies. Any mode of inheritance can be observed: sporadic, autosomal dominant or recessive, or maternal inheritance.

  7. Diclofenac induces proteasome and mitochondrial dysfunction in murine cardiomyocytes and hearts.

    Science.gov (United States)

    Ghosh, Rajeshwary; Goswami, Sumanta K; Feitoza, Luis Felipe B B; Hammock, Bruce; Gomes, Aldrin V

    2016-11-15

    One of the most common nonsteroidal anti-inflammatory drugs (NSAIDs) used worldwide, diclofenac (DIC), has been linked to increased risk of cardiovascular disease (CVD). The molecular mechanism(s) by which DIC causes CVD is unknown. Proteasome activities were studied in hearts, livers, and kidneys from male Swiss Webster mice treated with either 100mg/kg DIC for 18h (acute treatment) or 10mg/kg DIC for 28days (chronic treatment). Cultured H9c2 cells and neonatal cardiomyocytes were also treated with different concentrations of DIC and proteasome function, cell death and ROS generation studied. Isolated mouse heart mitochondria were utilized to determine the effect of DIC on various electron transport chain complex activities. DIC significantly inhibited the chymotrypsin-like proteasome activity in rat cardiac H9c2 cells, murine neonatal cardiomyocytes, and mouse hearts, but did not affect proteasome subunit expression levels. Proteasome activity was also affected in liver and kidney tissues from DIC treated animals. The levels of polyubiquitinated proteins increased in hearts from DIC treated mice. Importantly, the levels of oxidized proteins increased while the β5i immunoproteasome activity decreased in hearts from DIC treated mice. DIC increased ROS production and cell death in H9c2 cells and neonatal cardiomyocytes while the cardioprotective NSAID, aspirin, had no effect on ROS levels or cell viability. DIC inhibited mitochondrial Complex III, a major source of ROS, and impaired mitochondrial membrane potential suggesting that mitochondria are the major sites of ROS generation. These results suggest that DIC induces cardiotoxicity by a ROS dependent mechanism involving mitochondrial and proteasome dysfunction. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. An approach to the evaluation of fatal hypothermia.

    Science.gov (United States)

    Türk, E E; Sperhake, J P; Pueschel, K; Tsokos, Michael

    2005-03-01

    The diagnosis of death caused by hypothermia can often only be made by exclusion. In this article, we discuss the significance of rectal temperature determination at the death scene for establishing the diagnosis of fatal hypothermia. Six cases of fatal hypothermia subjected to medico-legal autopsy at the Institute of Legal Medicine, Hamburg, Germany, were reviewed. Findings at external examination, autopsy findings with special regard to characteristics hypothermia-related changes, histological findings, and toxicology results were analyzed. In all cases investigated, a discrepancy between a low rectal temperature and other parameters for estimation of the time since death such as still displaceable postmortem lividity and electrical excitability of skeletal muscles was present, leading to the prompt suspicion of fatal hypothermia at the medico-legal death scene investigation. An early death scene investigation by a forensic specialist is of striking importance for establishing the correct diagnosis, because this discrepancy can only be observed in the early postmortem interval.

  9. The challenges of neonatal magnetic resonance imaging

    International Nuclear Information System (INIS)

    Arthurs, Owen J.; Graves, Martin J.; Lomas, David J.; Edwards, Andrea; Austin, Topun

    2012-01-01

    Improved neonatal survival rates and antenatal diagnostic imaging is generating a growing demand for postnatal MRI examinations. Neonatal brain MRI is now becoming standard clinical care in many settings, but with the exception of some research centres, the technique has not been optimised for imaging neonates and small children. Here, we review some of the challenges involved in neonatal MRI, including recent advances in overall MR practicality and nursing practice, to address some of the ways in which the MR experience could be made more neonate-friendly. (orig.)

  10. The challenges of neonatal magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J.; Graves, Martin J.; Lomas, David J. [Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Edwards, Andrea [Addenbrooke' s Hospital, Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospital, Department of Neonatology, Cambridge (United Kingdom); Austin, Topun [Addenbrooke' s Hospital, Department of Neonatology, Cambridge (United Kingdom)

    2012-10-15

    Improved neonatal survival rates and antenatal diagnostic imaging is generating a growing demand for postnatal MRI examinations. Neonatal brain MRI is now becoming standard clinical care in many settings, but with the exception of some research centres, the technique has not been optimised for imaging neonates and small children. Here, we review some of the challenges involved in neonatal MRI, including recent advances in overall MR practicality and nursing practice, to address some of the ways in which the MR experience could be made more neonate-friendly. (orig.)

  11. Rising gasoline prices increase new motorcycle sales and fatalities.

    Science.gov (United States)

    Zhu, He; Wilson, Fernando A; Stimpson, Jim P; Hilsenrath, Peter E

    2015-12-01

    We examined whether sales of new motorcycles was a mechanism to explain the relationship between motorcycle fatalities and gasoline prices. The data came from the Motorcycle Industry Council, Energy Information Administration and Fatality Analysis Reporting System for 1984-2009. Autoregressive integrated moving average (ARIMA) regressions estimated the effect of inflation-adjusted gasoline price on motorcycle sales and logistic regressions estimated odds ratios (ORs) between new and old motorcycle fatalities when gasoline prices increase. New motorcycle sales were positively correlated with gasoline prices (r = 0.78) and new motorcycle fatalities (r = 0.92). ARIMA analysis estimated that a US$1 increase in gasoline prices would result in 295,000 new motorcycle sales and, consequently, 233 new motorcycle fatalities. Compared to crashes on older motorcycle models, those on new motorcycles were more likely to be young riders, occur in the afternoon, in clear weather, with a large engine displacement, and without alcohol involvement. Riders on new motorcycles were more likely to be in fatal crashes relative to older motorcycles (OR 1.14, 95 % confidence interval (CI) 1.02-1.28) when gasoline prices increase. Our findings suggest that, in response to increasing gasoline prices, people tend to purchase new motorcycles, and this is accompanied with significantly increased crash risk. There are several policy mechanisms that can be used to lower the risk of motorcycle crash injuries through the mechanism of gas prices and motorcycle sales such as raising awareness of motorcycling risks, enhancing licensing and testing requirements, limiting motorcycle power-to-weight ratios for inexperienced riders, and developing mandatory training programs for new riders.

  12. Fatal traumatic brain injury with electrical weapon falls.

    Science.gov (United States)

    Kroll, Mark W; Adamec, Jiri; Wetli, Charles V; Williams, Howard E

    2016-10-01

    While generally reducing morbidity and mortality, electrical weapons have risks associated with their usage, including eye injuries and falls. With sufficient probe spread, an uncontrolled fall to the ground typically occurs along with the possibility of a fatal brain injury. We analyzed possible risk factors including running and elevated surfaces with established head-injury criteria to estimate the risk of brain injury. We searched for cases of arrest-related or in-custody death, with TASER(®) electrical weapon usage where fall-induced injuries might have contributed to the death. We found 24 cases meeting our initial inclusion criteria of a fatal fall involving electronic control. We then excluded 5 cases as intentional jumps, leaving 19 cases of forced falls. Autopsy reports and other records were analyzed to determine which of these deaths were from brain injury caused by the fall. We found 16 probable cases of fatal brain injuries induced by electronic control from electrical weapons. Out of 3 million field uses, this gives a risk of 5.3 ± 2.6 PPM which is higher than the theoretical risk of electrocution. The mean age was 46 ± 14 years which is significantly greater that the age of the typical ARD (36 ± 10). Probe shots to the subject's back may present a higher risk of a fatal fall. The use of electronic control presents a small but real risk of death from fatal traumatic brain injury. Increased age represents an independent risk factor for such fatalities. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  13. Drug and Alcohol Involvement in Four Types of Fatal Crashes*

    Science.gov (United States)

    Romano, Eduardo; Voas, Robert B.

    2011-01-01

    Objective: The aim of this study was to explore the relationship of drunk and drugged driving to the occurrence of fatal crashes associated with speeding, failure to obey/yield, inattention, and seat belt nonuse. Method: We examined data for fatally injured drivers involved in single-vehicle crashes killed in states in which more than 79% of the drivers were tested for drugs other than alcohol and had a known result. Results: About 25% of the drivers tested positive for drugs, a figure almost double that estimated by the 2007 National Roadside Survey. Cannabinoids and stimulants each contributed to about 23% of the drug-positive results (6% among all fatally injured single-vehicle drivers). Stimulants more than cannabinoids were found to be associated with the four types of crashes under study. Some drugs showed a protective effect over the four crash types under study. Significant interactions between drugs and alcohol were observed. Stimulants contributed to the different types of fatal crashes irrespective of the levels of alcohol consumed by the drivers. Conclusions: This study provides further evidence of a link between drug consumption and fatal crashes. It also opens the door to some interesting and sometimes unexpected questions regarding the way drugs contribute to crashes, which we found varies depending on the type of crash considered, the class of drug, and the presence of alcohol. Research is also needed on drugs that could have a protective effect on the occurrence of fatal crashes. These findings could be highly relevant to the design of drug-related traffic laws and programs targeted at curbing drugged driving. PMID:21683038

  14. Mitochondrial rejuvenation after induced pluripotency.

    Directory of Open Access Journals (Sweden)

    Steven T Suhr

    2010-11-01

    Full Text Available As stem cells of the early embryo mature and differentiate into all tissues, the mitochondrial complement undergoes dramatic functional improvement. Mitochondrial activity is low to minimize generation of DNA-damaging reactive oxygen species during pre-implantation development and increases following implantation and differentiation to meet higher metabolic demands. It has recently been reported that when the stem cell type known as induced pluripotent stem cells (IPSCs are re-differentiated for several weeks in vitro, the mitochondrial complement progressively re-acquires properties approximating input fibroblasts, suggesting that despite the observation that IPSC conversion "resets" some parameters of cellular aging such as telomere length, it may have little impact on other age-affected cellular systems such as mitochondria in IPSC-derived cells.We have examined the properties of mitochondria in two fibroblast lines, corresponding IPSCs, and fibroblasts re-derived from IPSCs using biochemical methods and electron microscopy, and found a dramatic improvement in the quality and function of the mitochondrial complement of the re-derived fibroblasts compared to input fibroblasts. This observation likely stems from two aspects of our experimental design: 1 that the input cell lines used were of advanced cellular age and contained an inefficient mitochondrial complement, and 2 the re-derived fibroblasts were produced using an extensive differentiation regimen that may more closely mimic the degree of growth and maturation found in a developing mammal.These results - coupled with earlier data from our laboratory - suggest that IPSC conversion not only resets the "biological clock", but can also rejuvenate the energetic capacity of derived cells.

