WorldWideScience

Sample records for haemorrhagic fever incidence

  1. Haemorrhagic Fevers, Viral

    Science.gov (United States)

    ... is usually applied to disease caused by Arenaviridae (Lassa fever, Junin and Machupo), Bunyaviridae (Crimean-Congo haemorrhagic fever, ... fever Dengue and severe dengue Ebola virus disease Lassa fever Marburg haemorrhagic fever Rift Valley fever Multimedia, features ...

  2. The changing incidence of Dengue Haemorrhagic Fever in Indonesia : A 45-year registry-based analysis

    NARCIS (Netherlands)

    Karyanti, Mulya R.; Uiterwaal, Cuno S P M; Kusriastuti, Rita; Hadinegoro, Sri R.; Rovers, Maroeska M.; Heesterbeek, Hans; Hoes, Arno W.; Bruijning-Verhagen, Patricia

    2014-01-01

    Background: Increases in human population size, dengue vector-density and human mobility cause rapid spread of dengue virus in Indonesia. We investigated the changes in dengue haemorrhagic fever (DHF) incidence in Indonesia over a 45-year period and determined age-specific trends in annual DHF incid

  3. The changing incidence of Dengue Haemorrhagic Fever in Indonesia: a 45-year registry-based analysis

    NARCIS (Netherlands)

    Karyanti, M.R.; Uiterwaal, C.S.; Kusriastuti, R.; Hadinegoro, S.R.; Rovers, M.M.; Heesterbeek, H.; Hoes, A.W.; Bruijning-Verhagen, P.

    2014-01-01

    BACKGROUND: Increases in human population size, dengue vector-density and human mobility cause rapid spread of dengue virus in Indonesia. We investigated the changes in dengue haemorrhagic fever (DHF) incidence in Indonesia over a 45-year period and determined age-specific trends in annual DHF incid

  4. The changing incidence of Dengue Haemorrhagic Fever in Indonesia: a 45-year registry-based analysis

    NARCIS (Netherlands)

    Karyanti, M.R.; Uiterwaal, C.S.P.M.; Kusriastuti, R.; Hadinegoro, S.R.; Rovers, M.M.; Heesterbeek, J.A.P.; Hoes, A.W.; Bruijning-Verhagen, P.

    2014-01-01

    Background: Increases in human population size, dengue vector-density and human mobility cause rapid spread of dengue virus in Indonesia. We investigated the changes in dengue haemorrhagic fever (DHF) incidence in Indonesia over a 45-year period and determined age-specific trends in annual DHF incid

  5. The changing incidence of Dengue Haemorrhagic Fever in Indonesia : A 45-year registry-based analysis

    NARCIS (Netherlands)

    Karyanti, Mulya R.; Uiterwaal, Cuno S P M; Kusriastuti, Rita; Hadinegoro, Sri R.; Rovers, Maroeska M.; Heesterbeek, Hans; Hoes, Arno W.; Bruijning-Verhagen, Patricia

    2014-01-01

    Background: Increases in human population size, dengue vector-density and human mobility cause rapid spread of dengue virus in Indonesia. We investigated the changes in dengue haemorrhagic fever (DHF) incidence in Indonesia over a 45-year period and determined age-specific trends in annual DHF

  6. Crimean-Congo Haemorrhagic Fever

    Science.gov (United States)

    ... Questions & answers Features Multimedia Contacts Crimean-Congo haemorrhagic fever Fact sheet N°208 January 2013 Key facts ... the principal tick vector. The Crimean-Congo haemorrhagic fever virus in animals and ticks The hosts of ...

  7. Ebola haemorrhagic fever

    Science.gov (United States)

    Feldmann, Heinz; Geisbert, Thomas W

    2012-01-01

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

  8. An information value based analysis of physical and climatic factors affecting dengue fever and dengue haemorrhagic fever incidence

    Directory of Open Access Journals (Sweden)

    Tripathi Nitin

    2005-06-01

    Full Text Available Abstract Background Vector-borne diseases are the most dreaded worldwide health problems. Although many campaigns against it have been conducted, Dengue Fever (DF and Dengue Haemorrhagic Fever (DHF are still the major health problems of Thailand. The reported number of dengue incidences in 1998 for the Thailand was 129,954, of which Sukhothai province alone reported alarming number of 682. It was the second largest epidemic outbreak of dengue after 1987. Government arranges the remedial facilities as and when dengue is reported. But, the best way to control is to prevent it from happening. This will be possible only when knowledge about the relationship of DF/DHF with climatic and physio-environmental agents is discovered. This paper explores empirical relationship of climatic factors rainfall, temperature and humidity with the DF/DHF incidences using multivariate regression analysis. Also, a GIS based methodology is proposed in this paper to explore the influence of physio-environmental factors on dengue incidences. Remotely sensed data provided important data about physical environment and have been used for many vector borne diseases. Information Values (IV method was utilised to derive influence of various factors in the quantitative terms. Researchers have not applied this type of analysis for dengue earlier. Sukhothai province was selected for the case study as it had high number of dengue cases in 1998 and also due to its diverse physical setting with variety of land use/land cover types. Results Preliminary results demonstrated that physical factors derived from remotely sensed data could indicate variation in physical risk factors affecting DF/DHF. A composite analysis of these three factors with dengue incidences was carried out using multivariate regression analysis. Three empirical models ER-1, ER-2 and ER-3 were evaluated. It was found that these three factors have significant relation with DF/DHF incidences and can be related to

  9. Viral haemorrhagic fevers in healthcare settings.

    Science.gov (United States)

    Ftika, L; Maltezou, H C

    2013-03-01

    Viral haemorrhagic fevers (VHFs) typically manifest as rapidly progressing acute febrile syndromes with profound haemorrhagic manifestations and very high fatality rates. VHFs that have the potential for human-to-human transmission and onset of large nosocomial outbreaks include Crimean-Congo haemorrhagic fever, Ebola haemorrhagic fever, Marburg haemorrhagic fever and Lassa fever. Nosocomial outbreaks of VHFs are increasingly reported nowadays, which likely reflects the dynamics of emergence of VHFs. Such outbreaks are associated with an enormous impact in terms of human lives and costs for the management of cases, contact tracing and containment. Surveillance, diagnostic capacity, infection control and the overall preparedness level for management of a hospital-based VHF event are very limited in most endemic countries. Diagnostic capacities for VHFs should increase in the field and become affordable. Availability of appropriate protective equipment and education of healthcare workers about safe clinical practices and infection control is the mainstay for the prevention of nosocomial spread of VHFs.

  10. Viral haemorrhagic fevers in South Africa

    African Journals Online (AJOL)

    particle for some), the haemorrhagic fever (HF)-causing viruses have to be handled .... The filoviruses. The filoviruses, EVD and MVD viruses, are known to cause highly .... attributed to a previously unknown arenavirus, dubbed the Lujo virus.

  11. Ebola haemorrhagic fever among hospitalised children and ...

    African Journals Online (AJOL)

    Ebola haemorrhagic fever among hospitalised children and adolescents in nothern Uganda ... African Health Sciences ... Conclusion : Similar to previous Ebola outbreaks, a relative sparing of children in this outbreak was observed. The under ...

  12. Ebola and Marburg haemorrhagic fever.

    Science.gov (United States)

    Rougeron, V; Feldmann, H; Grard, G; Becker, S; Leroy, E M

    2015-03-01

    Ebolaviruses and Marburgviruses (family Filoviridae) are among the most virulent pathogens for humans and great apes causing severe haemorrhagic fever and death within a matter of days. This group of viruses is characterized by a linear, non-segmented, single-stranded RNA genome of negative polarity. The overall burden of filovirus infections is minimal and negligible compared to the devastation caused by malnutrition and other infectious diseases prevalent in Africa such as malaria, dengue or tuberculosis. In this paper, we review the knowledge gained on the eco/epidemiology, the pathogenesis and the disease control measures for Marburg and Ebola viruses developed over the last 15 years. The overall progress is promising given the little attention that these pathogen have achieved in the past; however, more is to come over the next decade given the more recent interest in these pathogens as potential public and animal health concerns. Licensing of therapeutic and prophylactic options may be achievable over the next 5-10 years.

  13. Filoviral haemorrhagic fevers: A threat to Zambia?

    Directory of Open Access Journals (Sweden)

    Katendi Changula

    2012-06-01

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

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

    Directory of Open Access Journals (Sweden)

    O Karabay

    2011-01-01

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

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

    Science.gov (United States)

    Tantawichien, Terapong

    2012-05-01

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

  16. Therapeutic management of Crimean-Congo haemorrhagic fever.

    Science.gov (United States)

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

    2017-06-29

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

  17. Dengue and dengue haemorrhagic fever: Indian perspective

    Indian Academy of Sciences (India)

    U C Chaturvedi; Rachna Nagar

    2008-11-01

    The relationship of this country with dengue has been long and intense. The first recorded epidemic of clinically dengue-like illness occurred at Madras in 1780 and the dengue virus was isolated for the first time almost simultaneously in Japan and Calcutta in 1943–1944. After the first virologically proved epidemic of dengue fever along the East Coast of India in 1963–1964, it spread to allover the country. The first full-blown epidemic of the severe form of the illness, the dengue haemorrhagic fever/dengue shock syndrome occurred in North India in 1996. Aedes aegypti is the vector for transmission of the disease. Vaccines or antiviral drugs are not available for dengue viruses; the only effective way to prevent epidemic degure fever/dengue haemorrhagic fever (DF/DHF) is to control the mosquito vector, Aedes aegypti and prevent its bite. This country has few virus laboratories and some of them have done excellent work in the area of molecular epidemiology, immunopathology and vaccine development. Selected work done in this country on the problems of dengue is presented here.

  18. T cell responses and dengue haemorrhagic fever.

    Science.gov (United States)

    Screaton, Gavin; Mongkolsapaya, Juthathip

    2006-01-01

    The enhancement of severe disease upon secondary infection makes dengue almost unique among infectious pathogens and presents a serious challenge to vaccine design. Several key observations have been made which shed light onto this phenomenon particularly that antibodies can enhance Fc receptor-dependent uptake of virus into macrophages thereby increasing virus replication. Furthermore there seems to be a relationship between the peak virus load and disease severity. However, a second key feature of dengue is that the life-threatening symptoms do not correlate with the period of high viraemia; instead they occur at a time when the virus load is in steep decline. The coincidence of severe disease manifestations with defervescence and virus control suggests that the symptoms may be a consequence of the immune response to the virus rather than virus induced cytopathology. One of the key elements in the immune response to viruses are T cells which can both secrete a host of inflammatory cytokines and also be directly cytotoxic to infected cells. There are a number of experimental models of T cell-induced immunopathology including in responses to viruses. Particularly interesting in this respect are models of RSV-induced immunopathology, which have direct relevance to vaccine design as a formalin-inactivated vaccine to RSV actually enhanced disease in children when they became naturally infected with RSV, an echo of the disease enhancement seen in dengue. We will present an analysis of CD8+ T cell responses to a number of novel T cell epitopes during dengue infection and also analyse the function and cytokine secretion of these cells. We suggest that an exaggerated and partially misdirected T cell response seen in secondary dengue infection may be part of the complex series of events leading to dengue haemorrhagic fever and shock.

  19. Bilateral eyelid ecchymosis and subconjunctival haemorrhage manifesting as presenting feature in a case of dengue haemorrhagic fever.

    Science.gov (United States)

    Jain, Sparshi; Goswami, Anup; Singh, Nidhi; Kaur, Savleen

    2015-10-01

    We report a case of bilateral eyelid ecchymosis and subconjunctival haemorrhage, a rare presenting feature of dengue haemorrhagic fever. A 17-year-old boy presented to the emergency department with complaints of redness in both eyes and vomiting. He had bilateral eyelid ecchymosis with subconjunctival haemorrhage. Complete blood count revealed a significantly reduced platelet count of 11000/µL suggestive of dengue haemorrhagic fever (DHF). Ocular manifestations were followed by other systemic haemorrhagic manifestations of dengue later on which violates the usual sequence of events of dengue fever. Bilateral eyelid ecchymosis is a rare clinical manifestation and a rare presenting feature of dengue fever and one has to keep high index of suspicion for presence of dengue whenever a case of fever presents with lid ecchymosis/haemorrhage. © The Author(s) 2014.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    Crimean-Congo haemorrhagic fever (CCHF) is a tickborne viral zoonosis with up to 50% mortality in humans caused by CCHF virus belonging to the genus Nairovirus, family Bunyaviridae. The geographical distribution of CCHF cases corresponds closely with the distribution of principle tick vectors...

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    be spread from person to person and is one of the rare haemorrhagic fever viruses able to cause nosocomial outbreaks in hospitals. Crimean-Congo haemorrhagic fever is a public health problem in many regions of the world such as Eastern Europe, Asia, the Middle East and Africa. In addition to clinical...

  2. Travellers and viral haemorrhagic fevers: what are the risks?

    Science.gov (United States)

    Beeching, Nick J; Fletcher, Tom E; Hill, David R; Thomson, Gail L

    2010-11-01

    Viral haemorrhagic fevers (VHF) are caused by zoonotic viral infections transmitted to humans directly or by ticks or mosquitoes. The overall risk to travellers is conservatively estimated at modern Western hospital settings. However, healthcare-associated transmission of infection has been a major problem in some endemic settings. The potential for healthcare-associated infection and the threats posed by unrecognised or new agents necessitate a high index of suspicion and a standardised risk assessment approach to febrile travellers. Travel-related hantavirus infections are increasingly being reported from Europe and the Americas. This article summarises the epidemiology and reports of travel-related VHF cases in the past 40 years, together with strategies for their recognition, management and prevention.

  3. Trends of fluid requirement in dengue fever and dengue haemorrhagic fever: a single centre experience in Sri Lanka.

    Science.gov (United States)

    Kularatne, Senanayake A M; Weerakoon, Kosala G A D; Munasinghe, Ruwan; Ralapanawa, Udaya K; Pathirage, Manoji

    2015-04-08

    Meticulous fluid management is the mainstay of treatment in dengue fever that is currently governed by consensus guidelines rather than by strong research evidence. To examine this issue we audited the fluid requirement of a cohort of adult patients with dengue fever (DF) and dengue haemorrhagic fever (DHF) in a tertiary care clinical setting. This retrospective cohort study was conducted from July 2012 to January 2013 in Teaching Hospital, Peradeniya, Sri Lanka. Adult patients with confirmed dengue infection managed according to the national and WHO guidelines were included. Their fluid requirement was audited once data collection was over in both DF and DHF groups. Out of 302 patients, 209 (69%) had serological confirmation of dengue infection, comprising 62 (30%) patients gone into critical phase of DHF. Mean age of the DHF group was 30 years (range 12-63 years) and included more males (n = 42, 68%, p fever on admission and total duration of fever were 4 days and 6 days respectively. DHF group had high incidence of vomiting, abdominal pain and flushing, lowest platelet counts and highest haematocrit values compared to DF group. In DHF group, the mean total daily requirements of fluid from 2(nd) to 7(th) day were 2123, 2733, 2846, 2981, 3139 and 3154 milliliters respectively to maintain a safe haematocrit value and the vital parameters. However, in DF group the fluid requirement was lowest on 3(rd) day (2158 milliliters). DHF group had significantly high fluid requirement on 5(th) -7(th) day compared to DF group (p fever and again on 5(th) to 7(th) day of fever. Despite being an audit, these finding could be useful in future updates of guidelines and designing research.

  4. Travelling waves in the occurrence of dengue haemorrhagic fever in Thailand

    Science.gov (United States)

    Cummings, Derek A. T.; Irizarry, Rafael A.; Huang, Norden E.; Endy, Timothy P.; Nisalak, Ananda; Ungchusak, Kumnuan; Burke, Donald S.

    2004-01-01

    Dengue fever is a mosquito-borne virus that infects 50-100 million people each year. Of these infections, 200,000-500,000 occur as the severe, life-threatening form of the disease, dengue haemorrhagic fever (DHF). Large, unanticipated epidemics of DHF often overwhelm health systems. An understanding of the spatial-temporal pattern of DHF incidence would aid the allocation of resources to combat these epidemics. Here we examine the spatial-temporal dynamics of DHF incidence in a data set describing 850,000 infections occurring in 72 provinces of Thailand during the period 1983 to 1997. We use the method of empirical mode decomposition to show the existence of a spatial-temporal travelling wave in the incidence of DHF. We observe this wave in a three-year periodic component of variance, which is thought to reflect host-pathogen population dynamics. The wave emanates from Bangkok, the largest city in Thailand, moving radially at a speed of 148km per month. This finding provides an important starting point for detecting and characterizing the key processes that contribute to the spatial-temporal dynamics of DHF in Thailand.

  5. European survey on laboratory preparedness, response and diagnostic capacity for crimean-congo haemorrhagic fever, 2012

    NARCIS (Netherlands)

    M.D. Fernandez-Garcia (Maria Dolores); A. Negredo; A. Papa (Anna); O. Donoso-Mantke; M. Niedrig; H. Zeller; A. Tenorio; L. Franco (Leticia); S.W. Aberle (Stephan W.); M. van Esbroeck (M.); I. Christova; A. Markotic (Alemka); I.-C. Kurolt (Ivan-Christian); H. Zelena (Hana); I. Golovljova; D. Pannetier (Delphine); R. Charrel (Remi); J. Schmidt-Chanasit (Jonas); R. Wölfel (Roman); A. Papa (Anna); M.R. Capobianchi (Maria Rosaria); X. Jakupi (Xhevat); J. Storozenko (Jelena); A. Griskevicius (Algis); G. Bosevska (Golubinka); C. Muscat (Clive); M. Schutten (Martin); S.G. Dudman (Susanne Gjeruldsen); M.J. Alves (M. João); C.S. Ceianu; A. Platonov (Alexander); B. Bozovic (Bojana); B. Klempa; T. Avsic (Tatjana); A. Tenorio; Å. Lundkvist (Åke); P. Cherpillod (Pascal); G. Korukluoglu; D.W.G. Brown (D. W G); T. Brooks (Tim)

    2014-01-01

    textabstractCrimean-Congo haemorrhagic fever (CCHF) is an infectious viral disease that has (re-)emerged in the last decade in south-eastern Europe, and there is a risk for further geographical expansion to western Europe. Here we report the results of a survey covering 28 countries, conducted in 20

  6. Nosocomial infection of Crimean-Congo haemorrhagic fever in eastern Iran: case report.

    Science.gov (United States)

    Chinikar, Sadegh; Shayesteh, Majid; Khakifirouz, Sahar; Jalali, Tahmineh; Rasi Varaie, Fereshteh Sadat; Rafigh, Mahboubeh; Mostafavi, Ehsan; Shah-Hosseini, Nariman

    2013-01-01

    An outbreak of Crimean-Congo haemorrhagic fever occurred in the county of Birjand in eastern Iran in November 2011. Four cases were involved in this outbreak. Two patients died after admission to hospital, one of whom was a nurse who acquired the infection nosocomially, and the others were treated successfully.

  7. Experimental respiratory Marburg virus haemorrhagic fever infection in the common marmoset (Callithrix jacchus).

    Science.gov (United States)

    Smither, Sophie J; Nelson, Michelle; Eastaugh, Lin; Laws, Thomas R; Taylor, Christopher; Smith, Simon A; Salguero, Francisco J; Lever, Mark S

    2013-04-01

    Marburg virus causes a highly infectious and lethal haemorrhagic fever in primates and may be exploited as a potential biothreat pathogen. To combat the infection and threat of Marburg haemorrhagic fever, there is a need to develop and license appropriate medical countermeasures. To determine whether the common marmoset (Callithrix jacchus) would be an appropriate model to assess therapies against Marburg haemorrhagic fever, initial susceptibility, lethality and pathogenesis studies were performed. Low doses of virus, between 4 and 28 TCID50 , were sufficient to cause a lethal, reproducible infection. Animals became febrile between days 5 and 6, maintaining a high fever before succumbing to disease between 8 and 11 days postchallenge. Typical signs of Marburg virus infection were observed including haemorrhaging and a transient rash. In pathogenesis studies, virus was isolated from the animals' lungs from day 3 postchallenge and from the liver, spleen and blood from day 5 postchallenge. Early signs of histopathology were apparent in the kidney and liver from day 3. The most striking features were observed in animals exhibiting severe clinical signs, which included high viral titres in all organs, with the highest levels in the blood, increased levels in liver function enzymes and blood clotting times, decreased levels in platelets, multifocal moderate-to-severe hepatitis and perivascular oedema.

  8. Computational Intelligence Method for Early Diagnosis Dengue Haemorrhagic Fever Using Fuzzy on Mobile Device

    Science.gov (United States)

    Salman, Afan; Lina, Yen; Simon, Christian

    2014-03-01

    Mortality from Dengue Haemorrhagic Fever (DHF) is still increasing in Indonesia particularly in Jakarta. Diagnosis of the dengue shall be made as early as possible so that first aid can be given in expectation of decreasing death risk. The Study will be conducted by developing expert system based on Computational Intelligence Method. On the first year, study will use the Fuzzy Inference System (FIS) Method to diagnose Dengue Haemorrhagic Fever particularly in Mobile Device consist of smart phone. Expert system application which particularly using fuzzy system can be applied in mobile device and it is useful to make early diagnosis of Dengue Haemorrhagic Fever that produce outcome faster than laboratory test. The evaluation of this application is conducted by performing accuracy test before and after validation using data of patient who has the Dengue Haemorrhagic Fever. This expert system application is easy, convenient, and practical to use, also capable of making the early diagnosis of Dengue Haemorraghic to avoid mortality in the first stage.

  9. Imported viral haemorrhagic fever with a potential for person-to-person transmission: review and recommendations for initial management of a suspected case in Belgium

    OpenAIRE

    Colebunders, R; Esbroeck, M.; Moreau, M; Borchert, M

    2002-01-01

    Viral haemorrhagic fevers are caused by a wide range of viruses. There are 4 types of viruses well known to spread from person to person and able to cause nosocomial outbreaks with a high case fatality rate: an arenavirus (Lassa fever and more exceptionally the Junin and Machupo virus), a bunyavirus (Crimean-Congo haemorrhagic fever) and the Filoviridae (Ebola and Marburg viruses). So far there have been only a limited number of imported cases of viral haemorrhagic fever in industrialized cou...

  10. High incidence of post-tonsillectomy secondary haemorrhage following coblation tonsillectomy.

    Science.gov (United States)

    Praveen, C V; Parthiban, Subashini; Terry, R M

    2013-01-01

    To examine the incidence of haemorrhage following tonsillectomy, to explore the usefulness of antibiotic in preventing postoperative haemorrhage and to examine if the haemorrhage depended on the level of expertise of the surgeon. A retrospective review analysing tonsillectomy method, the rate secondary haemorrhage, the grade of operating surgeon. A χ(2) analysis was used to determine the statistical difference between the haemorrhage rates of different tonsillectomy methods. One thousand three hundred and thirty-six tonsillectomies were performed during this period by four different methods: 615 by cold steel dissection, 582 by Coblation, 32 by bipolar dissection and 107 by Helica thermal coagulation. 621 tonsillectomies were performed by Consultant grade and middle grades performed 693 operations. 124 patients (9.3 %) were readmitted with haemorrhage. The secondary haemorrhage requiring surgery for controlling bleeding for cold steel dissection method was 1.5 % compared to 6.7 % for coblation method (P tonsillectomy haemorrhage rate of 5.5 % and middle grades had a rate of 3.7 %. 86.5 % of the patients were already on routine prophylactic oral antibiotics at the time of presentation with haemorrhage needing surgical arrest and 13.5 % were not on antibiotics (P coblation and cold steel dissection methods. Coblation tonsillectomies had an increased need for operative intervention to control secondary haemorrhage. Routine use of antibiotic and expertise of operating surgeon had no bearing on secondary haemorrhage rate.

  11. Fluid therapy monitoring for dengue haemorrhagic fever and other pathologies

    OpenAIRE

    Josà Rubens Costa Lima

    2014-01-01

    Dengue patients that were prematurely hydrated to prevent a dengue hemorrhagic fever (DHF) shock were investigated. These patients had complications and died in strong clinical and epidemiological association with progressive anemias, not caused by hemorrhages, and without presenting laboratorial proof of the specific natural sign of DHF, the hemoconcentration. It was demonstrated that the association between dengue and anemias in Fortaleza is not natural. Further investigation of admitted pa...

  12. Quantitative analysis of particles, genomes and infectious particles in supernatants of haemorrhagic fever virus cell cultures

    Directory of Open Access Journals (Sweden)

    Hedlund Kjell-Olof

    2011-02-01

    Full Text Available Abstract Information on the replication of viral haemorrhagic fever viruses is not readily available and has never been analysed in a comparative approach. Here, we compared the cell culture growth characteristics of haemorrhagic fever viruses (HFV, of the Arenaviridae, Filoviridae, Bunyaviridae, and Flavivridae virus families by performing quantitative analysis of cell culture supernatants by (i electron microscopy for the quantification of virus particles, (ii quantitative real time PCR for the quantification of genomes, and (iii determination of focus forming units by coating fluorescent antibodies to infected cell monolayers for the quantification of virus infectivity. The comparative analysis revealed that filovirus and RVFV replication results in a surplus of genomes but varying degrees of packaging efficiency and infectious particles. More efficient replication and packaging was observed for Lassa virus, and Dengue virus resulting in a better yield of infectious particles while, YFV turned out to be most efficient with only 4 particles inducing one FFU. For Crimean-Congo haemorrhagic fever virus (CCHFV a surplus of empty shells was observed with only one in 24 particles equipped with a genome. The complete particles turned out to be extraordinarily infectious.

  13. SUSCEPTIBILITY OF DENGUE HAEMORRHAGIC FEVER VECTOR (Aedes aegypti AGAINST ORGANOPHOSPHATE INSECTICIDES (MALATHION AND TEMEPHOS IN SOME DISTRICTS OF YOGYAKARTA AND CENTRAL JAVA PROVINCES

    Directory of Open Access Journals (Sweden)

    Damar Tri Boewono

    2012-11-01

    Full Text Available SUSCEPTIBILITY OF DENGUE HAEMORRHAGIC FEVER VECTOR (Aedes aegypti AGAINST ORGANOPHOSPHATE INSECTICIDES (MALATHION AND TEMEPHOS IN SOME DISTRICTS OF YOGYAKARTA AND CENTRAL JAVA PROVINCES

  14. Epidemiologic characteristics of haemorrhagic fever with renal syndrome in Mainland China from 2006 to 2010

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    Shiwen Wang

    2012-02-01

    Full Text Available Objective: To design effective prevention and control strategies for haemorrhagic fever with renal syndrome (HFRS in Mainland China, we evaluated the epidemiologic characteristics and trends of HFRS cases reported between 2006 and 2010.Methods: HFRS data from 1970 to 2010 were obtained from the China Notifiable Disease Reporting System (CNDRS. The cases analysed included clinical cases and laboratory-confirmed cases. Data was extracted for statistical analysis by time, region and profession; the incidence rate was obtained directly from CNDRS. In this study, we analysed the morbidity and mortality data of HFRS from 2006 to 2010.Results: HFRS cases trended downward from 2006 (15 098 to 2009 (8745, but exhibited a slight increase in 2010 (9526. Twenty-nine of 31 provinces reported HFRS cases between 2006 and 2010. Five provinces, namely, Heilongjiang, Jilin and Liaoning in the North-east, Shandong in the east, and Shaanxi in the central part of China, were characterized as high-endemic areas. Seasonal case distribution was bimodal, with peaks of cases in spring and winter. Young male farmers were the most susceptible population to HFRS. Early- to middle-aged adults (20–50 years old represented the largest groups of HFRS cases.Conclusion: The overall number of cases of HFRS in China has trended downward possibly due to national vaccine and rodent vector control programmes implemented in the past 25 years. However, this trend slowed down in the last five years. High-endemic regions and at-risk population groups still exist and will benefit from further targeted prevention strategies.

  15. Ebola haemorrhagic fever virus: pathogenesis, immune responses, potential prevention.

    Science.gov (United States)

    Marcinkiewicz, Janusz; Bryniarski, Krzysztof; Nazimek, Katarzyna

    2014-01-01

    Ebola zoonotic RNA filovirus represents human most virulent and lethal pathogens, which induces acute hemorrhagic fever and death within few days in a range of 60-90% of symptomatic individuals. Last outbreak in 2014 in West Africa caused panic that Ebola epidemic can be spread to other continents. Number of deaths in late December reached almost 8,000 individuals out of more than 20,000 symptomatic patients. It seems that only a coordinated international response could counteract the further spread of Ebola. Major innate immunity mechanisms against Ebola are associated with the production of interferons, that are inhibited by viral proteins. Activation of host NK cells was recognized as a leading immune function responsible for recovery of infected people. Uncontrolled cell infection by Ebola leads to an impairment of immunity with cytokine storm, coagulopathy, systemic bleeding, multi-organ failure and death. Tested prevention strategies to induce antiviral immunity include: i. recombinant virus formulations (vaccines); ii. cocktail of monoclonal antibodies (serotherapy); iii. alternative RNA-interference-based antiviral methods. Maintaining the highest standards of aseptic and antiseptic precautions is equally important. Present brief review summarizes a current knowledge concerning pathogenesis of Ebola hemorrhagic disease and the virus interaction with the immune system and discusses recent advances in prevention of Ebola infection by vaccination and serotherapy.

  16. First dengue haemorrhagic fever epidemic in the Americas, 1981: insights into the causative agent.

    Science.gov (United States)

    Rodriguez-Roche, Rosmari; Hinojosa, Yoandri; Guzman, Maria G

    2014-12-01

    Historical records describe a disease in North America that clinically resembled dengue haemorrhagic fever during the latter part of the slave-trading period. However, the dengue epidemic that occurred in Cuba in 1981 was the first laboratory-confirmed and clinically diagnosed outbreak of dengue haemorrhagic fever in the Americas. At that time, the presumed source of the dengue type 2 strain isolated during this epidemic was considered controversial, partly because of the limited sequence data and partly because the origin of the virus appeared to be southern Asia. Here, we present a molecular characterisation at the whole-genome level of the original strains isolated at different time points during the epidemic. Phylogenetic trees constructed using Bayesian methods indicated that 1981 Cuban strains group within the Asian 2 genotype. In addition, the study revealed that viral evolution occurred during the epidemic - a fact that could be related to the increasing severity from month to month. Moreover, the Cuban strains exhibited particular amino acid substitutions that differentiate them from the New Guinea C prototype strain as well as from dengue type 2 strains isolated globally.

  17. CLINICAL PROFILE OF DENGUE HAEMORRHAGIC FEVER FROM JAN 2009 TO DEC 2009 IN AND AROUND AURANGABAD

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    Duthade Mangala

    2013-11-01

    Full Text Available ABSTRACT: In present study 890 serum samples of patients suspected of dengue fever on clinical grounds were received in department of Microbiology. Out of these 249 cases showed thrombocytopenia (platelet count <1 lakh /cumm and were subjected to rapid dengue serological test as well as IgM capture ELISA. 11/ 249 (4% cases were diagnosed as primary dengue infection (only IgM positive by rapid dengue IgG/IgM bispot immunocomb test. There were 123(49% cases with only IgG positive suggesting secondary/past dengue infection. Both IgM and IgG were positive in 24(10% cases. Number of cases negative for both IgM and IgG were 91(37%. IgM positive cases were confirmed by IgM capture ELISA. Classical dengue fever (DF was noted in 168 (67% patients and dengue hemorrhagic fever (DHF in 81(33% cases. Common clinical presentations of DHF were fever 78(96%, body - ache 74(91%, arthralgia 74 (91%, retro - orbital pain 65(80%, abdominal pain 07(09%. Bleeding manifestation were in the form of petechiae, melena, epistaxis, hematuria, hemoptysis, hematemesis, bleeding gums and conjunctival hemorrhages. Out of 81 Dengue haemorrhagic fever (DHF patients 13(16% patients had platelet count between 50,000 and 1 lakh. 68(84% patients had platelet count below 50,000. Majority of these patients 47(58% had platelet below 20000 and were IgG posit ive. Thrombocytopenia correlated well with bleeding manifestations in our patients. In an epidemic setting if the patients present with fever, vomiting, musculoskeletal pain and bleeding along with low platelet count a strong possibility of DHF/ Dengu e shock syndrome (DSS should be kept in mind

  18. Imported viral haemorrhagic fever with a potential for person-to-person transmission: review and recommendations for initial management of a suspected case in Belgium.

    Science.gov (United States)

    Colebunders, R; Van Esbroeck, M; Moreau, M; Borchert, M

    2002-01-01

    Viral haemorrhagic fevers are caused by a wide range of viruses. There are 4 types of viruses well known to spread from person to person and able to cause nosocomial outbreaks with a high case fatality rate: an arenavirus (Lassa fever and more exceptionally the Junin and Machupo virus), a bunyavirus (Crimean-Congo haemorrhagic fever) and the Filoviridae (Ebola and Marburg viruses). So far there have been only a limited number of imported cases of viral haemorrhagic fever in industrialized countries. In recent years an increasing number of outbreaks of filovirus infections have occurred in Africa and in 2000 5 cases of Lassa fever were brought from Sierra Leone to Europe. Therefore European physicians should consider the possibility of a viral haemorrhagic fever in an acutely ill patient just returning from Africa or South-America with fever for which there is no obvious cause. Such patients should be questioned for risk factors for viral haemorrhagic fever. Using universal precautions for handling blood and body fluids and barrier nursing techniques there is little risk that if a patient with viral haemorrhagic fever arrives in Belgium there will be secondary cases.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    Crimean-Congo haemorrhagic fever (CCHF) is a viral haemorrhagic fever caused by the CCHF virus. It is mainly transmitted to humans and animals by ticks. In recent y, large numbers of livestock have been transported across the border areas of Ardabil Province resulting in an outbreak of CCHF...... in the adjacent districts. A comprehensive study was carried out to assess the epidemiological aspects of the disease in this province. In the study area, 130 ticks were collected from randomly selected villages and classified into 9 species of hard tick and 2 species of soft tick. All ticks were analyzed...... for the presence of CCHF virus genome using gel-based and real-time reverse transcriptase polymerase chain reactions (RT-PCR). The results showed CCHF infection in almost 28% of ticks collectively. Also, of 56 livestock sera, around 39% were IgG-positive. The presence of anti-CCHF virus IgG antibodies and the CCHF...

  20. Immunization effect of purified bivalent vaccine to haemorrhagic fever with renal syndrome manufactured from primary cultured hamster kidney cells

    Institute of Scientific and Technical Information of China (English)

    DONG Guan-mu; HAN Liang; AN Qi; LIU Wen-xue; KONG Yan; YANG Li-hong

    2005-01-01

    @@ Haemorrhagic fever with renal syndrome (HFRS) is a worldwide epidemic plaguing over thirty nations. This disease has spread across 26 provinces, cities and autonomous regions of China with an annual onsets number of more than a hundred thousand and a mortality rate of 5% to 15%, accounting for over 80% of cases in the world, and threatening the safety and health of Chinese people.1 Analysis of serum samples over recent years indicates that the plagued areas are expanding.

  1. Epidemiological, serological and herd immunity of Crimean-Congo haemorrhagic fever in Kosovo.

    Science.gov (United States)

    Humolli, Isme; Dedushaj, Isuf; Zupanac, Tatjana Avsic; Muçaj, Sefedin

    2010-01-01

    Crimean-Congo Haemorrhagic Fever (CCHF) is primarily a zoonotic disease, mostly present as sporadic cases, but outbreaks also occur, especially in the family. Disease as endemic form is presents in some countries of Africa, Europe and Asia. In 2001, outbreak of CCHF was registered in Kosova, Albania, Pakistan, Iran, and South Africa. Goal of the research was to establish a pattern of the disease, its natural flow and herd immunity. For this purpose we used epidemiological methods, laboratory confirmation (ELISA, PCR) and t-test and chi2-test for results significance verification. Morbidity rate of the disease for the period of fifteen years (1995-2009) is 0.49 in 100,000 inhabitants, and lethality rate is 26.76 deaths on 100 lab confirmed cases. CCHF in Kosovo is present in 50% of the territory with common characteristics: altitude, hot climate, low bush and farming. Hyper endemic zones are in Central and South West of Kosovo. Seroprevalence in entire healthy population is found to be 24.3%. Presence of the CCHF antibodies was found in 14% of livestock, and in 32.6% of sheep. A phylogenetic aspect of the CCHFvirus isolated in Kosovo is the same as of the virus isolated in Drosdov (Russia).