  15. Current Trends in Neonatal Tracheostomy.

    Science.gov (United States)

    Isaiah, Amal; Moyer, Kelly; Pereira, Kevin D

    2016-08-01

    The indications for neonatal tracheostomy may have changed with current noninvasive respiratory therapies compared with previous decades. To study the current trends in neonatal tracheostomy and identify the primary indication for the procedure and risk factors for failed extubation. This retrospective medical record review included 47 neonates who underwent tracheostomy from January 1, 2009, to December 31, 2013, at the University of Maryland Children's Hospital. Group 1 included infants undergoing tracheostomy for the primary indication of upper airway obstruction; group 2, infants with primary pulmonary disease. Data on weight, gestational age, comorbid conditions, congenital abnormalities, complications, outcomes, and indications for tracheostomy were compared statistically between groups. Differences in gestational age, birth weight, and age at tracheostomy. Among the 47 infants included in the study (30 boys; 17 girls, mean [SD] age, 113 [73] days), 31 (66%) demonstrated anatomical causes of airway obstruction, and 16 (34%) had significant pulmonary disease. Among infants with anatomical causes, subglottic stenosis represented the largest group (11 of 31 [35%]). The mean age at the time of tracheostomy was significantly lower in the group with airway obstruction (98.9 vs 146.9 days; difference, 48 [95% CI, 4.8-91.2] days; P = .04). No procedure-related morbidity or mortality was encountered. Anatomical upper airway obstruction may be returning as the most common indication for a neonatal tracheostomy, thereby supporting the belief that current respiratory therapies have lowered the burden of chronic lung disease and the need for prolonged ventilatory care.

  16. Photodegradation of riboflavin in neonates

    International Nuclear Information System (INIS)

    Sisson, T.R.

    1987-01-01

    The biologically most important flavins are riboflavin and its related nucleotides, all highly sensitive to light. It is because of its photoreactivity and its presence in almost all body fluids and tissues that riboflavin assumes importance in phototherapy of neonatal jaundice. The absorption maxima of both bilirubin and riboflavin in the body are nearly identical: 445-450 (447) nm. In consequence, blue visible light will cause photoisomerization of bilirubin accompanied by photodegradation of riboflavin. This results in diminished erythrocyte glutathione reductase, which indicates generalized tissue riboflavin deficiency and red cell lysis. Single- and double-strand breaks in intracellular DNA have occurred with phototherapy. This light exposure of neonates may result also in alterations of bilirubin-albumin binding in the presence of both riboflavin and theophylline (the latter frequently given to prevent neonatal apnea). Many newborns, especially if premature, have low stores of riboflavin at birth. The absorptive capacity of premature infants for enteral riboflavin is likewise reduced. Consequently, inherently low stores and low intake of riboflavin plus phototherapy for neonatal jaundice will cause a deficiency of riboflavin at a critical period for the newborn. Supplementation to those infants most likely to develop riboflavin deficiency is useful, but dosage, time, and mode of administration to infants undergoing phototherapy must be carefully adjusted to avoid unwanted side effects

  17. Internipple measurements in Indian neonates

    African Journals Online (AJOL)

    and transverse ocular distance are some important measurements when diagnosing dysmorphology.[4]. The internipple index (internipple distance (cm) × 100 ÷ circum ference of ... internipple distance to chest circumference compared with neonates ... first 3 days of life, and to correlate these measurements with gender,.

  18. Standardisation of neonatal clinical practice.

    Science.gov (United States)

    Bhutta, Z A; Giuliani, F; Haroon, A; Knight, H E; Albernaz, E; Batra, M; Bhat, B; Bertino, E; McCormick, K; Ochieng, R; Rajan, V; Ruyan, P; Cheikh Ismail, L; Paul, V

    2013-09-01

    The International Fetal and Newborn Growth Consortium for the 21(st) Century (INTERGROWTH-21(st) ) is a large-scale, population-based, multicentre project involving health institutions from eight geographically diverse countries, which aims to assess fetal, newborn and preterm growth under optimal conditions. Given the multicentre nature of the project and the expected number of preterm births, it is vital that all centres follow the same standardised clinical care protocols to assess and manage preterm infants, so as to ensure maximum validity of the resulting standards as indicators of growth and nutrition with minimal confounding. Moreover, it is well known that evidence-based clinical practice guidelines can reduce the delivery of inappropriate care and support the introduction of new knowledge into clinical practice. The INTERGROWTH-21(st) Neonatal Group produced an operations manual, which reflects the consensus reached by members of the group regarding standardised definitions of neonatal morbidities and the minimum standards of care to be provided by all centres taking part in the project. The operational definitions and summary management protocols were developed by consensus through a Delphi process based on systematic reviews of relevant guidelines and management protocols by authoritative bodies. This paper describes the process of developing the Basic Neonatal Care Manual, as well as the morbidity definitions and standardised neonatal care protocols applied across all the INTERGROWTH-21(st) participating centres. Finally, thoughts about implementation strategies are presented. © 2013 Royal College of Obstetricians and Gynaecologists.

  19. Pathophysiology of Equine Neonatal Septicemia

    Directory of Open Access Journals (Sweden)

    Juan Carlos Ospina Chirivi

    2014-07-01

    Full Text Available Neonatal septicemia is a major cause of mortality and morbidity in horses in their first seven days of life and within their pathophysiology. It is important to consider the extrinsic and intrinsic predisposing factors which make foals susceptible to agents of primarily bacterial etiology. However, other types of infectious etiology (viruses and fungi should be considered too, as well as noninfectious etiologies. The paper mentions a wide variety of mechanisms that produce different injuries that must be addressed with measures of critical neonatal care, so it is imperative for the veterinarian to know the pathogenic mechanisms of the disease, its clinical presentation and anatomo-pathological lesions. Thus, systemic inflammatory response syndrome (SIRS, multiple organ dysfunction syndrome (MODS, and peripheral circulatory collapse or shock are some of the elements defined as the pillars of the pathophysiology of neonatal septicemia, extensively studied in equine medicine. This paper presents a short review of the triggering mechanisms of neonatal septicemia highlighting the importance of epidemiological investigations in Colombia. It shows the need for retrospective and prospective studies and for divulgation of some of the preventive measures of the disease in horses.

  20. Time Perception during Neonatal Resuscitation.

    Science.gov (United States)

    Trevisanuto, Daniele; De Bernardo, Giuseppe; Res, Giulia; Sordino, Desiree; Doglioni, Nicoletta; Weiner, Gary; Cavallin, Francesco

    2016-10-01

    To assess the accuracy of time perception during a simulated complex neonatal resuscitation. Participants in 5 neonatal resuscitation program courses were directly involved in a complex simulation scenario. They were asked to assume the role of team leader, assistant 1, or assistant 2. At the end of the scenario, each participant completed a questionnaire on perceived time intervals for key resuscitation interventions. During the scenario, actual times were documented by an external observer and video recorded for later review. In addition, participants were asked to evaluate their self-perceived level of stress and preparation. Health care providers (68 physicians and 40 nurses) were involved in 36 scenarios. Perceived time intervals for the initiation of key resuscitation interventions were shorter than the actual time intervals, regardless of the participant's role in the scenario. Self-assessed levels of stress and preparation did not influence time perception. Health care providers underestimate the passage of time, irrespective of their role in a simulated complex neonatal resuscitation. Participant's self-assessed levels of stress and preparation were not related to the accuracy of their time perception. These findings highlight the importance of assigning a dedicated individual to document interventions and the passage of time during a neonatal resuscitation. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Neonatal blood gas sampling methods

    African Journals Online (AJOL)

    adequate collateral circulation before radial arterial puncture may not be a reliable predictor of subsequent risk of vascular injury.75. Conclusion and recommendations. Indwelling arterial catheters remain a practical, reliable and accurate method of neonatal blood gas sampling, provided they are inserted and maintained ...

  2. Caffeine impact on neonatal morbidities.

    Science.gov (United States)

    Aranda, Jacob V; Beharry, Kay; Valencia, Gloria B; Natarajan, Girija; Davis, Jonathan

    2010-10-01

    Caffeine is a silver bullet in neonatology. This ubiquitous trimethylxanthine, pervasively used in the human diet and beverages, significantly impacts on major acute neonatal morbidities including apnea of prematurity, bronchopulmonary dysplasia, patent ductus arteriousus with or without surgical ligation and post-operative apnea. Potential uses in respiratory distress syndrome as suggested by improved lung function in primate models is supported by the decreased time on mechanical ventilation and need for oxygen therapy. Improved later outcomes at 18 to 22 months include clinically significant decreases in cerebral palsy, cognitive impairment, and severe retinopathy of prematurity in those babies who received caffeine during the neonatal period compared to non-caffeine treated placebo neonates. Ongoing and future research studies focus on optimizing current dose regimens to determine whether benefits can be maximized while maintaining an impressive safety profile. Molecular pharmacologic studies focused on the molecular and the biochemical mechanisms underlying the protective effects of caffeine are also being done to optimize treatment regimes and to target potential molecular pathways leading to further decreases in acute and long term neonatal morbidities. Since its use in newborns three decades ago, caffeine is now one of the safest, most cost-beneficial and effective therapies in the newborn.

  3. Impairments of hepatic gluconeogenesis and ketogenesis in PPARα-deficient neonatal mice.

    Science.gov (United States)

    Cotter, David G; Ercal, Baris; d'Avignon, D André; Dietzen, Dennis J; Crawford, Peter A

    2014-07-15

    Peroxisome proliferator activated receptor-α (PPARα) is a master transcriptional regulator of hepatic metabolism and mediates the adaptive response to fasting. Here, we demonstrate the roles for PPARα in hepatic metabolic adaptations to birth. Like fasting, nutrient supply is abruptly altered at birth when a transplacental source of carbohydrates is replaced by a high-fat, low-carbohydrate milk diet. PPARα-knockout (KO) neonatal mice exhibit relative hypoglycemia due to impaired conversion of glycerol to glucose. Although hepatic expression of fatty acyl-CoA dehydrogenases is imparied in PPARα neonates, these animals exhibit normal blood acylcarnitine profiles. Furthermore, quantitative metabolic fate mapping of the medium-chain fatty acid [(13)C]octanoate in neonatal mouse livers revealed normal contribution of this fatty acid to the hepatic TCA cycle. Interestingly, octanoate-derived carbon labeled glucose uniquely in livers of PPARα-KO neonates. Relative hypoketonemia in newborn PPARα-KO animals could be mechanistically linked to a 50% decrease in de novo hepatic ketogenesis from labeled octanoate. Decreased ketogenesis was associated with diminished mRNA and protein abundance of the fate-committing ketogenic enzyme mitochondrial 3-hydroxymethylglutaryl-CoA synthase (HMGCS2) and decreased protein abundance of the ketogenic enzyme β-hydroxybutyrate dehydrogenase 1 (BDH1). Finally, hepatic triglyceride and free fatty acid concentrations were increased 6.9- and 2.7-fold, respectively, in suckling PPARα-KO neonates. Together, these findings indicate a primary defect of gluconeogenesis from glycerol and an important role for PPARα-dependent ketogenesis in the disposal of hepatic fatty acids during the neonatal period. Copyright © 2014 the American Physiological Society.

  4. Impairments of hepatic gluconeogenesis and ketogenesis in PPARα-deficient neonatal mice

    Science.gov (United States)

    Cotter, David G.; Ercal, Baris; André d'Avignon, D.; Dietzen, Dennis J.

    2014-01-01

    Peroxisome proliferator activated receptor-α (PPARα) is a master transcriptional regulator of hepatic metabolism and mediates the adaptive response to fasting. Here, we demonstrate the roles for PPARα in hepatic metabolic adaptations to birth. Like fasting, nutrient supply is abruptly altered at birth when a transplacental source of carbohydrates is replaced by a high-fat, low-carbohydrate milk diet. PPARα-knockout (KO) neonatal mice exhibit relative hypoglycemia due to impaired conversion of glycerol to glucose. Although hepatic expression of fatty acyl-CoA dehydrogenases is imparied in PPARα neonates, these animals exhibit normal blood acylcarnitine profiles. Furthermore, quantitative metabolic fate mapping of the medium-chain fatty acid [13C]octanoate in neonatal mouse livers revealed normal contribution of this fatty acid to the hepatic TCA cycle. Interestingly, octanoate-derived carbon labeled glucose uniquely in livers of PPARα-KO neonates. Relative hypoketonemia in newborn PPARα-KO animals could be mechanistically linked to a 50% decrease in de novo hepatic ketogenesis from labeled octanoate. Decreased ketogenesis was associated with diminished mRNA and protein abundance of the fate-committing ketogenic enzyme mitochondrial 3-hydroxymethylglutaryl-CoA synthase (HMGCS2) and decreased protein abundance of the ketogenic enzyme β-hydroxybutyrate dehydrogenase 1 (BDH1). Finally, hepatic triglyceride and free fatty acid concentrations were increased 6.9- and 2.7-fold, respectively, in suckling PPARα-KO neonates. Together, these findings indicate a primary defect of gluconeogenesis from glycerol and an important role for PPARα-dependent ketogenesis in the disposal of hepatic fatty acids during the neonatal period. PMID:24865983

  5. Projecting Fatalities in Crashes Involving Older Drivers, 2000-2025

    Energy Technology Data Exchange (ETDEWEB)

    Hu, P.S.

    2001-03-23

    As part of this research effort, we developed a new methodology for projecting elderly traffic crash fatalities. This methodology separates exposure to crashes from crash risk per se, and further divides exposure into two components, the number of miles driven and the likelihood of being a driver. This component structure permits conceptually different determinants of traffic fatalities to be projected separately and has thorough motivation in behavioral theory. It also permits finer targeting of particular aspects of projections that need improvement and closer linking of projections to possible policy instruments for influencing them.

  6. Asian and Hispanic Americans' cancer fatalism and colon cancer screening.

    Science.gov (United States)

    Jun, Jungmi; Oh, Kyeung Mi

    2013-03-01

    To explore fatalistic attributions of colon cancer development among Asian and Hispanic Americans in comparison with non-Hispanic whites; also to examine the impacts of fatalism on adherence to the colon cancer screening guideline. For the analysis, the 2005 Health Information National Trends Survey data were employed. Both Asian and Hispanic Americans were more likely to make fatalistic attribution and were less likely to follow the guideline than whites. Particularly for Asians, fatalism was a significant predictor for not adhering to the guideline. These findings emphasize the need for cultural interventions to disrupt fatalistic attitudes towards colon cancer preventions.

  7. An intervention to decrease cancer fatalism among rural elders.

    Science.gov (United States)

    Powe, B D; Weinrich, S

    1999-04-01

    To evaluate the effectiveness of a video intervention in decreasing cancer fatalism, increasing knowledge of colorectal cancer, and increasing participation in fecal-occult blood testing (FOBT). Repeated measures, pretest/post-test. Senior citizen centers in a rural southern state. Individuals were selected and assigned to the study group based on the center they attended. Centers were selected and assigned randomly to an intervention (n = 42) or control (n = 28) group. The age of the participants ranged from 52-92 years (X = 75). Pretest measures included the Powe Fatalism inventory, the Colorectal Cancer Knowledge Questionnaire, and the Demographic Data Questionnaire. The intervention group viewed the Medical University of South Carolina's video Telling the Story ... To Live is God's Will, and the control group viewed the American Cancer Society (ACS) video Colorectal Cancer: The Cancer No One Talks About. Hemoccult II kits were distributed to both groups at no cost. Post-test data were collected using the Powe Fatalism Inventory and the Colorectal Cancer Knowledge Questionnaire. Cancer fatalism, knowledge of colorectal cancer, and participation in FOBT. People who viewed the intervention video had a greater decrease in cancer fatalism scores and a greater increase in knowledge of colorectal cancer scores than the control group. Both groups had greater than 60% participation in FOBT. Telling the Story ... To Live is God's Will is an effective, self-contained, cost-effective intervention to decrease cancer fatalism and increase knowledge of colorectal cancer. The video was as effective as the ACS video on colorectal cancer in increasing participation in FOBT among rural elders. But, because Telling the Story ... To Live is God's Will also decreases cancer fatalism and increases knowledge, the potential exists for the increased screening behaviors to be maintained over time. Showing the video in waiting areas of community health centers to facilitate the discussion

  8. Fatal Cervical Spine Injury Following a Bicycle Crash

    Directory of Open Access Journals (Sweden)

    Uhrenholt Lars

    2017-06-01

    Full Text Available Spinal injury following direct loading of the head and neck is a rare sequel of bicycle crashes. Fatal head injuries following bicycle crashes have been described in great detail and safety measures such as bicycle helmets have been developed accordingly. Less frequently, however, potentially severe cervical spine injuries have been described. We present the case of a middle-aged female who sustained an ultimately fatal cervical spine injury following a collision with a car whilst biking wearing a helmet. We discuss the literature regarding the protective effects of bicycle helmets, the relevance to cervical spine injury and legislation on mandatory use of helmets for injury prevention.

  9. Pharyngitis – fatal infectious disease or medical error?

    Directory of Open Access Journals (Sweden)

    Marta Rorat

    2015-08-01

    Full Text Available Reporting on adverse events is essential to create a culture of safety, which focuses on protecting doctors and patients from medical errors. We present a fatal case of Streptococcus C pharyngitis in a 56-year-old man. The clinical course and the results of additional diagnostics and autopsy showed that sepsis followed by multiple organ failure was the ultimate cause of death. The clinical course appeared fatal due to a chain of adverse events, including errors made by the physicians caring for the patient for 10 days.

  10. Influence of civil defense on strategic countervalue fatalities

    International Nuclear Information System (INIS)

    Harvey, T.F.

    1982-01-01

    Two modeling studies were conducted to simulate the effect of fallout shelters on the outcome of a massive countervalue nuclear exchange between the Soviet Union and the United States. One was to determine the number of nuclear weapons required to mount an effective fallout attack against a country with dispersed population; the other was to determine the number of expected US fatalities resulting from a countervalue attack against US urban population centers. The results of these studies indicate that the number of weapons required to mount such an attack depends on the adequacy of the shelter system and that the evacuation of urban populations can substantially reduce expected fatality levels

  11. Mitochondrial defects associated with β-alanine toxicity: relevance to hyper-beta-alaninemia

    Science.gov (United States)

    Shetewy, Aza; Shimada-Takaura, Kayoko; Warner, Danielle; Jong, Chian Ju; Mehdi, Abu-Bakr Al; Alexeyev, Mikhail; Takahashi, Kyoko; Schaffer, Stephen W.