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

    Science.gov (United States)

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

    2015-09-01

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

  3. Molecular detection of Crimean-Congo haemorrhagic fever (CCHF) virus in ticks from southeastern Iran.

    Science.gov (United States)

    Mehravaran, Ahmad; Moradi, Maryam; Telmadarraiy, Zakyeh; Mostafavi, Ehsan; Moradi, Ali Reza; Khakifirouz, Sahar; Shah-Hosseini, Nariman; Varaie, Fereshteh Sadat Rasi; Jalali, Tahmineh; Hekmat, Soheila; Ghiasi, Seyed Mojtaba; Chinikar, Sadegh

    2013-02-01

    Crimean-Congo haemorrhagic fever (CCHF) virus is a tick-borne member of the genus Nairovirus, family Bunyaviridae. CCHF virus has been isolated from at least 31 different species of ticks. The virus is transmitted through the bite of an infected tick or by direct contact with CCHF virus-infected patients or the products of infected livestock. This study was conducted to determine the rate of CCHF virus infection in ticks in the district of Zahedan, in the province of Sistan and Baluchistan, southeastern Iran. A total of 140 ticks were collected from Sistan and Baluchistan. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used for the detection of the CCHF virus genome in the tick population. This genome was detected in 4.3% of ticks collected from livestock of different regions of Zahedan. The infected tick genera belonged to Hyalomma and Haemaphysalis. Although in the epidemiology of CCHF virus Hyalomma ticks are considered to be the most important vectors and reservoirs, the virus has also been reported to occur in other genera of ticks, which conforms to the current data in our study from Sistan and Baluchistan. Given that animals are common hosts for Hyalomma and Haemaphysalis, regular monitoring programmes for livestock should be applied for CCHF virus control.

  4. Aedes larval indices and the occurrence of Dengue Haemorrhagic Fever in urban community of Thanlyin Township

    Directory of Open Access Journals (Sweden)

    Thae’ Zar Chi Bo

    2016-02-01

    Full Text Available A cross-sectional study was conducted in urban community of Thanlyin Township, Yangon Region during 2014 to determine Aedes larval indices and the occurrence of Dengue Haemorrhagic Fever (DHF within past one year. A total of 327 households and 1491 members were included in the study. Aedes larval indices detected in this study were 25.7% for house index, 15.5% for container index and 48.0% for Breteau index. The occurrence of DHF among households and family members were 2.1% (95% CI: 0.9%, 4.4% and 0.6% (95% CI: 0.3%, 1.1%, respectively. The occurrence was highest among 5 to 14 years age-group. No case was reported among persons with equal or more than 60 years of age. Mortality and case fatality rates were 0% during study period. Larval positivity among households was significantly related to sufficiency of family income and number of water container they have. Surveillance and control procedures for both DHF and vector should be intensified in urban area. Awareness and participation of the community in prevention and control of DHF should also be raised. Socioeconomic status as well as proper water supply and storage should be improved in urban area.

  5. Climate controls on valley fever incidence in Kern County, California

    Science.gov (United States)

    Zender, Charles S.; Talamantes, Jorge

    2006-01-01

    Coccidiodomycosis (valley fever) is a systemic infection caused by inhalation of airborne spores from Coccidioides immitis, a soil-dwelling fungus found in the southwestern United States, parts of Mexico, and Central and South America. Dust storms help disperse C. immitis so risk factors for valley fever include conditions favorable for fungal growth (moist, warm soil) and for aeolian soil erosion (dry soil and strong winds). Here, we analyze and inter-compare the seasonal and inter-annual behavior of valley fever incidence and climate risk factors for the period 1980-2002 in Kern County, California, the US county with highest reported incidence. We find weak but statistically significant links between disease incidence and antecedent climate conditions. Precipitation anomalies 8 and 20 months antecedent explain only up to 4% of monthly variability in subsequent valley fever incidence during the 23 year period tested. This is consistent with previous studies suggesting that C. immitis tolerates hot, dry periods better than competing soil organisms and, as a result, thrives during wet periods following droughts. Furthermore, the relatively small correlation with climate suggests that the causes of valley fever in Kern County could be largely anthropogenic. Seasonal climate predictors of valley fever in Kern County are similar to, but much weaker than, those in Arizona, where previous studies find precipitation explains up to 75% of incidence. Causes for this discrepancy are not yet understood. Higher resolution temporal and spatial monitoring of soil conditions could improve our understanding of climatic antecedents of severe epidemics.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    Crimean-Congo haemorrhagic fever (CCHF) is a viral zoonotic disease with a high mortality rate in humans. The CCHF virus is transmitted to humans through the bite of Ixodid ticks or contact with blood or tissues of CCHF patients or infected livestock. In December 2008, a re-emerging outbreak...... herd were serologically analysed and more than half of them were positive for CCHFV. We demonstrated that two routes of transmission played a role in this outbreak: contact with tissue and blood of infected livestock, and nosocomial transmission. Phylogenetic analyses helped to identify the origin...

  7. Evaluation of Pyrethrin Formulations on Dengue/Dengue Haemorrhagic Fever Vectors in the Laboratory and Sublethal Effects

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    S Sulaiman

    2007-12-01

    Full Text Available In Southeast Asia, Aedes aegypti (L. has been incriminated as principal vector of dengue viruses and Ae. albopictus as the secondary vector of dengue fever. Therefore, the aim of this study was to investigate the effectiveness of three for-mula¬tions of pyrethrin derived from Tanacetum cinerariaefolium against the dengue/dengue haemorrhagic fever vectors Aedes aegypti and Ae. albopictus in the laboratory. The testings employed 2 methodologies: the WHO Larval Bioassay and WHO Adult Bioassay. The results showed that all the three pyrethrin formulations had larvicidal and adulticidal activi-ties. The impact of the sublethal doses of pyrethrin formulations on Aedes spp. larvae resulted in 4-6% of alive adult emergence compared to 90% of Ae. aegypti emerging adults and 96% Ae. albopictus alive adult emergence in the control. The impact of sublethal doses of the pyrethrin formulations caused very low fecundity on both Aedes spp. compared to the control (P< 0.05.

  8. Strategic approach to control of viral haemorrhagic fever outbreaks in the Eastern Mediterranean Region: report from a regional consultation.

    Science.gov (United States)

    Malik, M R; El Bushra, H E; Opoka, M; Formenty, P; Velayudhan, R; Eremin, S

    2013-10-01

    The viral haemorrhagic fevers (VHF) are a growing public health threat in the Eastern Mediterranean Region. Nearly all of them are of zoonotic origin. VHF often cause outbreaks with high fatalities and, except for yellow fever, currently there are no specific treatment or vaccination options available. In response to this growing threat, the Regional Office for the Eastern Mediterranean of the World Health Organization convened a technical consultation in Tehran on 27-30 November 2011 to review the current gaps in prevention and control of VHF outbreaks in the Region. The meeting recommended a number of strategic public health approaches for prevention and control of VHF outbreaks through synergizing effective collaboration between the human and animal health sectors on areas that involve better preparedness, early detection and rapid response. Implementation of these approaches would require working together with vision, commitment and a sense of purpose involving partnerships and cooperation from all relevant sectors.

  9. Ebola haemorrhagic fever outbreak in Masindi District, Uganda: outbreak description and lessons learned

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    Borchert Matthias

    2011-12-01

    Full Text Available Abstract Background Ebola haemorrhagic fever (EHF is infamous for its high case-fatality proportion (CFP and the ease with which it spreads among contacts of the diseased. We describe the course of the EHF outbreak in Masindi, Uganda, in the year 2000, and report on response activities. Methods We analysed surveillance records, hospital statistics, and our own observations during response activities. We used Fisher's exact tests for differences in proportions, t-tests for differences in means, and logistic regression for multivariable analysis. Results The response to the outbreak consisted of surveillance, case management, logistics and public mobilisation. Twenty-six EHF cases (24 laboratory confirmed, two probable occurred between October 21st and December 22nd, 2000. CFP was 69% (18/26. Nosocomial transmission to the index case occurred in Lacor hospital in Gulu, outside the Ebola ward. After returning home to Masindi district the index case became the origin of a transmission chain within her own extended family (18 further cases, from index family members to health care workers (HCWs, 6 cases, and from HCWs to their household contacts (1 case. Five out of six occupational cases of EHF in HCWs occurred after the introduction of barrier nursing, probably due to breaches of barrier nursing principles. CFP was initially very high (76% but decreased (20% due to better case management after reinforcing the response team. The mobilisation of the community for the response efforts was challenging at the beginning, when fear, panic and mistrust had to be countered by the response team. Conclusions Large scale transmission in the community beyond the index family was prevented by early case identification and isolation as well as quarantine imposed by the community. The high number of occupational EHF after implementing barrier nursing points at the need to strengthen training and supervision of local HCWs. The difference in CFP before and after

  10. The model of response to viral haemorrhagic fevers of the National Institute for Infectious Diseases "Lazzaro Spallanzani".

    Science.gov (United States)

    Armignacco, O; Lauria, F N; Puro, V; Macrì, G; Petrecchia, A; Ippolito, G

    2001-01-01

    Viral haemorrhagic fevers (VHF) are severe and life-threatening diseases caused by a range of viruses. However, only four agents of VHF are known to be readily capable of person-to-person spread: Lassa virus, Crimean/Congo haemorrhagic fever virus, Ebola and Marburg viruses. Diseases caused by these viruses are endemic only in few areas in the world, most notably Africa and some rural parts of the Middle East and Eastern Europe. Nonetheless, the increasing volume of international travel presents a greater likelihood for the importation of these infections or of suspected cases in non endemic countries. Four conditions can lead to the importation and to the subsequent recognition of VHF within Europe: 1) patients arriving as a result of a planned medical evacuation; 2) persons who became sick on route to their destination; 3) persons discovered ill when entering a country, for example during routine clinical examination at the airport; 4) persons becoming sick after their arrival. Public health implications and the risk of secondary spread of pathogens in the above reported circumstances are very different. Similarly, preparedness and response should vary. This paper summarizes the present knowledge on the four VHF capable of person-to-person spread, describes the high isolation area constructed at the Italian National Institute for Infectious Diseases Lazzaro Spallanzani in Rome to respond to the occurrence of VHF. A brief overview of procedures and equipment adopted is provided.

  11. Human Q fever incidence is associated to spatiotemporal environmental conditions

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    J.P.G. Van Leuken

    2016-12-01

    We conclude that environmental conditions are correlated to human Q fever incidence rate. Similar research with data from other outbreaks would be needed to more firmly establish our findings. This could lead to better estimations of the public health risk of a C. burnetii outbreak, and to more detailed and accurate hazard maps that could be used for spatial planning of livestock operations.

  12. Increase of plasminogen activator inhibitor-1 and decrease of transforming growth factor-b1 in children with dengue haemorrhagic fever in Indonesia.

    NARCIS (Netherlands)

    Djamiatun, K.; Faradz, S.M.; Setiati, T.E.; Netea, M.G.; Ven, A.J.A.M. van der; Dolmans, W.M.V.

    2011-01-01

    Mortality in children with severe dengue haemorrhagic fever (DHF) in Indonesia is high. The origin of the elevated plasminogen activator inhibitor-1 (PAI-1) levels in these children is unclear. We measured PAI-1, transforming growth factor-beta1 (TGF-beta1), platelet counts, plasma leakage and liver

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

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    Seif S. Al-Abri

    2017-05-01

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

  14. Testing the accuracy ratio of the Spatio-Temporal Epidemiological Modeler (STEM) through Ebola haemorrhagic fever outbreaks.

    Science.gov (United States)

    Baldassi, F; D'Amico, F; Carestia, M; Cenciarelli, O; Mancinelli, S; Gilardi, F; Malizia, A; DI Giovanni, D; Soave, P M; Bellecci, C; Gaudio, P; Palombi, L

    2016-05-01

    Mathematical modelling is an important tool for understanding the dynamics of the spread of infectious diseases, which could be the result of a natural outbreak or of the intentional release of pathogenic biological agents. Decision makers and policymakers responsible for strategies to contain disease, prevent epidemics and fight possible bioterrorism attacks, need accurate computational tools, based on mathematical modelling, for preventing or even managing these complex situations. In this article, we tested the validity, and demonstrate the reliability, of an open-source software, the Spatio-Temporal Epidemiological Modeler (STEM), designed to help scientists and public health officials to evaluate and create models of emerging infectious diseases, analysing three real cases of Ebola haemorrhagic fever (EHF) outbreaks: Uganda (2000), Gabon (2001) and Guinea (2014). We discuss the cases analysed through the simulation results obtained with STEM in order to demonstrate the capability of this software in helping decision makers plan interventions in case of biological emergencies.

  15. A novel vaccine against Crimean-Congo Haemorrhagic Fever protects 100% of animals against lethal challenge in a mouse model.

    Directory of Open Access Journals (Sweden)

    Karen R Buttigieg

    Full Text Available Crimean-Congo Haemorrhagic Fever (CCHF is a severe tick-borne disease, endemic in many countries in Africa, the Middle East, Eastern Europe and Asia. Between 15-70% of reported cases are fatal. There is no approved vaccine available, and preclinical protection in vivo by an experimental vaccine has not been demonstrated previously. In the present study, the attenuated poxvirus vector, Modified Vaccinia virus Ankara, was used to develop a recombinant candidate vaccine expressing the CCHF virus glycoproteins. Cellular and humoral immunogenicity was confirmed in two mouse strains, including type I interferon receptor knockout mice, which are susceptible to CCHF disease. This vaccine protected all recipient animals from lethal disease in a challenge model adapted to represent infection via a tick bite. Histopathology and viral load analysis of protected animals confirmed that they had been exposed to challenge virus, even though they did not exhibit clinical signs. This is the first demonstration of efficacy of a CCHF vaccine.

  16. Ebola and Marburg haemorrhagic fever viruses: major scientific advances, but a relatively minor public health threat for Africa.

    Science.gov (United States)

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

    2011-07-01

    Ebola and Marburg viruses are the only members of the Filoviridae family (order Mononegavirales), a group of viruses characterized by a linear, non-segmented, single-strand negative RNA genome. They are among the most virulent pathogens for humans and great apes, causing acute haemorrhagic fever and death within a matter of days. Since their discovery 50 years ago, filoviruses have caused only a few outbreaks, with 2317 clinical cases and 1671 confirmed deaths, which is negligible compared with the devastation caused by malnutrition and other infectious diseases prevalent in Africa (malaria, cholera, AIDS, dengue, tuberculosis …). Yet considerable human and financial resourses have been devoted to research on these viruses during the past two decades, partly because of their potential use as bioweapons. As a result, our understanding of the ecology, host interactions, and control of these viruses has improved considerably.

  17. Guidance for contact tracing of cases of Lassa fever, Ebola or Marburg haemorrhagic fever on an airplane: results of a European expert consultation

    Directory of Open Access Journals (Sweden)

    Gilsdorf Andreas

    2012-11-01

    Full Text Available Abstract Background Travel from countries where viral haemorrhagic fevers (VHF are endemic has increased significantly over the past decades. In several reported VHF events on airplanes, passenger trace back was initiated but the scale of the trace back differed considerably. The absence of guidance documents to help the decision on necessity and scale of the trace back contributed to this variation. This article outlines the recommendations of an expert panel on Lassa fever, Ebola and Marburg haemorrhagic fever to the wider scientific community in order to advise the relevant stakeholders in the decision and scale of a possible passenger trace back. Method The evidence was collected through review of published literature and through the views of an expert panel. The guidance was agreed by consensus. Results Only a few events of VHF cases during air travel are reported in literature, with no documented infection in followed up contacts, so that no evidence of transmission of VHF during air travel exists to date. Based on this and the expert opinion, it was recommended that passenger trace back was undertaken only if: the index case had symptoms during the flight; the flight was within 21 days after detection of the event; and for Lassa fever if exposure of body fluid has been reported. The trace back should only be done after confirmation of the index case. Passengers and crew with direct contact, seat neighbours (+/− 1 seat, crew and cleaning personal of the section of the index case should be included in the trace back. Conclusion No evidence has been found for the transmission of VHF in airplanes. This information should be taken into account, when a trace back decision has to be taken, because such a measure produces an enormous work load. The procedure suggested by the expert group can guide decisions made in future events, where a patient with suspected VHF infection travelled on a plane. However, the actual decision on start and scale

  18. [Fever monitoring program in areas with high incidence of typhoid and paratyphoid fever in Guizhou province].

    Science.gov (United States)

    Yao, Guang-hai; Tang, Guang-peng; Tian, Ke-cheng; Zhang, Jing; Sun, Jun-ling; Wang, Zi-jun; Jiang, You-qin; Zhao, Qi-liang; Chen, Xue; Chen, Shao-fen; Liu, Ming-qiang; Lu, Rong; Li, Ming; Wang, Ding-ming

    2013-03-01

    To understand the incidence rates of both typhoid fever and paratyphoid fever in the high prevalent areas of Guizhou province so as to provide evidence for the development of programs on comprehensive intervention and effectiveness evaluation. Six townships in Pingba county were selected as intervention areas while six townships in Kaiyang county were taken as control. All hospitals and clinics were classified into A, B and C types according to its level and the capacity of the blood culture. Surveillance on typhoid and paratyphoid fever was conducted based on all population and all hospitals, clinics and county CDCs among the patients with unknown fever. In the surveillance area in those two counties, there were 12 944 blood samples from patients with unknown fever which have been tested and cultured. Among them, 200 strains of Salmonella including 16 typhoid strains, 184 paratyphoid A strains were identified, with the total positive rate as 1.55%. The positive rate before the intervention program was higher than the after. The detection rate was 1.91% in the type A hospitals. 39 strains of Salmonella have been cultured from 2039 samples which accounting for 19.50% (39/200) of the total strains. 4315 blood samples were cultured at the 'Class B' sites which isolated 82 strains of Salmonella, accounting for 41.00% (82/200), with a detection rate as 1.90%. 6590 samples were cultured at the 'Class C' sites, which identified 79 strains of Salmonella, accounting for 39.50% (79/200), with a detection rate as 1.20%. The detection rate was much higher before the use of antibiotics than after using them (P typhoid and paratyphoid fever were not typical. Typhoid and paratyphoid monitoring programs which covered primary health care institutions in the high incidence area seemed to be effective in reflecting the pictures as well as the burden of both typhoid and paratyphoid.

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

    Directory of Open Access Journals (Sweden)

    Mustafa Sünbül

    2012-09-01

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

  20. Incidence of fever in labor and risk of neonatal sepsis.

    Science.gov (United States)

    Towers, Craig V; Yates, Angela; Zite, Nikki; Smith, Casey; Chernicky, Lindsey; Howard, Bobby

    2017-06-01

    (P = .3). The positive blood cultures in these 4 neonates were 3 group B streptococcus and 1 Enterococcus. The overall rate of early-onset neonatal sepsis in this population of newborns delivered at ≥36 weeks' gestation was 0.82/1000 deliveries. The incidence of an intrapartum fever of ≥38°C in pregnancies at ≥36 weeks' gestation is common at 6.8% and this is consistent with the findings of a few other large retrospective studies. The rate of an intrapartum fever occurs in approximately 1 in 15 women in labor. The risk of neonatal sepsis in newborns delivered of mothers with intrapartum fever or a diagnosis of clinical chorioamnionitis is low at 0.24%, a rate that is <1 in 400. The recommendation for universal laboratory work, cultures, and antibiotic treatment pending culture results for this newborn population needs further examination. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Host biomarkers are associated with progression to dengue haemorrhagic fever: a nested case-control study.

    Science.gov (United States)

    Conroy, Andrea L; Gélvez, Margarita; Hawkes, Michael; Rajwans, Nimerta; Tran, Vanessa; Liles, W Conrad; Villar-Centeno, Luis Angel; Kain, Kevin C

    2015-11-01

    Dengue represents the most important arboviral infection worldwide. Onset of circulatory collapse can be unpredictable. Biomarkers that can identify individuals at risk of plasma leakage may facilitate better triage and clinical management. Using a nested case-control design, we randomly selected subjects from a prospective cohort study of dengue in Colombia (n=1582). Using serum collected within 96 hours of fever onset, we tested 19 biomarkers by ELISA in cases (developed dengue hemorrhagic fever or dengue shock syndrome (DHF/DSS); n=46), and controls (uncomplicated dengue fever (DF); n=65) and healthy controls (HC); n=15. Ang-1 levels were lower and angptl3, sKDR, sEng, sICAM-1, CRP, CXCL10/IP-10, IL-18 binding protein, CHI3L1, C5a and Factor D levels were increased in dengue compared to HC. sICAM-1, sEng and CXCL10/IP-10 were further elevated in subjects who subsequently developed DHF/DSS (p=0.008, p=0.028 and p=0.025, respectively). In a logistic regression model, age (odds ratio (OR) (95% CI): 0.95 (0.92-0.98), p=0.001), hyperesthesia/hyperalgesia (OR; 3.8 (1.4-10.4), p=0.008) and elevated sICAM-1 (>298ng/mL: OR; 6.3 (1.5-25.7), p=0.011) at presentation were independently associated with progression to DHF/DSS. These results suggest that inflammation and endothelial activation are important pathways in the pathogenesis of dengue and sICAM-1 levels may identify individuals at risk of plasma leakage. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Analysis of significant factors for dengue fever incidence prediction.

    Science.gov (United States)

    Siriyasatien, Padet; Phumee, Atchara; Ongruk, Phatsavee; Jampachaisri, Katechan; Kesorn, Kraisak

    2016-04-16

    Many popular dengue forecasting techniques have been used by several researchers to extrapolate dengue incidence rates, including the K-H model, support vector machines (SVM), and artificial neural networks (ANN). The time series analysis methodology, particularly ARIMA and SARIMA, has been increasingly applied to the field of epidemiological research for dengue fever, dengue hemorrhagic fever, and other infectious diseases. The main drawback of these methods is that they do not consider other variables that are associated with the dependent variable. Additionally, new factors correlated to the disease are needed to enhance the prediction accuracy of the model when it is applied to areas of similar climates, where weather factors such as temperature, total rainfall, and humidity are not substantially different. Such drawbacks may consequently lower the predictive power for the outbreak. The predictive power of the forecasting model-assessed by Akaike's information criterion (AIC), Bayesian information criterion (BIC), and the mean absolute percentage error (MAPE)-is improved by including the new parameters for dengue outbreak prediction. This study's selected model outperforms all three other competing models with the lowest AIC, the lowest BIC, and a small MAPE value. The exclusive use of climate factors from similar locations decreases a model's prediction power. The multivariate Poisson regression, however, effectively forecasts even when climate variables are slightly different. Female mosquitoes and seasons were strongly correlated with dengue cases. Therefore, the dengue incidence trends provided by this model will assist the optimization of dengue prevention. The present work demonstrates the important roles of female mosquito infection rates from the previous season and climate factors (represented as seasons) in dengue outbreaks. Incorporating these two factors in the model significantly improves the predictive power of dengue hemorrhagic fever forecasting

  3. Epidemiology and Mutational Analysis of Global Strains of Crimean-Congo Haemorrhagic Fever Virus

    Institute of Scientific and Technical Information of China (English)

    Na Han; Simon Ravner

    2011-01-01

    Crimean-Congo hemorrhagic fever (CCHF) is a severe illness with high fatality.Cases are reported in several countries in Africa,Europe,the Middle East,and Asia.Phylogenetic analyses based on the virus S (nucleocapsid),M (glycoprotein),and L (polymerase) genome segments sequences indicate distinct geographic lineages exist but their specific genetic characteristics require elucidation.In this work we collected all full length S segment sequences and generated a phylogenetic tree based on the alignment of these 62 samples.We then analyzed the alignment using entries from AAIndex,the Amino Acid Index database,to identify amino acid mutations that performed significant changes in charge,pka,hydropathy and side chain volume.Finally,we mapped these changes back to the tree and alignment to identify correlated mutations or sites that characterized a specific lineage.Based on this analysis we are able to propose a number of sites that appear to be important for virus function and which would be good candidates for experimental mutational analysis studies.

  4. OSBPL10, RXRA and lipid metabolism confer African-ancestry protection against dengue haemorrhagic fever in admixed Cubans

    Science.gov (United States)

    Soares, Pedro; Garcia, Gissel; Perez, Ana B.; Aguirre, Eglys; Cavadas, Bruno; Regnault, Béatrice; Alvarez, Mayling; Ruiz, Didye; Guzman, Maria G.

    2017-01-01

    Ethnic groups can display differential genetic susceptibility to infectious diseases. The arthropod-born viral dengue disease is one such disease, with empirical and limited genetic evidence showing that African ancestry may be protective against the haemorrhagic phenotype. Global ancestry analysis based on high-throughput genotyping in admixed populations can be used to test this hypothesis, while admixture mapping can map candidate protective genes. A Cuban dengue fever cohort was genotyped using a 2.5 million SNP chip. Global ancestry was ascertained through ADMIXTURE and used in a fine-matched corrected association study, while local ancestry was inferred by the RFMix algorithm. The expression of candidate genes was evaluated by RT-PCR in a Cuban dengue patient cohort and gene set enrichment analysis was performed in a Thai dengue transcriptome. OSBPL10 and RXRA candidate genes were identified, with most significant SNPs placed in inferred weak enhancers, promoters and lncRNAs. OSBPL10 had significantly lower expression in Africans than Europeans, while for RXRA several SNPs may differentially regulate its transcription between Africans and Europeans. Their expression was confirmed to change through dengue disease progression in Cuban patients and to vary with disease severity in a Thai transcriptome dataset. These genes interact in the LXR/RXR activation pathway that integrates lipid metabolism and immune functions, being a key player in dengue virus entrance into cells, its replication therein and in cytokine production. Knockdown of OSBPL10 expression in THP-1 cells by two shRNAs followed by DENV2 infection tests led to a significant reduction in DENV replication, being a direct functional proof that the lower OSBPL10 expression profile in Africans protects this ancestry against dengue disease. PMID:28241052

  5. Clinical Manifestations and Case Management of Ebola Haemorrhagic Fever Caused by a Newly Identified Virus Strain, Bundibugyo, Uganda, 2007–2008

    Science.gov (United States)

    Roddy, Paul; Howard, Natasha; Van Kerkhove, Maria D.; Lutwama, Julius; Wamala, Joseph; Yoti, Zabulon; Colebunders, Robert; Palma, Pedro Pablo; Sterk, Esther; Jeffs, Benjamin; Van Herp, Michel; Borchert, Matthias

    2012-01-01

    A confirmed Ebola haemorrhagic fever (EHF) outbreak in Bundibugyo, Uganda, November 2007–February 2008, was caused by a putative new species (Bundibugyo ebolavirus). It included 93 putative cases, 56 laboratory-confirmed cases, and 37 deaths (CFR = 25%). Study objectives are to describe clinical manifestations and case management for 26 hospitalised laboratory-confirmed EHF patients. Clinical findings are congruous with previously reported EHF infections. The most frequently experienced symptoms were non-bloody diarrhoea (81%), severe headache (81%), and asthenia (77%). Seven patients reported or were observed with haemorrhagic symptoms, six of whom died. Ebola care remains difficult due to the resource-poor setting of outbreaks and the infection-control procedures required. However, quality data collection is essential to evaluate case definitions and therapeutic interventions, and needs improvement in future epidemics. Organizations usually involved in EHF case management have a particular responsibility in this respect. PMID:23285243

  6. SPATIAL DISTRIBUTION OF DENGUE HAEMORRHAGIC FEVER CASES IN BANYUMAS DISTRICT, CENTRAL JAVA PROVINCE

    Directory of Open Access Journals (Sweden)

    Sunaryo Sunaryo

    2014-08-01

    Full Text Available ABSTRAKDemam Berdarah Dengue (DBD masih menjadi masalah kesehatan di Indonesia yang perlu mendapat perhatian seriuskarena di beberapa daerah masih sering terjadi kejadian luar biasa. Kabupaten Banyumas merupakan salah satu daerahdengan kasus DBD selalu tinggi setiap tahunnya. Penelitian ini bertujuan untuk menggambarkan distribusi spasial DBD diKabupaten Banyumas berdasarkan lokasi, ketinggian, tata guna lahan dan kepadatan penduduk serta pola kasusberdasarkan curah hujan. Kajian ini dilakukan dengan penelusuran data sekunder kasus DBD di Dinas KesehatanKabupaten Banyumas. Data peta topografi skala 1: 25000 diperoleh dari Bakosurtanal dan Bappeda Kabupaten Banyumas.Proses pengolahan data dan analisis spasial DBD secara tumpang susun menggunakan aplikasi Arc Gis.10. Hasilpenelitian menunjukkan jumlah kasus DBD tahun 2012 sebanyak 200 kasus, tersebar hampir di setiap kecamatan (75%.Kluster kasus DBD terdapat di wilayah Purwokerto Timur, Purwokerto Selatan dan Purwokerto Utara yang merupakandaerah dataran rendah (12 -250 mdpl, lingkungan permukiman dekat persawahan, area perkotaan dengan permukimanpadat penduduk. Secara spasial kasus DBD terzonasi di wilayah dataran rendah dengan pemukiman padat penduduk dekatpersawahan. Kasus DBD meningkat pada saat musim hujan tinggi antara Januari –Mei.Kata kunci : distribusi spasial, DBD, BanyumasABSTRACTDengue Hemorrhagic Fever (DHF is the most important public health problem in Indonesia, that needs serious attention.DHF cases in Banyumas regency always high in every year, and decrease in 2011.This research aimed to describe spatialdistribution of DHF in Banyumas district based on location, altitude, landuse and population density and pattern of casesbased on rainfall. DHF cases data obtained from Banyumas District Health Office. Topography map scale 1:25.000obtained from Bakosurtanal and Bappeda of Banyumas regency. Processing data and DHF spatial analize by overlay usingArc Gis.10 software. This research

  7. Molecular diagnostic and genetic characterization of highly pathogenic viruses: application during Crimean-Congo haemorrhagic fever virus outbreaks in Eastern Europe and the Middle East.

    Science.gov (United States)

    Filippone, C; Marianneau, P; Murri, S; Mollard, N; Avsic-Zupanc, T; Chinikar, S; Desprès, P; Caro, V; Gessain, A; Berthet, N; Tordo, N

    2013-02-01

    Several haemorrhagic fevers are caused by highly pathogenic viruses that must be handled in Biosafety level 4 (BSL-4) containment. These zoonotic infections have an important impact on public health and the development of a rapid and differential diagnosis in case of outbreak in risk areas represents a critical priority. We have demonstrated the potential of a DNA resequencing microarray (PathogenID v2.0) for this purpose. The microarray was first validated in vitro using supernatants of cells infected with prototype strains from five different families of BSL-4 viruses (e.g. families Arenaviridae, Bunyaviridae, Filoviridae, Flaviviridae and Paramyxoviridae). RNA was amplified based on isothermal amplification by Phi29 polymerase before hybridization. We were able to detect and characterize Nipah virus and Crimean-Congo haemorrhagic fever virus (CCHFV) in the brains of experimentally infected animals. CCHFV was finally used as a paradigm for epidemics because of recent outbreaks in Turkey, Kosovo and Iran. Viral variants present in human sera were characterized by BLASTN analysis. Sensitivity was estimated to be 10(5) -10(6) PFU/mL of hybridized cDNA. Detection specificity was limited to viral sequences having ~13-14% of global divergence with the tiled sequence, or stretches of ~20 identical nucleotides. These results highlight the benefits of using the PathogenID v2.0 resequencing microarray to characterize geographical variants in the follow-up of haemorrhagic fever epidemics; to manage patients and protect communities; and in cases of bioterrorism. © 2012 The Authors Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

  8. First report of adult Hyalomma marginatum rufipes (vector of Crimean-Congo haemorrhagic fever virus on cattle under a continental climate in Hungary

    Directory of Open Access Journals (Sweden)

    Hornok Sándor

    2012-08-01

    Full Text Available Abstract Background South Hungary is being monitored for the northward spreading of thermophilic ixodid species, therefore ticks were collected from cattle and wild ruminants (red, fallow and roe deer in the autumn of 2011. Findings Besides indigenous species (1185 Dermacentor reticulatus and 976 Ixodes ricinus, two Hyalomma marginatum rufipes males were found on two cows, in September eight days apart. Conclusions This is the northernmost autochthonous infestation of the type host (cattle with H. m. rufipes, vector of Crimean-Congo haemorrhagic fever virus. The present findings are suggestive of the moulting success of this Afro-Mediterranean tick species in a continental climate in Central Europe.

  9. Availability of clean tap water and medical services prevents the incidence of typhoid Fever.

    Science.gov (United States)

    Lee, Deog-Yong; Lee, Esther; Park, Hyemin; Kim, Seonghan

    2013-04-01

    In this study, the factors that induced a decrease in the incidence of typhoid fever were analyzed. Based on the study results, we propose a quantitative and concrete solution to reduce the incidence of typhoid fever. We analyzed the incidence and fatality rate of typhoid fever in Korea. Tap water service rate and the number of pharmacies, which affect the incidence rate of typhoid fever, were used as environmental factors. To prevent typhoid fever in the community, it is necessary to provide clean tap water service to 35.5% of the population, with an individual requiring 173 L of clean water daily. Appropriate access to clean water (51% service coverage, 307 L) helped the population to maintain individual hygiene and food safety practices, which brought about a decrease in the incidence of typhoid fever, and subsequently a decrease in fatality rate, which was achieved twice. During the 8-year study period, the fatality rate decreased to 1% when the population has access to proper medical service. The fatality rate was primarily affected by the availability of medical services as well as by the incidence of typhoid fever. However, an analysis of the study results showed that the incidence of typhoid fever was affected only by the availability of clean water through the tap water system.

  10. Marburg Haemorrhagic Fever

    Science.gov (United States)

    ... the disease takes its name, and Frankfurt in Germany; and in Belgrade, Serbia. Marburg and Ebola viruses ... that occurred simultaneously in Marburg and Frankfurt in Germany, and in Belgrade, Serbia, in 1967, led to ...

  11. Ebola--haemorrhagic fever

    DEFF Research Database (Denmark)

    Fabiansen, C.; Kronborg, G.; Thybo, S.

    2008-01-01

    This review presents the latest findings on ebola. Ebola presents one of the highest case-fatality rates of all infectious diseases, and in 2007 outbreaks were observed first in the Democratic Republic of Congo and later in Uganda with a new subtype. Accumulating evidence suggests that fruit bats...... are a likely reservoir for the ebola virus. The frequency of filovirus outbreaks in Central Africa is increasing and the potential for introduction and patient care in Denmark is evaluated Udgivelsesdato: 2008/11/24...

  12. [Ebola haemorrhagic fever.

    DEFF Research Database (Denmark)

    Fabiansen, C.; Kronborg, G.; Thybo, S.

    2008-01-01

    This review presents the latest findings on ebola. Ebola presents one of the highest case-fatality rates of all infectious diseases, and in 2007 outbreaks were observed first in the Democratic Republic of Congo and later in Uganda with a new subtype. Accumulating evidence suggests that fruit bats...... are a likely reservoir for the ebola virus. The frequency of filovirus outbreaks in Central Africa is increasing and the potential for introduction and patient care in Denmark is evaluated Udgivelsesdato: 2008/11/24...

  13. Spatiotemporal Pattern Analysis of Scarlet Fever Incidence in Beijing, China, 2005–2014

    Directory of Open Access Journals (Sweden)

    Gehendra Mahara

    2016-01-01

    Full Text Available Objective: To probe the spatiotemporal patterns of the incidence of scarlet fever in Beijing, China, from 2005 to 2014. Methods: A spatiotemporal analysis was conducted at the district/county level in the Beijing region based on the reported cases of scarlet fever during the study period. Moran’s autocorrelation coefficient was used to examine the spatial autocorrelation of scarlet fever, whereas the Getis-Ord Gi* statistic was used to determine the hotspot incidence of scarlet fever. Likewise, the space-time scan statistic was used to detect the space-time clusters, including the relative risk of scarlet fever incidence across all settings. Results: A total of 26,860 scarlet fever cases were reported in Beijing during the study period (2005–2014. The average annual incidence of scarlet fever was 14.25 per 100,000 population (range, 6.76 to 32.03 per 100,000. The incidence among males was higher than that among females, and more than two-thirds of scarlet fever cases (83.8% were among children 3–8 years old. The seasonal incidence peaks occurred from March to July. A higher relative risk area was mainly in the city and urban districts of Beijing. The most likely space-time clusters and secondary clusters were detected to be diversely distributed in every study year. Conclusions: The spatiotemporal patterns of scarlet fever were relatively unsteady in Beijing from 2005 to 2014. The at-risk population was mainly scattered in urban settings and dense districts with high population, indicating a positive relationship between population density and increased risk of scarlet fever exposure. Children under 15 years of age were the most susceptible to scarlet fever.