    2016-01-01

    Hyper-beta-alaninemia is a rare metabolic condition that results in elevated plasma and urinary β-alanine levels and is characterized by neurotoxicity, hypotonia, and respiratory distress. It has been proposed that at least some of the symptoms are caused by oxidative stress; however, only limited information is available on the mechanism of reactive oxygen species generation. The present study examines the hypothesis that β-alanine reduces cellular levels of taurine, which are required for normal respiratory chain function; cellular taurine depletion is known to reduce respiratory function and elevate mitochondrial superoxide generation. To test the taurine hypothesis, isolated neonatal rat cardiomyocytes and mouse embryonic fibroblasts were incubated with medium lacking or containing β-alanine. β-alanine treatment led to mitochondrial superoxide accumulation in conjunction with a decrease in oxygen consumption. The defect in β-alanine-mediated respiratory function was detected in permeabilized cells exposed to glutamate/malate but not in cells utilizing succinate, suggesting that β-alanine leads to impaired complex I activity. Taurine treatment limited mitochondrial superoxide generation, supporting a role for taurine in maintaining complex I activity. Also affected by taurine is mitochondrial morphology, as β-alanine-treated fibroblasts undergo fragmentation, a sign of unhealthy mitochondria that is reversed by taurine treatment. If left unaltered, β-alanine-treated fibroblasts also undergo mitochondrial apoptosis, as evidenced by activation of caspases 3 and 9 and the initiation of the mitochondrial permeability transition. Together, these data show that β-alanine mediates changes that reduce ATP generation and enhance oxidative stress, factors that contribute to heart failure. PMID:27023909

  12. Hypertrophic Cardiomyopathy due to Mitochondrial Disease: Prenatal Diagnosis, Management, and Outcome

    Directory of Open Access Journals (Sweden)

    Lutgardo García-Díaz

    2013-01-01

    Full Text Available A case of prenatally diagnosed fetal hypertrophic cardiomyopathy is reported. The mother was referred to our department at 37 weeks' gestation because of suspected congenital heart disease. Prenatal echocardiography showed biventricular hypertrophy and pericardial effusion, without additional abnormalities. Postnatal echocardiography confirmed prenatal diagnosis. Neonatal EKG showed biventricular hypertrophy and Wolff-Parkinson-White syndrome. Skeletal muscle biopsy was consistent with mitochondrial oxidative phosphorylation defect involving a combined defect of respiratory complexes I and IV. Echocardiographic followup during the first year of life showed progressive regression of hypertrophy and evolution to left ventricular myocardial noncompaction.

  13. Fatal Eurasian Brown Bear Attacks-Two Swedish Fatalities in Modern Times.

    Science.gov (United States)

    Gustafsson, Torfinn; Eriksson, Anders

    2015-11-01

    Fatal bear attacks on humans are uncommon with only one reported case in Sweden since 1902. The bear population is, however, growing and the frequency of confrontations is likely to increase. Case I-A 40-year-old hunter and his dog were found dead near a bear's den. Autopsy showed that a large portion of the face, facial skeleton, and anterior portion of the brain was missing. Autopsy of the bear showed two nonfatal gunshot wounds. Case II-A 61-year-old man and his dog were found dead outside a hunting lodge. Autopsy revealed numerous wounds, including partial evisceration of the intestines. The victim's blood ethanol concentration was 0.27%. These cases confirm the presence of risk factors identified by the Scandinavian Brown Bear Research Project, that is, provocation by a dog, encountering an injured bear, and appearing close to its den. An additional possible factor in case II was ethanol intoxication. © 2015 American Academy of Forensic Sciences.

  14. Toxins in botanical dietary supplements: blue cohosh components disrupt cellular respiration and mitochondrial membrane potential.

    Science.gov (United States)

    Datta, Sandipan; Mahdi, Fakhri; Ali, Zulfiqar; Jekabsons, Mika B; Khan, Ikhlas A; Nagle, Dale G; Zhou, Yu-Dong

    2014-01-24

    Certain botanical dietary supplements have been associated with idiosyncratic organ-specific toxicity. Similar toxicological events, caused by drug-induced mitochondrial dysfunction, have forced the withdrawal or U.S. FDA "black box" warnings of major pharmaceuticals. To assess the potential mitochondrial liability of botanical dietary supplements, extracts from 352 authenticated plant samples used in traditional Chinese, Ayurvedic, and Western herbal medicine were evaluated for the ability to disrupt cellular respiration. Blue cohosh (Caulophyllum thalictroides) methanol extract exhibited mitochondriotoxic activity. Used by some U.S. midwives to help induce labor, blue cohosh has been associated with perinatal stroke, acute myocardial infarction, congestive heart failure, multiple organ injury, and neonatal shock. The potential link between mitochondrial disruption and idiosyncratic herbal intoxication prompted further examination. The C. thalictroides methanol extract and three saponins, cauloside A (1), saponin PE (2), and cauloside C (3), exhibited concentration- and time-dependent mitochondriotoxic activities. Upon treatment, cell respiration rate rapidly increased and then dramatically decreased within minutes. Mechanistic studies revealed that C. thalictroides constituents impair mitochondrial function by disrupting membrane integrity. These studies provide a potential etiological link between this mitochondria-sensitive form of cytotoxicity and idiosyncratic organ damage.

  15. Novel Functional Role of Heat Shock Protein 90 in Mitochondrial Connexin 43-Mediated Hypoxic Postconditioning

    Directory of Open Access Journals (Sweden)

    Rong-Hui Tu

    2017-11-01

    Full Text Available Background/Aims: Previous studies have shown that heat shock protein 90 (HSP90-mediated mitochondrial import of connexin 43 (Cx43 is critical in preconditioning cardioprotection. The present study was designed to test whether postconditioning has the same effect as preconditioning in promoting Cx43 translocation to mitochondria and whether mitochondrial HSP90 modulates this effect. Methods: Cellular models of hypoxic postconditioning (HPC from rat heart-derived H9c2 cells and neonatal rat cardiomyocytes were employed. The effects of HPC on cardiomyocytes apoptosis were examined by flow cytometry and Hoechst 33342 fluorescent staining. Reactive oxidative species (ROS production was assessed with the peroxide-sensitive fluorescent probe 2′,7′-dichlorofluorescin in diacetate (DCFH-DA. The anti- and pro-apoptotic markers Bcl-2 and Bax, HSP90 and Cx43 protein levels were studied by Western blot analysis in total cell homogenate and sarcolemmal and mitochondrial fractions. The effects on HPC of the HSP90 inhibitor geldanamycin (GA, ROS scavengers superoxide dismutase (SOD and catalase (CAT, and small interfering RNA (siRNA targeting Cx43 and HSP90 were also investigated. Results: HPC significantly reduced hypoxia/reoxygenation (H/R-induced cardiomyocyte apoptosis. These beneficial effects were accompanied by an increase in Bcl-2 levels and a decrease in Bax levels in both sarcolemmal and mitochondrial fractions. HPC with siRNA targeting Cx43 or the ROS scavengers SOD plus CAT significantly prevented ROS generation and HPC cardioprotection, but HPC with either SOD or CAT did not. These data strongly supported the involvement of Cx43 in HPC cardioprotection, likely via modulation of the ROS balance which plays a central role in HPC protection. Furthermore, HPC increased total and mitochondrial levels of HSP90 and the mitochondria-to-sarcolemma ratio of Cx43; blocking the function of HSP90 with the HSP90 inhibitor geldanamycin (GA or siRNA targeting

  16. Long-term trends in flood fatalities in the United State

    Science.gov (United States)

    Sharif, Hatim; Chaturvedi, Smita

    2015-04-01

    This presentation reviews flood-related fatalities in the United States between 1959 and 2013. Information on flood fatality victims and the flood-causing events was obtained from the National Climatic Data Center. The data collected included the date, time, location, and weather conditions and the gender and age of the flood victims. Long term trends in the numbers of fatalities and fatality rates were analyzed. For most of the states fatalities were largely caused by single catastrophic events. The analysis indicates that the standardized annual flood fatality rates are decreasing significantly for all states. Vehicle related fatalities represent more than 50% of flood fatalities for most of the states and can be as high as 77%. A combination of improved hydrometeorological forecasting, educational programs aimed at enhancing public awareness of flood risk and the seriousness of flood warnings, and timely and appropriate action by local emergency and safety authorities will help further reduce flood fatalities in Texas.

  17. A social autopsy of neonatal mortality suggests needed improvements in maternal and neonatal interventions in Balaka and Salima districts of Malawi

    Directory of Open Access Journals (Sweden)

    Alain K. Koffi

    2015-06-01

    Full Text Available Background The Every Newborn Action Plan calls for reducing the neonatal mortality rates to fewer than 10 deaths per 1000 live births in all countries by 2035. The current study aims to increase our understanding of the social and modifiable factors that can be addressed or reinforced to improve and accelerate the decline in neonatal mortality in Malawi. Methods The data come from the 2013 Verbal and Social Autopsy (VASA study that collected data in order to describe the biological causes and the social determinants of deaths of children under 5 years of age in Balaka and Salima districts of Malawi. This paper analyses the social autopsy data of the neonatal deaths and presents results of a review of the coverage of key interventions along the continuum of normal maternal and newborn care and the description of breakdowns in the care provided for neonatal illnesses within the Pathway to Survival framework. Results A total of 320 neonatal deaths were confirmed from the VASA survey. While one antenatal care (ANC visit was high at 94%, the recommended four ANC visits was much lower at 41% and just 17% of the mothers had their urines tested during the pregnancy. 173 (54% mothers of the deceased newborns had at least one labor/delivery complication that began at home. The caregivers of 65% (n = 75 of the 180 newborns that were born at home or born and left a health facility alive perceived them to be severely ill at the onset of their illness, yet only 44% (n = 80 attempted and 36% (n = 65could reach the first health provider after an average of 91 minutes travel time. Distance, lack of transport and cost emerged as the most important constraints to formal care–seeking during delivery and during the newborn fatal illness. Conclusions This study suggests that maternal and neonatal health organizations and the local government of Malawi should increase the demand for key maternal and child health interventions, including the recommended 4

  18. Child Fatality Review Teams: A Content Analysis of Social Policy

    Science.gov (United States)

    Douglas, Emily M.; McCarthy, Sean C.