  14. Incidence and Characteristics of Scarlet Fever, South Korea, 2008–2015

    Science.gov (United States)

    Park, Duck Woong; Kim, Sun-Hee; Park, Jung Wook; Kim, Min-Ji; Cho, Sun Ju; Park, Hye Jung; Jung, So Hyang; Seo, Mi Hee; Lee, Yong Seok; Kim, Byung Hee; Min, Hyeran; Lee, Su Ya; Ha, Dong Ryong; Kim, Eun Sun

    2017-01-01

    The incidence rate for scarlet fever in South Korea is rising. During 2008–2015, we collected group A Streptococcus isolates and performed emm and exotoxin genotyping and disk-diffusion antimicrobial tests. Scarlet fever in South Korea was most closely associated with emm types emm4, emm28, emm1, and emm3. In 2015, tetracycline resistance started increasing. PMID:28322696

  15. Trends in incidence and in short term survival following a subarachnoid haemorrhage in Scotland, 1986 - 2005: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Walters Matthew

    2011-03-01

    Full Text Available Abstract Background To examine age and sex specific incidence and 30 day case fatality for subarachnoid haemorrhage (SAH in Scotland over a 20 year period. Methods A retrospective cohort study using routine hospital discharge data linked to death records. Results Between 1986 and 2005, 12,056 individuals experienced an incident SAH. Of these 10,113 (84% survived to reach hospital. Overall age-standardised incidence rates were greater in women than men and remained relatively stable over the study period. In 2005, incidence in women was 12.8 (95% CI 11.5 to 14.2 and in men 7.9 (95% CI 6.9 to 9.1. 30 day case fatality in individuals hospitalised with SAH declined substantially, falling from 30.0% in men and 33.9% in women in 1986-1990 to 24.5% in men and 29.1% in women in 2001-2005. For both men and women, the largest reductions were observed in those aged between 40 to 59 years. After adjustment for age, socio-economic status and co-morbidity, the odds of death at 30 days in 2005 compared to odds of death in 1986 was 0.64 (0.54 to 0.76, p Conclusions Incidence rates for SAH remained stable between 1986 and 2005 suggesting that a better understanding of SAH risk factors and their reduction is needed. 30 day case fatality rates have declined substantially, particularly in middle-age. However, they remain high and it is important to ensure that this is not due to under-diagnosis or under-treatment.

  16. Protective effects of a Modified Vaccinia Ankara-based vaccine candidate against Crimean-Congo Haemorrhagic Fever virus require both cellular and humoral responses.

    Directory of Open Access Journals (Sweden)

    Stuart D Dowall

    Full Text Available Crimean-Congo Haemorrhagic Fever (CCHF is a severe tick-borne disease, endemic in many countries in Africa, the Middle East, Eastern Europe and Asia. There is no approved vaccine currently available against CCHF. The most promising candidate, which has previously been shown to confer protection in the small animal model, is a modified Vaccinia Ankara virus vector expressing the CCHF viral glycoprotein (MVA-GP. It has been shown that MVA-GP induces both humoral and cellular immunogenicity. In the present study, sera and T-lymphocytes were passively and adoptively transferred into recipient mice prior to challenge with CCHF virus. Results demonstrated that mediators from both arms of the immune system were required to demonstrate protective effects against lethal challenge.

  17. Protective effects of a Modified Vaccinia Ankara-based vaccine candidate against Crimean-Congo Haemorrhagic Fever virus require both cellular and humoral responses.

    Science.gov (United States)

    Dowall, Stuart D; Graham, Victoria A; Rayner, Emma; Hunter, Laura; Watson, Robert; Taylor, Irene; Rule, Antony; Carroll, Miles W; Hewson, Roger

    2016-01-01

    Crimean-Congo Haemorrhagic Fever (CCHF) is a severe tick-borne disease, endemic in many countries in Africa, the Middle East, Eastern Europe and Asia. There is no approved vaccine currently available against CCHF. The most promising candidate, which has previously been shown to confer protection in the small animal model, is a modified Vaccinia Ankara virus vector expressing the CCHF viral glycoprotein (MVA-GP). It has been shown that MVA-GP induces both humoral and cellular immunogenicity. In the present study, sera and T-lymphocytes were passively and adoptively transferred into recipient mice prior to challenge with CCHF virus. Results demonstrated that mediators from both arms of the immune system were required to demonstrate protective effects against lethal challenge.

  18. Incidence, Etiology, Risk Factors, and Outcome of Hospital-acquired Fever

    Science.gov (United States)

    Kaul, Daniel R; Flanders, Scott A; Beck, James M; Saint, Sanjay

    2006-01-01

    OBJECTIVES Temperature is universally measured in the hospitalized patient, but the literature on hospital-acquired fever has not been systematically reviewed. This systematic review is intended to provide clinicians with an overview of the incidence, etiology, and outcome of hospital-acquired fever. DATA SOURCES We searched MEDLINE (1970 to 2005), EMBASE (1988 to 2004), and Web of Knowledge. References of all included articles were reviewed. Articles that focused on children, fever in the developing world, classic fever of unknown origin, or specialized patient populations were excluded. REVIEW METHODS Articles were reviewed independently by 2 authors before inclusion; a third author acted as arbiter. RESULTS Of over 1,000 studies reviewed, 7 met the criteria for inclusion. The incidence of hospital-acquired fever ranged from 2% to 17%. The etiology of fever was infection in 37% to 74%. Rates of antibiotic use for patients with a noninfectious cause of fever ranged from 29% to 55% for a mean duration of 6.6 to 9.6 days. Studies varied widely in their methodology and the patient population studied. CONCLUSIONS Limited information is available to guide an evidence-based approach to hospital-acquired fever. We propose criteria to help standardize future studies of this important clinical situation. PMID:17026728

  19. Sustained High Levels of Both Total and High Molecular Weight Adiponectin in Plasma during the Convalescent Phase of Haemorrhagic Fever with Renal Syndrome Are Associated with Disease Severity

    Directory of Open Access Journals (Sweden)

    Kang Tang

    2017-01-01

    Full Text Available Haemorrhagic fever with renal syndrome (HFRS is characterised by an uncontrolled immune response that causes vascular leakage. Adiponectin (APN is an adipocytokine involved in prorevascularisation and immunomodulation. To investigate the possible effects of APN in the pathogenesis of HFRS, total and high molecular weight (HMW APN levels in the plasma of patients with HFRS were quantified using enzyme-linked immunosorbent assay (ELISA. Compared with those in healthy controls, the plasma total and HMW APN levels in patients were elevated to different degrees from the fever onset and remained high at the convalescent phase. Consistent with these results, western blot analysis additionally showed that low molecular weight (LMW, middle molecular weight (MMW, and HMW APN levels were all elevated and contributed to the elevation of the total APN level. Importantly, sustained high levels of total and HMW APN at the convalescent phase were significantly higher in patients with critical disease than those in patients with mild or moderate disease. Moreover, total and HMW APN levels negatively correlated with white blood cell count and positively correlated with platelet count and serum albumin level. These results may provide insights into understanding the roles of total and HMW APN in the pathogenesis of HFRS.

  20. Primary dengue haemorrhagic fever in patients from northeast of Brazil is associated with high levels of interferon-β during acute phase

    Science.gov (United States)

    Oliveira, Renato Antônio dos Santos; da Silva, Mayara Marques Carneiro; Calzavara-Silva, Carlos Eduardo; Silva, Ana Maria; Cordeiro, Marli Tenório; de Moura, Patrícia Muniz Mendes Freire; Baptista, Paulo Neves; Marques, Ernesto Torres de Azevedo; Gil, Laura Helena Vega Gonzales

    2016-01-01

    Dengue is an acute febrile disease caused by the mosquito-borne dengue virus (DENV) that according to clinical manifestations can be classified as asymptomatic, mild or severe dengue. Severe dengue cases have been associated with an unbalanced immune response characterised by an over secretion of inflammatory cytokines. In the present study we measured type I interferon (IFN-I) transcript and circulating levels in primary and secondary DENV infected patients. We observed that dengue fever (DF) and dengue haemorrhagic fever (DHF) patients express IFN-I differently. While DF and DHF patients express interferon-α similarly (52,71 ± 7,40 and 49,05 ± 7,70, respectively), IFN- β were associated with primary DHF patients. On the other hand, secondary DHF patients were not able to secrete large amounts of IFN- β which in turn may have influenced the high-level of viraemia. Our results suggest that, in patients from our cohort, infection by DENV serotype 3 elicits an innate response characterised by higher levels of IFN- β in the DHF patients with primary infection, which could contribute to control infection evidenced by the low-level of viraemia in these patients. The present findings may contribute to shed light in the role of innate immune response in dengue pathogenesis. PMID:27223651

  1. Evaluation of the incidence of occult bacteremia among children with fever of unknown origin

    OpenAIRE

    Eitan Naaman Berezin; Marco Antonio Iazzetti

    2006-01-01

    We reviewed the incidence of occult bacteremia, to identify the most frequent etiological agents of bacteremias in otherwise healthy children from one month to 10 years old, who had fever of unknown origin attended at the emergency ward of an urban, university-affiliated pediatric referral center. This was a retrospective medical record review, evaluating children with fever. Data were collected from the initial visit, when blood cultures, hematological properties and hemosedimentation rates ...

  2. Dengue fever among Israeli expatriates in Delhi, 2015: implications for dengue incidence in Delhi, India.

    Science.gov (United States)

    Neuberger, Ami; Turgeman, Avigail; Lustig, Yaniv; Schwartz, Eli

    2016-03-01

    We present the data of 13 dengue cases diagnosed between 1 August and 15 September 2015 among 240 Israeli expatriates residing in Delhi. Attack rates were similar between adults (6/128, 4.7%) and children (7/112, 6.3%). dengue virus (DENV-2) was identified in two and DENV-1 in one dengue-seropositive sample. Another febrile patient was diagnosed with chikungunya virus infection. The reported incidence of dengue fever among people living in Delhi was lower than 0.1% as of September 2015. Based on our results, we hypothesize that the incidence of dengue fever in Delhi is grossly underestimated.

  3. Impact of meteorological changes on the incidence of scarlet fever in Hefei City, China

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    Duan, Yu; Huang, Xiao-lei; Wang, Yu-jie; Zhang, Jun-qing; Zhang, Qi; Dang, Yue-wen; Wang, Jing

    2016-10-01

    Studies on scarlet fever with meteorological factors included were few. We aimed to illustrate meteorological factors' effects on monthly incidence of scarlet fever. Cases of scarlet fever were collected from the report of legal infectious disease in Hefei City from 1985 to 2006; the meteorological data were obtained from the weather bureau of Hefei City. Monthly incidence and corresponding meteorological data in these 22 years were used to develop the model. The model of auto regressive integrated moving average with covariates was used in statistical analyses. There was a highest peak from March to June and a small peak from November to January. The incidence of scarlet fever ranges from 0 to 0.71502 (per 105 population). SARIMAX (1,0,0)(1,0,0)12 model was fitted with monthly incidence and meteorological data optimally. It was shown that relative humidity ( β = -0.002, p = 0.020), mean temperature ( β = 0.006, p = 0.004), and 1 month lag minimum temperature ( β = -0.007, p City, China. Besides, the ARIMA model could be useful not only for prediction but also for the analysis of multiple correlations.

  4. Factors influencing the seasonal abundance of Aedes (Stegomyia) aegypti and the control strategy of dengue and dengue haemorrhagic fever in Thanlyin Township, Yangon City, Myanmar.

    Science.gov (United States)

    Oo, T T; Storch, V; Madon, M B; Becker, N

    2011-08-01

    From June 2006 to May 2007, mosquito surveys were conducted in Thanlyin Township, Yangon City, Myanmar, to determine factors influencing the abundance of Aedes aegypti (Stegomyia aegypti) during the rainy season. Both the biological and environmental factors were included in this study. Increase in the hatchability of egg, larval survival rate, the shortened larval life-span and increased pupation rates supplemented by rainfall (i.e. continuous flooding of the containers, stimulate the continuous hatching of eggs) were observed for correlation with the increase in population density of Ae. aegypti during the rainy season in the study area. Control strategy of Ae. aegypti to analyze the infestation in the community (study area) with larval Ae. aegypti, integrated management measures including health education, attitudes and practices regarding dengue and dengue haemorrhagic fever, transmission of the disease and possible preventive measures, reduction of breeding sites and testing the efficacy of Bacillus thuringiensis israelensis (B.t.i.) with respect to the reduction level of Ae. aegypti larvae in breeding sources, were taken into consideration.

  5. The feasibility of developing a risk assessment for the impact of climate change on the emergence of Crimean-Congo haemorrhagic fever in livestock in Europe: a review.

    Science.gov (United States)

    Gale, P; Estrada-Peña, A; Martinez, M; Ulrich, R G; Wilson, A; Capelli, G; Phipps, P; de la Torre, A; Muñoz, M J; Dottori, M; Mioulet, V; Fooks, A R

    2010-06-01

    Crimean-Congo haemorrhagic fever virus (CCHFV) is one of the most widespread of all medically important arboviruses with ticks of the Hyalomma spp. serving as the main vectors. Infection of livestock by CCHFV serves as a route of exposure to humans, as a reservoir of disease and as a route of importation. This study discusses the pathways and data requirements for a qualitative risk assessment for the emergence of CCHFV in livestock in Europe. A risk map approach is proposed based on layers that include the potential routes of release (e.g. by migrating birds carrying infected ticks) together with the main components for exposure, namely the distributions of the tick vectors, the small vertebrate host reservoirs and the livestock. A layer on landscape fragmentation serves as a surrogate for proximity of livestock to the tick cycle. Although the impact of climate change on the emergence of CCHF is not clear, comparing the distribution of risk factors in each layer currently with those predicted in the 2080s with climate change can be used to speculate how potential high-risk areas may shift. According to the risk pathway, transstadial and/or transovarial transmission in the tick vector are crucial for CCHFV spread. Vector competence and tick vector switching, however, remain critical factors for CCHFV colonization of new regions in Europe. The species of migratory bird is also an important consideration in the release assessment with greater abundance and biodiversity of ground-dwelling birds in southern Europe than in northern Europe.

  6. Serological and Virological Evidence of Crimean-Congo Haemorrhagic Fever Virus Circulation in the Human Population of Borno State, Northeastern Nigeria

    Science.gov (United States)

    Bukbuk, David N.; Dowall, Stuart D.; Lewandowski, Kuiama; Bosworth, Andrew; Baba, Saka S.; Varghese, Anitha; Watson, Robert J.; Bell, Andrew; Atkinson, Barry; Hewson, Roger

    2016-01-01

    Background Despite several studies on the seroprevalence of antibodies against Crimean-Congo Haemorrhagic Fever virus (CCHFV) from humans and cattle in Nigeria, detailed investigation looking at IgG and IgM have not been reported. Additionally, there have been no confirmed cases of human CCHFV infection reported from Nigeria. Principal Findings Samples from sera (n = 1189) collected from four Local Government Areas in Borno State (Askira/Uba, Damboa, Jere and Maiduguri) were assessed for the presence of IgG and IgM antibodies. The positivity rates for IgG and IgM were 10.6% and 3.5%, respectively. Additionally, sera from undiagnosed febrile patients (n = 380) were assessed by RT-PCR assay for the presence of CCHFV RNA. One positive sample was characterised by further by next generation sequencing (NGS) resulting in complete S, M and L segment sequences. Conclusions This article provides evidence for the continued exposure of the human population of Nigeria to CCHFV. The genomic analysis provides the first published evidence of a human case of CCHFV in Nigeria and its phylogenetic context. PMID:27926935

  7. Incidence and clinical features of acute rheumatic fever in Kayseri, Central Anatolia, 1998-2011.

    Science.gov (United States)

    Narin, Nazmi; Mutlu, Fatma; Argun, Mustafa; Ozyurt, Abdullah; Pamukcu, Ozge; Baykan, Ali; Baykan, Zeynep; Uzum, Kazım

    2015-04-01

    In developing countries, acute rheumatic fever is the most common cause of acquired heart disease in the paediatric and adolescent population. It is believed that vulnerability to developing acute rheumatic fever is associated with several factors such as socio-economic and living conditions. Aim Determine the incidence and clinical characteristics of acute rheumatic fever in the Central Anatolia region of Kayseri within the last 14 years, and to make a comparison of two 7-year periods. Material and methods We performed a retrospective analysis of 624 patients who were diagnosed with acute rheumatic fever at the Department of Pediatric Cardiology in the Medical Faculty of Erciyes University between January, 1998 and December, 2011. The mean age of patients was 10.9±2.7 years. The female/male ratio was 1.4. When patients were categorised according to age groups, the largest group represented 376 patients (60.3%) aged between 10 and 14 years. The estimated incidence rate of acute rheumatic fever was 7.4/100,000 in the Central Anatolia region of Kayseri. Among the major findings, the most common included carditis at 54%, arthritis at 35%, Sydenham's chorea at 25%, and subcutaneous nodules at 0.5%, respectively. No significant difference was found between the first 7-year period and second 7-year period in distributions of age, gender, and major findings. Although there has been socio-economic development in Turkey in the recent years, the incidence of acute rheumatic fever is still high in the Central Anatolia region of Kayseri.

  8. Impact of meteorological factors on the spatiotemporal patterns of dengue fever incidence.

    Science.gov (United States)

    Chien, Lung-Chang; Yu, Hwa-Lung

    2014-12-01

    Dengue fever is one of the most widespread vector-borne diseases and has caused more than 50 million infections annually over the world. For the purposes of disease prevention and climate change health impact assessment, it is crucial to understand the weather-disease associations for dengue fever. This study investigated the nonlinear delayed impact of meteorological conditions on the spatiotemporal variations of dengue fever in southern Taiwan during 1998-2011. We present a novel integration of a distributed lag nonlinear model and Markov random fields to assess the nonlinear lagged effects of weather variables on temporal dynamics of dengue fever and to account for the geographical heterogeneity. This study identified the most significant meteorological measures to dengue fever variations, i.e., weekly minimum temperature, and the weekly maximum 24-hour rainfall, by obtaining the relative risk (RR) with respect to disease counts and a continuous 20-week lagged time. Results show that RR increased as minimum temperature increased, especially for the lagged period 5-18 weeks, and also suggest that the time to high disease risks can be decreased. Once the occurrence of maximum 24-hour rainfall is >50 mm, an associated increased RR lasted for up to 15 weeks. A temporary one-month decrease in the RR of dengue fever is noted following the extreme rain. In addition, the elevated incidence risk is identified in highly populated areas. Our results highlight the high nonlinearity of temporal lagged effects and magnitudes of temperature and rainfall on dengue fever epidemics. The results can be a practical reference for the early warning of dengue fever.

  9. Evaluation of the incidence of occult bacteremia among children with fever of unknown origin

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    Eitan Naaman Berezin

    2006-12-01

    Full Text Available We reviewed the incidence of occult bacteremia, to identify the most frequent etiological agents of bacteremias in otherwise healthy children from one month to 10 years old, who had fever of unknown origin attended at the emergency ward of an urban, university-affiliated pediatric referral center. This was a retrospective medical record review, evaluating children with fever. Data were collected from the initial visit, when blood cultures, hematological properties and hemosedimentation rates were examined. Fever was considered as the highest temperature assessed in the hospital or reported by the responsible adult. Occult bacteremia was discovered in 1.4% of the 1,051 children evaluated, and the most common etiologic agent was Streptococcus pneumoniae. Total leukocyte count and blood sedimentation rates greater than 30 mm³ were not predictive factors for occult bacteremia. Fever greater than 39ºC was the most important factor for predicting occult bacteremia (P<0.001. The presence of occult bacteremia was significantly correlated with patient hospitalization.

  10. Evaluation of the incidence of occult bacteremia among children with fever of unknown origin.

    Science.gov (United States)

    Berezin, Eitan Naaman; Iazzetti, Marco Antonio

    2006-12-01

    We reviewed the incidence of occult bacteremia, to identify the most frequent etiological agents of bacteremias in otherwise healthy children from one month to 10 years old, who had fever of unknown origin attended at the emergency ward of an urban, university-affiliated pediatric referral center. This was a retrospective medical record review, evaluating children with fever. Data were collected from the initial visit, when blood cultures, hematological properties and hemosedimentation rates were examined. Fever was considered as the highest temperature assessed in the hospital or reported by the responsible adult. Occult bacteremia was discovered in 1.4% of the 1,051 children evaluated, and the most common etiologic agent was Streptococcus pneumoniae. Total leukocyte count and blood sedimentation rates greater than 30 mm(3) were not predictive factors for occult bacteremia. Fever greater than 39 masculineC was the most important factor for predicting occult bacteremia (P<0.001). The presence of occult bacteremia was significantly correlated with patient hospitalization.

  11. Evaluation of the incidence of occult bacteremia among children with fever of unknown origin

    Directory of Open Access Journals (Sweden)

    Eitan Naaman Berezin

    Full Text Available We reviewed the incidence of occult bacteremia, to identify the most frequent etiological agents of bacteremias in otherwise healthy children from one month to 10 years old, who had fever of unknown origin attended at the emergency ward of an urban, university-affiliated pediatric referral center. This was a retrospective medical record review, evaluating children with fever. Data were collected from the initial visit, when blood cultures, hematological properties and hemosedimentation rates were examined. Fever was considered as the highest temperature assessed in the hospital or reported by the responsible adult. Occult bacteremia was discovered in 1.4% of the 1,051 children evaluated, and the most common etiologic agent was Streptococcus pneumoniae. Total leukocyte count and blood sedimentation rates greater than 30 mm³ were not predictive factors for occult bacteremia. Fever greater than 39ºC was the most important factor for predicting occult bacteremia (P<0.001. The presence of occult bacteremia was significantly correlated with patient hospitalization.

  12. Intracerebral haemorrhage.

    Science.gov (United States)

    Qureshi, Adnan I; Mendelow, A David; Hanley, Daniel F

    2009-05-09

    Intracerebral haemorrhage is an important public health problem leading to high rates of death and disability in adults. Although the number of hospital admissions for intracerebral haemorrhage has increased worldwide in the past 10 years, mortality has not fallen. Results of clinical trials and observational studies suggest that coordinated primary and specialty care is associated with lower mortality than is typical community practice. Development of treatment goals for critical care, and new sequences of care and specialty practice can improve outcome after intracerebral haemorrhage. Specific treatment approaches include early diagnosis and haemostasis, aggressive management of blood pressure, open surgical and minimally invasive surgical techniques to remove clot, techniques to remove intraventricular blood, and management of intracranial pressure. These approaches improve clinical management of patients with intracerebral haemorrhage and promise to reduce mortality and increase functional survival.

  13. Evaluation of Hydrologic and Meteorological Impacts on Dengue Fever Incidences in Southern Taiwan using Time- Frequency Method

    Science.gov (United States)

    Tsai, Christina; Yeh, Ting-Gu

    2017-04-01

    Extreme weather events are occurring more frequently as a result of climate change. Recently dengue fever has become a serious issue in southern Taiwan. It may have characteristic temporal scales that can be identified. Some researchers have hypothesized that dengue fever incidences are related to climate change. This study applies time-frequency analysis to time series data concerning dengue fever and hydrologic and meteorological variables. Results of three time-frequency analytical methods - the Hilbert Huang transform (HHT), the Wavelet Transform (WT) and the Short Time Fourier Transform (STFT) are compared and discussed. A more effective time-frequency analysis method will be identified to analyze relevant time series data. The most influential time scales of hydrologic and meteorological variables that are associated with dengue fever are determined. Finally, the linkage between hydrologic/meteorological factors and dengue fever incidences can be established.

  14. Demographic and clinical features of suspected dengue and dengue haemorrhagic fever in the Northern Province of Sri Lanka, a region afflicted by an internal conflict for more than 30 years-a retrospective analysis.

    Science.gov (United States)

    Murugananthan, K; Kandasamy, M; Rajeshkannan, N; Noordeen, F

    2014-10-01

    The aim of this study was to determine the demographic, clinical, and notification data of suspected dengue fever (DF) and dengue hemorrhagic fever (DHF) cases admitted to Jaffna Teaching Hospital, Sri Lanka. The data were collected from bed head tickets of all patients presenting with clinically suspected DF/DHF from October 2009 to September 2010. A total of 1085 clinically suspected DF/DHF cases were identified, with high numbers occurring during December 2009 to March 2010. The majority of the reported patients were females (n = 550, 50.7%) and approximately three-quarters of the patients (n = 797, 73.5%) were adults. All had fever, but fever spikes were noted in only 129 cases (11.9%; 95% confidence interval (CI) 10.1-13.9%). Over 50% of cases had vomiting (95% CI 47.5-53.5%). Haemorrhages were noted in 266 (24.5%), with gum bleeding in 99 patients (37.2%). Low white blood cell and platelet counts were noted in 27.1% and 85.6% of cases, respectively. Of the 1085 cases, only 24 (2.2%) were screened for dengue IgM/IgG and only 458 cases (42.2%) were notified to the Epidemiology Unit, Ministry of Health, Sri Lanka. The absence of laboratory diagnosis and poor notification to the Epidemiology Unit were the major drawbacks noted. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Potential association of dengue hemorrhagic fever incidence and remote senses land surface temperature, Thailand, 1998.

    Science.gov (United States)

    Nitatpattana, Narong; Singhasivanon, Pratap; Kiyoshi, Honda; Andrianasolo, Haja; Yoksan, Sutee; Gonzalez, Jean-Paul; Barbazan, Philippe

    2007-05-01

    A pilot study was designed to analyze a potential association between dengue hemorrhagic fever (DHF) incidence and, temperature computed by satellite. DHF is a mosquito transmitted disease, and water vapor and humidity are known to have a positive effect on mosquito life by increasing survival time and shortening the development cycle. Among other available satellite data, Land Surface Temperature (LST) was chosen as an indicator that combined radiated earth temperature and atmospheric water vapor concentration. Monthly DHF incidence was recorded by province during the 1998 epidemic and obtained as a weekly combined report available from the National Ministry of Public Health. Conversely, LST was calculated using remotely sensed data obtained from thermal infrared sensors of NOAA satellites and computed on a provincial scale. Out of nine selected study provinces, five (58.3%) exhibited an LST with a significant positive correlation with rainfall (p < 0.05). In four out of nineteen surveyed provinces (21.3%), LST showed a significant positive correlation with DHF incidence (p < 0.05). Positive association between LST and DHF incidence was significantly correlated in 75% of the cases during non-epidemic months, while no correlation was found during epidemic months. Non-climatic factors are supposed to be at the origin of this discrepancy between seasonality in climate (LST) and DHF incidence during epidemics.

  16. Association between the incidence of typhoid and paratyphoid fever and meteorological variables in Guizhou, China

    Institute of Scientific and Technical Information of China (English)

    WANG Lu-xi; LI Xiu-jun; FANG Li-qun; WANG Duo-chun; CAO Wu-chun; KAN Biao

    2012-01-01

    Background Typhoid/paratyphoid fever (TPF) is endemic in Guizhou.We conducted wavelet analysis and Spearman's rank correlation analysis to explore the impact of meteorological variations on TPF infection in Guizhou,in an attempt to assess the risk factors associated with TPF epidemics.Methods We examined the association between TPF incidence in Guizhou and temperature,precipitation and relative humidity using 24 years of data from 1984 to 2007.Periodicities of TPF incidence and the impact of climate factors on the TPF were detected by Spearman's rank correlation and wavelet analysis,Results Temperature and precipitation with a 1-month lag were positively correlated with the monthly incidence of TPF.The multiyear incidence pattern of TPF in Guizhou was explicitly periodic.Moreover,the association and driving effect of precipitation on TPF were observed,and the results showed that the incidence of TPF in Guizhou had a closer correlation with precipitation than with temperature.Conclusions Safe water supply is the key issue for TPF control in Guizhou.Moreover,climate variation might impact the enteric infections,which may inform policy assessment for TPF control in Guizhou.

  17. Analysis of incidence and related factors of hemorrhagic fever with renal syndrome in Hebei Province, China.

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    Qi Li

    Full Text Available BACKGROUND: Hemorrhagic fever with renal syndrome (HFRS is an important infectious disease in Hebei province, China. The average annual incidence is 3.10/100000. Although the incidence of HFRS is stable with a general decline in trend since 2004, an increase in the trend was observed in 2011. Few studies have been conducted to investigate the underlying risk factors for this disease. METHODS: The epidemiological data of HFRS and the population data, meteorology, and remote sensing aspects of cities in Hebei province from 1999 to 2011 were collected. The epidemiological data included the population density in the region, seasonal data and rat density and rat's virus carriage rate. The data were analyzed by descriptive study, correlation analysis and multivariate linear analysis. RESULTS: There were 26837 cases of HFRS was reported from 1999 to 2011. The infection occurred mainly in males, aged 20∼49 years, who were farmers. Rattus norvegicus was the main host animal. The incidence of HFRS was related to NDVI value, rat density and rat's virus carriage rate by multiple linear regression (F = 25.936, P<0.01. The pseudo- R2value for the model was 0.644. CONCLUSION: The incidence of HFRS was related to NDVI value, rat density and rat's virus carriage rate. Control of these factors should be used to prevent HFRS in Hebei province.

  18. Typhoid fever with caecal ulcer bleed: managed conservatively.

    Science.gov (United States)

    Boopathy, Vinoth; Periyasamy, Sivakumar; Alexander, Thomas; Balasubramanian, Padhmini

    2014-03-31

    Typhoid fever is caused by enteroinvasive Gram-negative organism Salmonella typhi. The well-known complications of typhoid fever are intestinal haemorrhage and perforation. In the pre-antibiotic era, these complications were quite common, but in the current antibiotic era the incidence of these complications is on the decline. We report a case of a patient with typhoid fever who developed haematochezia during the hospital stay and was found to have caecal ulcer with an adherent clot on colonoscopy. He was managed successfully with conservative measures without endotherapy and there was no rebleed.

  19. The Association between Environmental Factors and Scarlet Fever Incidence in Beijing Region: Using GIS and Spatial Regression Models.

    Science.gov (United States)

    Mahara, Gehendra; Wang, Chao; Yang, Kun; Chen, Sipeng; Guo, Jin; Gao, Qi; Wang, Wei; Wang, Quanyi; Guo, Xiuhua

    2016-11-04

    (1) Background: Evidence regarding scarlet fever and its relationship with meteorological, including air pollution factors, is not very available. This study aimed to examine the relationship between ambient air pollutants and meteorological factors with scarlet fever occurrence in Beijing, China. (2) Methods: A retrospective ecological study was carried out to distinguish the epidemic characteristics of scarlet fever incidence in Beijing districts from 2013 to 2014. Daily incidence and corresponding air pollutant and meteorological data were used to develop the model. Global Moran's I statistic and Anselin's local Moran's I (LISA) were applied to detect the spatial autocorrelation (spatial dependency) and clusters of scarlet fever incidence. The spatial lag model (SLM) and spatial error model (SEM) including ordinary least squares (OLS) models were then applied to probe the association between scarlet fever incidence and meteorological including air pollution factors. (3) Results: Among the 5491 cases, more than half (62%) were male, and more than one-third (37.8%) were female, with the annual average incidence rate 14.64 per 100,000 population. Spatial autocorrelation analysis exhibited the existence of spatial dependence; therefore, we applied spatial regression models. After comparing the values of R-square, log-likelihood and the Akaike information criterion (AIC) among the three models, the OLS model (R² = 0.0741, log likelihood = -1819.69, AIC = 3665.38), SLM (R² = 0.0786, log likelihood = -1819.04, AIC = 3665.08) and SEM (R² = 0.0743, log likelihood = -1819.67, AIC = 3665.36), identified that the spatial lag model (SLM) was best for model fit for the regression model. There was a positive significant association between nitrogen oxide (p = 0.027), rainfall (p = 0.036) and sunshine hour (p = 0.048), while the relative humidity (p = 0.034) had an adverse association with scarlet fever incidence in SLM. (4) Conclusions: Our findings indicated that

  20. Sugar, dental caries and the incidence of acute rheumatic fever: a cohort study of Māori and Pacific children.

    Science.gov (United States)

    Thornley, Simon; Marshall, Roger J; Bach, Katie; Koopu, Pauline; Reynolds, Gary; Sundborn, Gerhard; Ei, Win Le Shwe Sin

    2017-04-01

    To determine whether dental caries, as an indicator of cumulative exposure to sugar, is associated with the incidence of acute rheumatic fever and chronic rheumatic heart disease, in Māori and Pacific children aged 5 and 6 years at their first dental visit. A cohort study was undertaken which linked school dental service records of caries with national hospital discharge and mortality records. Cox models were used to investigate the strength of the association between dental caries and rheumatic fever incidence. A total of 20 333 children who were free of rheumatic heart disease at enrolment were available for analysis. During a mean follow-up time of 5 years, 96 children developed acute rheumatic fever or chronic rheumatic heart disease. After adjustment for potential confounders, children with five or more primary teeth affected by caries were 57% (95% CI: 20% to 106%) more likely to develop disease during follow-up, compared to children whose primary teeth were caries free. The population attributable to the risk for caries in this cohort was 22%. Dental caries is positively associated with the incidence of acute rheumatic fever and chronic rheumatic heart disease in Māori and Pacific children. Sugar intake, an important risk factor for dental caries, is also likely to influence the aetiology of rheumatic fever. 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/.

  1. Comparative study of four time series methods in forecasting typhoid fever incidence in China.

    Science.gov (United States)

    Zhang, Xingyu; Liu, Yuanyuan; Yang, Min; Zhang, Tao; Young, Alistair A; Li, Xiaosong

    2013-01-01

    Accurate incidence forecasting of infectious disease is critical for early prevention and for better government strategic planning. In this paper, we present a comprehensive study of different forecasting methods based on the monthly incidence of typhoid fever. The seasonal autoregressive integrated moving average (SARIMA) model and three different models inspired by neural networks, namely, back propagation neural networks (BPNN), radial basis function neural networks (RBFNN), and Elman recurrent neural networks (ERNN) were compared. The differences as well as the advantages and disadvantages, among the SARIMA model and the neural networks were summarized and discussed. The data obtained for 2005 to 2009 and for 2010 from the Chinese Center for Disease Control and Prevention were used as modeling and forecasting samples, respectively. The performances were evaluated based on three metrics: mean absolute error (MAE), mean absolute percentage error (MAPE), and mean square error (MSE). The results showed that RBFNN obtained the smallest MAE, MAPE and MSE in both the modeling and forecasting processes. The performances of the four models ranked in descending order were: RBFNN, ERNN, BPNN and the SARIMA model.

  2. Comparative study of four time series methods in forecasting typhoid fever incidence in China.

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    Xingyu Zhang

    Full Text Available Accurate incidence forecasting of infectious disease is critical for early prevention and for better government strategic planning. In this paper, we present a comprehensive study of different forecasting methods based on the monthly incidence of typhoid fever. The seasonal autoregressive integrated moving average (SARIMA model and three different models inspired by neural networks, namely, back propagation neural networks (BPNN, radial basis function neural networks (RBFNN, and Elman recurrent neural networks (ERNN were compared. The differences as well as the advantages and disadvantages, among the SARIMA model and the neural networks were summarized and discussed. The data obtained for 2005 to 2009 and for 2010 from the Chinese Center for Disease Control and Prevention were used as modeling and forecasting samples, respectively. The performances were evaluated based on three metrics: mean absolute error (MAE, mean absolute percentage error (MAPE, and mean square error (MSE. The results showed that RBFNN obtained the smallest MAE, MAPE and MSE in both the modeling and forecasting processes. The performances of the four models ranked in descending order were: RBFNN, ERNN, BPNN and the SARIMA model.

  3. Feto-maternal haemorrhage in therapeutic abortion

    Science.gov (United States)

    Voigt, J. C.; Britt, R. P.

    1969-01-01

    The incidence of feto-maternal haemorrhage in induced abortion has been studied with the Kleihauer technique. All four methods of termination used were shown to result in such haemorrhages. The incidence below 12 weeks' gestation, however, was very small and there seems to be no reason for offering routine rhesus-immunoglobulin to these women. When it is essential to terminate a pregnancy of 12 weeks' size or more in a rhesus-negative woman immunoglobulin should be given. PMID:4187694

  4. Incidence of acute rheumatic fever and chronic rheumatic heart disease, trends in deaths in the Tula region (1991—2011

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    Valentina Nikolayevna Sorotskaya

    2013-01-01

    Full Text Available The paper analyzes the incidence of acute rheumatic fever (ARF and chronic rheumatic heart disease (CRHD and theirs outcomes in the Tula Region in 1991 to 2011. In this period, the incidence of ARF decreased to 0.002, which was much lower than Russia's rates. That of CRHD in 2011 accounted for 1.6 per 1,000 adult population, which was comparable to the values in Russia. CRHD mortality rates showed a 2.5-fold decrease. The main causes of fatal outcomes were cardiovascular disorders.

  5. Studies on the incidence of intracranial haemorrhages and their relation to the delivery by using the cranial computer-tomography (CT) in full-term newborns

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    Brockerhoff, P.; Brand, M.; Ludwig, B.

    1981-09-01

    The cranial computer-tomography is a new non-invasive method for the diagnosis of perinatal intracranial haemorrhage. Among 80 neonates, who were examined by CT after delivery at term between the 3. and 5. day of life, there were 43 newborns without any neurological symptom. These were examined voluntarily with the permission of their parents. A significant correlation between the CT-finding of an intracranial haemorrhage and the neurological observations was found, whereas there was no relation to the mode of delivery. Parity, birth weight, Apgar-score, cord blood-pH did not correspond to the CT-findings. An extremely short duration of the second stage of labor in spontaneous delivery seems to increase the risk of perinatal intracranial haemorrhage.

  6. Epidemiology of intracerebral haemorrhage in Livorno district

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    Luca Masotti

    2011-08-01

    Full Text Available BACKGROUND: Intracranial haemorrhage represents the most feared stroke subtype. AIM: To evaluate the burden of intracranial haemorrhage in Tuscany hospitals with special reference to Livorno district. MATERIALS AND METHODS: Data of patients discharged in 2009 from Tuscan and Livorno hospitals with codes ICD-9-CM related to any type of spontaneous intracranial haemorrhage were selected and analyzed. RESULTS: 3,472 patients were discharged from Tuscan hospitals with these diagnoses. Overall mortality was 24.3%. 50% of patients were admitted in Internal Medicine wards. Incidence of intracranial haemorrhage and intracerebral haemorrhage (ICH in population of Livorno district was 64 and 45/100,000 inhabitants/year with related mortality of 36.5% and 39.4%respectively. Intra-hospital mortality of patients admitted in Livorno hospitals for intracranial haemorrhage were 36.7%. 40% of deaths occurred in the first 48 hours. 69.6% of intracranial haemorrhage were ICHs, 16.8% subaracnoideal. Intra-hospital mortality, admissions for intracranial haemorrhage in respect of total admissions and mortality for intracranial haemorrhage in respect to total mortality increased in the last decade. 23% of patients with intracranial haemorrhage and 16% of patients with ICH underwent to surgical procedures. ICHs related to antithrombotic treatment significantly increased in the last years. Mortality in patients on antithrombotic drugs was three times over compared to that in patients not undergone these drugs (43.7% vs 12.8%, p < 0.01. CONCLUSION: There is an increasing trend in frequency, mortality and hospital burden of intracranial haemorrhage and ICH. Efforts aimed at reducing the burden and consequences of this devasting disease are warranted.

  7. Dengue incidence in urban and rural Cambodia: results from population-based active fever surveillance, 2006-2008.

    Directory of Open Access Journals (Sweden)

    Sirenda Vong

    Full Text Available BACKGROUND: Dengue vaccines are now in late-stage development, and evaluation and robust estimates of dengue disease burden are needed to facilitate further development and introduction. In Cambodia, the national dengue case-definition only allows reporting of children less than 16 years of age, and little is known about dengue burden in rural areas and among older persons. To estimate the true burden of dengue in the largest province of Cambodia, Kampong Cham, we conducted community-based active dengue fever surveillance among the 0-to-19-year age group in rural villages and urban areas during 2006-2008. METHODS AND FINDINGS: Active surveillance for febrile illness was conducted in 32 villages and 10 urban areas by mothers trained to use digital thermometers combined with weekly home visits to identify persons with fever. An investigation team visited families with febrile persons to obtain informed consent for participation in the follow-up study, which included collection of personal data and blood specimens. Dengue-related febrile illness was defined using molecular and serological testing of paired acute and convalescent blood samples. Over the three years of surveillance, 6,121 fever episodes were identified with 736 laboratory-confirmed dengue virus (DENV infections for incidences of 13.4-57.8/1,000 person-seasons. Average incidence was highest among children less than 7 years of age (41.1/1,000 person-seasons and lowest among the 16-to-19-year age group (11.3/1,000 person-seasons. The distribution of dengue was highly focal, with incidence rates in villages and urban areas ranging from 1.5-211.5/1,000 person-seasons (median 36.5. During a DENV-3 outbreak in 2007, rural areas were affected more than urban areas (incidence 71 vs. 17/1,000 person-seasons, p<0.001. CONCLUSION: The large-scale active surveillance study for dengue fever in Cambodia found a higher disease incidence than reported to the national surveillance system, particularly

  8. Dengue Incidence in Urban and Rural Cambodia: Results from Population-Based Active Fever Surveillance, 2006–2008

    Science.gov (United States)

    Vong, Sirenda; Khieu, Virak; Glass, Olivier; Ly, Sowath; Duong, Veasna; Huy, Rekol; Ngan, Chantha; Wichmann, Ole; Letson, G. William; Margolis, Harold S.; Buchy, Philippe

    2010-01-01

    Background Dengue vaccines are now in late-stage development, and evaluation and robust estimates of dengue disease burden are needed to facilitate further development and introduction. In Cambodia, the national dengue case-definition only allows reporting of children less than 16 years of age, and little is known about dengue burden in rural areas and among older persons. To estimate the true burden of dengue in the largest province of Cambodia, Kampong Cham, we conducted community-based active dengue fever surveillance among the 0-to-19–year age group in rural villages and urban areas during 2006–2008. Methods and Findings Active surveillance for febrile illness was conducted in 32 villages and 10 urban areas by mothers trained to use digital thermometers combined with weekly home visits to identify persons with fever. An investigation team visited families with febrile persons to obtain informed consent for participation in the follow-up study, which included collection of personal data and blood specimens. Dengue-related febrile illness was defined using molecular and serological testing of paired acute and convalescent blood samples. Over the three years of surveillance, 6,121 fever episodes were identified with 736 laboratory-confirmed dengue virus (DENV) infections for incidences of 13.4–57.8/1,000 person-seasons. Average incidence was highest among children less than 7 years of age (41.1/1,000 person-seasons) and lowest among the 16-to-19–year age group (11.3/1,000 person-seasons). The distribution of dengue was highly focal, with incidence rates in villages and urban areas ranging from 1.5–211.5/1,000 person-seasons (median 36.5). During a DENV-3 outbreak in 2007, rural areas were affected more than urban areas (incidence 71 vs. 17/1,000 person-seasons, pdengue fever in Cambodia found a higher disease incidence than reported to the national surveillance system, particularly in preschool children and that disease incidence was high in both rural

  9. Dengue incidence in urban and rural Cambodia: results from population-based active fever surveillance, 2006-2008.

    Science.gov (United States)

    Vong, Sirenda; Khieu, Virak; Glass, Olivier; Ly, Sowath; Duong, Veasna; Huy, Rekol; Ngan, Chantha; Wichmann, Ole; Letson, G William; Margolis, Harold S; Buchy, Philippe

    2010-11-30

    Dengue vaccines are now in late-stage development, and evaluation and robust estimates of dengue disease burden are needed to facilitate further development and introduction. In Cambodia, the national dengue case-definition only allows reporting of children less than 16 years of age, and little is known about dengue burden in rural areas and among older persons. To estimate the true burden of dengue in the largest province of Cambodia, Kampong Cham, we conducted community-based active dengue fever surveillance among the 0-to-19-year age group in rural villages and urban areas during 2006-2008. Active surveillance for febrile illness was conducted in 32 villages and 10 urban areas by mothers trained to use digital thermometers combined with weekly home visits to identify persons with fever. An investigation team visited families with febrile persons to obtain informed consent for participation in the follow-up study, which included collection of personal data and blood specimens. Dengue-related febrile illness was defined using molecular and serological testing of paired acute and convalescent blood samples. Over the three years of surveillance, 6,121 fever episodes were identified with 736 laboratory-confirmed dengue virus (DENV) infections for incidences of 13.4-57.8/1,000 person-seasons. Average incidence was highest among children less than 7 years of age (41.1/1,000 person-seasons) and lowest among the 16-to-19-year age group (11.3/1,000 person-seasons). The distribution of dengue was highly focal, with incidence rates in villages and urban areas ranging from 1.5-211.5/1,000 person-seasons (median 36.5). During a DENV-3 outbreak in 2007, rural areas were affected more than urban areas (incidence 71 vs. 17/1,000 person-seasons, pdengue fever in Cambodia found a higher disease incidence than reported to the national surveillance system, particularly in preschool children and that disease incidence was high in both rural and urban areas. It also confirmed the

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

    DEFF Research Database (Denmark)

    Gaist, D; Vaeth, M; Tsiropoulos, I

    2000-01-01

    OBJECTIVE: To estimate the risk of occurrence of subarachnoid haemorrhage in first degree relatives (parents, siblings, children) of patients with subarachnoid haemorrhage. DESIGN: Population based cohort study using data from the Danish National Discharge Registry and the Central Person Registry....... SUBJECTS: Incident cases of subarachnoid haemorrhage admitted to hospital from 1977 to 1995 (9367 patients) and their first degree relatives (14 781). MAIN OUTCOME MEASURES: The incidence rate of subarachnoid haemorrhage was determined for the relatives and compared with that of the entire population......, standardised for age, sex, and calendar period. This process was repeated for patients discharged from neurosurgery units, as diagnoses from these wards had high validity (93%). RESULTS: 18 patients had a total of 19 first degree relatives with subarachnoid haemorrhage during the study period, corresponding...

  11. European research priorities for intracerebral haemorrhage

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  12. Ebolavirus and Haemorrhagic Syndrome

    Directory of Open Access Journals (Sweden)

    Gerald A. Matua

    2015-05-01

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

  13. Assessing spatio-temporal trend of vector breeding and dengue fever incidence in association with meteorological conditions.

    Science.gov (United States)

    Malik, Afifa; Yasar, Abdullah; Tabinda, Amtul Bari; Zaheer, Ihsan Elahi; Malik, Khalida; Batool, Adeeba; Mahfooz, Yusra

    2017-04-01

    Th aim of this study is to investigate spatio-temporal trends of dengue vector breeding and epidemic (disease incidence) influenced by climatic factors. The spatio-temporal (low-, medium-, and high-intensity periods) evaluation of entomological and epidemiological investigations along with climatic factors like rainfall (RF), temperature (Tmax), relative humidity (RH), and larval indexing was conducted to develop correlations in the area of Lahore, Pakistan. The vector abundance and disease transmission trend was geo-tagged for spatial insight. The sufficient rainfall events and optimum temperature and relative humidity supported dengue vector breeding with high larval indices for water-related containers (27-37%). Among temporal analysis, the high-intensity period exponentially projected disease incidence followed by post-rainfall impacts. The high larval incidence that was observed in early high-intensity periods effected the dengue incidence. The disease incidence had a strong association with RF (r = 0.940, α = 0.01). The vector larva occurrence (r = 0.017, α = 0.05) influenced the disease incidence. Similarly, RH (r = 0.674, α = 0.05) and average Tmax (r = 0.307, α = 0.05) also induced impact on the disease incidence. In this study, the vulnerability to dengue fever highly correlates with meteorological factors during high-intensity period. It provides area-specific understanding of vector behavior, key containers, and seasonal patterns of dengue vector breeding and disease transmission which is essential for preparing an effective prevention plan against the vector.

  14. Retinal haemorrhages in vacuum extraction deliveries

    Directory of Open Access Journals (Sweden)

    Bahgat Mostafa

    1987-01-01

    Full Text Available Two hundred and thirty eight newly born infants were subjected to fundus examination in the first 5 hours of labour then daily till discharge from the hospital then weekly till complete absorption of retinal haemorrhages The 238 infants were 23 delivered by caesarean section, 90 with spontaneous vaginal delivery,45 babies (over3.5 kgm delivered vaginallyand80 delivered by vacuum extraction. It was found that 37.39% of the newborns had retinal haemorrhages. The incidence, type and severity of retinal haemorrhages were related to the extent of obstetric trauma during birth. They were least with caesarean section. (4.35%, more in babies with spontaneous vaginal delivery (20%, more higher in infants over 3.5 kgm birth weight (33.33% and maximum in vacuum extraction deliveries (68.75%. A good correlation was made between the site and duration of cup application, level and rate of increase of negative pressure, the presence and size of cephalhematoma and the incidence and severity of retinal haemorrhages A good choice of cases as well as good control of the technique of vacuum extraction will minimize the incidence and severity of retinal haemorrhages in the new born.

  15. Yellow fever.

    Science.gov (United States)

    Monath, Thomas P; Vasconcelos, Pedro F C

    2015-03-01

    Yellow fever, a mosquito-borne flavivirus disease occurs in tropical areas of South America and Africa. It is a disease of major historical importance, but remains a threat to travelers to and residents of endemic areas despite the availability of an effective vaccine for nearly 70 years. An important aspect is the receptivity of many non-endemic areas to introduction and spread of yellow fever. This paper reviews the clinical aspects, pathogenesis, and epidemiology of yellow fever, with an emphasis on recent changes in the distribution and incidence of the disease. Recent knowledge about yellow fever 17D vaccine mechanism of action and safety are discussed.

  16. Municipality Level Simulations of Dengue Fever Incidence in Puerto Rico Using Ground Based and Remotely Sensed Climate Data

    Science.gov (United States)

    Quattrochi, Dale A.; Morin, Cory

    2015-01-01

    Dengue fever (DF) is caused by a virus transmitted between humans and Aedes genus mosquitoes through blood feeding. In recent decades incidence of the disease has drastically increased in the tropical Americas, culminating with the Pan American outbreak in 2010 which resulted in 1.7 million reported cases. In Puerto Rico dengue is endemic, however, there is significant inter-annual, intraannual, and spatial variability in case loads. Variability in climate and the environment, herd immunity and virus genetics, and demographic characteristics may all contribute to differing patterns of transmission both spatially and temporally. Knowledge of climate influences on dengue incidence could facilitate development of early warning systems allowing public health workers to implement appropriate transmission intervention strategies. In this study, we simulate dengue incidence in several municipalities in Puerto Rico using population and meteorological data derived from ground based stations and remote sensing instruments. This data was used to drive a process based model of vector population development and virus transmission. Model parameter values for container composition, vector characteristics, and incubation period were chosen by employing a Monte Carlo approach. Multiple simulations were performed for each municipality and the results were compared with reported dengue cases. The best performing simulations were retained and their parameter values and meteorological input were compared between years and municipalities. Parameter values varied by municipality and year illustrating the complexity and sensitivity of the disease system. Local characteristics including the natural and built environment impact transmission dynamics and produce varying responses to meteorological conditions.

  17. Study on Incidence of Typhoid Fever and Paratyphoid Fever with Seasonal Trend Model%全国伤寒、副伤寒发病的季节趋势模型研究

    Institute of Scientific and Technical Information of China (English)

    郭海强; 刘红波; 曲波; 孙高

    2011-01-01

    目的 分析全国2006-2010年伤寒、副伤寒报告病例数据,应用季节趋势模型预测2011年的发病例数.方法 应用SPSS 15.0和Excel软件拟合2006-2010年全国伤寒、副伤寒逐月报告发病人数的季节趋势模型.结果 全国伤寒、副伤寒的发病情况呈逐年下降趋势,应用逐月报告发病人数建立的季节趋势模型差异有统计学意义(F=11.688,P=0.001).应用模型预测2011年全国伤寒、副伤寒的发病人数为12 543例,较上年减少2 169例.结论 季节趋势模型充分考虑了疾病流行的长期趋势和季节性流行特点,拟合近年全国伤寒、副伤寒发病数据效果较好,可利用模型进行短期预测.%Objective To explore the reported incidence data of typhoid fever and paratyphoid fever in China from 2006 to 2010 by fitting a seasonal trend model, and to predict the incidence of the diseases in 2011 with the established model.Methods SPSS 15.0 and Excel XP were applied to fit the seasonal trend model on the incidence of typhoid fever and paratyphoid fever. Results Tho reported cases of typhoid fever and paratyphoid fever declined annually during the period of 2006~2010, and the difference was statistically significant ( F = 11. 688, P = 0. 001 ). With tho established seasonal trend model, the predictive cases of the diseases in 2011 would be 12,543, which are 2,169 less than those of 2010. Conclusions The long- term epidemic trend and seasonal epidemic character are all taken into account in the seasonal trend model. Tho fitted result of the established model is acceptable on the incidence of typhoid fever and paratyphoid fever, and the model can be applied to predict future short - term incidence.

  18. Viral Haemorrhagic Septicaemia Virus

    DEFF Research Database (Denmark)

    Olesen, Niels Jørgen; Skall, Helle Frank

    2013-01-01

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

  19. Viral Haemorrhagic Septicaemia Virus

    DEFF Research Database (Denmark)

    Olesen, Niels Jørgen; Skall, Helle Frank

    2013-01-01

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

  20. Transplacental haemorrhage and maternal iso-immunization

    Directory of Open Access Journals (Sweden)

    Mehta Daxa

    1979-01-01

    Full Text Available Foetomaternal haemorrhage is one of the important factors influencing maternal iso-immunization. In the present report at-tempt is made to study various aspects of foetomaternal haemor-rhage. While the overall incidence of foetal cell leak was observed in 21.43%, the incidence in the complicated deliveries ranged from. 27.94 to 85.72%. Incidence was not influenced by parity, however ABO compatible deliveries showed slight increase in the incidence (22.56% as compared to ABO incompatible (18.75% deliveries. ABO incompatible foetal cells were eliminated within 24 hours after delivery. Incidence of foetal cell leak was 8.28% in medical termination of pregnancy. Anth-Rh was produced in two out of nine women having foetal cell leak.

  1. review article marburg haemorrhagic fever: recent advances

    African Journals Online (AJOL)

    Dr Oboro VO

    2010-07-02

    Jul 2, 2010 ... reservoir, but humans are not the natural reservoir. With the exception of a .... Massive cytolysis, immune dysfunction, fluid shifts, microvascular ... often have little or no memory of being sick, though only 10-40% survive (16).

  2. European research priorities for intracerebral haemorrhage

    DEFF Research Database (Denmark)

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

    2011-01-01

    Over 2 million people are affected by intracerebral haemorrhage (ICH) worldwide every year, one third of them dying within 1 month, and many survivors being left with permanent disability. Unlike most other stroke types, the incidence, morbidity and mortality of ICH have not declined over time. N...

  3. Prevention of intracerebral haemorrhage.

    Science.gov (United States)

    Mitchell, Patrick; Mitra, Dipayan; Gregson, Barbara A; Mendelow, A David

    2007-07-01

    Nontraumatic intracerebral haemorrhages arise from a wide range of causes falling into two broad groups: discreet vascular "ictohaemorrhagic" lesions such as aneurysms, arteriovenous malformations, cavernomas, tumours, and dural fistulae; and more generalised amyloid or hypertension related conditions. It is now possible using family history, associated risk factors and gradient echo MRI to predict cases at high risk of hypertensive or amyloid related haemorrhage. There is considerable potential for prevention of hypertensive haemorrhages by treatment of high risk cases with antihypertensive medication. As yet no effective preventative treatment for amyloid angiopathy related ICH has emerged although a variety of drugs are under investigation. Prevention of haemorrhage from ictohaemorrhagic lesions revolves around removal or obliteration of the lesion. Although there is a wide range of such lesions available treatments come down to three modalities. These are surgical excision, stereotactic radiosurgery and endovascular embolisation.

  4. Milk fever and subclinical hypocalcaemia--an evaluation of parameters on incidence risk, diagnosis, risk factors and biological effects as input for a decision support system for disease control

    DEFF Research Database (Denmark)

    Houe, H; Østergaard, S; Thilsing-Hansen, T

    2001-01-01

    of risk factors is outlined. The clinical symptoms of milk fever are highly specific and the disease level may thus be determined from recording of treatments. Diagnosis of subclinical hypocalcaemia needs to include laboratory examinations or it may be determined by multiplying the incidence of milk fever...... strategy. Several studies have been carried out revealing an incidence of milk fever most often in the level of 5-10%. Few studies indicate that the incidence of subclinical hypocalcaemia is several times higher than milk fever. The diagnosis based on clinical or laboratory methods or based on presence...... concerning incidence, diagnosis, risk factors and effects seems sufficient for a systematic inclusion in a decision support system. A model on milk fever should take into consideration the variation in biological data and individual herd characteristics. The inclusion of subclinical hypocalcaemia would...

  5. Epidemiology and Epizootiological Investigations of Hemorrhagic Fever Viruses in Kenya

    Science.gov (United States)

    1988-05-30

    in East Africa. Dengue virus type 2 has Deen isolated in Coastal Kenya once out with no haemorrhagic manifestations. Marourg virus was initially...virus, Rift Valley fever virus, Congo-Crimean haemorrhagic fever virus, Lassa virus, Dengue virus, West Nile viruq or fellow Fever virus). Electron...to conduct the proposed field investigations. I. Office of the President 2. Ministry of Tourism and Wildlife 3. Ministry of Research, Science and

  6. Population-based incidence of typhoid fever in an urban informal settlement and a rural area in Kenya: implications for typhoid vaccine use in Africa.

    Directory of Open Access Journals (Sweden)

    Robert F Breiman

    Full Text Available BACKGROUND: High rates of typhoid fever in children in urban settings in Asia have led to focus on childhood immunization in Asian cities, but not in Africa, where data, mostly from rural areas, have shown low disease incidence. We set out to compare incidence of typhoid fever in a densely populated urban slum and a rural community in Kenya, hypothesizing higher rates in the urban area, given crowding and suboptimal access to safe water, sanitation and hygiene. METHODS: During 2007-9, we conducted population-based surveillance in Kibera, an urban informal settlement in Nairobi, and in Lwak, a rural area in western Kenya. Participants had free access to study clinics; field workers visited their homes biweekly to collect information about acute illnesses. In clinic, blood cultures were processed from patients with fever or pneumonia. Crude and adjusted incidence rates were calculated. RESULTS: In the urban site, the overall crude incidence of Salmonella enterica serovar Typhi (S. Typhi bacteremia was 247 cases per 100,000 person-years of observation (pyo with highest rates in children 5-9 years old (596 per 100,000 pyo and 2-4 years old (521 per 100,000 pyo. Crude overall incidence in Lwak was 29 cases per 100,000 pyo with low rates in children 2-4 and 5-9 years old (28 and 18 cases per 100,000 pyo, respectively. Adjusted incidence rates were highest in 2-4 year old urban children (2,243 per 100,000 pyo which were >15-fold higher than rates in the rural site for the same age group. Nearly 75% of S. Typhi isolates were multi-drug resistant. CONCLUSIONS: This systematic urban slum and rural comparison showed dramatically higher typhoid incidence among urban children <10 years old with rates similar to those from Asian urban slums. The findings have potential policy implications for use of typhoid vaccines in increasingly urban Africa.

  7. Dengue Fever/Dengue Haemorrhagic Fever : Case Management

    OpenAIRE

    Nimmannitya, Suchitra

    1995-01-01

    Dengue infections caused by the four antigenically distinct dengue virus serotypes (dengue virus 1, dengue virus 2, dengue virus 3, dengue virus 4) of the family Flavivindae, are the most important arbovirus disease in man, both in terms of morbidity and mortality. The infection is transmitted from man to man by Aedes mosquitoes. Since 1956, dengue virus infection has resulted in more than 3 million hospital admissions and more than 50,000 deaths in Southeast Asia, Western Pacific countries, ...

  8. Incidence of Peri-Intraventricular Haemorrhage and Its Associated Factors in Preterm Infants%早产儿脑室周围-脑室内出血影响因素分析

    Institute of Scientific and Technical Information of China (English)

    庞永红; 王建梅; 卢青; 邓晓毅; 刘松林; 丁玉红

    2012-01-01

    Objective; The aim of this study was to investigate the prevalence and potential risk factors of Peri/intraventricular hemorrhage (PIVH) in preterm infants. Methods: The studied population comprised 1,079 preterm infants treated at the Xuzhou Women and Children' s Health Care Hospital between January 1, 2011 to December 31, 2011. Haemorrhage was diagnosed on the basis of repeated ultrasounds performed between the first 48 and 72 hours of life. The relation between the incidence of PIVH and obstetrical risk factors were analyzed by contingency tables. Results: The investigations showed the incidence of haemorrhages was 63. 3% (683 infants). The 546 (79.9%) cases were diagnosed as PIVH I, 122 (17.9%) as PIVH II and 15 (2.2%) as PIVH III. A large percentage of cases had no clinical manifestations. With the decreasing of the gestational age, birth weight and Apgar score, the incidence of PIVH was increased (P2,500 g, 65. 0% in weight 1,500 ~ 2,500 g and 80. 2% in weight <1,500 g; 57.2% with Apgar scores 8-10 points, 82.0% with 4 ~7 points and 88.9% with 0 ~3 points. Conclusions: (1) The incidence of PIVH was very high. This study suggests that ultrasound screening should be reserved to all premature infants. (2) The incidence of PIVH is related to gestational age, birth weight and perinatal asphyxia in preterm infants.%目的:探讨早产儿脑室周围-脑室内出血(peri/intraventricular hemorrhage,PIVH)的发生率及影响因素.方法:对2011年1月1日至2011年12月31日在徐州市妇幼保健院住院的1079例早产儿于生后48~ 72 h做头颅B超检查,用列联表法调查早产儿PIVH发生率与胎龄、出生体重和窒息之间的关系.结果:(1)2011年全年该院早产儿PIVH发生率为63.3%,其中Ⅰ级546例(79.9%),Ⅱ级122例(17.9%),Ⅲ级15例(2.2%).大部分病例没有临床表现.(2)随着胎龄、出生体重和Apgar评分的降低,PIVH的发生率升高(P<0.01).34 ~ 36 w、31~ 33 w和28~ 30 w三组

  9. Airborne Transmission of Coxiella burnetii : Spatial dispersion modelling and the effects of meteorological and environmental conditions on Q fever incidence

    NARCIS (Netherlands)

    van Leuken, J.P.G.

    2015-01-01

    The Netherlands experienced the largest human and veterinary Q fever epidemic ever described. From 2007 through 2010, over 4,000 human cases were notified and approximately a twelve-fold higher number was probably infected by Coxiella burnetii, the causative agent of Q fever. Dairy goat farms, and t

  10. The Effects of Socioeconomic and Environmental Factors on the Incidence of Dengue Fever in the Pearl River Delta, China, 2013.

    Directory of Open Access Journals (Sweden)

    Xiaopeng Qi

    2015-10-01

    Full Text Available An outbreak of dengue fever (DF occurred in Guangdong Province, China in 2013 with the highest number of cases observed within the preceding ten years. DF cases were clustered in the Pearl River Delta economic zone (PRD in Guangdong Province, which accounted for 99.6% of all cases in Guangdong province in 2013. The main vector in PRD was Aedes albopictus. We investigated the socioeconomic and environmental factors at the township level and explored how the independent variables jointly affect the DF epidemic in the PRD.Six factors associated with the incidence of DF were identified in this project, representing the urbanization, poverty, accessibility and vegetation, and were considered to be core contributors to the occurrence of DF from the perspective of the social economy and the environment. Analyses were performed with Generalized Additive Models (GAM to fit parametric and non-parametric functions to the relationships between the response and predictors. We used a spline-smooth technique and plotted the predicted against the observed co-variable value. The distribution of DF cases was over-dispersed and fit the negative binomial function better. The effects of all six socioeconomic and environmental variables were found to be significant at the 0.001 level and the model explained 45.1% of the deviance by DF incidence. There was a higher risk of DF infection among people living at the prefectural boundary or in the urban areas than among those living in other areas in the PRD. The relative risk of living at the prefectural boundary was higher than that of living in the urban areas. The associations between the DF cases and population density, GDP per capita, road density, and NDVI were nonlinear. In general, higher "road density" or lower "GDP per capita" were considered to be consistent risk factors. Moreover, higher or lower values of "population density" and "NDVI" could result in an increase in DF cases.In this study, we presented an

  11. Pulmonary haemorrhage and nephritis

    African Journals Online (AJOL)

    1983-04-30

    Apr 30, 1983 ... Treatment was commenced with penicillin and cefamandole and the patient was ..... reports may have described patients not as ill as this woman. Pathological discussion ... only possible with a direct immunofluorescence study, upon which classification of lung ... phages suggesting previous haemorrhage.

  12. Anterior ischemic optic neuropathy following dengue fever.

    Science.gov (United States)

    Ramakrishnan, Reshma; Shrivastava, Saurabh; Deshpande, Shrikant; Patkar, Priyanka

    2016-01-01

    Dengue fever is caused by a flavivirus. This infection is endemic in the tropics and warm temperate regions of the world. Ocular manifestations of dengue fever include subconjunctival, vitreous, and retinal haemorrhages; posterior uveitis; optic neuritis; and maculopathies, haemorrhage, and oedema. However anterior ischemic optic neuropathy is a rare presentation. Optic nerve ischemia most frequently occurs at the optic nerve head, where structural crowding of nerve fibers and reduction of the vascular supply may combine to impair perfusion to a critical degree and produce optic disc oedema. Here we present a case of anterior ischemic optic neurapathy associated with dengue fever.

  13. Korean Hemorrhagic Fever.

    Science.gov (United States)

    1981-03-31

    infectious virus was present in this organ at least 440 days after infection. Virus was recovered from kidney and parotid glands from about 15 to 43...beginning 10-15 days after inoculation. This type of host response provides excellent experimental evidence confirming the long-held epidemiological ...30. Vasyuta, Yu, S. The epidemiology of haemorrhagic fever with renal syndrome in the E.S.F.S.R.Zh. Mikrobiol. Epidemiol. Immunol., 32: 49-56, 1961. 31

  14. [Haemorrhage after thyroid surgery].

    Science.gov (United States)

    Swirta, Jarosław S; Barczyński, Marcin

    2014-01-01

    Haemorrhage after thyroid surgery is rare, but if it occurs it is a life-threatening condition necessitating emergency surgery. The aim of this study was to evaluate prevalence and risk factors of haemorrhage after thyroid surgery. A retrospective analysis was undertaken in a group of 8931 consecutive patients with various thyroid diseases treated in 2004-2013 at our institution. Potential risk factors for postoperative haemorrhage after thyroid surgery were analysed using logistic regression model. Haemorrhage after thyroid operation necessitating emergency surgery occurred in 40 (0.45%) of 8931 patients. None of the patients died within the perioperative period. Bleeding occurred within first 24 hours following surgery in 38 (95%) patients, and in the remaining 2 (5%) patients in more than 24 hours after initial surgery. The following risk factors for bleeding after thyroid operation were identified: male sex (OR 3.618; 1.762-7.430; p or = 70 years (OR 3.052; 1.275-7.304; p = 0.012), surgery for hyperthyroidism (OR 2.873; 1.511-5.462; p = 0.001), smoking (OR 2.855; 1.502-5.428; p = 0.001), subtotal thyroidectomy in contrast to total thyroidectomy or lobectomy (OR 2.853; 1.356-6.004; p=0.006), and thyroid operation undertaken by resident in training in general surgery (OR 2.596; 1.393-4.837; p = 0.003). Haemorrhage after thyroid operation necessitating emergency surgical intervention occurs most frequently within first 24 hour following surgery. Hence, for safety reasons a minimum of 24-hour hospital stay is recommended in all patients with risk factors for postoperative bleeding after thyroid operation. Quality monitoring of thyroid surgery should include also risk factors for postoperative bleeding.

  15. Incidence of Dengue Hemorrhagic Fever Related to Annual Rainfall, Population Density, Larval Free Index and Prevention Program in Bandung 2008 to 2011

    Directory of Open Access Journals (Sweden)

    Anggia Karina

    2015-06-01

    Full Text Available Background: Dengue Hemorrhagic Fever (DHF remains one of health problems in all provinces in Indonesia including West Java. Bandung as the capital of West Java province has dengue prevalence that is above the average prevalence of all provinces. This study aimed to describe the pattern of dengue incidence rate, annual rainfall, population density, and larval free index as well as the implementation of prevention program in sub-districts with the highest incidence rate in Bandung between 2008 and 2011. Methods: A descriptive retrospective study was conducted in September 2012 using secondary data during the period of January 2008 to December 2011. The incidence rate was calculated based on DHF patients who live in Bandung. Data were analyzed using computer and Arc View 3.3. Pattern of incidence rate was characterized with red, yellow, and green region respectively. Results: The highest incidence rate of DHF occurred in 2009. Incidence increased in January to February and declined in the end of the year. Subdistricts with highest incidence had no highest annual rainfall and the population density below the average of population density in Bandung. The highest implementation of fogging program was not only performed in high incidence subdistricts but also in area with larval free index less than 95%. Larval free index in subdistricts with highest incidence were not all below 95%. Conclusions: Incidence of DHF increases after months of highly rainfall. The pattern of incidence rate in all subdistrict is dynamic and suspected do not related to annual rainfall, population density, high larva free index, and frequency of fogging.

  16. Expulsive choroidal haemorrhage

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    Srinivasan M

    1992-01-01

    Full Text Available Expulsive choroidal haemorrhage is a dramatic and serious complication of cataract surgery that occurred in five patients out of ten thousand consecutive cataract surgeries performed by the author during the year 1989 and 1990. Report about this dreaded complication after cataract surgery are scanty and as far as I can remember I have not seen any report in Indian ophthalmic literature recently. Since cataract surgery forms the major part of intra ocular surgeries performed in our country, I thought it would be appropriate to report about this rare complication which may occur to all of us. Out of five cases 3 were males and 2 were females in the age group ranging between 45-72 years. Two eyes regained vision up to 6/12 after intra operative expulsive haemorrhage. All the eyes were salvaged by doing anterior sclerotomy. Diabetes, hypertension, glaucoma and myopia are the commonest predisposing factors.

  17. Haemorrhage from Pancreatic Pseudocysts Presenting as Upper Gastrointestinal Haemorrhage

    Directory of Open Access Journals (Sweden)

    Giuseppe Garcea

    2004-04-01

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

  18. European research priorities for intracerebral haemorrhage.

    Science.gov (United States)

    Steiner, Thorsten; Petersson, Jesper; Al-Shahi Salman, Rustam; Christensen, Hanne; Cordonnier, Charlotte; Csiba, Laszlo; Harnof, Sagi; Krieger, Derk; Mendelow, David; Molina, Carlos; Montaner, Joan; Overgaard, Karsten; Roine, Risto O; Schmutzhard, Erich; Tatlisumak, Turgut; Toni, Danilo; Stapf, Christian

    2011-01-01

    Over 2 million people are affected by intracerebral haemorrhage (ICH) worldwide every year, one third of them dying within 1 month, and many survivors being left with permanent disability. Unlike most other stroke types, the incidence, morbidity and mortality of ICH have not declined over time. No standardised diagnostic workup for the detection of the various underlying causes of ICH currently exists, and the evidence for medical or surgical therapeutic interventions remains limited. A dedicated European research programme for ICH is needed to identify ways to reduce the burden of ICH-related death and disability. The European Research Network on Intracerebral Haemorrhage EURONICH is a multidisciplinary academic research collaboration that has been established to define current research priorities and to conduct large clinical studies on all aspects of ICH.

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  20. The incidence of fever in US Critical Care Air Transport Team combat trauma patients evacuated from the theater between March 2009 and March 2010.

    Science.gov (United States)

    Minnick, Joanne M; Bebarta, Vikhyat S; Stanton, Marietta; Lairet, Julio R; King, James; Torres, Pedro; Aden, James; Ramirez, Rosemarie

    2013-11-01

    Most critically ill injured patients are transported out of the theater by Critical Care Air Transport Teams (CCATTs). Fever after trauma is correlated with surgical complications and infection. The purposes of this study are to identify the incidence of elevated temperature in patients managed in the CCATT environment and to describe the complications reported and the treatments used in these patients. We performed a retrospective review of available records of trauma patients from the combat theater between March 1, 2009, and March 31, 2010, who were transported by the US Air Force CCATT and had an incidence of hyperthermia. We then divided the cohort into 2 groups, patients transported with an elevation in temperature greater than 100.4°F and patients with no documented elevation in temperature. We used a standardized, secure electronic data collection form to abstract the outcomes. Descriptive data collected included injury type, temperature, use of a mechanical ventilator, cooling treatment modalities, antipyretics, intravenous fluid administration, and use of blood products. We also evaluated the incidence of complications during the transport in patients who had a recorded elevation in temperature greater than 100.4°F. A total of 248 trauma patients met the inclusion criteria, and 101 trauma patients (40%) had fever. The mean age was 28 years, and 98% of patients were men. The mechanism of injury was an explosion in 156 patients (63%), blunt injury in 11 (4%), and penetrating injury in 45 (18%), whereas other trauma-related injuries accounted for 36 patients (15%). Of the patients, 209 (84%) had battle-related injuries and 39 (16%) had non-battle-related injuries. Traumatic brain injury was found in 24 patients (24%) with an incidence of elevated temperature. The mean temperature was 101.6°F (range, 100.5°F-103.9°F). After evaluation of therapies and treatments, 80 trauma patients (51%) were intubated on a mechanical ventilator (P trauma patients with

  1. Relationship of climate, geography, and geology to the incidence of Rift Valley fever in Kenya during the 2006-2007 outbreak.

    Science.gov (United States)

    Hightower, Allen; Kinkade, Carl; Nguku, Patrick M; Anyangu, Amwayi; Mutonga, David; Omolo, Jared; Njenga, M Kariuki; Feikin, Daniel R; Schnabel, David; Ombok, Maurice; Breiman, Robert F

    2012-02-01

    We estimated Rift Valley fever (RVF) incidence as a function of geological, geographical, and climatological factors during the 2006-2007 RVF epidemic in Kenya. Location information was obtained for 214 of 340 (63%) confirmed and probable RVF cases that occurred during an outbreak from November 1, 2006 to February 28, 2007. Locations with subtypes of solonetz, calcisols, solonchaks, and planosols soil types were highly associated with RVF occurrence during the outbreak period. Increased rainfall and higher greenness measures before the outbreak were associated with increased risk. RVF was more likely to occur on plains, in densely bushed areas, at lower elevations, and in the Somalia acacia ecological zone. Cases occurred in three spatial temporal clusters that differed by the date of associated rainfall, soil type, and land usage.

  2. Milk fever and subclinical hypocalcaemia--an evaluation of parameters on incidence risk, diagnosis, risk factors and biological effects as input for a decision support system for disease control.