    2011-01-01

    Child fatality review teams (CFRTs) have existed since the 1970s; yet, a comprehensive understanding of their procedures, practices, and outcomes is lacking. This article addresses that gap in this study of CFRT state statutes. Findings indicate CFRT laws address nine areas of practice, from team composition, to purpose, to outcomes. Results also…

  19. Fatal Cryptococcal Meningitis in a Patient With Chronic Lymphocytic Leukemia

    Directory of Open Access Journals (Sweden)

    Oguzhan Sıtkı Dizdar

    2012-06-01

    Full Text Available Patients with chronic lymphocytic leukemia (CLL are susceptible to infections, especially opportunistic infections. We have described a patient with CLL who had cryptococcal meningitis. Despite lack of previous immunosuppressive treatment history, the patient experienced serious and fatal fungal infection. Physicians should be alert for a diagnosis of cryptococcal meningitis in patient with CLL who developed fever and headache.

  20. Fatal Fulminant Hepatic Failure in a Diabetic with Primary Dengue

    Science.gov (United States)

    Viswanathan, Stalin; Iqbal, Nayyar; Anemon, P. Philip; Kumar, G. Shyam

    2010-01-01

    We report a 49-year-old diabetic with dengue hemorrhagic fever who developed fulminant hepatitis, severe coagulopathy, shock, and refractory metabolic acidosis and died on the eighth day of illness. This is the only second report of an adult with fatal fulminant hepatic failure due to dengue, and the first case arising from a primary dengue infection. PMID:21234316

  1. Fatal Gastrointestinal Perforations in sudden death cases in Last 10 ...

    African Journals Online (AJOL)

    Pathology unit of University Malaya, Kuala Lumpur in the year 2006 by reviewing the autopsy reports. There were 61 cases of GIT perforation out of 5579 autopsies conducted during a period of ten years (1996-2005). The incidence rate of fatal gastrointestinal perforation was 1.09% during this period. Out of these 61 cases, ...

  2. Fatal splenic rupture in Ehlers-Danlos syndrome.

    OpenAIRE

    Harris, S. C.; Slater, D. N.; Austin, C. A.

    1985-01-01

    A fatal case of Ehlers-Danlos syndrome (Type IV) is described. Autopsy revealed splenic rupture that had resulted from spontaneous haemorrhage into the splenic parenchyma. This is a previously unrecorded complication of Ehlers-Danlos syndrome and should be considered in the differential diagnosis of chest and abdominal pain in patients with this condition.

  3. Pattern of road traffic fatalities in Nairobi | Okemwa | Annals of ...

    African Journals Online (AJOL)

    Background: Road traffic injuries continue to exert a huge burden on Kenya's healthcare services. Over 134,000 crashes occur on the Kenyan roads killing more than 2,600 and seriously injuring 11,000 people annually. Injury pattern among traffic trauma admissions have been recently described while that of fatalities ...

  4. Fatal angioedema induced by angiotensin conversion enzyme (ACE ...

    African Journals Online (AJOL)

    ACE inhibitors are often prescribed in the treatment of hypertension, heart failure and kidney disease. These drugs are on the Essential Drugs List, and are therefore used at primary to tertiary health care levels in South Africa. Angioedema is considered a rare, but potentially fatal side-effect of this agent, with a reported ...

  5. Prediction of traffic fatalities and prospects for mobility becoming ...

    Indian Academy of Sciences (India)

    Economic growth inevitably stimulates the growth of motorization levels. (motor vehicles per inhabitant, including 2- and 3-wheel motor vehicles). The higher the gross national income per capita (GNI/p) the higher the motorization level is, while the fatality rate per number of motor vehicle decays over time (Oppe & Koornstra ...

  6. Identification of new molecular alterations in Fatal Familial Insomnia.

    Science.gov (United States)

    Fatal familial insomnia (FFI) is an autosomal dominant prion disease caused by a D178N mutation in PRNP in combination with methionine (Met) at codon 129 in the mutated allele of the same gene (D178N-129M haplotype). The present study analyzes pathological and molecular features in seven FFI cases c...

  7. Femme fatale'i kütkes / Kadri Kõusaar

    Index Scriptorium Estoniae

    Kõusaar, Kadri, 1980-

    2006-01-01

    15.-21. maini on kinos Sõprus Manifesti filminädal "Femme fatale", mis pühendatud prantsuse mängufilmidele 1960.-1970. aastate tipprežissööridelt, kus keskne karakter on saatuslik naine. Lähemalt festivali filmidest, kus peaosades Brigitte Bardot, Catherine Deneuve, Jeanne Moreau

  8. Childhood and adolescent fatalities at the Pretoria Medico-Legal ...

    African Journals Online (AJOL)

    violence (assault).[4]. The high incidence of child fatalities due to road traffic accidents has been well documented worldwide. In San Diego, Fraga et al.[1] reported. (in their study conducted at the medico-legal mortuary) that road traffic fatalites were the leading cause of accidental death (40.2% of cases). In. Nebraska ...

  9. Fatal motorcycle crashes: a growing public health problem in Cambodia.

    Science.gov (United States)

    Roehler, Douglas R; Ear, Chariya; Parker, Erin M; Sem, Panhavuth; Ballesteros, Michael F

    2015-01-01

    This study examines the risk characteristics of fatal motorcycle crashes in Cambodia over a 5-year period (2007-2011). Secondary data analyses were conducted using the Cambodia Road Crash and Victim Information System, the only comprehensive and integrated road crash surveillance system in the country. Researchers from the Centers for Disease Control and Prevention and Handicap International found that (1) males are dying in motorcycle crashes roughly seven times more frequently than females; (2) motorcyclist fatalities increased by about 30% from 2007 to 2011; (3) the motorcyclist death rates per 100,000 population increased from 7.4 to 8.7 deaths from 2007 to 2011; and (4) speed-related crashes and not wearing motorcycle helmet were commonly reported for motorcyclist fatalities at approximately 50% and over 80% through the study years, respectively. Additionally, this study highlights that Cambodia has the highest motorcycle death rate in South-East Asia, far surpassing Thailand, Malaysia, and Myanmar. By recognising the patterns of fatal motorcycle crashes in Cambodia, local road-safety champions and stakeholders can design targeted interventions and preventative measures to improve road safety among motorcyclists.

  10. Childhood and adolescent fatalities at the Pretoria Medico-Legal ...

    African Journals Online (AJOL)

    In Brazil, Modelli et al.,[8] reporting on deaths in children <12 years, found the leading external cause of death to be road traffic fatalities (22% of cases). ... Cross War Memorial Children's Hospital in Cape Town. They indicated that 430 children were involved as pedestrians in accidents over a. 12-month period, with 106 ...

  11. Near-fatal asthma phenotype in the ENFUMOSA Cohort

    NARCIS (Netherlands)

    Romagnoli, M.; Caramori, G.; Braccioni, F.; Ravenna, F.; Barreiro, E.; Siafakas, N. M.; Vignola, A. M.; Chanez, P.; Fabbri, L. M.; Papi, A.; Bel, E. H.

    2007-01-01

    BACKGROUND: Near-fatal asthma (NFA) is characterized by severe asthma attacks usually requiring intensive care unit admission. This phenotype of asthma has been studied mainly in acute conditions. METHODS: The aim of our study was to compare the clinical, functional and inflammatory characteristics

  12. Second Fatal Case of Infective Endocarditis caused by Gemella bergeriae

    Directory of Open Access Journals (Sweden)

    Aijan Ukudeeva

    2017-03-01

    Full Text Available Our case illustrates a fatal course of infection with Gemella bergeriae endocarditis that was complicated by cardiogenic shock due to perforation of the mitral valve with severe mitral regurgitation, extension of infection into the myocardium adjacent to the mitral valve, and coronary sinus thrombosis.

  13. Mapping patterns of pedestrian fatal accidents in Israel

    DEFF Research Database (Denmark)

    Prato, Carlo Giacomo; Gitelman, Victoria; Bekhor, Shlomo

    2012-01-01

    This study intends to provide insight into pedestrian accidents by uncovering their patterns in order to design preventive measures and to allocate resources for identified problems. Kohonen neural networks are applied to a database of pedestrian fatal accidents occurred during the four-year period...

  14. Cancer fatalism and breast cancer screening in African American women.

    Science.gov (United States)

    Spurlock, Wanda Raby; Cullins, Leah S

    2006-01-01

    Despite significant advances in science, medicine, and technology African American women are more likely to die from breast cancer than Caucasian women. There is a growing body of literature that describes strategies to improve breast cancer screening among African American women. However, data suggest that African American women, compared to Caucasian women, are less likely to participate in regular breast cancer screening. The belief that a diagnosis of cancer will result in death has been identified as a potential barrier to cancer screening in African American population groups. However, research examining the degree to which perceptions of fatalism influence breast cancer screening in culturally and ethnically diverse population groups is scant. This repot describes the outcomes of a study undertaken to examine relationships between perceptions of cancer fatalism and breast cancer screening in African American women. Findings support the postulation that fatalism negatively influences health promoting practices such as breast cancer screening. However, contrary to prior research findings age was observed to be inversely associated with cancer fatalism.

  15. Postpartum Clostridium sordellii infection associated with fatal toxic shock syndrome

    DEFF Research Database (Denmark)

    Rørbye, C; Petersen, Ina Sleimann; Nilas, Lisbeth

    2000-01-01

    , respectively) are responsible for this potential. Reviewing the obstetric literature, only six cases of postpartum endometritis caused by C. sordellii, are described - all being fatal. In addition, one lethal case of spontaneous endometritis resulting from C. sordellii is reported. The clinical aspects...

  16. Non-fatal suicidal behaviour at the Johannesburg General Hospital

    African Journals Online (AJOL)

    Adele

    served high rates are increasing on an international scale. Figures from the World Health Organization ... feelings or acts. They include high self-esteem and social “con- ... Keywords: Non-fatal suicidal behaviour, Non-suicide attempters, Past psychiatric history, Physical abuse, Sexual abuse, Self-harm. Received: 12.10.04.

  17. Cervical necrotizing fasciitis: A potentially fatal disease with varied ...

    African Journals Online (AJOL)

    Necrotizing fasciitis was recognized centuries ago by physicians. It is a rapidly progressive and potentially fatal soft‑tissue infection that is typified by soft‑tissue necrosis, especially affecting the subcutaneous tissues and fascia. Cervico‑facial necrotizing fasciitis is said to be uncommon, but when it occurs, it is often of ...

  18. Cervical Necrotizing Fasciitis: A Potentially Fatal Disease with ...

    African Journals Online (AJOL)

    She was referred from a primary health-care facility. Dental and medical history revealed no relevant. Cervical Necrotizing Fasciitis: A Potentially Fatal. Disease with Varied Etiology. Abdurrazaq TO, Ibikunle AA, Braimah RO. Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University, Usmanu Danfodiyo ...

  19. Prevalence, circumstances and consequences of non-fatal road traffi ...

    African Journals Online (AJOL)

    Prevalence, circumstances and consequences of non-fatal road traffi c injuries and other bodily injuries among older people in China, Ghana, India, Mexico, Russia ... injury, while younger age, residing in a rural area, hazardous or harmful alcohol use and having a sleeping problem were associated with other bodily injury.

  20. Non-fatal suicidal behaviour at the Johannesburg General Hospital ...

    African Journals Online (AJOL)

    Objective: Non-fatal suicidal behaviour (NFSB) severely impacts on the health services and the resources of a country and should be prevented. The aim of this control study was to describe a group of patients with NFSB and to elicit, if any, the factors associated with this behaviour compared to a non-suicidal control group.

  1. Ethylene Glycol and Metabolite Concentrations in Fatal Ethylene Glycol Poisonings.

    Science.gov (United States)

    Viinamäki, Jenni; Sajantila, Antti; Ojanperä, Ilkka

    2015-01-01

    Ethylene glycol (EG) is used in antifreeze and other industrial products. It metabolizes to glycolic acid (GA) and oxalic acid (OX) that cause metabolic acidosis and are mainly responsible for the toxicity of EG. During 2010-2014, EG or GA was found in 25 postmortem cases in Finland. Of these cases, 21 were classified as fatal EG poisonings and 3 were classified as methanol (MeOH) poisonings. In this study, we report the concentrations of EG and GA in postmortem blood and urine samples of fatal EG or mixed MeOH/EG poisonings. In the fatal EG poisonings, the median EG and GA concentrations were 0.87 and 1.6 g/L in blood and 4.3 and 5.3 g/L in urine. The median urine-blood ratios were 3.8 and 3.1 for EG and GA. These results warrant the use of urine as a primary matrix for screening. In EG positive cases, the quantification of both EG and GA in blood is crucial as GA concentration appears to best indicate a fatal poisoning with an approximate threshold of 1.5 g/L. The measurement of urinary OX does not offer much additional value to toxic alcohol screening as it may originate from varying dietary conditions. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Accidental fatal lung injury by compressed air: a case report.

    Science.gov (United States)

    Rayamane, Anand Parashuram; Pradeepkumar, M V

    2015-03-01

    Compressed air is being used extensively as a source of energy at industries and in daily life. A variety of fatal injuries are caused by improper and ignorant use of compressed air equipments. Many types of injuries due to compressed air are reported in the literature such as colorectal injury, orbital injury, surgical emphysema, and so on. Most of these injuries are accidental in nature. It is documented that 40 pounds per square inch pressure causes fatal injuries to the ear, eyes, lungs, stomach, and intestine. Openings of body are vulnerable to injuries by compressed air. Death due to compressed air injuries is rarely reported. Many cases are treated successfully by conservative or surgical management. Extensive survey of literature revealed no reports of fatal injury to the upper respiratory tract and lungs caused by compressed air. Here, we are reporting a fatal event of accidental death after insertion of compressed air pipe into the mouth. The postmortem findings are corroborated with the history and discussed in detail.

  3. Prediction of traffic fatalities and prospects for mobility becoming ...

    Indian Academy of Sciences (India)

    Logo of the Indian Academy of Sciences ... Global road safety; global prediction model; traffic volume; fatality risk; time-dependent model; income-dependent model; prediction scenarios; knowledge transfer. ... Also this model implies that at some point in time road traffic deaths will start declining for ever, also worldwide.

  4. 77 FR 74695 - Preventing Backover Injuries and Fatalities

    Science.gov (United States)

    2012-12-17

    ... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2010-0059] RIN... Administration (OSHA), Labor. ACTION: Notice of stakeholder meetings. SUMMARY: OSHA invites interested parties to participate in informal stakeholder meetings on preventing backover injuries and fatalities. OSHA plans to use...

  5. Substance use among Iranian drivers involved in fatal road accidents

    Directory of Open Access Journals (Sweden)

    Shervin eAssari

    2014-08-01

    Full Text Available Background: Although the problem of substance use among drivers is not limited to a special part of the world, most published epidemiological reports on this topic is from industrial world.Aim: To determine drug use among Iranian adults who were imprisoned for vehicle accidents with fatality. Methods: This study enrolled 51 Iranian adults who were imprisoned for vehicle accidents with fatality. This sample came from a national survey of prisoners. Data was collected at entry to prisons during the last 4 months of 2008 in 7 prisons in different parts of the country. Self reported drug use was registered. Commercial substance use screening tests were also done. Results: Drug test was positive for opioids, cannabis and both in 37.3%, 2.0% and 13.7%, respectively. 29.4% tested positive for benzodiazepines. Using test introduced 23.5% of our sample as drug users, who had declined to report any drug use. Conclusion: Opioids are the most used illicit drug in the case of vehicle accidents with fatality, however, 20% of users do not declare their use. This high rate of drug use in vehicle accidents with fatality reflects the importance of drug use control as a part of injury prevention in Iran. There might be a need for drug screening after severe car accidents.

  6. Children in Hot Cars Result in Fatal Consequences

    Medline Plus

    Full Text Available ... I Waiting So Long? Admission to the Hospital Heroes on Medicine's Front Line Observation Emergency Care Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Health Tips Share this! Home » Health Tips » Holiday and Seasonal Children in Hot Cars Result in Fatal Consequences Emergency ...

  7. Clinical characteristics of Taiwanese children with congenital adrenal hyperplasia due to 21-hydroxylase deficiency detected by neonatal screening.

    Science.gov (United States)

    Liu, Shih-Yao; Lee, Cheng-Ting; Tung, Yi-Ching; Chien, Yin-Hsiu; Hwu, Wuh-Liang; Tsai, Wen-Yu

    2018-02-01

    Neonatal screening for congenital adrenal hyperplasia (CAH) has been conducted in Taiwan since 2000. This study aimed to determine the clinical characteristics of Taiwanese children with CAH due to 21-hydroxylase deficiency (21-OHD) detected by neonatal screening. From 2000 to 2015, 26 neonates (14 boys and 12 girls) with classic 21-OHD detected by neonatal screening and confirmed at National Taiwan University Hospital were enrolled. Among them, 22 were diagnosed as salt wasting (SW) type and four as simple virilizing (SV) type. Through a review of medical records, their clinical presentations, laboratory data, and molecular studies were analyzed. The most common manifestation was hyperpigmentation. All female neonates regardless of 21-OHD type had atypical genitalia, clitoromegaly, and posterior labial fusion. All of the patients had baseline serum 17-hydroxyprogesterone levels higher than normal. Of the 26 patients, 24 had elevated adrenocorticotropic hormone levels, but only four had low serum cortisol levels. The median baseline adrenocorticotropic hormone, 17-hydroxyprogesterone, and androstenedione levels were significantly higher in patients with SW than in those with SV 21-OHD. All patients with SW 21-OHD had elevated plasma renin activity. The most frequent SW 21-OHD mutations were c.293-13C>G and gene deletion, whereas Ile173Asn and c.293-13C>G were the most frequently detected in SV 21-OHD. In Taiwan, neonatal screening effectively leads to the early diagnosis of CAH and reduces fatal adrenal crisis in neonates. This study may provide physicians with a better understanding of the clinical findings among children with early-diagnosed CAH, allowing for better care in the future. Copyright © 2017. Published by Elsevier B.V.

  8. Hepatic failure, neonatal hemochromatosis and porto-pulmonary hypertension in a newborn with trisomy 21 - a case report

    Directory of Open Access Journals (Sweden)

    Poulik Janet

    2010-05-01

    Full Text Available Abstract Liver failure in neonates is a rare but often fatal disease. Trisomy 21 is not usually associated with significant infantile liver disease. If present, hepatic dysfunction in an infant with Trisomy 21 is likely to be attributed to transient myeloproliferative disorder with hepatic infiltration by hematopoietic elements and may be associated with secondary hemosiderosis. A less commonly recognized cause of liver failure in neonates with Trisomy 21 is neonatal hemochromatosis (NH; this association has been reported in nine cases of Trisomy 21 in literature. NH is a rare, severe liver disease of intra-uterine onset that is characterized by neonatal liver failure and hepatic and extrahepatic iron accumulation that spares the reticuloendothelial system. NH is the most frequently recognized cause of liver failure in neonates and the commonest indication for neonatal liver transplantation. Although porto-pulmonary hypertension (PPH has been reported as a complication of liver failure in adults and older children, this has not been reported in neonates with liver failure of any etiology. This is probably due to the rarity of liver failure in newborns, delayed diagnosis and high mortality. The importance of recognizing PPH is that it is reversible with liver transplantation but at the same time increases the risk of post-operative mortality. Therefore, early diagnosis of PPH is critical so that early intervention can improve the chances of successful liver transplantation. We report for the first time the association of liver failure with porto-pulmonary hypertension secondary to NH in an infant with Trisomy 21.