    Science.gov (United States)

    Houe, H; Østergaard, S; Thilsing-Hansen, T; Jørgensen, R J; Larsen, T; Sørensen, J T; Agger, J F; Blom, J Y

    2001-01-01

    The present review analyses the documentation on incidence, diagnosis, risk factors and effects of milk fever and subclinical hypocalcaemia. It is hereby evaluated whether the existing documentation seems sufficient for further modelling in a decision support system for selection of a control strategy. Several studies have been carried out revealing an incidence of milk fever most often in the level of 5-10%. Few studies indicate that the incidence of subclinical hypocalcaemia is several times higher than milk fever. The diagnosis based on clinical or laboratory methods or based on presence of risk factors is outlined. The clinical symptoms of milk fever are highly specific and the disease level may thus be determined from recording of treatments. Diagnosis of subclinical hypocalcaemia needs to include laboratory examinations or it may be determined by multiplying the incidence of milk fever by a certain factor. From the documentation on risk factors, it is very complex to predict the incidence from the exposure level of the risk factors. Due to uncertainty, sensitivity analyses over a wide range of values for each parameter are needed. The documentation of cow characteristics, nutrition, environment and management as risk factors are described. Among cow characteristics, parity or age, body condition and production level were found to be important. Risk factors associated with nutrition included most importantly dietary cation-anion difference and calcium level whereas the importance of general feeding related factors like type of feed stuff and feeding level were less clear. Environment and management included season, climate, housing, pasturing, exercise, length of dry period and prepartum milking. Several of the parameters on environment and management were confounded among each other and therefore firm conclusions on the importance were difficult. The documentation of the effect of milk fever includes the downer cows, reproductive disorders, occurrence of

  3. African tick bite fever

    DEFF Research Database (Denmark)

    Johansen, Jakob Aaquist; Thybo, Søren

    2011-01-01

    The incident of spotted fever imported to Denmark is unknown. We present a classic case of African Tick Bite Fever (ATBF) to highlight a disease, which frequently infects wildlife enthusiasts and hunters on vacation in South Africa. ATBF has a good prognosis and is easily treated with doxycyclin...

  4. 经皮冠状动脉介入治疗1年内上消化道出血分析%Incidence and predictors of upper gastrointestinal haemorrhage post percutaneous coronary interventions within one year

    Institute of Scientific and Technical Information of China (English)

    赵新国; 岳玉国; 陈伟良; 邸军军

    2011-01-01

    目的:探讨冠心病患者经皮冠状动脉介入治疗(PCI)后1年内,引起上消化道出血(UGH)的主要危险因素.方法:选择行PCI的冠心病患者432例,分析比较1年内发生UGH和未发生UGH患者的临床资料的差异.结果:本组UGH发生率为5.3%(23/432),其中,高龄、急性心肌梗死、既往有消化性溃疡病史、合并慢性支气管炎的患者UGH发生率较高,分别为6.7%、11.5%、9.6%和9.8%,与相应患者比较差异有统计学意义(P<0.05).术中应用血小板GPⅡb/Ⅲa受体拮抗剂的患者UGH发生率(12.5%)高于未应用血小板GPⅡb/Ⅲa受体拮抗剂的患者(2.7%),差异有统计学意义(P<0.01).围术期使用和术后1年内间断使用质子泵抑制剂的患者UGH发生率(2.2%)与未使用的患者(13.7%)比较,差异有统计学意义(P<0.05).结论:高龄、急性心肌梗死、既往有消化性溃疡病史、合并慢性支气管炎增加PCI后UGH的发生,术中应用Ⅱb/Ⅲa受体拮抗剂进一步增加UGH,制酸药物质子泵抑制剂可减小UGH的风险.%Objective: To observe the incidence and the predictors of upper gastrointestinal haemorrhage (UGH) in patients underwent percutaneous coronary interventions (PCI) within one year. Method: From April 2005 to April 2008, a total of 432 patients underwent PCI in our hospital were recruited. The clinical characteristics were analyzed for comparing the differences between UGH and no-UGH patients during one year after procedure. Result:UGH occurred in 23 out of 432 PCI patients (5.3%), and the incidence of UGH was significantly higher in patients aged more than 75 years (6.7%), admission with acute myocardial infarction (11.5 %), peptic ulcer history (9.6%) , chronic bronchitis (9.8%) than patients without above factors. There were significant differences (P<0.05). Low molecular weight heparin and platelet glucoprotein Ⅱ b/Ⅲ a receptor antagonist use during the procedure contributed to the development of UGH, so a higher

  5. Consent for Brain Tissue Donation after Intracerebral Haemorrhage: A Community-Based Study.

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    Neshika Samarasekera

    Full Text Available Spontaneous intracerebral haemorrhage is a devastating form of stroke and its incidence increases with age. Obtaining brain tissue following intracerebral haemorrhage helps to understand its cause. Given declining autopsy rates worldwide, the feasibility of establishing an autopsy-based collection and its generalisability are uncertain.We used multiple overlapping sources of case ascertainment to identify every adult diagnosed with intracerebral haemorrhage between 1st June 2010-31st May 2012, whilst resident in the Lothian region of Scotland. We sought consent from patients with intracerebral haemorrhage (or their nearest relative if the patient lacked mental capacity to conduct a research autopsy.Of 295 adults with acute intracerebral haemorrhage, 110 (37% could not be approached to consider donation. Of 185 adults/relatives approached, 91 (49% consented to research autopsy. There were no differences in baseline demographic variables or markers of intracerebral haemorrhage severity between consenters and non-consenters. Adults who died and became donors (n = 46 differed from the rest of the cohort (n = 249 by being older (median age 80, IQR 76-86 vs. 75, IQR 65-83, p = 0.002 and having larger haemorrhages (median volume 23 ml, IQR 13-50 vs. 13 ml, IQR 4-40; p = 0.002.Nearly half of those approached consent to brain tissue donation after acute intracerebral haemorrhage. The characteristics of adults who gave consent were comparable to those in an entire community, although those who donate early are older and have larger haemorrhage volumes.

  6. Intracerebral haemorrhage after carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Boesen, J

    1987-01-01

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

  7. Q Fever Update, Maritime Canada

    Science.gov (United States)

    Marrie, Thomas J.; Campbell, Nancy; McNeil, Shelly A.; Webster, Duncan

    2008-01-01

    Since the 1990s, reports of Q fever in Nova Scotia, Canada, have declined. Passive surveillance for Q fever in Nova Scotia and its neighboring provinces in eastern Canada indicates that the clinical manifestation of Q fever in the Maritime provinces is pneumonia and that incidence of the disease may fluctuate. PMID:18258080

  8. Towards an improved understanding of African swine fever virus transmission

    NARCIS (Netherlands)

    Cardoso de Carvalho Ferreira, H.

    2013-01-01

    African swine fever is a haemorrhagic disease of swine caused by African swine fever virus (ASFV). Estimates of virus transmission (direct or indirect) parameters for ASFV are necessary in order to model the spread of the virus, and to design more efficient control measures. Results presented on thi

  9. Fever monitoring program in areas with high incidence of typhoid and paratyphoid fever in Guizhou province%贵州省伤寒、副伤寒高发区发热症状监测分析

    Institute of Scientific and Technical Information of China (English)

    姚光海; 唐光鹏; 田克诚; 张静; 孙军玲; 王子军; 蒋有琴; 赵启良; 陈学

    2013-01-01

    Objective To understand the incidence rates of both typhoid fever and paratyphoid fever in the high prevalent areas of Guizhou province so as to provide evidence for the development of programs on comprehensive intervention and effectiveness evaluation.Methods Six townships in Pingba county were selected as intervention areas while six townships in Kaiyang county were taken as control.All hospitals and clinics were classified into A,B and C types according to its level and the capacity of the blood culture.Surveillance on typhoid and paratyphoid fever was conducted based on all population and all hospitals,clinics and county CDCs among the patients with unknown fever.Results In the surveillance area in those two counties,there were 12 944 blood samples from patients with unknown fever which have been tested and cultured.Among them,200 strains of Salmonella including 16 typhoid strains,184 paratyphoid A strains were identified,with the total positive rate as 1.55%.The positive rate before the intervention program was higher than the after.The detection rate was 1.91% in the type A hospitals.39 strains of Salmonella have been cultured from 2039 samples which accounting for 19.50% (39/200) of the total strains.4315 blood samples were cultured at the 'Class B' sites which isolated 82 strains of Salmonella,accounting for 41.00%(82/200),with a detection rate as 1.90%.6590 samples were cultured at the 'Class C' sites,which identified 79 strains of Salmonella,accounting for 39.50% (79/200),with a detection rate as 1.20%.The detection rate was much higher before the use of antibiotics than after using them (P<0.05).The annual peak time of positive detection was in spring and fall.The outbreaks or epidemics often appeared in the same places,with farmers,students as the high-risk populations.Symptoms of both typhoid and paratyphoid fever were not typical.Conclusion Typhoid and paratyphoid monitoring programs which covered primary health care institutions in

  10. Hemorragia postparto Postpartum haemorrhage

    Directory of Open Access Journals (Sweden)

    H. Karlsson

    2009-01-01

    Full Text Available La hemorragia postparto es una de las complicaciones obstétricas más temidas y es una de las tres primeras causas de mortalidad materna en el mundo. Universalmente se define como la pérdida hemática superior a 500 ml tras un parto vaginal o a 1.000 ml tras una cesárea. La hemorragia postparto precoz (HPP es aquella que ocurre durante las primeras 24 horas tras el parto y es generalmente la más grave. Las causas de HPP incluyen atonía uterina, traumas/laceraciones, retención de productos de la concepción y alteraciones de la coagulación, siendo la más frecuente la atonía. El diagnóstico es clínico y el tratamiento ha de abarcar unas medidas generales de soporte vital y otras más específicas de carácter etiológico. Afortunadamente, es potencialmente evitable en la mayoría de los casos si se sigue una adecuada estrategia de prevención activa y sistemática en la fase de alumbramiento de todos los partos.Postpartum haemorrhage is one of the most dreaded obstetric complications and one of the three main causes of maternal mortality in the world. It is universally defined as haematic loss above 500 ml following a vaginal delivery or above 1,000 ml following a caesarean. An early postpartum haemorrhage (EPH is one that occurs during the first 24 hours following delivery and is generally the most serious. The causes of EPH include uterine atony, trauma/lacerations, retention of products of conception and alterations of coagulation, with atony being the most frequent. Diagnose is clinical and treatment must include general life support measures and other more specific measures of an etiological character. Fortunately, in the majority of cases it is potentially avoidable if an adequate strategy of active and systematic prevention is followed in the delivery phase of all labors.

  11. Modelling spatial concordance between Rocky Mountain spotted fever disease incidence and habitat probability of its vector Dermacentor variabilis (American dog tick

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    Samuel F. Atkinson

    2012-11-01

    Full Text Available The spatial distribution of Dermacentor variabilis, the most commonly identified vector of the bacterium Rickettsia rickettsii which causes Rocky Mountain spotted fever (RMSF in humans, and the spatial distribution of RMSF, have not been previously studied in the south central United States of America, particularly in Texas. From an epidemiological perspective, one would tend to hypothesise that there would be a high degree of spatial concordance between the habitat suitability for the tick and the incidence of the disease. Both maximum-entropy modelling of the tick’s habitat suitability and spatially adaptive filters modelling of the human incidence of RMSF disease provide reliable portrayals of the spatial distributions of these phenomenons. Even though rates of human cases of RMSF in Texas and rates of Dermacentor ticks infected with Rickettsia bacteria are both relatively low in Texas, the best data currently available allows a preliminary indication that the assumption of high levels of spatial concordance would not be correct in Texas (Kappa coefficient of agreement = 0.17. It will take substantially more data to provide conclusive findings, and to understand the results reported here, but this study provides an approach to begin understanding the discrepancy.

  12. Subarachnoid Haemorrhage and Sports

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    Liliana Sousa Nanji

    2015-11-01

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

  13. The incidence of acute rheumatic fever and chronic rheumatic heart disease in the Russian population (2011–2012

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    Rimma Mikhailovna Balabanova

    2014-03-01

    Full Text Available The problems of acute rheumatic fever (ARF and chronic rheumatic heart disease (CRHD are discussed. Carditis, polyarthritis, erythema annulare, subcutaneous nodules, and chorea minor are the main clinical manifestations of ARF caused by β-hemolytic streptococcus A. Cardiac failures emerge in 60–65% of patients after the first ARF episode. Repeated ARF attacks promote CRHD. The aim of the study is to evaluate the prevalence of rheumatic heart disease in different age groups in the regions of Russian Federation in 2011–2012. Materials and Methods. Analysis of the Ministry of Healthcare of the Russian Federation reports on population morbidity in 2011–2012 (Form N12.Results. The highest ARF prevalence was observed in 15–17-year-old teenagers, while the lowest, in adults over 18-year-old. The lowest CRHD figures were registered in juniors, while the highest ones, in adults. No ARF cases in 0–14-year-old children were registered in 31 entities of the Russian Federation; single cases, in 17 entities; no ARF cases in 15–17-year-old teenagers was registered in 37 entities, and 1–2 ARF cases were registered in 23 entities. Only in 10 entities, no ARF cases were registered in adults, and single cases were registered in 22 entities. Extremely unfavorable situations were found in the Chechen Republic (140 ARF cases in 0–14-year-old children and in the Dagestan Republic (140 cases. High morbidity among 15–17-year-old teenagers was registered in tje Kaliningrad region (83 cases and the Chechen Republic (100. ARF cases in adults were most frequent in St. Petersburg (124 cases, the Chechen Republic (154, and the Moscow region (161.The article lists the ARF and CRHD preventive measures.

  14. The incidence of acute rheumatic fever and chronic rheumatic heart disease in the Russian population (2011–2012

    Directory of Open Access Journals (Sweden)

    Rimma Mikhailovna Balabanova

    2014-01-01

    Full Text Available The problems of acute rheumatic fever (ARF and chronic rheumatic heart disease (CRHD are discussed. Carditis, polyarthritis, erythema annulare, subcutaneous nodules, and chorea minor are the main clinical manifestations of ARF caused by β-hemolytic streptococcus A. Cardiac failures emerge in 60–65% of patients after the first ARF episode. Repeated ARF attacks promote CRHD. The aim of the study is to evaluate the prevalence of rheumatic heart disease in different age groups in the regions of Russian Federation in 2011–2012. Materials and Methods. Analysis of the Ministry of Healthcare of the Russian Federation reports on population morbidity in 2011–2012 (Form N12.Results. The highest ARF prevalence was observed in 15–17-year-old teenagers, while the lowest, in adults over 18-year-old. The lowest CRHD figures were registered in juniors, while the highest ones, in adults. No ARF cases in 0–14-year-old children were registered in 31 entities of the Russian Federation; single cases, in 17 entities; no ARF cases in 15–17-year-old teenagers was registered in 37 entities, and 1–2 ARF cases were registered in 23 entities. Only in 10 entities, no ARF cases were registered in adults, and single cases were registered in 22 entities. Extremely unfavorable situations were found in the Chechen Republic (140 ARF cases in 0–14-year-old children and in the Dagestan Republic (140 cases. High morbidity among 15–17-year-old teenagers was registered in tje Kaliningrad region (83 cases and the Chechen Republic (100. ARF cases in adults were most frequent in St. Petersburg (124 cases, the Chechen Republic (154, and the Moscow region (161.The article lists the ARF and CRHD preventive measures.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  16. The role of histology and other risk factors for post-tonsillectomy haemorrhage.

    Science.gov (United States)

    Schrock, A; Send, T; Heukamp, L; Gerstner, A O; Bootz, F; Jakob, M

    2009-12-01

    Tonsillectomy is a frequently performed surgical procedure in children and adults. Postoperative bleeding is the most severe complication; however, the factors leading to postoperative haemorrhage are still discussed controversially. 1,522 tonsillectomies were retrospectively reviewed. Histopathological tonsil composition was correlated with the incidence of postoperative haemorrhage. Patient charts were analysed with regard to demographic data, characteristics of postoperative haemorrhage and indication for surgery. Patients with post-tonsillectomy haemorrhage were compared with uneventful cases. Histopathological signs of cryptic tonsillitis and actinomyces infection displayed a statistically significant correlation with the risk of postoperative haemorrhage (P = 0.018 and P = 0.02), but the odds ratio was low (1.9 and 2.0). 7.7% of all patients had postoperative bleeding and 3.5% had to return to theatre for haemostasis. The incidence of haemorrhages within hospitalization (5 postoperative days) was 45% and after discharge 55%, respectively. In 11% of cases bleeding occurred on the fourth or fifth day after surgery. While gender, season of surgery, abscess tonsillectomy "en chaud" in comparison with elective tonsillectomy were not associated with an increased rate of postoperative haemorrhage (P > 0.05), significant more postoperative haemorrhages were detected in the group of adults (P = 0.02). Despite significant correlation of cryptic tonsillitis and actinomyces infection with postoperative haemorrhage, the risk for postoperative bleeding is only slightly elevated and, therefore, the predictive value is low. Because a multifactorial aetiology of post-tonsillectomy haemorrhage has to be assumed, large multicenter studies are necessary to evaluate the significance of different risk factors.

  17. Hemorrhagic Fevers

    Science.gov (United States)

    ... of viruses. These include the Ebola and Marburg, Lassa fever, and yellow fever viruses. VHFs have common features: ... the animals that carry them live. For example, Lassa fever is limited to rural areas of West Africa ...

  18. Acute Compressive Ulnar Neuropathy in a Patient of Dengue Fever: An Unusual Presentation

    Directory of Open Access Journals (Sweden)

    Anil K Mehtani

    2013-04-01

    Full Text Available Introduction: Dengue haemorrhagic fever is known for its haemorrhagic and neurologic complications. Neurologic complications are caused by three mechanism namely neurotropism, systemic complications causing encephalopathy and postinfectious immune-mediated mechanisms. However acute compressive neuropathy due to haemorrhage is not frequent and we could find no literature describing this Case Report: We report a case of acute compressive ulnar neuropathy due to peri neural hematoma, following an attempt at intravenous cannulation in the cubital fossa in a patient of dengue haemorrhagic fever with thrombocytopenia. Immediate fasciotomy and removal of haematoma was performed to relieve the symptoms. Conclusion: Compression neuropathies can be seen in dengue hemorrhagic fever and removal of compressing hematoma relieves symptoms. Keywords: Dengue haemmorrhagic fever; coagulopathy; peri neural haematoma.

  19. Male-female differences in the number of reported incident dengue fever cases in six Asian countries

    Directory of Open Access Journals (Sweden)

    Martha Anker

    2011-06-01

    Full Text Available Introduction. Demographic factors, such as age and sex, are associated with the likelihood of exposure to Aedes aegypti, the vector for dengue. However, dengue date disaggregated by both sex and ageare not routinely reported or analyzed by national surveillance systems. This study analysed the reported number of incident dengue cases by age and sex for six countries in Asia. Methods. Data for the Lao People's Democratic Republic, the Philippines, Singapore and Sri Lanka were obtained from DengueNet; the number of male and female dengue cases was available for four age groups ( 15 years over a cumulative period of six to 10 years. Data for Cambodia (2010 and Malaysia (1997–2008 were obtained from their respective ministries of health. Results. An excess of males was found among reported dengue cases > 15 years of age. This pattern was observed consistently over several years across six culturally and economically diverse countries. Discussion. These data indicated the importance of reporting data stratified by both sex and age since collapsing the data over all ages would have masked some of the observed differences. In order to target preventive measures appropriately, assessment of gender by age is important for dengue because biological or gender-related factors can change over the human lifespan and gender-related factors may differ across countries.

  20. Haemorrhagic Colitis Caused by Dasatinib

    Directory of Open Access Journals (Sweden)

    Nishant Patodi

    2012-01-01

    Full Text Available Gastrointestinal bleeding appears to be a common adverse event associated with dasatinib therapy. Here we present a case of a 59-year-old man with chronic myeloid leukaemia (CML developing the rarest complication of haemorrhagic colitis with dasatinib therapy which resolved rapidly after treatment withdrawal.

  1. Haemorrhagic Colitis Caused by Dasatinib

    Science.gov (United States)

    Patodi, Nishant; Sagar, Nidhi; Rudzki, Zbigniew; Langman, Gerald; Sharma, Naveen

    2012-01-01

    Gastrointestinal bleeding appears to be a common adverse event associated with dasatinib therapy. Here we present a case of a 59-year-old man with chronic myeloid leukaemia (CML) developing the rarest complication of haemorrhagic colitis with dasatinib therapy which resolved rapidly after treatment withdrawal. PMID:23316400

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

    OpenAIRE

    Abhiram Chakrabarti; Manab Nandy; Dipankar Pal; Sudesna Mallik

    2014-01-01

    Leptospirosis, a disease of protean manifestations occurs sporadically throughout the year with a peak seasonal incidence during the rainy season mimicking other febrile viral illness. In the rare case, the disease leads to renal and hepatic involvement with hemorrhage which may be associated with multisystem organ dysfunction in form of pulmonary, cardiac and central nervous system, when it is known as Weil's disease. Rarely haemorrhagic manifestations are assosciated. Early diagnosis is imp...

  3. Dengue fever with unusual thalamic involvement.

    Science.gov (United States)

    Mallick, Asim Kumar; Purkait, Radheshyam; Sinhamahapatra, Tapan Kumar

    2012-01-01

    Dengue is the most important mosquito-borne viral disease in the world and is caused by four distinct viruses (type 1 to 4) that are closely related antigenically. Infection by dengue virus may be asymptomatic or may lead to undifferentiated fever, dengue fever or dengue haemorrhagic fever. Recent observations indicate that the clinical profile of dengue is changing and the neurological complications are being reported more frequently. The neurological features includeheadache, seizures, neck stiffness, depressed sensorium, behavioural disorders, delirium, paralysis and cranial nerve palsies. Such neurological symptoms in dengue fever wereattributed to cerebral oedema, haemorrhage, haemoconcentration due to increasing vascular permeability, coagulopathy and release of toxic substances. Cerebral oedema, encephalitis-like changes (oedema and scattered focal lesions), intracranial haemorrhages as well as selective involvement of bilateral hippocampus in dengue infection have been reported previously on selective neuro-imaging but thalamic involvement is rare. We here report a case of a typical presentation of encephalopathy with left sided complete hemiplegia due to thalamic involvement in dengue infection.

  4. 埃博拉出血热%Ebola haemorrhagic fever

    Institute of Scientific and Technical Information of China (English)

    孙超

    2001-01-01

    埃博拉出血热(Ebola hemorrhagic fever,EbHF)亦称埃博拉病毒病(Ebola virus disease,EVD),是病死率很高的一种病毒性出血热。“埃博拉”原是刚果一条河流,1976年首宗埃博拉病例在那里出现,从此它成为这致命传染病的代号。

  5. Takotsubo cardiomyopathy following subarachnoid haemorrhage.

    Science.gov (United States)

    Maekawa, Hidetsugu; Hadeishi, Hiromu

    2014-08-01

    A 67-year-old woman was admitted with aneurysmal subarachnoid haemorrhage and a 12-lead ECG showed ST segment elevation. Transthoracic echocardiography confirmed akinesis of the left ventricular mid-apical segment, with an ejection fraction of 26%, features characteristic of takotsubo cardiomyopathy. Five days later, we identified thrombus in the apex of the left ventricle. Sixteen days after onset, the thrombus had disappeared and wall motion improved (ejection fraction 58%) without evidence of cardioembolism. Takotsubo cardiomyopathy is a cause of cardiac dysfunction after stroke, including SAH. It is characterised by transiently depressed contractile function of the left mid and apical ventricle, without obstructive coronary artery disease. Clinicians should suspect takotsubo cardiomyopathy in patients with subarachnoid haemorrhage who have an ECG abnormality. Echocardiography is needed to detect the distinctive regional wall motion abnormality. Despite its severity in the acute phase, takotsubo cardiomyopathy is self-limiting and its management is conservative.

  6. Return to theatre in secondary post-tonsillectomy haemorrhage: a comparison of coblation and dissection techniques.

    Science.gov (United States)

    Amir, Ida; Belloso, Antonio; Broomfield, Stephen J; Morar, Pradeep

    2012-02-01

    The aim of this study is to examine the incidence of return to theatre (RTT) for post-operative haemorrhage following coblation and dissection tonsillectomy and to investigate those that required RTT more than 10 days post-surgery. Retrospective review of post-tonsillectomy haemorrhages requiring RTT from April 2005 to March 2009 was conducted. Of 2,541 tonsillectomies performed, 81% were by coblation and 19% by dissection methods. The overall RTT rate was 1.7%. No difference was found in the overall RTT rates for primary and secondary haemorrhage between the two techniques. However, the overall RTT rates for primary and secondary haemorrhage were higher in adults than children (P = 0.0456 and P = 0.0215, respectively). RTT for secondary haemorrhage during the first ten post-operative days occurred in both coblation and dissection tonsillectomy with no significant difference. After the first post-operative week, late secondary bleeding requiring RTT occurred only in the coblation group (P = 0.0676). Four patients required blood transfusion; all were in the coblation group, three of which were required during RTT in the late secondary haemorrhage (after 10 days). The post-operative RTT rates for coblation tonsillectomy did not reveal a change of trend over the 4-year study period. Our RTT rate for secondary haemorrhage is higher than earlier published results. A learning curve could not be identified in RTT for coblation tonsillectomy haemorrhage. Late secondary haemorrhages requiring surgical intervention have only been identified in cases performed by coblation and could potentially be life threatening as 33% (3/9) required blood transfusion. This phenomenon may be explained by a particular physiological healing process associated with coblation.

  7. relapsing fever, a disappearing cause of fever and maternal death in ...

    African Journals Online (AJOL)

    2013-04-01

    Apr 1, 2013 ... Objective: To study the incidence of tick borne relapsing fever (TBRF) during the last. 50 years ... fever was a disease of major worldwide importance, affecting ... of Diseases (ICD) of the World Health Organization. Reporting ...

  8. Sensorineural hearing loss in Lassa fever: two case reports

    Directory of Open Access Journals (Sweden)

    Okokhere Peter O

    2009-01-01

    Full Text Available Abstract Introduction Lassa fever is an acute arena viral haemorrhagic fever with varied neurological sequelae. Sensorineural hearing loss is one of the rare complications which occur usually during the convalescent stage of the infection. Case presentation The cases of two female patients aged 19 and 43 years old, respectively, with clinical features suggestive of Lassa fever and confirmed by immunoserological/Lassa-virus-specific reverse transcriptase polymerase chain reaction are presented. Both patients developed severe sensorineural hearing loss at acute phases of the infections. Conclusion Sensorineural hearing loss from Lassa fever infections can occur in both acute and convalescent stages and is probably induced by an immune response.

  9. Valley Fever

    Science.gov (United States)

    Valley Fever is a disease caused by a fungus (or mold) called Coccidioides. The fungi live in the soil ... from person to person. Anyone can get Valley Fever. But it's most common among older adults, especially ...

  10. Lassa Fever

    Science.gov (United States)

    ... The CDC Cancel Submit Search The CDC Lassa Fever Note: Javascript is disabled or is not supported ... French) Recommend on Facebook Tweet Share Compartir Lassa fever is an acute viral illness that occurs in ...

  11. Scarlet fever

    Science.gov (United States)

    ... the throat infection. This is crucial to prevent rheumatic fever, a serious complication of strep throat and scarlet ... with the right treatment, but may include: Acute rheumatic fever , which can affect the heart, joints, skin, and ...

  12. Increased post-operative haemorrhage seen in adult coblation tonsillectomy.

    Science.gov (United States)

    Noon, A P; Hargreaves, S

    2003-09-01

    Coblation is a new soft tissue surgical technique that is being used for tonsillectomy. Published results show a significant decrease in the amount of post-operative pain experienced by patients undergoing coblation tonsillectomy. There has been no published work to date on the incidence of post-operative haemorrhage. From August 2001 to November 2002 one surgeon performed 36 coblation tonsillectomies on adults. On another list he performed 29 by his standard method of dissection and bipolar coagulation. Retrospective analysis found a significant increase in the secondary haemorrhage rate in adult patients undergoing coblation tonsillectomy (22.2 vs. 3.4 per cent). At our department coblation tonsillectomy has been abandoned until further work into its safety has been published.

  13. Dengue fever presenting as acute liver failure- a case report

    Institute of Scientific and Technical Information of China (English)

    Rajat Jhamb; Bineeta Kashyap; Ranga GS; Kumar A

    2011-01-01

    Dengue fever(DF) and dengue haemorrhagic fever(DHF) are important mosquito-borne viral diseases of humans and recognized as important emerging infectious diseases in the tropics and subtropics. Compared to nine reporting countries in the 1950s, today the geographic distribution includes more than100 countries worldwide. Dengue viral infections are known to present a diverse clinical spectrum, ranging from asymptomatic illness to fatal dengue shock syndrome. Mild hepatic dysfunction in dengue haemorrhagic fever is usual. However, its presentation as acute liver failure(ALF)is unusual. We report a patient with dengue shock syndrome who presented with acute liver failure and hepatic encephalopathy in a recent outbreak of dengue fever in Delhi, India.

  14. Influence of Fever and Hospital-Acquired Infection on the Incidence of Delayed Neurological Deficit and Poor Outcome after Aneurysmal Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    G. Logan Douds

    2012-01-01

    Full Text Available Although fever and infection have been implicated in the causation of delayed neurological deficits (DND and poor outcome after aneurysmal subarachnoid hemorrhage (SAH, the relationship between these two often related events has not been extensively studied. We reviewed these events through of our retrospective database of patients with SAH. Multivariate logistic regression was used to determine independent predictors of DND and poor outcome. A total of 186 patients were analyzed. DND was noted in 76 patients (45%. Fever was recorded in 102 patients (55%; infection was noted in 87 patients (47%. A patient with one infection was more likely to experience DND compared to a patient with no infections (adjusted OR 3.73, 95% CI 1.62, 8.59. For those with more than two infections the likelihood of DND was even greater (adjusted OR 4.24, 95% CI 1.55, 11.56. Patients with 1-2 days of fever were less likely to have a favorable outcome when compared to their counterparts with no fever (adjusted OR 0.19, 95% CI 0.06, 0.62. This trend worsened as the number of days febrile increased. These data suggest that the presence of infection is associated with DND, but that fever may have a stronger independent association with overall outcome.

  15. Adult-onset acute rheumatic fever.

    Science.gov (United States)

    Nakashima, Dainari; Ueda, Kohei; Tsukuda, Kyozo; Utsu, Noriaki; Kohki, Shimazu; Fushimi, Hiroaki; Miyakoshi, Kazuho

    2012-01-01

    A 62-year-old man was hospitalized for acute rheumatic fever. He had previously suffered from rheumatic fever at 15 years of age. The rheumatic fever was complicated by carditis, which caused valve disease that required surgical treatment. The incidence of rheumatic fever has decreased in most developed countries with improvements in sanitary conditions. The low incidence of this disease makes a timely and accurate diagnosis difficult. Due to the fact that both the first occurrence and recurrence of acute rheumatic fever can occur in the elderly and adults, this potential disease should not be overlooked when making a differential diagnosis.

  16. Leptospirosis among the self-supporting convicts of Andaman Island during the 1920s--the first report on pulmonary haemorrhage in leptospirosis?

    Science.gov (United States)

    Vijayachari, P; Sugunan, A P; Singh, S S; Mathur, P P

    2015-07-01

    Several researchers had carried out investigations on the possibility of existence of Weil's disease in Andaman Islands during early 20 th century. The first report of a series of confirmed cases of leptospirosis that occurred during 1929 was published in 1931.There were several reports during 1995 to 2009 that described detailed account of leptospirosis including various clinical syndromes. The possibility of pulmonary involvement in leptospirosis being a manifestation historically overlooked rather than newly emerged during the past two decades is examined in this review in the context of Andaman Islands. Two case series of leptospirosis, one occurred in 1929 and the other in 1996-1997 were reviewed with special emphasis on pulmonary involvement and haemorrhagic manifestations. The similarities and differences in the clinical profile of patients of the two case series were analysed. The review shows that respiratory system involvement and pulmonary haemorrhage as evidenced by presence of haemoptysis as a complication of leptospirosis was occurring during 1920s in Andaman Islands. The incidence of pulmonary involvement, however, rose from 9.4 per cent during 1929 to 52 per cent in 1996-1997. The case fatality ratio in patients with pulmonary involvement, which was 50 per cent during 1929 and 42.9 per cent during 1996-1997, was higher than that in cases without pulmonary involvement.Fever, conjunctival congestion, jaundice, vomiting, diarrhoea, hepatomagaly, haemoptysis, haematemesis and subconjunctival haemorrhage were common in both series. The case series in Andaman Islands in 1929 was probably the first report of pulmonary haemorrhage as a manifestation of leptospirosis. The increase in the incidence of pulmonary involvement in leptospirosis in the recent past is probably due to the increase in the density and diversity of its animal vectors,the broadening of the range of circulating serovars and the interactions between the vector and the agent. An increased

  17. Correlation between incidence of typhoid fever and climate changes in Beijing from the perspective of Six-qi%从六气角度探讨北京地区伤寒与气象变动的相关性

    Institute of Scientific and Technical Information of China (English)

    黄羚; 刘柳青; 宋娜; 吕智燚; 刘张博方; 贺娟

    2014-01-01

    Objective To investigate the correlation between incidence of typhoid fever and climate changes in Beijing from the perspective of Six -qi.Methods Meteorological data and clinical data were collected in Beijing from 1985 to 2004 including:average temperature , water-vapor pressure , relative humidity , precipitation and wind speed.Each year was divided into six stages from the perspective of Six -qi theory.Correlation between incidence of typhoid fever and climate changes was analyzed with SPSS 19.0 in method of one-factor ANOVA and multiple linear regression.Results The outcome number of typhoid fever in the third stage was larger than other stages .The inci-dence of typhoid fever was positively correlated with average temperature , relative humidity, water-vapor pressure andprecipitation,thecorrelationwasstatisticallysignificant(P<0.05).Conclusion :Theincidenceoftyphoid fever in Beijing was correlated with climate changes .Different meteorological factors inordinately influenced the inci-dence of typhoid fever .It is feasible to predict the prevalence of typhoid fever by using the meteorological data in pre -vious year .%目的:根据中医运气学说理论,从六气角度探讨伤寒发病与气象变动的相关性,讨论各气象因素对伤寒发病的影响。方法回顾北京市1985-2004年907例伤寒发病人数及相应的气象资料,包括平均气温、平均降水量、平均湿度、平均水汽压及平均风速。将各气象因子与伤寒发病数据按六气分段进行相关性分析。分别将前一年和当年的气象资料与伤寒发病人数进行单因素相关分析,将相关性较高的气象因子纳入多元逐步回归方程,建立回归模型,比较二者的关联性。结果终之气、初之气为伤寒低发时期,三之气和四之气期间为高发时期,三之气最高。伤寒的发病与前一年平均气温、平均降水量、平均湿度、平均水汽压呈正相关,与

  18. African swine fever : transboundary diseases

    Directory of Open Access Journals (Sweden)

    M-L. Penrith

    2009-09-01

    Full Text Available African swine fever (ASF is a devastating haemorrhagic fever of pigs that causes up to 100 % mortality, for which there is no vaccine. It is caused by a unique DNA virus that is maintained in an ancient cycle between warthogs and argasid ticks, making it the only known DNA arbovirus. ASF has a high potential for transboundary spread, and has twice been transported from Africa to other continents - Europe and subsequently the Caribbean and Brazil (1957, 1959 and the Caucasus (2007. It is also a devastating constraint for pig production in Africa. Research at Onderstepoort Veterinary Institute has made and is making important contributions to knowledge of this disease, focusing on the cycle in warthogs and tampans and transmission from that cycle to domestic pigs, resistance to its effects in domestic pigs, and the molecular genetic characterisation and epidemiology of the virus.

  19. The clinical presentation of preterm cerebellar haemorrhage

    NARCIS (Netherlands)

    G.M. Ecury-Goossen (Ginette); J. Dudink (Jeroen); M. Leguin (Maarten); M. Feijen-Roon (Monique); S. Horsch (Sandra); P. Govaert (Paul)

    2010-01-01

    textabstractThe objective of this study was to evaluate clinical symptoms and findings on cranial ultrasound (CUS) in preterm infants with cerebellar haemorrhage through retrospective analysis of all preterm infants with a postnatal CUS or MRI diagnosis of cerebellar haemorrhage admitted in a tertia

  20. Acute recurrent haemorrhage of an intracranial meningioma.

    Science.gov (United States)

    Bellut, David; Nern, Christian; Burkhardt, Jan-Karl; Könü, Dilek; Bertalanffy, Helmut; Krayenbühl, Niklaus

    2011-07-01

    Meningioma-associated haemorrhages are rare. To our knowledge this is the first report of a patient with an acute two-stage haemorrhage of a benign intracranial meningioma (World Health Organization grade I) verified by cranial CT scan and histopathological examination. Early surgery with complete tumour removal led to a good outcome for the patient. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Ultrasonically detectable cerebellar haemorrhage in preterm infants.