  9. Neonatal characteristics and perinatal complications in neonates with Down syndrome.

    Science.gov (United States)

    Ergaz-Shaltiel, Zivanit; Engel, Offra; Erlichman, Ira; Naveh, Yaron; Schimmel, Michael S; Tenenbaum, Ariel

    2017-05-01

    The annual rate of Down syndrome (DS) births in Jerusalem is stable, regardless of prenatal screening, and diagnostic measures. We aimed to evaluate our historical cohort for obstetrical characteristics and the neonatal course and complications. We reviewed computerized medical files of neonates with the diagnosis of DS born in the four main hospitals in Jerusalem between the years 2000 and 2010 and evaluated for maternal history and primary neonatal hospitalization. A total of 403 neonates were diagnosed with DS. The average maternal age was 35.6 years, 73% were born via spontaneous vaginal delivery. In all gestational ages, the mean birth weight and head circumference percentiles were significantly lower than the general population (P < 0.001 for both) and at each week the HC percentile was lower than the weight percentile (P < 0.0001), worse among males. Mortality during the primary hospitalization was 3.7%. The most common anomalies were cardiac (79%) with either congenital defects or functional abnormalities, neither influenced the length of hospitalization. The main reasons for prolonged hospitalization were prematurity and anomalies of other (non-cardiac) organs. Common perinatal complications included respiratory failure or need for oxygen supplementation (32%), hyperbilirubinemia (23%), sepsis (6.4%), and feeding difficulties (13%). About 84% were fed by human milk; of those, two thirds were exclusively breast-fed and one third were supplemented with infant formula. In conclusion, infants with DS were small for gestational age with relatively reduced head circumference. Despite the increased rate of congenital anomalies and perinatal complications, most infants were discharged home in good medical condition and were exclusively breastfed. © 2017 Wiley Periodicals, Inc.

  10. Diagnostic imaging in neonatal stroke; Bildgebende Diagnostik des Neonatal stroke

    Energy Technology Data Exchange (ETDEWEB)

    Kuhle, S.; Ipsiroglu, O.; Weninger, M. [Universitaetsklinik fuer Kinder- und Jugendheilkunde, Wien (Austria). Abt. fuer Neonatologie, angeborene Stoerungen und Intensivmedizin; Puig, S.; Prayer, D. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    2000-01-01

    A cerebral artery infarction is an important differential diagnosis in the newborn with neurological abnormalities. Based on clinical data, its incidence is estimated to be 1 in 4000 newborns. Since the course is often subclinical, the true incidence is probably higher. Diagnosis: Cerebral ultrasound and Doppler sonography as readily available screening tools play a central role in the initial diagnosis of neonatal cerebral infarction. Definitive diagnosis is made by computed tomography or magnetic resonance imaging. Beside symptomatic anticonvulsive therapy, treatment aims at the prevention of secondary ischemic injury. Discussion: Three term infants with different clinical courses of neonatal stroke are presented to sensitize the clinician and the radiologist for this probably underdiagnosed entity. The role of imaging modalities in the diagnosis and follow-up of neonatal cerebral infarction is discussed. (orig.) [German] Ein Infarkt im Stromgebiet der Zerebralarterien stellt eine wichtige Differentialdiagnose bei neurologischen Auffaelligkeiten in der Neonatalperiode dar. Die Inzidenz wird anhand von klinischer Daten auf 1:4000 Lebendgeborene geschaetzt. Da der Verlauf oft subklinisch ist, liegt die wahre Inzidenz wahrscheinlich hoeher. Diagnose: Bei der Diagnosestellung kommen dem Schaedelultraschall und der Doppelsonographie als leicht verfuegbaren Screening-Methoden eine zentrale Rolle zu. Die definitive Diagnose wird, je nach Verfuegbarkeit, mittels Computertomographie oder Kernspintomographie gestellt. Die Behandlung ist neben der symptomatischen (antikonvulsiven) Therapie auf die Vermeidung von ischaemischen Sekundaerschaeden gerichtet. Diskussion: Wir wollen mit der vorliegenden Arbeit anhand von 3 Kindern mit verschiedenen klinischen Verlaeufen eines sog. Neonatal stroke den Stellenwert der bildgebenden Verfahren bei der Diagnostik und Verlaufskontrolle aufzeigen und die Sensibilitaet fuer dieses vermutlich unterdiagnostizierte Krankheitsbild erhoehen

  11. Violent and Fatal Youth Trauma: Is There a Missed Opportunity?

    Directory of Open Access Journals (Sweden)

    Robert Madlinger, DO

    2012-05-01

    Full Text Available Introduction: Accidents and assaults (homicides are the leading causes of death among the youth of the United States, accounting for 53.3% of deaths among children aged 1 to19 years. Victim recidivism,defined as repeated visits to the emergency department (ED as a victim of violent trauma, is a significantly growing public health problem. As 5-year mortality rates for recidivism are as high as 20%,it is important to determine whether victims with a history of violent trauma are at increased risk for fatal outcome with their next trauma. We hypothesized that victims of violent trauma who have had 1 prior ED visit for violent trauma will have increased odds of fatal outcome.Methods: A retrospective chart review was conducted for patients presenting with penetrating trauma to the ED from January 1, 1999 to December 31, 2009. All patients between the ages of 15 to 25 years who presented to the ED for any penetrating trauma were included. Patients with prior presentations for penetrating trauma were compared to those patients who were first-time presenters to determine the odds ratio of fatal outcome.Results: Overall, 15,395 patients were treated for traumatic presentations. Of these, 1,044 met inclusion criteria. Demographically, 79.4% were Hispanic, 19.4% were African American, and 0.96% were Caucasian. The average age was 21 years, and 98% of the population was male. One hundred and forty-seven (14% had prior presentations, and 897 (86% did not. Forty of the 147 patients (27%with prior presentations had a fatal outcome as compared to 29 patients of the 868 (3% without prior presentations, with odds ratio of 10.8 (95% confidence interval, 6.4–18.1; Pearson v2, P , 0.001. The 5-year mortality rate for those patients with fatal outcomes was calculated at 16.5%.Conclusion: Patients who had prior ED visits for penetrating trauma were at greater risk for fatal outcomes compared to those with no prior visits. Therefore, trauma-related ED visits might

  12. Colestase neonatal prolongada: estudo prospectivo

    Directory of Open Access Journals (Sweden)

    PRADO Elizabeth Teixeira Mendes Livramento

    1999-01-01

    Full Text Available Em razão da urgência de se decidir por um tratamento clínico ou por uma intervenção cirúrgica imediata, o estudo da colestase neonatal prolongada envolve dois objetivos básicos: o diagnóstico diferencial entre atresia biliar e hepatite neonatal e a pesquisa dos agentes etiológicos associados. Desta maneira, através de estudo prospectivo desenvolvido na década de 1970, foram avaliadas 77 crianças portadoras de colestase neonatal prolongada para estabelecer o diagnóstico diferencial entre atresia biliar e hepatite neonatal e, numa segunda fase, 108 crianças, visando esclarecer a etiopatogenia da colestase neonatal prolongada. Os resultados do diagnóstico diferencial revelaram que, dos 18 atributos avaliados, apenas oito mostraram-se bons indicadores de atresia biliar, em ordem decrescente: ductos proliferados (espaço-porta, fibrose (espaço-porta, colestase (espaço-porta, cor das fezes -- acolia, hepatomegalia, colestase canalicular (lóbulo, infiltrado (espaço-porta, células gigantes (lóbulo. Estes oito atributos foram então compostos, mediante uma ponderação, em um único indicador de grande poder discriminativo, capaz de decidir o diagnóstico diferencial em 99% dos casos. Quanto à etiopatogenia, registrou-se: vírus rubéola 0%, vírus herpes simples 0%, listeriose 0%, citomegalovirose 2,2%, vírus hepatite B 2,4%, toxoplasmose 2,8%, deficiência de alfa-1-antitripsina 13,1%, sífilis 21,1 %, auto-anticorpos hepáticos 58,4%. O trabalho desenvolvido mostra que as 8 variáveis mais decisivas, como indicadoras diferenciais entre atresia biliar e hepatite neonatal, permanecem como índices fundamentais, auxiliando, em conjunto com novos métodos diagnósticos, na composição de uma estratégia multifatorial cada vez menos invasiva e mais precisa. O estudo da etiopatogenia, dependente das condições epidemiológicas locais e da época, com a introdução de novos métodos diagnósticos, torna-se atualmente cada vez mais

  13. Acute symptomatic neonatal seizures in preterm neonates: etiologies and treatments.

    Science.gov (United States)

    Pisani, Francesco; Spagnoli, Carlotta

    2017-12-15

    Acute symptomatic neonatal seizures in preterm newborns are a relevant clinical challenge due to the presence of many knowledge gaps. Etiology-wise, acute symptomatic seizures have an age-specific epidemiology, with intraventricular hemorrhage and its complications representing the first cause in extremely and very preterm neonates, whereas other etiologies have similar occurrence rates as in full-term infants. Specific treatment strategies for the premature neonates are not yet available. Studies suggest a similarly low response rate with even more unfavorable prognosis than in full-term infants. Pharmacodynamic and pharmacokinetic changes are likely under way during the preterm period, with the potential to affect both effectiveness and safety of antiepileptic drugs in these patients. However, due to the lack of clear evidence to guide prioritization of second-line drugs, off-label medications are frequently indicated by review papers and flow-charts, and are prescribed in clinical practice. We therefore conclude by exploring potential future lines of research. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Analysis of 86 fatal motorcycle frontal crashes in

    Directory of Open Access Journals (Sweden)