    LENUS (Irish Health Repository)

    McCarthy, Lisa Kenyon

    2011-07-01

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

  2. Estimation of acute and chronic Q fever incidence in children during a three-year outbreak in the Netherlands and a comparison with international literature

    NARCIS (Netherlands)

    Slok, Edwin N E; Dijkstra, Frederika; de Vries, Esther; Rietveld, Ariene; Wong, Albert; Notermans, Daan W; van Steenbergen, Jim E

    2015-01-01

    BACKGROUND: In the Dutch 2007-2009 Q fever outbreak Coxiella burnetii was transmitted aerogenically from dairy goat farms to those living in the surrounding areas. Relatively few children were reported. The true number of pediatric infections is unknown. In this study, we estimate the expected numbe

  3. Non-haemorrhagic obstetric shock.

    Science.gov (United States)

    Thomson, A J; Greer, I A

    2000-02-01

    The causes of non-haemorrhagic obstetric shock (pulmonary thromboembolism, amniotic fluid embolism, acute uterine inversion and sepsis) are uncommon but responsible for the majority of maternal deaths in the developed world. Clinically suspected pulmonary thromboembolism should be treated initially with heparin and objective testing should be performed. If the diagnosis is confirmed, heparin is usually continued until delivery, following which anticoagulation in the puerperium is achieved with either warfarin or heparin. Amniotic fluid embolism is a rare complication of pregnancy, occurring most commonly during labour. The management of amniotic fluid embolism involves maternal oxygenation, the maintenance of cardiac output and blood pressure, and the management of any associated coagulopathy. Acute uterine inversion arises most commonly following mismanagement of the third stage of labour. The shock in uterine inversion is neurogenic in origin, although there may also be profound haemorrhage. The management of this condition includes maternal resuscitation and replacement of the uterus either manually, surgically or by hydrostatic pressure. Genital tract sepsis remains a significant cause of maternal death, the most common predisposing factor being prolonged rupture of the fetal membranes. The management of septic shock in pregnancy includes resuscitation, identification of the source of infection and alteration of the systemic inflammatory response.

  4. Desmopressin Acetate in Intracranial Haemorrhage

    Directory of Open Access Journals (Sweden)

    Thomas Kapapa

    2014-01-01

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

  5. Rheumatic Fever.

    Science.gov (United States)

    Visvanathan; Manjarez; Zabriskie

    1999-10-01

    There have been numerous reports stating that treatment of acute rheumatic fever with either aspirin or corticosteroids does not alter the long-term outcome of rheumatic heart disease. Yet, it should be emphasized that most of these studies were carried out with the first generic corticosteroids before the advent of the more active and more potent corticosteroid agents. In spite of this caveat, there is no question that all the clinical and laboratory parameters of inflammation (erythrocyte sedimentation rate, C-reactive protein) return to normal much more rapidly with corticosteroids than with aspirin alone. It is therefore our belief that steroids should be used when clinical and laboratory evidence of carditis exists, and aspirin should be reserved for cases of acute rheumatic arthritis with no evidence of carditis. The incidence of long-term valvular disease in active carditis may be decreased with steroid therapy. For example, the number of valve replacements differs markedly in centers that do use steroids and in those that do not. In Capetown, South Africa, where steroids are routinely used for carditis, valve replacement is quite rare. In contrast, in Johannesburg, where steroids are rarely used, the rate of valve replacement is quite high. The racial backgrounds of both groups of patients are similar, thus eliminating the question of racial differences. Concerning secondary prophylaxis, there is also controversy concerning the best second-line therapy. It is now well known that monthly intramuscular injections of benzathine penicillin are really effective for only 20 days. Thus, there is a window in which penicillin coverage is not adequate. To circumvent this problem, some investigators give benzathine penicillin every 3 weeks. These injections are quite painful, however, and it has been our "rule" that compliance with this treatment is inversely proportional to the ratio of the size of the child to the mother. In our own experience over 30 years with the

  6. The Incidence of Fever in US Critical Care Air Transport Team Combat Trauma Patients Evacuated from the Theater between March 2009 and March 2010

    Science.gov (United States)

    2013-11-01

    Trauma patients with fever Total IED 70 56 126 GSW 20 16 36 Rocket 18 7 25 Other 17 9 26 Fall 8 2 10 MVC 6 8 14 Shrapnel 4 1 5 Helicopter crash 3 1 4 Crush...1 9 10 Total 147 101 248 GSW, Gunshot wound; MVC , motor vehicle collision. RESEARCH/Minnick et al e104 JOURNAL OF EMERGENCY NURSING VOLUME 39 • ISSUE

  7. Haemostatic management of obstetric haemorrhage.

    Science.gov (United States)

    Collis, R E; Collins, P W

    2015-01-01

    The haemostatic management of major obstetric haemorrhage remains challenging, and current published guidance relies heavily on experience from the non-pregnant population and expert opinion. In recent years, an interest in the implications of relative hypofibrinogenaemia, point-of-care monitoring of coagulation abnormalities, and the potential to give goal-directed therapy to correct coagulopathies, have created the possibility of significantly challenging and changing guidance. There is evidence that the haemostatic impairment in the pregnant population is different from trauma-induced bleeding, and the type and rate of onset of coagulopathies differ depending on the underlying cause. This review examines areas such as possible intervention points, describes evidence for over-transfusion of fresh frozen plasma in some situations and challenges conventional thinking on formulaic management. It also examines the rationale for other therapeutic options, including fibrinogen concentrate and tranexamic acid.

  8. Prediction of peripartum hysterectomy and end organ dysfunction in major obstetric haemorrhage.

    LENUS (Irish Health Repository)

    O'Brien, D

    2010-12-01

    The aims of this study are to determine the incidence and aetiology of major obstetric haemorrhage (MOH) in our population, to examine the success rates of medical and surgical interventions and to identify risk factors for peripartum hysterectomy and end organ dysfunction (EOD).

  9. Surgical Craniotomy for Intracerebral Haemorrhage.

    Science.gov (United States)

    Mendelow, A David

    2015-01-01

    Craniotomy is probably indicated for patients with superficial spontaneous lobar supratentorial intracerebral haemorrhage (ICH) when the level of consciousness drops below 13 within the first 8 h of the onset of the haemorrhage. Once the level drops below 9, it is probably too late to consider craniotomy for these patients, so clinical vigilance is paramount. While this statement is only backed up by evidence that is moderately strong, meta-analysis of available data suggests that it is true in the rather limited number of patients with ICH. Meta-analyses like this can often predict the results of future prospective randomised controlled trials a decade or more before the trials are completed and published. Countless such examples exist in the literature, as is the case for thrombolysis in patients with myocardial infarction in the last millennium: meta-analysis determined the efficacy more than a decade BEFORE the last trial (ISIS-2) confirmed the benefit of thrombolysis for myocardial infarction. Careful examination of the meta-analysis' Forest plots in this chapter will demonstrate why this statement is made at the outset. Other meta-analyses of surgery for ICH have also indicated that minimal interventional techniques using topical thrombolysis or endoscopy via burrholes or even twist drill aspiration may be particularly successful for the treatment of supratentorial ICH, especially when the clot is deep seated. Ongoing clinical trials (CLEAR III and MISTIE III) should confirm this in the fullness of time. There are 2 exceptions to these generalisations. First, based on trial evidence, aneurysmal ICH is best treated with surgery. Second, cerebellar ICH represents a special case because of the development of hydrocephalus, which may require expeditious drainage as the intracranial pressure rises. The cerebellar clot will then require evacuation, usually via posterior fossa craniectomy, rather than craniotomy. Technical advances suggest that image-guided surgery

  10. Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010

    Science.gov (United States)

    Buckle, Geoffrey C.; Walker, Christa L. Fischer; Black, Robert E.

    2012-01-01

    Background Typhoid and paratyphoid fever remain important causes of morbidity worldwide. Accurate disease burden estimates are needed to guide policy decisions and prevention and control strategies. Methods We conducted a systematic literature review of the PubMed and Scopus databases using pre-defined criteria to identify population-based studies with typhoid fever incidence data published between 1980 and 2009. We also abstracted data from annual reports of notifiable diseases in countries with advanced surveillance systems. Typhoid and paratyphoid fever input data were grouped into regions and regional incidence and mortality rates were estimated. Incidence data were extrapolated across regions for those lacking data. Age-specific incidence rates were derived for regions where age-specific data were available. Crude and adjusted estimates of the global typhoid fever burden were calculated. Results Twenty-five studies were identified, all of which contained incidence data on typhoid fever and 12 on paratyphoid fever. Five advanced surveillance systems contributed data on typhoid fever; 2 on paratyphoid fever. Regional typhoid fever incidence rates ranged from typhoid fever episodes in 2010 was 13.5 million (interquartile range 9.1–17.8 million). The adjusted estimate accounting for the low sensitivity of blood cultures for isolation of the bacteria was 26.9 million (interquartile range 18.3–35.7 million) episodes. These findings are comparable to the most recent analysis of global typhoid fever morbidity, which reported crude and adjusted estimates of 10.8 million and 21.7 million typhoid fever episodes globally in 2000. Conclusion Typhoid fever remains a significant health burden, especially in low- and middle-income countries. Despite the availability of more recent data on both enteric fevers, additional research is needed in many regions, particularly Africa, Latin America and other developing countries. PMID:23198130

  11. Hypopituitarism is uncommon after aneurysmal subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Klose, Marianne; Brennum, Jannick; Poulsgaard, Lars

    2010-01-01

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

  12. [A group fever: safari's fever].

    Science.gov (United States)

    Cantiniaux, S; Serratrice, J; De Roux-Serratrice, C; Disdier, P; Perez, L; Bricaire, F; Caumes, E; Mary, C; Weiller, P J

    2004-12-01

    Acute schistosomiasis, called safari's fever in Africa and Katayama fever in Japan, is an immunoallergic reaction due to transcutaneous penetration of infective cercaria. We report the collective case of seven young adults spending holidays in Mali. An eighteen years-old girl presents fever, headache, diarrhoea and abdominal pains at return from Dogon country (south of Mali). After turned down malaria and with the notion of bathing in fresh water followed by pruritus, we think to safari's fever. So we alarm all other members of the group. All can be treated to avoid chronic schistosomiasis. These observations recall that acute schistosomiasis is a real danger for tourists when bathing in fresh water in endemic areas of Africa. Education of travellers is necessary. Occurrence of safari's fever should alert physicians to prevent chronic schistosomiasis.

  13. 广东省1950-2011年猩红热发病趋势变化及流行特征分析%Incidence trendency and epidemiological characteristics of scarlet fever in Guangdong Province,1950-2011

    Institute of Scientific and Technical Information of China (English)

    杨芬; 钟豪杰; 洪腾; 张锦清; 林文青

    2013-01-01

    能会继续处于猩红热高流行期;托幼机构和小学等集体单位将是今后防控工作的重点.%Objective To analyze the incidence trends and epidemic characteristics of scarlet fever in Guangdong Province during 1950 -2011 and provide evidence for preventing and controlling scarlet fever. Methods Descriptive statistical analysis was performed on epidemiological data of scarlet fever during 1950-2011 obtained from Guangdong Diseases Reporting Information System. Results A total of 15 581 cases were reported to the Guangdong Notifiable Disease Database during 1950 -2011 with the annual incidence ranging between 0 to 49. 00/100 000. There are four epidemic stages; Distributed Period (1950 - 1973, the average annual incidence was 0. 12/100 000), Outbreak Period (1974 - 1987, the average annual incidence was 15. 16/100 000), Low-level Epidemic Period(1988 -2003, the average annual incidence was 1. 68/100 000) and Epidemic Rebound Period (2004 - 2011 , the average annual incidence was 4. 82/100 000). The incidence of scarlet fever in Guangdong appeared two seasonal peaks; the first peak ( autumn peak) increased since September and reached the summit between November to January (the constituent ratio is 35. 4% ) ; the second peak ( spring peak) is lower than the first peak which increased since March and reached the summit between April to June (the constituent ratio is 28. 9% ). The two peaks were almost in accordance with the school fall semester and spring semester, respectively. A total of 3 large outbreaks were reported in key areas of Guangdong. The first outbreak occurred in Shantou City in 1974 when 1 712 cases were reported (the incidence was 484. 02/100 000) and children under 15 years of age accounted for 90. 5% of all cases. Ten years later, the second outbreak occurred in the same city in 1984 when 360 cases were reported (the incidence was 80. 62/100 000) and children under 15 years of age accounted for 91. 4% of all cases. The third

  14. Typhoid fever

    Science.gov (United States)

    ... most commonly caused due to a bacteria called Salmonella typhi ( S typhi ). Causes S typhi is spread through contaminated food, ... as food handlers. Alternative Names Enteric fever Images Salmonella typhi organism Fly Digestive system organs References Harris JB, ...

  15. Dengue fever

    Science.gov (United States)

    ... the mosquito Aedes aegypti , which is found in tropic and subtropic regions. This area includes parts of: ... encephalitis, St. Louis encephalitis, tick-borne encephalitis, Kyasanur forest disease, Alkhurma hemorrhagic fever, Zika). In: Bennett JE, ...

  16. Recurrent fevers.

    Science.gov (United States)

    Isaacs, David; Kesson, Alison; Lester-Smith, David; Chaitow, Jeffrey

    2013-03-01

    An 11-year-old girl had four episodes of fever in a year, lasting 7-10 days and associated with headache and neck stiffness. She had a long history of recurrent urticaria, usually preceding the fevers. There was also a history of vague pains in her knees and in the small joints of her hands. Her serum C-reactive protein was moderately raised at 41 g/L (normal <8). Her rheumatologist felt the association of recurrent fevers that lasted 7 or more days with headaches, arthralgia and recurrent urticaria suggested one of the periodic fever syndromes. Genetic testing confirmed she had a gene mutation consistent with one of tumour necrosis factor receptor-associated periodic syndrome.

  17. Bilateral adrenal haemorrhage associated with heparin-induced thrombocytopaenia during treatment of Fournier gangrene.

    Science.gov (United States)

    Tattersall, Timothy Lee; Thangasamy, Isaac A; Reynolds, Jamie

    2014-10-14

    We present a case of bilateral adrenal haemorrhage (BAH) associated with heparin-induced thrombocytopaenia (HIT) in a 61-year-old man admitted to hospital for the treatment of Fournier's gangrene. He presented to hospital with scrotal swelling and fever, and developed spreading erythaema and a gangrenous scrotum. His scrotum was surgically debrided and intravenous broad-spectrum antibiotics were administered. Unfractionated heparin was given postoperatively for venous thromboembolism prophylaxis. The patient deteriorated clinically 8-11 days postoperatively with delirium, chest pain and severe hypertension followed by hypotension and thrombocytopaenia. Abdominal CT scan revealed bilateral adrenal haemorrhage. Antibodies to the heparin-platelet factor 4 complex were present. HIT-associated BAH was diagnosed and heparin was discontinued. Intravenous bivalirudin and hydrocortisone were started, with rapid improvement in clinical status. BAH is a rare complication of HIT and should be considered in the postoperative patient with unexplained clinical deterioration.

  18. An Emerging Pulmonary Haemorrhagic Syndrome in Dogs: Similar to the Human Leptospiral Pulmonary Haemorrhagic Syndrome?

    Directory of Open Access Journals (Sweden)

    R. Klopfleisch

    2010-01-01

    Full Text Available Severe pulmonary haemorrhage is a rare necropsy finding in dogs but the leptospiral pulmonary haemorrhagic syndrome (LPHS is a well recognized disease in humans. Here we report a pulmonary haemorrhagic syndrome in dogs that closely resembles the human disease. All 15 dogs had massive, pulmonary haemorrhage affecting all lung lobes while haemorrhage in other organs was minimal. Histologically, pulmonary lesions were characterized by acute, alveolar haemorrhage without identifiable vascular lesions. Seven dogs had mild alveolar wall necrosis with hyaline membranes and minimal intraalveolar fibrin. In addition, eight dogs had acute renal tubular necrosis. Six dogs had a clinical diagnosis of leptospirosis based on renal and hepatic failure, positive microscopic agglutination test (MAT and/or positive blood/urine Leptospira-specific PCR. Leptospira could not be cultured post mortem from the lungs or kidneys. However, Leptospira-specific PCR was positive in lung, liver or kidneys of three dogs. In summary, a novel pulmonary haemorrhagic syndrome was identified in dogs but the mechanism of the massive pulmonary erythrocyte extravasation remains elusive. The lack of a consistent post mortem identification of Leptospira spp. in dogs with pulmonary haemorrhage raise questions as to whether additional factors besides Leptospira may cause this as yet unrecognized entity in dogs.

  19. Rheumatic Fever Programme in Samoa.

    Science.gov (United States)

    Viali, Satupaitea; Saena, Puleiala; Futi, Vailogoua

    2011-02-11

    Rheumatic fever is very common in Samoa. The following paper describes the Rheumatic Fever Programme in Samoa and looks at the incidence of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). The incidence of ARF has decreased to 30 per 100,000 in 2005, 12.8 per 100,000 in 2007, 7.3 per 100,000 in 2008, and 9.5 per 100,000 in 2009. The incidence of RHD has decreased to 40.2 per 100,000 in 2007, 34 per 100,000 in 2008, and 31.8 per 100,000 in 2009. Cardiac surgery in New Zealand is expensive, but is cheaper to perform in Samoa. RHD screening with echocardiogram at schools may be the best way to reduce the burden and suffering from RHD.

  20. Yellow Fever in Africa: estimating the burden of disease and impact of mass vaccination from outbreak and serological data.

    Directory of Open Access Journals (Sweden)

    Tini Garske

    2014-05-01

    Full Text Available Yellow fever is a vector-borne disease affecting humans and non-human primates in tropical areas of Africa and South America. While eradication is not feasible due to the wildlife reservoir, large scale vaccination activities in Africa during the 1940s to 1960s reduced yellow fever incidence for several decades. However, after a period of low vaccination coverage, yellow fever has resurged in the continent. Since 2006 there has been substantial funding for large preventive mass vaccination campaigns in the most affected countries in Africa to curb the rising burden of disease and control future outbreaks. Contemporary estimates of the yellow fever disease burden are lacking, and the present study aimed to update the previous estimates on the basis of more recent yellow fever occurrence data and improved estimation methods.Generalised linear regression models were fitted to a dataset of the locations of yellow fever outbreaks within the last 25 years to estimate the probability of outbreak reports across the endemic zone. Environmental variables and indicators for the surveillance quality in the affected countries were used as covariates. By comparing probabilities of outbreak reports estimated in the regression with the force of infection estimated for a limited set of locations for which serological surveys were available, the detection probability per case and the force of infection were estimated across the endemic zone. The yellow fever burden in Africa was estimated for the year 2013 as 130,000 (95% CI 51,000-380,000 cases with fever and jaundice or haemorrhage including 78,000 (95% CI 19,000-180,000 deaths, taking into account the current level of vaccination coverage. The impact of the recent mass vaccination campaigns was assessed by evaluating the difference between the estimates obtained for the current vaccination coverage and for a hypothetical scenario excluding these vaccination campaigns. Vaccination campaigns were estimated to

  1. Childhood fever.

    Science.gov (United States)

    Chong, C Y; Allen, D M

    1996-02-01

    Childhood fever is a common symptom, reflective of multiple causes. As the child is often unable to express himself, the physician must rely on parents' observations and the physical examination. The majority of febrile children have non-bacterial upper respiratory tract infection and indiscriminate use of antibiotics is inappropriate, ineffective and leads to drug-resistance such as the emergence of Penicillin-resistant Streptococcus pneumoniae. In this article, we attempt to identify the possible causes of fever by a simple approach using the presence or absence of associated or localising symptoms. Infants less than 3 months constitute a unique group as the fever may be related to perinatal events and as serious bacterial infections can still occur despite unremarkable physical findings. Management of fever needs to take into account the toxicity, immune status and age of the patients as well as the source of the infection. Zealous overprescription of antipyretics needs to be avoided with attention directed to the cause of the fever, the child's capacity to cope with the illness and parental education.

  2. Modeling spatio-temporal risk changes in the incidence of dengue fever in Saudi Arabia: a geographical information system case study

    Directory of Open Access Journals (Sweden)

    Hassan M. Khormi

    2011-11-01

    Full Text Available The aim of this study was to use geographical information systems to demonstrate the Dengue fever (DF risk on a monthly basis in Jeddah, Saudi Arabia with the purpose to provide documentation serving to improve surveillance and monitor the Aedes aegypti mosquito vector. Getis-Ord Gi* statistics and a frequency index covering a five-year period (2006- 2010 were used to map DF and model the risk spatio-temporally. The results show that monthly hotspots were mainly concentrated in central Jeddah districts and that the pattern changes considerably with time. For example, on a yearly basis, for the month of January, the Burman district was identified as a low risk area in 2006, a high-risk area in 2007, medium risk in 2008, very low risk in 2009 and low risk in 2010. The results demonstrate that it would be useful to follow the monthly DF pattern, based on the average weekly frequency, as this can facilitate the allocation of resources for the treatment of the disease, preventing its prevalence and monitoring its vector.

  3. Modeling spatio-temporal risk changes in the incidence of Dengue fever in Saudi Arabia: a geographical information system case study.

    Science.gov (United States)

    Khormi, Hassan M; Kumar, Lalit; Elzahrany, Ramze A

    2011-11-01

    The aim of this study was to use geographical information systems to demonstrate the Dengue fever (DF) risk on a monthly basis in Jeddah, Saudi Arabia with the purpose to provide documentation serving to improve surveillance and monitor the Aedes aegypti mosquito vector. Getis-Ord Gi* statistics and a frequency index covering a five-year period (2006-2010) were used to map DF and model the risk spatio-temporally. The results show that monthly hotspots were mainly concentrated in central Jeddah districts and that the pattern changes considerably with time. For example, on a yearly basis, for the month of January, the Burman district was identified as a low risk area in 2006, a high-risk area in 2007, medium risk in 2008, very low risk in 2009 and low risk in 2010. The results demonstrate that it would be useful to follow the monthly DF pattern, based on the average weekly frequency, as this can facilitate the allocation of resources for the treatment of the disease, preventing its prevalence and monitoring its vector.

  4. Typhoid fever

    DEFF Research Database (Denmark)

    Wain, John; Hendriksen, Rene S.; Mikoleit, Matthew L.

    2015-01-01

    Control of typhoid fever relies on clinical information, diagnosis, and an understanding for the epidemiology of the disease. Despite the breadth of work done so far, much is not known about the biology of this human-adapted bacterial pathogen and the complexity of the disease in endemic areas...... with shifting trends in enteric fever. This knowledge is crucial, both to control the disease and to manage cases. Additionally, salmonella serovars that cause human infection can change over time and location. In areas of Asia, multidrug-resistant Salmonella enterica serovar Typhi (S Typhi) has been the main...... cause of enteric fever, but now S Typhi is being displaced by infections with drug-resistant S enterica serovar Paratyphi A. New conjugate vaccines are imminent and new treatments have been promised, but the engagement of local medical and public health institutions in endemic areas is needed to allow...

  5. Rat-bite fever

    Science.gov (United States)

    Streptobacillary fever; Streptobacillosis; Haverhill fever; Epidemic arthritic erythema; Spirillary fever; Sodoku ... Rat-bite fever can be caused by 2 different bacteria, Streptobacillus moniliformis or Spirillum minus. Both of these are found in ...

  6. Kid's Guide to Fever

    Science.gov (United States)

    ... in the Operating Room? A Kid's Guide to Fever KidsHealth > For Kids > A Kid's Guide to Fever ... some lighter-weight pajamas. previous continue Fighting a Fever For almost all kids, fevers aren't a ...

  7. Dengue fever (image)

    Science.gov (United States)

    Dengue fever, or West Nile fever, is a mild viral illness transmitted by mosquitoes which causes fever, ... second exposure to the virus can result in Dengue hemorrhagic fever, a life-threatening illness.

  8. [Volume replenishment in haemorrhage: caution advised].

    Science.gov (United States)

    Kooter, Albertus J; Zweegman, Sonja; Smulders, Yvo M

    2011-01-01

    Acute haemorrhage is a frequent problem in medicine. Patients with acute bleeding may present with signs of hypotension and reduced organ perfusion. The physician's reflex action is often to treat such patients with intravenous volume replenishment using colloid or cristalloid liquids. Intravenous volume replenishment has, however, a downside: it increases the tendency to bleed and therefore can increase blood loss. Previous clinical observations and experimental animal and human studies addressing volume replenishment in haemorrhagic shock have repeatedly shown that accepting hypotension favourably affects prognosis. However, relevant practice guidelines, such as for gastrointestinal bleeding, usually advise liberal intravenous volume replenishment if hypotension is present. In this article we advocate caution when considering intravenous blood volume adjustment in haemorrhage.

  9. [Surveillance data on typhoid fever and paratyphoid fever in 2015, China].

    Science.gov (United States)

    Liu, F F; Zhao, S L; Chen, Q; Chang, Z R; Zhang, J; Zheng, Y M; Luo, L; Ran, L; Liao, Q H

    2017-06-10

    Objective: Through analyzing the surveillance data on typhoid fever and paratyphoid fever in 2015 to understand the related epidemiological features and most possible clustering areas of high incidence. Methods: Individual data was collected from the passive surveillance program and analyzed by descriptive statistic method. Characteristics on seasonal, regional and distribution of the diseases were described. Spatial-temporal clustering characteristics were estimated, under the retrospective space-time method. Results: A total of 8 850 typhoid fever cases were reported from the surveillance system, with incidence rate as 0.65/100 000. The number of paratyphoid fever cases was 2 794, with incidence rate as 0.21/100 000. Both cases of typhoid fever and paratyphoid fever occurred all year round, with high epidemic season from May to October. Most cases involved farmers (39.68%), children (15.89%) and students (12.01%). Children under 5 years showed the highest incidence rate. Retrospective space-time analysis for provinces with high incidence rates would include Yunnan, Guangxi, Guizhou, Hunan and Guangdong, indicating the first and second class clusters were mainly distributed near the bordering adjacent districts and counties among the provinces. Conclusion: In 2015, the prevalence rates of typhoid fever and paratyphoid fever were low, however with regional high prevalence areas. Cross regional transmission existed among provinces with high incidence rates which might be responsible for the clusters to appear in these areas.

  10. Emergency percutaneous transcatheter embolisation of acute arterial haemorrhage.

    LENUS (Irish Health Repository)

    Keeling, A N

    2010-09-01

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

  11. Non-inferiority of nitric oxide releasing intranasal spray compared to sub-therapeutic antibiotics to reduce incidence of undifferentiated fever and bovine respiratory disease complex in low to moderate risk beef cattle arriving at a commercial feedlot.

    Science.gov (United States)

    Regev-Shoshani, G; McMullin, B; Nation, N; Church, J S; Dorin, C; Miller, C

    2017-03-01

    Undifferentiated fever, or bovine respiratory disease complex (BRDc), is a challenging multi-factorial health issue caused by viral/bacterial pathogens and stressors linked to the transport and mixing of cattle, negatively impacting the cattle feedlot industry. Common practice during processing at feedlots is administration of antibiotic metaphylaxis to reduce the incidence of BRDc. Nitric oxide (NO) is a naturally occurring nano-molecule with a wide range of physiological attributes. This study evaluated the metaphylactic use of intranasal NO releasing spray (NORS) to control BRDc incidence in calves at low-moderate risk of developing BRDc, arriving at a commercial feedlot as compared to conventional antibiotic metaphylaxis. One thousand and eighty crossbred, multiple-sourced, commingled, commercial, weaned beef calves were screened, enrolled, randomized and treated upon arrival. Animals appearing sick were pulled (from their pen) by blinded pen keepers then assessed for BRDc symptoms; blood samples were taken for haptoglobin quantification and the animals were rescued with an antibiotic. After 35 days both groups showed no significant difference in BRDc incidence (5.2% of animals from NORS group and 3.2% from antibiotic group). Average daily weight gain of animals at day 150 for the NORS cohort was 1.17kg compared to 1.18kg for the antibiotic group (p>0.05). There was no significant difference in mortality in the first 35 days (p=0.7552), however, general mortality over 150 days trended higher in the antibiotic cohort. NORS treatment was shown to be safe, causing neither distress nor adverse effects on the animals. This large randomized controlled study in low-moderate BRDc incidence risk calves demonstrates that NORS treatment, as compared to conventional metaphylactic antibiotics, is non-inferior based on BRDc incidence and other metrics like weight and mortality. These data justify further studies in higher BRDc incidence risk populations to evaluate NORS as

  12. Haemorrhagic shock due to spontaneous splenic haemorrhage complicating antiplatelet therapy: endovascular management

    Directory of Open Access Journals (Sweden)

    Garge S Shaileshkumar

    2015-01-01

    Full Text Available Spontaneous splenic haemorrahge and rupture is a rare but life-threatening condition requiring urgent diagnosis and treatment. Splenic haemorrhage and rupture precipitated by thrombolytic or antiocoagulant therapy has been reported frequently in the literature, but only two cases due to ticlopidine and one case due to salicyclate have been reported. We report the case of a 54-year-old man with haemorrhagic shock due to spontaneous splenic haemorrhage and rupture following dual antiplatelet (aspirin and clopidogrel therapy. He was successfully treated with selective angioembolization of the bleeding branch of the splenic artery.

  13. Ultrasound and necropsy study of periventricular haemorrhage in preterm infants.

    OpenAIRE

    Szymonowicz, W; Schafler, K; Cussen, L J; Yu, V Y

    1984-01-01

    The diagnostic accuracy of cerebral ultrasound for periventricular haemorrhage was determined by comparing this with necropsy findings in 30 preterm neonates of 30 weeks' gestation or less and birthweight under 1500 g. Ultrasound gave an accurate diagnosis of 85% in infants with germinal layer haemorrhage, 92% in intraventricular haemorrhage, and 97% in intracerebral haemorrhage. False positive errors were caused by vascular congestion; false negative errors occurred when the maximum dimensio...

  14. Forecasting incidence of dengue in Rajasthan, using time series analyses

    Directory of Open Access Journals (Sweden)

    Sunil Bhatnagar

    2012-01-01

    Full Text Available Aim: To develop a prediction model for dengue fever/dengue haemorrhagic fever (DF/DHF using time series data over the past decade in Rajasthan and to forecast monthly DF/DHF incidence for 2011. Materials and Methods: Seasonal autoregressive integrated moving average (SARIMA model was used for statistical modeling. Results: During January 2001 to December 2010, the reported DF/DHF cases showed a cyclical pattern with seasonal variation. SARIMA (0,0,1 (0,1,1 12 model had the lowest normalized Bayesian information criteria (BIC of 9.426 and mean absolute percentage error (MAPE of 263.361 and appeared to be the best model. The proportion of variance explained by the model was 54.3%. Adequacy of the model was established through Ljung-Box test (Q statistic 4.910 and P-value 0.996, which showed no significant correlation between residuals at different lag times. The forecast for the year 2011 showed a seasonal peak in the month of October with an estimated 546 cases. Conclusion: Application of SARIMA model may be useful for forecast of cases and impending outbreaks of DF/DHF and other infectious diseases, which exhibit seasonal pattern.

  15. [Postoperative fever in orthopedic and urologic surgery].

    Science.gov (United States)

    Saavedra, Federico; Myburg, Cristina; Lanfranconi, Marisa B; Urtasun, Martin; De Oca, Luis Montes; Silberman, Andres; Lambierto, Alberto; Gnocchi, Cesar A

    2008-01-01

    Post-operative fever incidence varies widely. In clean and clean-contaminated surgery the non-infectious fever is more frequent than the infectious fever. We performed a prospective study including 303 patients who underwent orthopedic and urologic elective surgery. The aims of our study were to investigate the incidence of post-operative fever, its etiology, the relationship between time of onset and the etiology, and the usefulness of extensive fever work-up to determine post-operative infection. The incidence of post-operative fever was 14% (42/303) of which 81% (34/42) was noninfectious and 19% (8/42) was infectious. The etiology of the fever in the first 48 hours after surgery was always non-infectious (p fever work-up was performed in patients who presented fever only after the initial 48 hours of surgery with normal physical examination (n = 19) consisting of chest x-ray, blood (2) and urine cultures. The chest x-ray was normal in all the patients, the urine cultures were positive in four cases (21%, IC 95%: 6-45) and the blood cultures in only one case (5%, IC 95%: 0.1-26). Seven patients had post-operative infections without fever as a clinical sign. The most frequently observed etiology of post-operative fever was non-infectious, related to the normal inflammatory host response to surgery. Based on the present results, the extensive fever work-up performed to investigate post-operative infection does not seem to be a useful tool. The diagnosis of post-operative infection was based on clinical follow up and the correct interpretation of the patient's symptoms and signs.

  16. Scarlet Fever

    Centers for Disease Control (CDC) Podcasts

    2011-06-09

    Katherine Fleming-Dutra, pediatrician, discusses scarlet fever, its cause, how to treat it, and how to prevent its spread.  Created: 6/9/2011 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 6/9/2011.

  17. Yellow fever

    Directory of Open Access Journals (Sweden)

    Prata Aluízio

    2000-01-01

    Full Text Available With the infestation by Aedes aegypti, urban yellow fever might already exist. This did not occur because of either the lacking of a sufficient contact between the diseased individual and the A. aegypti or perhaps because this, after sixty years without transmitting the virus, needs an adaptation phase to infecting again.

  18. Q fever

    Science.gov (United States)

    ... Coxiella burnetii . These bacteria can infect: Sheep Goats Cattle Dogs Cats Birds Rodents Ticks Infected animals shed ... The main treatment for Q fever is antibiotics. For early-stage Q ... If you have the infection for more than 6 months, it is called ...

  19. Quality of life after aneurysmal subarachnoid haemorrhage

    NARCIS (Netherlands)

    Passier, P.E.C.A.

    2011-01-01

    The general aim of this thesis was to increase our understanding of quality of life (QoL) after aneurysmal subarachnoid haemorrhage (SAH), and the most important determinants of QoL, in order to tailor appropriate rehabilitation programs and thereby enhance their effectiveness. We reviewed the liter

  20. Antithrombotic drugs and subarachnoid haemorrhage risk

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  1. Steroid treatment in primary intracerebral haemorrhage

    NARCIS (Netherlands)

    De Reuck, J; De Bleecker, J; Reyntjens, K

    1989-01-01

    The efficiency of two types of steroid treatment was assessed in primary intracerebral haemorrhages. No significant difference in clinical evolution was observed between 57 cases treated with dexamethasone, 28 cases with methylprednisolone and 44 cases without corticosteroids. In a subgroup of 46 pa

  2. Sanitation of viral haemorrhagic septicaemia (VHS)

    DEFF Research Database (Denmark)

    Olesen, Niels Jørgen

    1998-01-01

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

  3. Waldenstrom′s macroglobulinaemia with intracerebral haemorrhage.

    Directory of Open Access Journals (Sweden)

    Khan G

    2000-07-01

    Full Text Available A 65-year-old male was admitted for evaluation of severe anaemia, recurrent epistaxis, axillary lymphadenopathy, and hepatomegaly. The diagnosis of Waldenstrom′s macroglobulinaemia was made on the basis of clinical and laboratory findings. The patient developed intracerebral haemorrhage without associated hypertension and with normal coagulation profile.

  4. Mapping the zoonotic niche of Lassa fever in Africa

    OpenAIRE

    Mylne, AQ; Pigott, DM; Longbottom, J; Shearer, F; Duda, KA; Messina, JP; Weiss, DJ; Moyes, CL; Golding, N; Hay, SI

    2015-01-01

    Background Lassa fever is a viral haemorrhagic illness responsible for disease outbreaks across West Africa. It is a zoonosis, with the primary reservoir species identified as the Natal multimammate mouse, Mastomys natalensis. The host is distributed across sub-Saharan Africa while the virus' range appears to be restricted to West Africa. The majority of infections result from interactions between the animal reservoir and human populations, although secondary transmission between humans can o...

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

    Science.gov (United States)

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

    2014-01-01

    Leptospirosis, a disease of protean manifestations occurs sporadically throughout the year with a peak seasonal incidence during the rainy season mimicking other febrile viral illness. In the rare case, the disease leads to renal and hepatic involvement with hemorrhage which may be associated with multisystem organ dysfunction in form of pulmonary, cardiac and central nervous system, when it is known as Weil's disease. Rarely haemorrhagic manifestations are assosciated. Early diagnosis is important as sometimes the disease may be life threatening. Proper antibiotics results in dramatic improvement. We hereby presented a case that had clinical features of Weil's disease with cough, dyspnoea and haemoptysis. Leptospirosis was detected on ELISA testing. Patient was cured rapidly with antibiotics. PMID:25183149

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

    Directory of Open Access Journals (Sweden)

    Abhiram Chakrabarti

    2014-05-01

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

  7. RETINAL HAEMORRHAGE IN PLASMODIUM VIVAX PATIENTS- 2 RARE CASE REPORTS

    Directory of Open Access Journals (Sweden)

    Sangeeta

    2012-12-01

    Full Text Available ABSTRACT: Retinal haemorrhage is commonly detected during opht halmoscopic examination of patients with Plasmodium falciparum infections. Ho wever, it is observed very rarely in Plasmodium vivax infections. Only six cases of reti nal haemorrhage have been reported so far in Plasmodium vivax infections. We review the literatu re and discuss two such cases of retinal haemorrhage that presented at our hospital. It is sug gested that retinal haemorrhage be routinely ruled out in all malaria patients, and Pla smodium vivax infection be considered in patients with unexplained retinal haemorrhage and fev er.