    ZHAO Hui

    2012-06-01

    Full Text Available 【Abstract】Objective: To analyze the injuries of motorcyclists involved in fatal motorcycle frontal crashes. Methods: A survey group involving multi-discipline experts was built to randomly collect data on fatal motor-cycle frontal collision accidents that occurred in Chongqing during 2006-2010. The sampled information included medi-cal or autopsy reports, blood alcohol concentration (BAC level, helmet use, accident witness, field sketch as well as field photos. The motorcyclist injuries were scored accord-ing to the Abbreviated Injury Scale (AIS 2005. The involved riders with a BAC level≥20 mg/ml were attributed to alco-hol use. Data were processed statistically with nonparamet-ric test via software SPSS 11.0. Results: A total of 86 fatal motorcycle frontal crashes were sampled and further analyzed. The age of motorcy-clists enrolled in this investigation showed nominal distri-bution and the middle-aged (30-39 years occupied the high-est percentage of fatalities. There were only 14 motorcyclists (16.3% wearing helmets at the moment of collision. And 12.8% of these motorcyclist crashes were attributable to alcohol use. Impact injury was the main fatal cause, accounting for 72% of motorcyclist deaths, followed by tumbling injury (26% and run-over (2%. Respectively 84%, 22% and 19% of motorcyclists who sustained head, chest and abdominal trauma died. Extremity injury was the most frequently ob-served injury type. Conclusions: This investigation is helpful to build accident prevention programs and develop protection de-vices which may effectively mitigate injuries and prevent deaths following motorcycle frontal collision accidents. Further investigations on motorcycle collision accidents are still needed. Key words: Motorcycles; Mortality; Accidents, traffic; Wounds and injuries

  15. Fatal childhood injuries in Finland, 1971-2010.

    Science.gov (United States)

    Parkkari, Jari; Mattila, Ville; Kivistö, Juho; Niemi, Seppo; Palvanen, Mika; Kannus, Pekka

    2013-06-01

    Childhood injuries are a major public health problem worldwide, injuries being the leading cause of death and disability from early childhood through adolescence. To examine the 40-year nationwide trends in the number and incidence of fatal injuries among children aged 0-14 years in Finland, a country with a white European population of 5.3 million. Data were obtained from the Official Cause-of-Death Statistics of Finland during 1971-2010. The main categories for unintentional injury deaths were road traffic injury, water traffic injury, falls, drowning and poisoning. For intentional injury deaths, the main categories were suicide and homicide. In 1971, there were 109 fatal injuries involving girls and 207 involving boys, and in 2010, these numbers were 10 and 16. The corresponding incidence rates (per 100 000 children per year) were 20.1 and 2.3 (girls), and 36.7 and 3.5 (boys). The reduction in fatal injuries was mostly due to fewer unintentional injuries. The greatest decline occurred in the number of fatal motor vehicle injuries: from 57 (girls) and 92 (boys) in 1971 to 5 (girls) and 2 (boys) in 2010. Drownings followed a similar pattern. Violence-related deaths also showed a decreasing trend. In 1971, there were 14 intentional deaths in girls and 15 in boys, while in 2010 these numbers were 0 and 3, respectively. This nationwide study confirms a decline in childhood injury deaths over the last four decades, with the greatest declines occurring in the number of fatal motor vehicle injuries, drownings and intentional injuries.

  16. Fuel economy and traffic fatalities: multivariate analysis of international data

    International Nuclear Information System (INIS)

    Noland, Robert B.

    2005-01-01

    In the US motor vehicle fuel economy standards were imposed in the late 1970s, in response to the oil crises of that decade. Since then, efforts to increase the standards have not occurred, one reason being the argument that smaller vehicles (which are generally more efficient) are considered less safe. Recent analyses (Energy J.( 2004)) suggests that variance in vehicle weights may be more important than the absolute weights of vehicles in making the highway network less safe. In Europe and other countries, which generally have smaller more efficient vehicle fleets, due to relatively high gasoline taxes, this debate has not occurred. In particular, countries such as Great Britain and Sweden have far safer road transport systems than the US but also have much more efficient vehicle fleets. This suggests that either vehicle weight and size are unimportant or if they have an effect it is small compared to other factors. This paper uses international data to build econometric models that examine whether average vehicle fuel economy has any association with road traffic fatalities, while controlling for other factors that are associated with fatalities. The effect on pedestrian fatalities is also analyzed. Cross-sectional time-series data on traffic fatalities from OECD countries is used and negative binomial regression models are developed using panel data to determine whether any associations are present. Results find that changes in vehicle efficiency are not associated with changes in traffic fatalities, suggesting either that size and weight changes over time have not had a strong effect or are not associated with fuel economy improvements

  17. Mitochondrial Respiration and Oxygen Tension.

    Science.gov (United States)

    Shaw, Daniel S; Meitha, Karlia; Considine, Michael J; Foyer, Christine H

    2017-01-01

    Measurements of respiration and oxygen tension in plant organs allow a precise understanding of mitochondrial capacity and function within the context of cellular oxygen metabolism. Here we describe methods that can be routinely used for the isolation of intact mitochondria, and the determination of respiratory electron transport, together with techniques for in vivo determination of oxygen tension and measurement of respiration by both CO 2 production and O 2 consumption that enables calculation of the respiratory quotient [CO 2 ]/[O 2 ].

  18. Mitochondrial disorders in congenital myopathies

    Directory of Open Access Journals (Sweden)

    D. A. Kharlamov

    2014-01-01

    Full Text Available The literature review gives data on the role of mitochondrial disorders in the pathogenesis of congenital myopathies: congenital muscular dystrophies and congenital structural myopathies. It describes changes in congenital muscular dystrophies with type VI collagen, in myodystrophy with giant mitochondria, in congenital central core myopathies, myotubular myopathy, etc. Clinical and experimental findings are presented. Approaches to therapy for energy disorders in congenital myopathies are depicted.

  19. Prospective neonatal screening for severe T- and B-lymphocyte deficiencies in Seville.

    Science.gov (United States)

    de Felipe, Beatriz; Olbrich, Peter; Lucenas, José Manuel; Delgado-Pecellin, Carmen; Pavon-Delgado, Antonio; Marquez, Josefina; Salamanca, Carmen; Soler-Palacin, Pere; Gonzalez-Granado, Luis Ignacio; Antolin, Laura Ferreras; Borte, Stephan; Neth, Olaf

    2016-02-01

    Early diagnosis of primary immunodeficiency such as severe combined immunodeficiency (SCID) and X-linked agammaglobulinemia (XLA) improves outcome of affected children. T-cell-receptor-excision circles (TRECs) and kappa-deleting-recombination-excision circles (KRECs) determination from dried blood spots (DBS) identify neonates with severe T- and/or B-lymphopenia. No prospective data exist of the impact of gestational age (GA) and birth weight (BW) on TRECs and KRECs values. TRECs and KRECs determination using triplex RT-PCR (TRECS-KRECS-β-actin-Assay) from prospectively collected DBS between 02/2014 and 02/2015 in three hospitals in Seville, Spain. Cut-off levels were TRECs 700/punch. Internal (SCID, XLA, ataxia telangiectasia) and external controls (NBS quality assurance program, CDC) were included. A total of 5160 DBS were tested. Re-punch was needed in 77 samples (1.5%) due to insufficient β-actin (<700 copies/punch). Pre-term neonates (GA<37 weeks) and neonates with a BW<2500 g showed significantly lower TRECs and KRECs levels (p < 0.001). Due to repeat positive results five neonates were re-called (<0.1%): Fatal chromosomopathy (n = 1; TRECs 1/KRECs 4); extreme pre-maturity (n = 2; TRECs 0/KRECs 0 and TRECs 1/KRECs 20 copies/punch); neonates born to mothers receiving azathioprine during pregnancy (n = 2; TRECs 92/KRECs 1 and TRECs 154/KRECs 3 copies/punch). All internal and external controls were correctly identified. TRECS-KRECS-β-actin-Assay correctly identifies T- and B-cell lymphopenias. Pre-maturity and low BW is associated with lower TREC and KREC levels. Extreme pre-maturity and maternal immune suppressive therapy may be a cause for false positive results of TRECs and KRECs values, respectively. To reduce the rate of insufficient samples, DBS extraction and storage need to be improved. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Implementation of the Neonatal Sepsis Calculator in an Australian Tertiary Perinatal Centre.

    Science.gov (United States)

    Strunk, Tobias; Buchiboyina, Ashok; Sharp, Mary; Nathan, Elizabeth; Doherty, Dorota; Patole, Sanjay

    2018-03-07

    Early-onset sepsis (EOS) is a potentially fatal condition that affects about 0.3-0.8/1,000 infants born at ≥35 weeks' gestation in developed countries. Current EOS management algorithms result in 8-15% of infants receiving antibiotics for suspected sepsis. The Neonatal Sepsis Calculator provides evidence-based estimates of individual sepsis risk, but data on its clinical application is limited. To evaluate the feasibility, safety, and effect on the newborn infants that were investigated and that received antibiotic treatment for suspected EOS following the introduction of the Neonatal Sepsis Calculator. This was a prospective, observational, single-centre cohort study comparing the rates of newborn infants born at ≥35 weeks' gestation requiring evaluation and/or treatment for suspected EOS in a large tertiary perinatal centre before versus after the prospective introduction of the Neonatal Sepsis Calculator (Epoch 1: October 2014 to January 2015 vs. Epoch 2: July to December 2016). There were 1,732 and 2,502 eligible infants born during Epochs 1 and 2, respectively. Of these, 425 (24.2%) and 530 (21.2%), respectively, were admitted to the neonatal unit. The proportion of infants investigated for sepsis decreased from 15.2 to 11.1%, and that of infants treated with antibiotics from 12.0 to 7.6%. One case of EOS occurred during each Epoch. The implementation of the Neonatal Sepsis Calculator was feasible and safe in our unit. Application of this clinical decision support tool may reduce the number of infants undergoing investigations and empirical treatment for suspected EOS. © 2018 S. Karger AG, Basel.