  8. Risk Maps of Lassa Fever in West Africa

    OpenAIRE

    Elisabeth Fichet-Calvet; David John Rogers

    2009-01-01

    BACKGROUND: Lassa fever is caused by a viral haemorrhagic arenavirus that affects two to three million people in West Africa, causing a mortality of between 5,000 and 10,000 each year. The natural reservoir of Lassa virus is the multi-mammate rat Mastomys natalensis, which lives in houses and surrounding fields. With the aim of gaining more information to control this disease, we here carry out a spatial analysis of Lassa fever data from human cases and infected rodent hosts covering the peri...

  9. Pharmacological manipulation of gastric juice: thrombelastographic assessment and implications for treatment of gastrointestinal haemorrhage.

    OpenAIRE

    Patchett, S E; O'Donoghue, D P

    1995-01-01

    The impairment of formation and maintenance of a formed fibrin clot contributes to the prolonged bleeding and high incidence of rebleeding in upper gastrointestinal haemorrhage. To investigate the basis for the use of drug therapy in gastric bleeding, this study used thrombelastography to determine the effects of pharmacological manipulation of gastric juice on coagulation and fibrinolysis. The thrombelastograph is a mechanical device that provides a visual assessment of all stages of coagula...

  10. Disseminated intravascular coagulation does not play a major role in the pathogenesis of classical swine fever.

    Science.gov (United States)

    Blome, Sandra; Meindl-Böhmer, Alexandra; Nowak, Götz; Moennig, Volker

    2013-03-23

    Classical swine fever (CSF) is a multi-systemic disease that can be accompanied by severe haemorrhagic lesions. The underlying pathogenetic mechanisms are still far from being understood, though disseminated intravascular coagulation (DIC) was discussed as a major factor. In the presented study, the direct thrombin inhibitor hirudin was used in an attempt to elucidate the role of the coagulation system in the pathogenesis of CSF-induced haemorrhagic lesions. Two groups of piglets (n=5) were infected with highly virulent CSF virus (CSFV) strain CSF0634. One group underwent daily treatment with hirudin, the other served as untreated challenge infection control. Assessment of clinical signs using a clinical score system, coagulation tests, and blood counts were performed daily. Both groups developed acute-lethal CSF with haemorrhagic lesions. Although changes in the coagulation system were seen in the late stages of CSFV infection, our results strongly suggest that DIC does not present the crucial event in the pathogenesis of haemorrhagic lesions.

  11. An increase in rates of obstetric haemorrhage in a setting of high HIV seroprevalence

    Directory of Open Access Journals (Sweden)

    E Shabalala

    2017-07-01

    Full Text Available Background. Obstetric haemorrhage (OH is the leading cause of maternal mortality worldwide, although, indirectly, HIV is also a leading cause of maternal mortality in some settings with a high HIV seroprevalence. Objective. To determine the possible association between increasing rates of OH and HIV or its treatment. Methods. We conducted a retrospective chart review of women with OH at King Edward VIII Hospital, Durban, South Africa, over a 3-year period (2009 - 2011, during which the drug regimen for the prevention of mother-to-child transmission was evolving from single-dose nevirapine to antenatal zidovudine combined with intrapartum nevirapine (also referred to as dual therapy, and finally to a combination or highly active antiretroviral therapy (cART or HAART. Cases of OH (including abruptio placentae, placenta praevia, unspecified antepartum haemorrhage (APH, and postpartum haemorrhage (PPH were identified from maternity delivery records, and the relevant data extracted. Results. We analysed the records of 448 women diagnosed with OH. Even though the incidence of OH was low, the study found an increasing number of cases during the 3-year period. PPH – not APH – was associated with HIV seropositivity (odds ratio 1.84, 95% confi­dence interval 1.14 - 2.95. cART was not associated with an increased risk of haemorrhage. Conclusion. HIV was associated with a high risk of PPH, and its possible association with HIV treatment needs further research.

  12. [Milk fever].

    Science.gov (United States)

    Dumont, M

    1989-05-01

    Infectious complications following delivery were, in the past, attributed to "milk fever": these were milk congestion, milk deposits, rancid milk, etc., that were held responsible. The milk was reabsorbed into the blood of the patient and settled in the peritoneum ("milk peritonitis"), in the broad ligaments (pelvic abscess), in the thighs (phlebitis) and also in the breasts (breast abscess). This belief, originated by Aristotle, was accepted by excellent authors like Andre Levret (1703-1780), one of the most famous French obstetricians and Nicolas Puzos, at the same time. More recently, authors alluded to it and blamed "milk fever" for being at the origin of dramatic pictures which they described in their novels, like Victor Hugo and Guy de Maupassant, for instance.

  13. Typhoid fever.

    Science.gov (United States)

    Wain, John; Hendriksen, Rene S; Mikoleit, Matthew L; Keddy, Karen H; Ochiai, R Leon

    2015-03-21

    Control of typhoid fever relies on clinical information, diagnosis, and an understanding for the epidemiology of the disease. Despite the breadth of work done so far, much is not known about the biology of this human-adapted bacterial pathogen and the complexity of the disease in endemic areas, especially those in Africa. The main barriers to control are vaccines that are not immunogenic in very young children and the development of multidrug resistance, which threatens efficacy of antimicrobial chemotherapy. Clinicians, microbiologists, and epidemiologists worldwide need to be familiar with shifting trends in enteric fever. This knowledge is crucial, both to control the disease and to manage cases. Additionally, salmonella serovars that cause human infection can change over time and location. In areas of Asia, multidrug-resistant Salmonella enterica serovar Typhi (S Typhi) has been the main cause of enteric fever, but now S Typhi is being displaced by infections with drug-resistant S enterica serovar Paratyphi A. New conjugate vaccines are imminent and new treatments have been promised, but the engagement of local medical and public health institutions in endemic areas is needed to allow surveillance and to implement control measures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. A model of dengue fever

    Directory of Open Access Journals (Sweden)

    Boutayeb A

    2003-02-01

    Full Text Available Abstract Background Dengue is a disease which is now endemic in more than 100 countries of Africa, America, Asia and the Western Pacific. It is transmitted to the man by mosquitoes (Aedes and exists in two forms: Dengue Fever and Dengue Haemorrhagic Fever. The disease can be contracted by one of the four different viruses. Moreover, immunity is acquired only to the serotype contracted and a contact with a second serotype becomes more dangerous. Methods The present paper deals with a succession of two epidemics caused by two different viruses. The dynamics of the disease is studied by a compartmental model involving ordinary differential equations for the human and the mosquito populations. Results Stability of the equilibrium points is given and a simulation is carried out with different values of the parameters. The epidemic dynamics is discussed and illustration is given by figures for different values of the parameters. Conclusion The proposed model allows for better understanding of the disease dynamics. Environment and vaccination strategies are discussed especially in the case of the succession of two epidemics with two different viruses.

  15. Dengue fever mimicking acute appendicitis: A case report.

    Science.gov (United States)

    McFarlane, M E C; Plummer, J M; Leake, P A; Powell, L; Chand, V; Chung, S; Tulloch, K

    2013-01-01

    Dengue fever is an acute viral disease, which usually presents as a mild febrile illness. Patients with severe disease present with dengue haemorrhagic fever or dengue toxic shock syndrome. Rarely, it presents with abdominal symptoms mimicking acute appendicitis. We present a case of a male patient presenting with right iliac fossa pain and suspected acute appendicitis that was later diagnosed with dengue fever following a negative appendicectomy. A 13-year old male patient presented with fever, localized right-sided abdominal pain and vomiting. Abdominal ultrasound was not helpful and appendicectomy was performed due to worsening abdominal signs and an elevated temperature. A normal appendix with enlarged mesenteric nodes was found at surgery. Complete blood count showed thrombocytopenia with leucopenia. Dengue fever was now suspected and confirmed by IgM enzyme-linked immunosorbent assay against dengue virus. This unusual presentation of dengue fever mimicking acute appendicitis should be suspected during viral outbreaks and in patients with atypical symptoms and cytopenias on blood evaluation in order to prevent unnecessary surgery. This case highlights the occurrence of abdominal symptoms and complications that may accompany dengue fever. Early recognition of dengue fever mimicking acute appendicitis will avoid non-therapeutic operation and the diagnosis may be aided by blood investigations indicating a leucopenia, which is uncommon in patients with suppurative acute appendicitis. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Application of grey model ( 1, 1 ) in predicting incidence of typhoid and paratyphoid fevers in Yunnan%GM(1,1)灰色模型在云南省伤寒、副伤寒发病率预测中的应用

    Institute of Scientific and Technical Information of China (English)

    刘志涛; 李琼芬; 王荣华; 刘晓强; 郝林会; 余建兴

    2012-01-01

    目的 预测云南省未来几年伤寒、副伤寒发病趋势,为制定针对性的防治管理措施提供依据.方法 根据云南省2001-2010年的伤寒、副伤寒发病率,应用灰色系统理论,建立伤寒、副伤寒发病率预测模型,进行预测研究.结果 求得云南省伤寒、副伤寒发病率(1/10万)的灰色预测模型为:X(k+1)=- 245.5667e-0.1067k+270.2939.拟合检验显示本模型拟合精度好(C =0.342 <0.35,P=1),能够较好地预测伤寒、副伤寒发病率的趋势.结论 预测表明2011-2014年云南省伤寒、副伤寒年发病率将继续呈下降趋势,应继续加强健康教育、治疗管理等综合性防治措施控制伤寒、副伤寒的发病.%Objective To predict the incidence trend of typhoid and paratyphoid fevers in Yunnan province, and provide reference for the government in policy making. Methods According to the incidence data of typhoid and paratyphoid fevers in Yunnan from 2001 to 2010, the predicting model for typhoid and paratyphoid fevers incidence was established by using grey system theory to carry out predicting research. Results The grey model was X( k + 1) = -245.5667 e-0.1067k + 270.2939. The goodness-of-fit test indicated that the precision (degree 1) was qualified (C = 0.342 < 0. 35, P = 1) and the grey model was capable in predicting the incidence of typhoid and paratyphoid fevers. Conclusion The predicting results indicates that the incidence of typhoid and paratyphoid fevers will continue to decrease in Yunnan from 2011 to 2014,but it is still necessary to strengthen the comprehensive prevention and control of typhoid and paratyphoid fevers, including health education and treatment management.

  17. [Alveolar haemorrhage following a cannabis water pipe].

    Science.gov (United States)

    Moatemri, Z; Zaibi, H; Dabboussi, S; Mhamedi, S; Aichaouia, C; Khadhraoui, M; Cheikh, R

    2016-10-01

    Respiratory toxicity of cannabis is well-known today particularly with the new consumption patterns. We report the case of a 25-year-old man admitted for haemoptysis, with unfavourable outcome and acute respiratory failure. Various explorations concluded to acute respiratory distress syndrome secondary to diffuse alveolar haemorrhage. Etiological assessment was initially negative. Outcome was favourable during hospitalization, authorizing the discharge of our patient. Two days later, alveolar haemorrhage recur, with positive toxicological tests for cannabis and the patient admits smoking cannabis by plastic "bang". We illustrate, through this case, the severity of respiratory complications caused by new methods of using cannabis, particularly with plastic 'bang', hence the need to insist of the importance of supported withdrawal and to inform young people how these techniques are serious.ssss. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. Demgue Fever

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    登革热的病名源于西班牙语,是形容患者由于发烧、关节疼痛导致走路时步履蹒跚、步态造作。研究者根据其症状,称其为"关节热"或"碎骨热"。1869年,英国伦敦皇家内科学会正式将其命名为"登革热"(dengue fever,DF)。

  19. [Typhoid fever].

    Science.gov (United States)

    Marchou, B

    1996-01-15

    Endemic in regions with poor hygienic conditions, Enteric fevers are imported in France by returning travellers. They are caused by Salmonella strains, mainly S. Typhi, transmitted via fecal-oral route. Salmonella reach the blood stream after proliferating in mesenteric lymph nodes. At an initial stage blood and bone marrow cultures, later on Widal-Felix serology permit diagnosis. Antibiotics have rendered death exceptional. Quinolones and ceftriaxone allow treatments shorter than 10 days. Immunization (Typhim Vi) and improvement of hygienic standards are the cornerstone of prevention.

  20. Allergies and Hay Fever

    Science.gov (United States)

    ... an ENT Doctor Near You Allergies and Hay Fever Allergies and Hay Fever Patient Health Information News media interested in covering ... suffer from nasal allergies, commonly known as hay fever. An ear, nose, and throat specialist can help ...

  1. Rocky Mountain Spotted Fever

    Science.gov (United States)

    ... facebook share with twitter share with linkedin Rocky Mountain Spotted Fever Rocky Mountain spotted fever is a ... New Mexico. Why Is the Study of Rocky Mountain Spotted Fever a Priority for NIAID? Tickborne diseases ...

  2. Viral Hemorrhagic Fevers

    Science.gov (United States)

    ... 4 viruses that cause two other hemorrhagic fevers, dengue hemorrhagic fever and yellow fever. Virus Families Information ... 2014 Content source: Centers for Disease Control and Prevention National Center for Emerging and Zoonotic Infectious Diseases ( ...

  3. Dengue Fever Testing

    Science.gov (United States)

    ... AACC products and services. Advertising & Sponsorship: Policy | Opportunities Dengue Fever Testing Share this page: Was this page helpful? Also known as: Dengue Fever Antibodies; Dengue Fever Virus Formal name: Dengue ...

  4. Acute abdominal pain in patients with lassa fever: Radiological assessment and diagnostic challenges

    Directory of Open Access Journals (Sweden)

    Kenneth C Eze

    2014-01-01

    Full Text Available Background: To highlight the problems of diagnosis and management of acute abdomen in patients with lassa fever. And to also highlight the need for high index of suspicion of lassa fever in patients presenting with acute abdominal pain in order to avoid surgical intervention with unfavourable prognosis and nosocomial transmission of infections, especially in Lassa fever-endemic regions. Materials and Methods: A review of experiences of the authors in the management of lassa fever over a 4-year period (2004-2008. Literature on lassa fever, available in the internet and other local sources, was studied in November 2010 and reviewed. Results: Normal plain chest radiographic picture can change rapidly due to pulmonary oedema, pulmonary haemorrhage and acute respiratory distress syndrome. Plain abdominal radiograph may show dilated bowels with signs of paralytic ileus or dynamic intestinal obstruction due to bowel wall haemorrhage or inflamed and enlarged Peyer′s patches. Ultrasound may show free intra-peritoneal fluid due to peritonitis and intra-peritoneal haemorrhage. Bleeding into the gall bladder wall may erroneously suggest infective cholecystitis. Pericardial effusion with or without pericarditis causing abdominal pain may be seen using echocardiography. High index of suspicion, antibody testing for lassa fever and viral isolation in a reference laboratory are critical for accurate diagnosis. Conclusion: Patients from lassa fever-endemic regions may present with features that suggest acute abdomen. Radiological studies may show findings that suggest acute abdomen but these should be interpreted in the light of the general clinical condition of the patient. It is necessary to know that acute abdominal pain and vomiting in lassa fever-endemic areas could be caused by lassa fever, which is a medical condition. Surgical option should be undertaken with restraint as it increases the morbidity, may worsen the prognosis and increase the risk of

  5. A rare cause of fatal intracranial haemorrhage.

    LENUS (Irish Health Repository)

    Neligan, A

    2012-01-31

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

  6. Subarachnoid haemorrhage of unknown origin: clinical and tomographical aspects.

    Science.gov (United States)

    Cioffi, F; Pasqualin, A; Cavazzani, P; Da Pian, R

    1989-01-01

    65 patients with negative but technically satisfactory 4 vessel angiography - all admitted to our Department in the years 1976-1983 - were evaluated in the present study. CT scan was undertaken in all cases (in 47 cases within 4 days of haemorrhage). Arterial hypertension was present on admission in 9% of cases. The period of follow-up ranged from 4 to 11 years, with a mean of 5.3 years. The study group was compared to a control group, comprising 760 patients with subarachnoid haemorrhage from ruptured aneurysms, admitted during the same period. Clinical grade on admission (Hunt's classification) was better in patients belonging to the study group. The amount of cisternal deposition on CT scan was less significant than in patients with ruptured aneurysms, and the deposition was often atypical (circumpeduncular, ambiental, and/or tentorial). Clinical deterioration associated with vasospasm was observed in 5% of patients in this study and in 27% of patients in the control group. In patients with a consistent or thick cisternal layer (CT scan "at risk") the incidence of clinical vasospasm was 21%, against 47% in controls. One or more rebleedings occurred in 12% of patients in the study group, against 25% of patients in the control group. A significant ventricular dilatation was observed in 15% of patients in the first group (requiring a shunt in 8%), against 25% of patients in the second group (requiring a shunt in 11%). Final outcome was favourable in 95% of patients in this study group and in 63% of patients in the control group, with a mortality rate of 5% in the first group and 32% in the second group.

  7. A study on gender-related differences in laboratory characteristics of dengue fever.

    Science.gov (United States)

    Chakravarti, A; Roy, P; Malik, S; Siddiqui, O; Thakur, P

    2016-01-01

    Studies have reported significant gender-related differences in serological tests for detection of NS1 antigen and IgM antibody used for diagnosing dengue fever. However, no such study has been undertaken in India though dengue fever is endemic in this country. Therefore, this study was planned to study the association of serological findings with gender in 700 patients suspected to be suffering from dengue fever in the Indian setting. Haematological parameters of seropositive patients were also studied. Seropositivity and haemorrhagic findings were significantly associated with the female gender. Positive NS1 antigen and IgM antibody results were significantly associated with females and males, respectively.

  8. Seroprevalence of Rift Valley fever virus in sheep and goats in Zambézia, Mozambique

    OpenAIRE

    Blomström, Anne-Lie; Figueiredo, Jaquline; Nhambirre, Ofélia; Albilio, Ana; Berg, Mikael; Fafetine, José; Scharin, Isabelle; Stenberg, Hedvig

    2016-01-01

    Background: The Rift Valley fever virus (RVFV) is a vector-borne virus that causes disease in ruminants, but it can also infect humans. In humans, the infection can be asymptomatic but can also lead to illness, ranging from a mild disease with fever, headache and muscle pain to a severe disease with encephalitis and haemorrhagic fever. In rare cases, death can occur. In infected animals, influenza-like symptoms can occur, and abortion and mortality in young animals are indicative of RVFV infe...

  9. Trends in monitoring patients with aneurysmal subarachnoid haemorrhage

    DEFF Research Database (Denmark)

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

    2005-01-01

    After aneurysmal subarachnoid haemorrhage (SAH), the clinical outcome depends upon the primary haemorrhage and a number of secondary insults in the acute post-haemorrhagic period. Some secondary insults are potentially preventable but prevention requires prompt recognition of cerebral or systemic...... with the conventional monitoring systems, for example intracranial pressure measurements, transcranial Doppler ultrasound and modern neuro-imaging, direct assessment of biochemical markers by intracerebral microdialysis is promising in the advancement of neurointensive care of patients with SAH. A successfully...

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

    Directory of Open Access Journals (Sweden)

    H Kapyepye

    2006-09-01

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

  11. Molecular confirmation of Lassa fever imported into Ghana

    Directory of Open Access Journals (Sweden)

    Joseph H.K. Bonney

    2016-02-01

    Full Text Available Background: Recent reports have shown an expansion of Lassa virus from the area where it was first isolated in Nigeria to other areas of West Africa. Two Ghanaian soldiers on a United Nations peacekeeping mission in Liberia were taken ill with viral haemorrhagic fever syndrome following the death of a sick colleague and were referred to a military hospital in Accra, Ghana, in May 2013. Blood samples from the soldiers and five asymptomatic close contacts were subjected to laboratory investigations.Objective: We report the results of these investigations to highlight the importance of molecular diagnostic applications and the need for heightened awareness about Lassa fever in West Africa.Methods: We used molecular assays on sera from the two patients to identify the causativeorganism. Upon detection of positive signals for Lassa virus ribonucleic material by two differentpolymerase chain reaction assays, sequencing and phylogenetic analyses were performed.Results: The presence of Lassa virus in the soldiers’ blood samples was shown by L-gene segment homology to be the Macenta and las803792 strains previously isolated in Liberia, with close relationships then confirmed by phylogenetic tree construction. The five asymptomatic close contacts were negative for Lassa virus.Conclusions: The Lassa virus strains identified in the two Ghanaian soldiers had molecular epidemiological links to strains from Liberia. Lassa virus was probably responsible for the outbreak of viral haemorrhagic fever in the military camp. These data confirm Lassa fever endemicity in West Africa.

  12. Lassa fever in West African sub-region: an overview

    Directory of Open Access Journals (Sweden)

    O. Ogbu

    2007-01-01

    Full Text Available Lassa fever is an acute viral zoonotic illness caused by Lassa virus, an arenavirus known to beresponsible for a severe haemorrhagic fever characterised by fever, muscle aches, sore throat, nausea,vomiting and, chest and abdominal pain. The virus exhibits persistent, asymptomatic infection withprofuse urinary virus excretion in the ubiquitous rodent vector, Mastomys natalensis. Lassa fever isendemic in West Africa and has been reported from Sierra Leone, Guinea, Liberia, and Nigeria. Somestudies indicate that 300,000 to 500,000 cases of Lassa fever and 5000 deaths occur yearly across WestAfrica. Studies reported in English, that investigated Lassa fever with reference to West Africa wereidentified using the Medline Entrez-PubMed search and were used for this review. The scarcity ofresources available for health care delivery system and the political instability that characterise theWest African countries would continue to impede efforts for the control of Lassa fever in the sub-region.There is need for adequate training of health care workers regarding diagnostics, intensive care ofpatients under isolation, contact tracing, adequate precautionary measures in handling infectiouslaboratory specimens, control of the vector as well as care and disposal of infectious waste.

  13. Lassa fever in West African sub-region: an overview.

    Science.gov (United States)

    Ogbu, O; Ajuluchukwu, E; Uneke, C J

    2007-03-01

    Lassa fever is an acute viral zoonotic illness caused by Lassa virus, an arenavirus known to be responsible for a severe haemorrhagic fever characterised by fever, muscle aches, sore throat, nausea, vomiting and, chest and abdominal pain. The virus exhibits persistent, asymptomatic infection with profuse urinary virus excretion in the ubiquitous rodent vector, Mastomys natalensis. Lassa fever is endemic in West Africa and has been reported from Sierra Leone, Guinea, Liberia, and Nigeria. Some studies indicate that 300,000 to 500,000 cases of Lassa fever and 5000 deaths occur yearly across West Africa. Studies reported in English, that investigated Lassa fever with reference to West Africa were identified using the Medline Entrez-PubMed search and were used for this review. The scarcity of resources available for health care delivery system and the political instability that characterise the West African countries would continue to impede efforts for the control of Lassa fever in the sub-region. There is need for adequate training of health care workers regarding diagnostics, intensive care of patients under isolation, contact tracing, adequate precautionary measures in handling infectious laboratory specimens, control of the vector as well as care and disposal of infectious waste.

  14. Historical aspects of rheumatic fever.

    Science.gov (United States)

    Steer, Andrew C

    2015-01-01

    Few diseases have experienced such a remarkable change in their epidemiology over the past century, without the influence of a vaccine, than rheumatic fever. Rheumatic fever has all but disappeared from industrialised countries after being a frequent problem in the 1940s and 1950s. That the disease still occurs at high incidence in resource limited settings and in Indigenous populations in industrialised countries, particularly in Australia and New Zealand, is an indication of the profound effect of socio-economic factors on the disease. Although there have been major changes in the epidemiology of rheumatic fever, diagnosis remains reliant on careful clinical judgement and management is remarkably similar to that 50 years ago. Over the past decade, increasing attention has been given to rheumatic fever and rheumatic heart disease as public health issues, including in Australia and particularly in New Zealand, as well as in selected low and middle income countries. Perhaps the greatest hope for public health control of rheumatic fever is the development of a vaccine against Streptococcus pyogenes, and there are encouraging initiatives in this area. However, an effective vaccine is some time away and in the meantime public health efforts need to focus on effective translation of the known evidence around primary and secondary prophylaxis into policy and practice.

  15. Milk fever control principles: a review

    DEFF Research Database (Denmark)

    Thilsing-Hansen, T; Jørgensen, R J; Østergaard, S

    2002-01-01

    Three main preventive principles against milk fever were evaluated in this literature review, and the efficacy of each principle was estimated from the results of controlled investigations. Oral calcium drenching around calving apparently has a mean efficacy of 50%-60% in terms of milk fever...... prevention as well as prevention of milk fever relapse after intravenous treatment with calcium solutions. However, some drenches have been shown to cause lesions in the forestomacs. When using the DCAD (dietary cation-anion difference) principle, feeding rations with a negative DCAD (measured as (Na + K......)-(Cl + S)) significantly reduce the milk fever incidence. Calculating the relative risk (RR) of developing milk fever from controlled experiments results in a mean RR between 0.19 and 0.35 when rations with a negative versus positive DCAD are compared. The main drawback from the DCAD principle...

  16. Unusual Presentation of Dengue Fever Leading to Unnecessary Appendectomy.

    Science.gov (United States)

    Kumar, Lovekesh; Singh, Mahendra; Saxena, Ashish; Kolhe, Yuvraj; Karande, Snehal K; Singh, Narendra; Venkatesh, P; Meena, Rambabu

    2015-01-01

    Dengue fever is the most important arbovirus illness with an estimated incidence of 50-100 million cases per year. The common symptoms of dengue include fever, rash, malaise, nausea, vomiting, and musculoskeletal pain. Dengue fever may present as acute abdomen leading to diagnostic dilemma. The acute surgical complications of dengue fever include acute pancreatitis, acute acalculous cholecystitis, nonspecific peritonitis, and acute appendicitis. We report a case of dengue fever that mimicked acute appendicitis leading to unnecessary appendectomy. A careful history examination for dengue-related signs, and serial hemogram over the first 3-4 days of disease may prevent unnecessary appendectomy.

  17. Unusual Presentation of Dengue Fever Leading to Unnecessary Appendectomy

    Directory of Open Access Journals (Sweden)

    Lovekesh Kumar

    2015-01-01

    Full Text Available Dengue fever is the most important arbovirus illness with an estimated incidence of 50–100 million cases per year. The common symptoms of dengue include fever, rash, malaise, nausea, vomiting, and musculoskeletal pain. Dengue fever may present as acute abdomen leading to diagnostic dilemma. The acute surgical complications of dengue fever include acute pancreatitis, acute acalculous cholecystitis, nonspecific peritonitis, and acute appendicitis. We report a case of dengue fever that mimicked acute appendicitis leading to unnecessary appendectomy. A careful history examination for dengue-related signs, and serial hemogram over the first 3-4 days of disease may prevent unnecessary appendectomy.

  18. Unusual Presentation of Dengue Fever Leading to Unnecessary Appendectomy

    Science.gov (United States)

    Kumar, Lovekesh; Singh, Mahendra; Saxena, Ashish; Kolhe, Yuvraj; Karande, Snehal K.; Singh, Narendra; Venkatesh, P.; Meena, Rambabu

    2015-01-01

    Dengue fever is the most important arbovirus illness with an estimated incidence of 50–100 million cases per year. The common symptoms of dengue include fever, rash, malaise, nausea, vomiting, and musculoskeletal pain. Dengue fever may present as acute abdomen leading to diagnostic dilemma. The acute surgical complications of dengue fever include acute pancreatitis, acute acalculous cholecystitis, nonspecific peritonitis, and acute appendicitis. We report a case of dengue fever that mimicked acute appendicitis leading to unnecessary appendectomy. A careful history examination for dengue-related signs, and serial hemogram over the first 3-4 days of disease may prevent unnecessary appendectomy. PMID:26167314

  19. Epidemiological features of typhoid/paratyphoid fever in provinces with high incidence rate and in the whole country, in 2012%2012年全国和高发省份伤寒、副伤寒流行特征分析

    Institute of Scientific and Technical Information of China (English)

    孙军玲; 张静; 马会来; 常昭瑞

    2013-01-01

    Objective Through analyzing the national statutory reporting data on typhoid,paratyphoid fever in 2012,we were trying to understand the whole picture of typhoid,paratyphoid fever at the national level as well as to understand the trends and characteristics of typhoid and paratyphoid fever in provinces with high incidence rate,so as to the development of prevention and control strategies of the diseases in those high-incidence rate provinces.Methods We descriptively analyzed the national typhoid and paratyphoid fever statutory reporting data which was reported through disease surveillance information reporting system in 2012.Results 11 998 cases with typhoid and paratyphoid fever were reported with 3 fatal ones,in 2012 in the whole country.The incidence rate was 0.89 per 100 000.Compared to the data gathered in 2011,the incidence rates of typhoid/paratyphoid fever increased by 1.20%.The total number of the confirmed cases on typhoid and paratyphoid fever was 6522 and was accounted for 54.36% of the total cases,in which paratyphoid fever accounted for 36.86%.Cases were mainly involved farmers and followed by students and children.Incidence rates of typhoid and paratyphoid fever in children aged 0-4 years old appeared the highest (respectively 1.31/100 000 and 0.46/100 000).Yunnan,Guizhou,Guangdong,Guangxi,Zhejiang,Hunan and Xinjiang provinces (autonomous regions) were identified as provinces with high-incidence rates of typhoid and paratyphoid fever.During 2005-2012,the incidence rates in most of the above high-incidence provinces showed a downward trend,except for in Guangdong which had only showed a slight change.There were variations on peak period and highly-hit population in seven high-incidence provinces.Conclusion The incidence rate of typhoid/paratyphoid fever was in a relatively low level in China.Prevention and control strategies on the diseases in children under 5 years old remained a challenge,warranted more work to be done.The epidemiological

  20. Fever: First Aid

    Science.gov (United States)

    First aid Fever: First aid Fever: First aid By Mayo Clinic Staff A fever is a rise in body temperature. It's usually a sign of infection. The ... 2 C) or higher Should I treat a fever? When you or your child is sick, the ...

  1. CLINICAL PROFILE OF DENGUE FEVER IN KANYAKUMARI GOVERNMENT MEDICAL COLLEGE- A STUDY FROM KANYAKUMARI, INDIA

    Directory of Open Access Journals (Sweden)

    Brinda J

    2017-01-01

    Full Text Available BACKGROUND Dengue infection is viral infection with different clinical presentation. This study was conducted in Kanyakumari Government Medical College Hospital, Asaripallam, Tamil Nadu, to study the various clinical profile and polyserositis involvement in dengue. MATERIALS AND METHODS The clinical profile and polyserositis involvement in dengue infection were determined by the retrospective study of all dengue infection in Kanyakumari Government Medical College Hospital, Asaripallam, Nagercoil, Tamilnadu. It was a retrospective study. All probable cases that had high-grade fever, lymphadenopathy, hepatomegaly, features of hock or haemorrhage and so forth and were admitted with provisional diagnosis of dengue fever were taken into account. All patients with positive dengue tests, either NS1 antigen, IgM, IgG antibody rapid serological test kit or ELISA were taken into the study group. As the duration of history of fever might be fallacious, the patients were subjected to all three serological tests. Patients who were positive for malaria, meningitis and enteric fever were excluded from the study. The whole number of patients included in our study was 40 (=40. RESULTS In this study, it was found that the bleeding manifestation had no correlation with thrombocytopenia, hepatomegaly and raised SGOT. All 40 patients had fever and they were treated with antipyretics (paracetamol in appropriate doses. Patients who presented with warning signs and stable vital signs were initially encouraged to take oral fluids; if they were not tolerated, intravenous fluids were started according to the WHO guidelines. CONCLUSION Dengue is an important arboviral infection in tropical countries. 1 Global incidence of dengue fever has increased dramatically in the recent decades. There are very few studies based on the revised new dengue classification. In our study, the total number of cases analysed was 40, out of which 28 (70% were categorised as cases of non

  2. Fever during anaesthesia.

    Science.gov (United States)

    Negishi, Chiharu; Lenhardt, Rainer

    2003-12-01

    Fever occurs when pyrogenic stimulation activates thermal control centres. Fever is common during the perioperative period, but rare during anaesthesia. Although only a limited number of studies are available to explain how anaesthesia affects fever, general anaesthesia seems to inhibit fever by decreasing the thermoregulatory-response thresholds to cold. Opioids also inhibit fever; however, the effect is slightly less than that of general anaesthesia. In contrast, epidural anaesthesia does not affect fever. This suggests that hyperthermia, which is often associated with epidural infusions during labour or in the post-operative period, may be a true fever caused by inflammatory activation. Accordingly, this fever might be diminished in patients who receive opioids for pain treatment. Post-operative fever is a normal thermoregulatory response usually of non-infectious aetiology. Fever may be important in the host defence mechanisms and should not be routinely treated lest the associated risks exceed the benefits.

  3. Molecular diagnosis of Haemorrhagic Septicaemia - A Review

    OpenAIRE

    Ranjan Rajeev; Panda S.K.; Acharya A.P.; Singh A.P. and Gupta M.K.

    2011-01-01

    Pasteurella multocida is associated with hemorrhagic septicaemia in cattle and buffaloes, pneumonic pasteurellosis in sheep and goats, fowl cholera in poultry, atrophic rhinitis in pigs and snuffles in rabbits. Haemorrhagic septicaemia is caused by Pasteurella multocida type B:2, B:2,5 and B:5 in Asian countries and type E:2 in African countries. Pasteurella multocida have five types of capsular serotype i.e. type A, B, D, E and F. Diagnosis of the disease is mainly based on the clinical sign...

  4. Does microbleed predict haemorrhagic transformation after acute atherothrombotic or cardioembolic stroke?

    Science.gov (United States)

    Lee, S-H; Kang, B-S; Kim, N; Roh, J-K

    2008-08-01

    Cerebral microbleeds (MBs) are known to be indicative of bleeding-prone microangiopathy and may predict incident intracerebral haemorrhage. However, there is controversy concerning the causal relationship between the presence of MBs and haemorrhagic transformation (HTf) after ischaemic stroke. Of the 1034 patients with acute ischaemic stroke who were consecutively admitted to our hospital, 377 patients with stroke due to large-artery atherothrombosis or cardioembolism were selected for participation in this study. We examined the MBs using T2*-weighted gradient-echo MRI performed within 24 hours after admission, and the incidence of HTf was assessed using follow-up brain MRI during the hospitalisation period. Of the 377 patients with stroke, 234 were male (62.1%) and the mean age was 66.2 +/-11.7 years. MBs were initially found in 109 patients (28.9%), and newly incident HTf was noted during the hospitalisation period in 74 patients (19.6%). The presence of MBs was not increased in the patients with HTf (24.3% vs. 30.0% in the patients without HTf; p = 0.331). In addition, the number of MBs was not higher in the patients with HTf (0.7+/-1.5 vs. 1.8+/-8.1; p = 0.234). This lack of significance between MBs and HTf persisted after stratification by stroke mechanism. This study suggests that underlying MBs do not predict incident HTf after acute ischaemic stroke. The clinical significance of MBs should be differentially evaluated according to the type of disease (intracerebral haemorrhage vs. HTf).

  5. Thalamic haemorrhage vs internal capsule-basal ganglia haemorrhage: clinical profile and predictors of in-hospital mortality

    Directory of Open Access Journals (Sweden)

    García-Eroles Luis

    2007-10-01

    Full Text Available Abstract Background There is a paucity of clinical studies focused specifically on intracerebral haemorrhages of subcortical topography, a subject matter of interest to clinicians involved in stroke management. This single centre, retrospective study was conducted with the following objectives: a to describe the aetiological, clinical and prognostic characteristics of patients with thalamic haemorrhage as compared with that of patients with internal capsule-basal ganglia haemorrhage, and b to identify predictors of in-hospital mortality in patients with thalamic haemorrhage. Methods Forty-seven patients with thalamic haemorrhage were included in the "Sagrat Cor Hospital of Barcelona Stroke Registry" during a period of 17 years. Data from stroke patients are entered in the stroke registry following a standardized protocol with 161 items regarding demographics, risk factors, clinical features, laboratory and neuroimaging data, complications and outcome. The region of the intracranial haemorrhage was identified on computerized tomographic (CT scans and/or magnetic resonance imaging (MRI of the brain. Results Thalamic haemorrhage accounted for 1.4% of all cases of stroke (n = 3420 and 13% of intracerebral haemorrhage (n = 364. Hypertension (53.2%, vascular malformations (6.4%, haematological conditions (4.3% and anticoagulation (2.1% were the main causes of thalamic haemorrhage. In-hospital mortality was 19% (n = 9. Sensory deficit, speech disturbances and lacunar syndrome were significantly associated with thalamic haemorrhage, whereas altered consciousness (odds ratio [OR] = 39.56, intraventricular involvement (OR = 24.74 and age (OR = 1.23, were independent predictors of in-hospital mortality. Conclusion One in 8 patients with acute intracerebral haemorrhage had a thalamic hematoma. Altered consciousness, intraventricular extension of the hematoma and advanced age were determinants of a poor early outcome.

  6. Cerebral abscesses among Danish patients with hereditary haemorrhagic telangiectasia

    DEFF Research Database (Denmark)

    Kjeldsen, A D; Tørring, P M; Nissen, H;

    2013-01-01

    Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited disease characterized by a wide variety of clinical manifestations, including pulmonary arteriovenous malformations (PAVMs), which due to paradoxical embolization may cause cerebral abscess.......Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited disease characterized by a wide variety of clinical manifestations, including pulmonary arteriovenous malformations (PAVMs), which due to paradoxical embolization may cause cerebral abscess....

  7. [Rheumatic fever].

    Science.gov (United States)

    Cherkashin, D V; Kumchin, A N; Shchulenin, S N; Svistov, A S

    2013-01-01

    This lecture-style paper highlights all major problems pertinent to rheumatic fever Definition of acute RF and chronic rheumatic heart disease is proposed and desirability of the use of these terms in clinical practice is explained. Present-day epidemiology of RF is described with reference to marked differences in its prevalence in developed and developing countries. Modern classification of acute RF is described as adopted by the Russian Association of Rheumatologists and recommended for the use in Russian medical facilities. Discussion of etiological issues is focused on such virulence factors as beta-hemolytic streptococcus A and genetic predisposition confirming hereditary nature of RE Its clinical features are described along with laboratory and instrumental methods applied for its diagnostics. Large and small diagnostic criteria of RF are considered. Special attention is given to the treatment of RF and its complications (antibiotic, pathogenetic, and drug therapy). Its primary and secondary prophylaxis is discussed in detail, preparations for the purpose are listed (with doses and duration of application). In conclusion, criteria for the efficacy of therapy are presented along with indications for hospitalization and emergency treatment.

  8. Antenatal corticosteroid treatment for the prevention of peri-intraventricular haemorrhage in preterm newborns: a retrospective cohort study using transfontanelle ultrasonography

    Directory of Open Access Journals (Sweden)

    Bianca A. Almeida

    2017-06-01

    Full Text Available Objective: The objective of this study was to assess the correlation between antenatal corticosteroids and peri-intraventricular haemorrhage (PIVH using transfontanelle ultrasonography, as well as to evaluate the risk factors for its incidence. Methods: We performed a retrospective cohort study using medical records of preterm newborns. The protocol for maternal corticoid administration for foetal lung maturation included dexamethasone 4 mg (intramuscular 8/8 hours per 48 hours, with one cycle per week. The diagnosis of periintraventricular haemorrhage was based on transfontanelle ultrasonography, using the Papile’s classification. The following risk factors for peri-intraventricular haemorrhage were assessed: birth weight, gestational age at delivery, type of delivery, newborn’s sex, surfactant administration, premature rupture of membranes and previous history of infection during the current pregnancy. The student’s t-test and chi-square test were used for statistical analysis. Results: Our sample population included 184 preterm newborns. Transfontanelle ultrasonography revealed peri-intraventricular haemorrhage in 32 (74.4% and periventricular leukomalacia in 11 (25.6% newborns. Grade I haemorrhage was found in 20 (62.5%, grade II in five (15.6%, and grade III in seven (21.8% newborns, as in accordance with Papile’s classification. Vaginal delivery (p = 0.010, birth weight <1500 g (p = 0.024, gestational age at delivery ≤32 weeks (p = 0.018, and previous history of infection during pregnancy (p = 0.013 were considered risk factors for peri-intraventricular haemorrhage in preterm newborns. Conclusion: Maternal corticoid administration for foetal lung maturation showed a protective effect against peri-intraventricular haemorrhage in preterm newborns. The risk factors for peri-intraventricular haemorrhage were determined.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-05-01

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

  10. Molecular diagnosis of Haemorrhagic Septicaemia - A Review

    Directory of Open Access Journals (Sweden)

    Ranjan Rajeev

    2011-08-01

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

  11. A nairovirus isolated from African bats causes haemorrhagic gastroenteritis and severe hepatic disease in mice.

    Science.gov (United States)

    Ishii, Akihiro; Ueno, Keisuke; Orba, Yasuko; Sasaki, Michihito; Moonga, Ladslav; Hang'ombe, Bernard M; Mweene, Aaron S; Umemura, Takashi; Ito, Kimihito; Hall, William W; Sawa, Hirofumi

    2014-12-02

    Bats can carry important zoonotic pathogens. Here we use a combination of next-generation sequencing and classical virus isolation methods to identify novel nairoviruses from bats captured from a cave in Zambia. This nairovirus infection is highly prevalent among giant leaf-nosed bats, Hipposideros gigas (detected in samples from 16 individuals out of 38). Whole-genome analysis of three viral isolates (11SB17, 11SB19 and 11SB23) reveals a typical bunyavirus tri-segmented genome. The strains form a single phylogenetic clade that is divergent from other known nairoviruses, and are hereafter designated as Leopards Hill virus (LPHV). When i.p. injected into mice, the 11SB17 strain causes only slight body weight loss, whereas 11SB23 produces acute and lethal disease closely resembling that observed with Crimean-Congo Haemorrhagic Fever virus in humans. We believe that our LPHV mouse model will be useful for research on the pathogenesis of nairoviral haemorrhagic disease.

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

    LENUS (Irish Health Repository)

    Johnson, S N

    2012-02-01

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

  13. Dengue fever in patients admitted in tertiary care hospitals in Pakistan.

    Science.gov (United States)

    Munir, Muhammad Arif; Alam, Syed Ejaz; Khan, Zareef Uddin; Saeed, Quaid; Arif, Ambreen; Iqbal, Rizwan; Saqib, Muhammad Arif Nadeem; Qureshi, Huma

    2014-05-01

    To assess the gaps in the diagnosis and management of dengue fever cases. The retrospective descriptive analytical study was done with a case record analysis of patients with dengue fever admitted from January to December 2010 at five tertiary care hospitals in different Pakistani cities. Using a questionnaire, information was gathered on demography, haematological profile, management, use of blood and platelet transfusions and the outcome. For comparison, data of serologically-confirmed dengue patients from a private laboratory in Islamabad was collected to see the age, gender and month-wise distribution of cases tested over the same period. SPSS 16 was used for statistical analysis. Out of the 841 confirmed dengue cases, 514 (79%) were males and 139 (21%) females. The overall mean age was 31.3 +/- 14.0 years. Dengue fever was seen in 653 (78%) and dengue haemorrhagic fever (DHF) in 188 (22%) patients. Most cases were between 20 and 49 years of age. A gradual increase in dengue fever and dengue haemorrhagic fever was seen from August, with a peak in October/November. Tourniquet test was done only in 20 (2.3%) cases, out of which 11 (55%) were positive and 9 (45%) were negative. Serial haematocrit was not done in any case. Total deaths were 5 (0.6%). Most cases were seen in October/November with the majority being in the 20-39 age group. Tourniquet test and serial haematocrit were infrequently used. No standard national guidelines were employed.

  14. Successful Resolution of Preretinal Haemorrhage with Intravitreal Ranibizumab

    Directory of Open Access Journals (Sweden)

    Baharuddin Noorlaila

    2016-01-01

    Full Text Available We would like to report two cases of preretinal haemorrhage from two different aetiology courses of bleeding being treated with intravitreal ranibizumab and its outcome. Our first case was a 39-year-old man with a diagnosis of severe aplastic anaemia that presented with bilateral premacular haemorrhages in both eyes. His right eye vision was 6/45 and it was counting finger in the left eye. He was treated with intravitreal ranibizumab once to the right eye and twice to the left eye. Right eye showed complete resolution of premacular haemorrhage and minimal residual premacular haemorrhage in the left eye at 3 months after initial presentation. Our second case was a 32-year-old healthy teacher that presented with preretinal haemorrhage at superotemporal region extending to macular area in left eye secondary to valsalva retinopathy. Her left vision was counting finger. She was treated with single intravitreal ranibizumab to the left eye. There was significant reduction of premacular haemorrhage and her left eye vision improved to 6/6 at 10 weeks after injection. Both cases had favourable outcome with intravitreal ranibizumab and can be considered as nonsurgical treatment option in treating premacular haemorrhage.

  15. Neurogenic Fever after Acute Traumatic Spinal Cord Injury: A Qualitative Systematic Review

    Science.gov (United States)

    Savage, Katherine E.; Oleson, Christina V.; Schroeder, Gregory D.; Sidhu, Gursukhman S.; Vaccaro, Alexander R.

    2016-01-01

    Study Design  Systematic review. Objective  To determine the incidence, pathogenesis, and clinical outcomes related to neurogenic fevers following traumatic spinal cord injury (SCI). Methods  A systematic review of the literature was performed on thermodysregulation secondary to acute traumatic SCI in adult patients. A literature search was performed using PubMed (MEDLINE), Cochrane Central Register of Controlled Trials, and Scopus. Using strict inclusion and exclusion criteria, seven relevant articles were obtained. Results  The incidence of fever of all origins (both known and unknown) after SCI ranged from 22.5 to 71.7% with a mean incidence of 50.6% and a median incidence of 50.0%. The incidence of fever of unknown origin (neurogenic fever) ranged from 2.6 to 27.8% with a mean incidence of 8.0% and a median incidence of 4.7%. Cervical and thoracic spinal injuries were more commonly associated with fever than lumbar injuries. In addition, complete injuries had a higher incidence of fever than incomplete injuries. The pathogenesis of neurogenic fever after acute SCI is not thoroughly understood. Conclusion  Neurogenic fevers are relatively common following an acute SCI; however, there is little in the scientific literature to help physicians prevent or treat this condition. The paucity of research underscored by this review demonstrates the need for further studies with larger sample sizes, focusing on incidence rate, clinical outcomes, and pathogenesis of neurogenic fever following acute traumatic SCI. PMID:27556002

  16. Pulmonary hypertension in hereditary haemorrhagic telangiectasia

    Institute of Scientific and Technical Information of China (English)

    Veronique; MM; Vorselaars; Sebastiaan; Velthuis; Repke; J; Snijder; Jan; Albert; Vos; Johannes; J; Mager; Martijn; C; Post

    2015-01-01

    Hereditary haemorrhagic telangiectasia(HHT) is an autosomal dominant inherited disorder characterised by vascular malformations in predominantly the brain,liverand lungs.Pulmonary hypertension(PH) is increasingly recognised as a severe complication of HHT.PH may be categorised into two distinct types in patients with HHT.Post-capillary PH most often results from a high pulmonary blood flow that accompanies the high cardiac output state associated with liver arteriovenous malformations.Less frequently,the HHT-related gene mutations in ENG or ACVRL1 appear to predispose patients with HHT to develop pre-capillary pulmonary arterial hypertension.Differentiation between both forms of PH by right heart catheterisation is essential,since both entities are associated with severe morbidity and mortality with different treatment options.Therefore all HHT patients should be referred to an HHT centre.

  17. Hyperbaric oxygen treatment for haemorrhagic radiation cystitis

    Energy Technology Data Exchange (ETDEWEB)

    Bevers, R.F.M.; Kurth, K.H. [Amsterdam Univ. (Netherlands). Academic Medical Center; Bakker, D.J. [Amsterdam Univ. (Netherlands). Depts. of Urology and Surgery

    1995-09-23

    Radiation-induced severe haemorrhagic cystitis is difficult to treat. Conventional treatments may decrease haematuria but do not affect the radiocystitis itself. Hyperbaric oxygen treatment has been reported to do both. We report the results of a prospective study of hyperbaric oxygen (20 sessions of 100% oxygen inhalation at 3 bar for 90 min in a multiplace hyperbaric chamber) to 40 patients with biopsy-proven radiation cystitis and severe haematuria. Haematuria disappeared completely or improved in 37 patients after treatment. Mean follow-up was 23.1 months (range 1-74); and the recurrence rate was 0.12/year. There were no adverse effects. Hyperbaric oxygen treatment should be considered for patients with severe radiation-induced haematuria. (author).

  18. Familial Mediterranean fever

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000363.htm Familial Mediterranean fever To use the sharing features on this page, please enable JavaScript. Familial Mediterranean fever (FMF) is a rare disorder passed down through ...

  19. Fever due to levamisole

    Directory of Open Access Journals (Sweden)

    Gupta R

    2003-05-01

    Full Text Available Fever is rarely caused by levamisole. We report a 26-year-old woman who repeatedly developed fever 4-12 hrs after taking levamisole. The association was confirmed by repeated provocation tests.

  20. Rocky Mountain spotted fever

    Science.gov (United States)

    ... Mountain spotted fever is caused by the bacteria Rickettsia rickettsii (R. Rickettsii) , which is carried by ticks. ... Saunders; 2014:chap 212. Walker DH, Blaton LS. Rickettsia rickettsii and other spotted fever group rickettsiae (Rocky ...

  1. Fever in Children: Pearls and Pitfalls.

    Science.gov (United States)

    Barbi, Egidio; Marzuillo, Pierluigi; Neri, Elena; Naviglio, Samuele; Krauss, Baruch S

    2017-09-01

    Fever in children is a common concern for parents and one of the most frequent presenting complaints in emergency department visits, often involving non-pediatric emergency physicians. Although the incidence of serious infections has decreased after the introduction of conjugate vaccines, fever remains a major cause of laboratory investigation and hospital admissions. Furthermore, antipyretics are the most common medications administered to children. We review the epidemiology and measurement of fever, the meaning of fever and associated clinical signs in children of different ages and under special conditions, including fever in children with cognitive impairment, recurrent fevers, and fever of unknown origin. While the majority of febrile children have mild, self-resolving viral illness, a minority may be at risk of life-threatening infections. Clinical assessment differs markedly from adult patients. Hands-off evaluation is paramount for a correct evaluation of breathing, circulation and level of interaction. Laboratory markers and clinical prediction rules provide limited help in identifying children at risk for serious infections; however, clinical examination, prudent utilization of laboratory tests, and post-discharge guidance ("safety netting") remain the cornerstone of safe management of febrile children.

  2. Fever in Children: Pearls and Pitfalls

    Science.gov (United States)

    Barbi, Egidio; Marzuillo, Pierluigi; Neri, Elena; Krauss, Baruch S.

    2017-01-01

    Fever in children is a common concern for parents and one of the most frequent presenting complaints in emergency department visits, often involving non-pediatric emergency physicians. Although the incidence of serious infections has decreased after the introduction of conjugate vaccines, fever remains a major cause of laboratory investigation and hospital admissions. Furthermore, antipyretics are the most common medications administered to children. We review the epidemiology and measurement of fever, the meaning of fever and associated clinical signs in children of different ages and under special conditions, including fever in children with cognitive impairment, recurrent fevers, and fever of unknown origin. While the majority of febrile children have mild, self-resolving viral illness, a minority may be at risk of life-threatening infections. Clinical assessment differs markedly from adult patients. Hands-off evaluation is paramount for a correct evaluation of breathing, circulation and level of interaction. Laboratory markers and clinical prediction rules provide limited help in identifying children at risk for serious infections; however, clinical examination, prudent utilization of laboratory tests, and post-discharge guidance (“safety netting”) remain the cornerstone of safe management of febrile children. PMID:28862659

  3. Fever in Children: Pearls and Pitfalls

    Directory of Open Access Journals (Sweden)

    Egidio Barbi

    2017-09-01

    Full Text Available Fever in children is a common concern for parents and one of the most frequent presenting complaints in emergency department visits, often involving non-pediatric emergency physicians. Although the incidence of serious infections has decreased after the introduction of conjugate vaccines, fever remains a major cause of laboratory investigation and hospital admissions. Furthermore, antipyretics are the most common medications administered to children. We review the epidemiology and measurement of fever, the meaning of fever and associated clinical signs in children of different ages and under special conditions, including fever in children with cognitive impairment, recurrent fevers, and fever of unknown origin. While the majority of febrile children have mild, self-resolving viral illness, a minority may be at risk of life-threatening infections. Clinical assessment differs markedly from adult patients. Hands-off evaluation is paramount for a correct evaluation of breathing, circulation and level of interaction. Laboratory markers and clinical prediction rules provide limited help in identifying children at risk for serious infections; however, clinical examination, prudent utilization of laboratory tests, and post-discharge guidance (“safety netting” remain the cornerstone of safe management of febrile children.

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010

    OpenAIRE

    Buckle, Geoffrey C; Fischer Walker, Christa L.; Black, Robert E.

    2012-01-01

    Background Typhoid and paratyphoid fever remain important causes of morbidity worldwide. Accurate disease burden estimates are needed to guide policy decisions and prevention and control strategies. Methods We conducted a systematic literature review of the PubMed and Scopus databases using pre-defined criteria to identify population-based studies with typhoid fever incidence data published between 1980 and 2009. We also abstracted data from annual reports of notifiable diseases in countries ...

  6. Q fever in Greenland

    DEFF Research Database (Denmark)

    Koch, Anders; Svendsen, Claus Bo; Christensen, Jens Jorgen

    2010-01-01

    We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection.......We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection....

  7. Q fever in Greenland

    DEFF Research Database (Denmark)

    Koch, Anders; Svendsen, Claus Bo; Christensen, Jens Jorgen

    2010-01-01

    We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection.......We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection....

  8. [Acute rheumatic fever].

    Science.gov (United States)

    Maier, Alexander; Kommer, Vera

    2016-03-01

    We report on a young women with acute rheumatic fever. Acute rheumatic fever has become a rare disease in Germany, especially in adults. This carries the risk that it can be missed in the differential diagnostic considerations of acute rheumatic disorders and febrile status. If rheumatic fever is not diagnosed and treated correctly, there is a considerable risk for rheumatic valvular heart disease. In this article diagnosis, differential diagnosis and therapy of rheumatic fever are discussed extensively.

  9. Rat Bite Fever

    Science.gov (United States)

    ... Español Text Size Email Print Share Rat Bite Fever Page Content Article Body Rat-bite fever is a disease that occurs in humans who ... ingestion of contaminated food or milk products (Haverhill fever). Most cases in the United States are caused ...

  10. Scarlet Fever (For Parents)

    Science.gov (United States)

    ... Feeding Your 1- to 2-Year-Old Scarlet Fever KidsHealth > For Parents > Scarlet Fever Print A A A What's in this article? ... to Call the Doctor en español Escarlatina Scarlet fever is caused by an infection with group A ...

  11. Seasonal Allergies (Hay Fever)

    Science.gov (United States)

    ... 1- to 2-Year-Old Seasonal Allergies (Hay Fever) KidsHealth > For Parents > Seasonal Allergies (Hay Fever) Print A A A What's in this article? ... are at work. Seasonal allergies , sometimes called "hay fever" or seasonal allergic rhinitis, are allergy symptoms that ...

  12. Neurogenic fever after traumatic brain injury: an epidemiological study

    OpenAIRE

    Thompson, H; Pinto-Martin, J; Bullock, M.

    2003-01-01

    Objectives: To determine the incidence of neurogenic fever (NF) in a population of patients in the acute phase following severe traumatic brain injury (TBI); to identify factors associated with the development of NF following severe TBI in adults.

  13. Rainfall and sloth births in may, Q fever in July, Cayenne, French Guiana.

    Science.gov (United States)

    Eldin, Carole; Mahamat, Aba; Djossou, Felix; Raoult, Didier

    2015-05-01

    Q fever in French Guiana is correlated with the rainy season. We found a 1- to 2-month lagged correlation between Q fever incidence and the number of births of three-toed sloth. This result strengthens the hypothesis that the three-toed sloth is the wild reservoir of Q fever in French Guiana.

  14. Rainfall and Sloth Births in May, Q Fever in July, Cayenne, French Guiana

    OpenAIRE

    Eldin, Carole; Mahamat, Aba; Djossou, Felix; Raoult, Didier

    2015-01-01

    Q fever in French Guiana is correlated with the rainy season. We found a 1- to 2-month lagged correlation between Q fever incidence and the number of births of three-toed sloth. This result strengthens the hypothesis that the three-toed sloth is the wild reservoir of Q fever in French Guiana.

  15. Lassa Fever in Pregnancy: Report of 2 Cases Seen at the University College Hospital, Ibadan.

    Science.gov (United States)

    Bello, O O; Akinajo, O R; Odubamowo, K H; Oluwasola, T A O

    2016-01-01

    Lassa fever (LF), an acute viral haemorrhagic fever, is an endemic zoonotic viral infection in West Africa countries with up to 15% case fatality rate. Though a rodent-borne infection, it can also be transmitted from person to person during the care of sick relations or more commonly in health care settings as a nosocomial infection. Vertical transmission from mother to child has been documented. We report 2 cases of LF among pregnant women which were managed at the University College Hospital, Ibadan, between September and October 2014. Both patients were in their early 20s with only one surviving the disease. Both had supportive therapy but none had antiviral therapy. This report emphasized the importance of early presentation, high index of suspicion, prompt diagnosis, and early commencement of supportive therapy in the management of patients suspected with LF especially in the era of other viral haemorrhagic infections.

  16. Lassa Fever in Pregnancy: Report of 2 Cases Seen at the University College Hospital, Ibadan

    Directory of Open Access Journals (Sweden)

    O. O. Bello

    2016-01-01

    Full Text Available Lassa fever (LF, an acute viral haemorrhagic fever, is an endemic zoonotic viral infection in West Africa countries with up to 15% case fatality rate. Though a rodent-borne infection, it can also be transmitted from person to person during the care of sick relations or more commonly in health care settings as a nosocomial infection. Vertical transmission from mother to child has been documented. We report 2 cases of LF among pregnant women which were managed at the University College Hospital, Ibadan, between September and October 2014. Both patients were in their early 20s with only one surviving the disease. Both had supportive therapy but none had antiviral therapy. This report emphasized the importance of early presentation, high index of suspicion, prompt diagnosis, and early commencement of supportive therapy in the management of patients suspected with LF especially in the era of other viral haemorrhagic infections.

  17. Diagnostic criteria of acute rheumatic fever.

    Science.gov (United States)

    Burke, Rebecca J; Chang, Christopher

    2014-01-01

    Acute rheumatic fever is an inflammatory sequela of Group A Streptococcal pharyngitis that affects multiple organ systems. The incidence of acute rheumatic fever has been declining even before the use of antibiotics became widespread, however the disease remains a significant cause of morbidity and mortality in children, particularly in developing countries and has been estimated to affect 19 per 100,000 children worldwide. Acute rheumatic fever is a clinical diagnosis, and therefore subject to the judgment of the clinician. Because of the variable presentation, the Jones criteria were first developed in 1944 to aid clinicians in the diagnosis of acute rheumatic fever. The Jones criteria have been modified throughout the years, most recently in 1992 to aid clinicians in the diagnosis of initial attacks of acute rheumatic fever and to minimize overdiagnosis of the disease. Diagnosis of acute rheumatic fever is based on the presence of documented preceding Group A Streptococcal infection, in addition to the presence of two major manifestations or one major and two minor manifestations of the Jones criteria. Without documentation of antecedent Group A Streptococcal infection, the diagnosis is much less likely except in a few rare scenarios. Carditis, polyarthritis and Sydenham's chorea are the most common major manifestations of acute rheumatic fever. However, despite the predominance of these major manifestations of acute rheumatic fever, there can be significant overlap with other disorders such as Lyme disease, serum sickness, drug reactions, and post-Streptococcal reactive arthritis. This overlap between disease processes has led to continued investigation of the pathophysiology as well as development of new biomarkers and laboratory studies to aid in the diagnosis of acute rheumatic fever and distinction from other disease processes.

  18. Isolated spinal artery aneurysm: a rare culprit of subarachnoid haemorrhage.

    Science.gov (United States)

    Sung, Tony H T; Leung, Warren K W; Lai, Bill M H; Khoo, Jennifer L S

    2015-04-01

    Isolated spinal artery aneurysm is a rare lesion which could be accountable for spontaneous spinal subarachnoid haemorrhage. We describe the case of a 74-year-old man presenting with sudden onset of chest pain radiating to the neck and back, with subsequent headache and confusion. Initial computed tomography aortogram revealed incidental finding of subtle acute spinal subarachnoid haemorrhage. A set of computed tomography scans of the brain showed further acute intracranial subarachnoid haemorrhage with posterior predominance, small amount of intraventricular haemorrhage, and absence of intracranial vascular lesions. Subsequent magnetic resonance imaging demonstrated a thrombosed intradural spinal aneurysm with surrounding sentinel clot, which was trapped and excised during surgical exploration. High level of clinical alertness is required in order not to miss this rare but detrimental entity. Its relevant aetiopathological features and implications for clinical management are discussed.

  19. Immediate post-partum haemorrhage: Epidemiological aspects and ...

    African Journals Online (AJOL)

    Objective: To identify the causes of post-partum haemorrhage and identify ..... by Massachusetts General Hospital's Maternal, Newborn and Child ... This Lancet series on obesity (at http://www.thelancet.com/series/obesity-2015) exposes the ...

  20. Cases of typhoid fever in Copenhagen region

    DEFF Research Database (Denmark)

    Barrett, Freja Cecille; Knudsen, Jenny Dahl; Johansen, Isik Somuncu

    2013-01-01

    Typhoid fever is a systemic illness which in high-income countries mainly affects travellers. The incidence is particularly high on the Indian subcontinent. Travellers who visit friends and relatives (VFR) have been shown to have a different risk profile than others. We wished to identify main ch...

  1. Aspirin-induced post-gingivectomy haemorrhage: a timely reminder.

    Science.gov (United States)

    Thomason, J M; Seymour, R A; Murphy, P; Brigham, K M; Jones, P

    1997-02-01

    A case report is described of significant aspirin-induced haemorrhage following a gingivectory procedure in an organ transplant patient. Aspirin-induced platelet impairment secondary to low-dose aspirin was implicated as the cause of the haemorrhage. Haemostasis was eventually achieved after platelet transfusion. The case illustrates the problems that can arise when carrying out gingival surgery on patients medicated with low-dose aspirin.

  2. Fetal germinal matrix and intraventricular haemorrhage diagnosed by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Fukui, K.; Morioka, T.; Nishio, S.; Fukui, M. [Dept. of Neurosurgery, Kyushu Univ., Fukuoka (Japan); Mihara, F. [Dept. of Clinical Radiology, Kyushu Univ., Fukuoka (Japan); Nakayama, H. [Dept. of Paediatrics, Kyushu Univ., Fukuoka (Japan); Tsukimori, K. [Dept. of Obstetrics, Kyushu Univ., Fukuoka (Japan)

    2001-01-01

    Subependymal germinal matrix haemorrhage and intraventricular haemorrhage (GMIVH) is a common complication of delivery in preterm neonates but has rarely been observed in the fetus. We report two cases of GMIVH in fetuses of 36 weeks gestation, clearly demonstrated by antenatal MRI. In both cases progressive ventriculomegaly was observed, and ventriculoperitoneal shunts were placed at 19 and 6 months of age, respectively. Prenatal GMIVH may be a cause of congenital hydrocephalus, for which no aetiology has yet been found. (orig.)

  3. Haemorrhage in a scrotal lymphangioma in a child: A rarity

    Directory of Open Access Journals (Sweden)

    Rattan Kamal

    2009-01-01

    Full Text Available We report here a case of cystic lymphangioma of scrotum presenting as acute scrotum due to haemorrhage. The diagnosis was confirmed on ultrasonography and magnetic resonance imaging and managed successfully by surgical excision. There was past history of bilateral congenital cataract for which the patient had undergone surgery with complete visual recovery. Scrotal cystic lymphangioma complicated by haemorrhage is rare; hence, the case is being reported with a review of literature.

  4. Enhanced gastric mucosal haemostasis after upper gastrointestinal haemorrhage.

    OpenAIRE

    Allison, M C; Fullarton, G M; Brown, I.L.; Crean, G P; McColl, K E

    1991-01-01

    An endoscopic technique for the measurement of gastric mucosal bleeding time has been developed to study gastric haemostasis in patients with acute upper gastrointestinal haemorrhage. The relation of gastric mucosal bleeding time to skin bleeding time and nonsterodial anti-inflammatory drug usage was examined in 61 control patients and in 47 patients presenting with bleeding peptic ulcers or erosions. Gastric mucosal bleeding time was shorter in patients with haemorrhage (median 2 minutes, ra...

  5. Blood transfusion and the anaesthetist: management of massive haemorrhage

    Science.gov (United States)

    Thomas, D; Wee, M; Clyburn, P; Walker, I; Brohi, K; Collins, P; Doughty, H; Isaac, J; Mahoney, PF; Shewry, L

    2010-01-01

    Hospitals must have a major haemorrhage protocol in place and this should include clinical, laboratory and logistic responses. Immediate control of obvious bleeding is of paramount importance (pressure, tourniquet, haemostatic dressings). The major haemorrhage protocol must be mobilised immediately when a massive haemorrhage situation is declared. A fibrinogen 1.5 times normal represents established haemostatic failure and is predictive of microvascular bleeding. Early infusion of fresh frozen plasma (FFP; 15 ml.kg−1) should be used to prevent this occurring if a senior clinician anticipates a massive haemorrhage. Established coagulopathy will require more than 15 ml.kg−1 of FFP to correct. The most effective way to achieve fibrinogen replacement rapidly is by giving fibrinogen concentrate or cryoprecipitate if fibrinogen is unavailable. 1:1:1 red cell:FFP:platelet regimens, as used by the military, are reserved for the most severely traumatised patients. A minimum target platelet count of 75 × 109.l−1 is appropriate in this clinical situation. Group-specific blood can be issued without performing an antibody screen because patients will have minimal circulating antibodies. O negative blood should only be used if blood is needed immediately. In hospitals where the need to treat massive haemorrhage is frequent, the use of locally developed shock packs may be helpful. Standard venous thromboprophylaxis should be commenced as soon as possible after haemostasis has been secured as patients develop a prothrombotic state following massive haemorrhage. PMID:20963925

  6. Burden of typhoid fever in Sulaimania, Iraqi Kurdistan.

    Science.gov (United States)

    Dworkin, Jonathan; Saeed, Rebeen; Mykhan, Hawar; Kanan, Shwan; Farhad, Dlawer; Ali, Kocher Omer; Abdulwahab, Runak Hama Kareem; Palardy, John; Neill, Marguerite A

    2014-10-01

    Typhoid fever imposes a high disease burden worldwide, but resource limitations mean that the burden of typhoid fever in many countries is poorly understood. The authors conducted a prospective surveillance study at the adult and pediatric teaching hospitals in Sulaimania, Iraqi Kurdistan. All patients presenting with an undifferentiated febrile illness consistent with typhoid were eligible for enrollment. Enrolled patients had blood cultures and Brucella serologies performed. Incidence was calculated with reference to census data. Both typhoid fever and brucellosis were common, and the incidence of typhoid fever was 21 cases/100 000 patient-years. Classic disease symptoms were uncommonly observed. Cost-effective surveillance projects to calculate disease burden of typhoid fever are practical and replicable. Typhoid has successfully adapted to the healthcare environment in Sulaimania. Additional work in the region should focus on antibiotic resistance and other enteric pathogens such as Brucella spp. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Rabbit haemorrhagic disease (RHD and rabbit haemorrhagic disease virus (RHDV: a review

    Directory of Open Access Journals (Sweden)

    Abrantes Joana

    2012-02-01

    Full Text Available Abstract Rabbit haemorrhagic disease virus (RHDV is a calicivirus of the genus Lagovirus that causes rabbit haemorrhagic disease (RHD in adult European rabbits (Oryctolagus cuniculus. First described in China in 1984, the virus rapidly spread worldwide and is nowadays considered as endemic in several countries. In Australia and New Zealand where rabbits are pests, RHDV was purposely introduced for rabbit biocontrol. Factors that may have precipitated RHD emergence remain unclear, but non-pathogenic strains seem to pre-date the appearance of the pathogenic strains suggesting a key role for the comprehension of the virus origins. All pathogenic strains are classified within one single serotype, but two subtypes are recognised, RHDV and RHDVa. RHD causes high mortality in both domestic and wild adult animals, with individuals succumbing between 48-72 h post-infection. No other species has been reported to be fatally susceptible to RHD. The disease is characterised by acute necrotising hepatitis, but haemorrhages may also be found in other organs, in particular the lungs, heart, and kidneys due to disseminated intravascular coagulation. Resistance to the disease might be explained in part by genetically determined absence or weak expression of attachment factors, but humoral immunity is also important. Disease control in rabbitries relies mainly on vaccination and biosecurity measures. Such measures are difficult to be implemented in wild populations. More recent research has indicated that RHDV might be used as a molecular tool for therapeutic applications. Although the study of RHDV and RHD has been hampered by the lack of an appropriate cell culture system for the virus, several aspects of the replication, epizootology, epidemiology and evolution have been disclosed. This review provides a broad coverage and description of the current knowledge on the disease and the virus.

  8. Rabbit haemorrhagic disease (RHD) and rabbit haemorrhagic disease virus (RHDV): a review

    Science.gov (United States)

    2012-01-01

    Rabbit haemorrhagic disease virus (RHDV) is a calicivirus of the genus Lagovirus that causes rabbit haemorrhagic disease (RHD) in adult European rabbits (Oryctolagus cuniculus). First described in China in 1984, the virus rapidly spread worldwide and is nowadays considered as endemic in several countries. In Australia and New Zealand where rabbits are pests, RHDV was purposely introduced for rabbit biocontrol. Factors that may have precipitated RHD emergence remain unclear, but non-pathogenic strains seem to pre-date the appearance of the pathogenic strains suggesting a key role for the comprehension of the virus origins. All pathogenic strains are classified within one single serotype, but two subtypes are recognised, RHDV and RHDVa. RHD causes high mortality in both domestic and wild adult animals, with individuals succumbing between 48-72 h post-infection. No other species has been reported to be fatally susceptible to RHD. The disease is characterised by acute necrotising hepatitis, but haemorrhages may also be found in other organs, in particular the lungs, heart, and kidneys due to disseminated intravascular coagulation. Resistance to the disease might be explained in part by genetically determined absence or weak expression of attachment factors, but humoral immunity is also important. Disease control in rabbitries relies mainly on vaccination and biosecurity measures. Such measures are difficult to be implemented in wild populations. More recent research has indicated that RHDV might be used as a molecular tool for therapeutic applications. Although the study of RHDV and RHD has been hampered by the lack of an appropriate cell culture system for the virus, several aspects of the replication, epizootology, epidemiology and evolution have been disclosed. This review provides a broad coverage and description of the current knowledge on the disease and the virus. PMID:22325049

  9. Typhoid Fever Presenting With Acute Renal Failure And Hepatitis Simultaneously - A Rare Presentation

    OpenAIRE

    Rajput R.; Jain D; Kumar A.; Mittal A

    2016-01-01

    Typhoid fever is an important health problem worldwide but its incidence is more in developing countries. Hepatic involvement is common, but both hepatic and renal involvement is rare in typhoid fever. We report a case of typhoid fever presenting with hepatitis and acute renal failure. A 17 year old male presenting with fever and pain abdomen was found to have raised blood urea, creatinine, liver enzymes and bilirubin. Widal and typhidot (IgM,IgG) test were positive. His symptoms subsided and...

  10. Primary postpartum haemorrhage in women with von Willebrand disease or carriership of haemophilia despite specialised care: a retrospective survey.

    Science.gov (United States)

    Stoof, S C M; van Steenbergen, H W; Zwagemaker, A; Sanders, Y V; Cannegieter, S C; Duvekot, J J; Leebeek, F W G; Peters, M; Kruip, M J H A; Eikenboom, J

    2015-07-01

    Pregnant women with bleeding disorders require specialised peripartum care to prevent postpartum haemorrhage (PPH). If third trimester coagulation factor levels are complicated by PPH. We found an increased PPH risk in deliveries given prophylactic treatment compared with deliveries without (OR 2.7, 95% CI 1.2-6.3). In conclusion, PPH incidence was highest in deliveries with the lowest factor levels in the third trimester. Currently, delivery outcome in women with bleeding disorders is unsatisfactory, given the high PPH incidence despite specialised care. Future studies are required to optimise management of deliveries in this patient population.

  11. Typhoid Fever in South Africa in an Endemic HIV Setting.

    Science.gov (United States)

    Keddy, Karen H; Sooka, Arvinda; Smith, Anthony M; Musekiwa, Alfred; Tau, Nomsa P; Klugman, Keith P; Angulo, Frederick J

    2016-01-01

    Typhoid fever remains an important disease in Africa, associated with outbreaks and the emerging multidrug resistant Salmonella enterica serotype Typhi (Salmonella Typhi) haplotype, H58. This study describes the incidence of, and factors associated with mortality due to, typhoid fever in South Africa, where HIV prevalence is high. Nationwide active laboratory-based surveillance for culture-confirmed typhoid fever was undertaken from 2003-2013. At selected institutions, additional clinical data from patients were collected including age, sex, HIV status, disease severity and outcome. HIV prevalence among typhoid fever patients was compared to national HIV seroprevalence estimates. The national reference laboratory tested Salmonella Typhi isolates for antimicrobial susceptibility and haplotype. Unadjusted and adjusted logistic regression analyses were conducted determining factors associated with typhoid fever mortality. We identified 855 typhoid fever cases: annual incidence ranged from 0.11 to 0.39 per 100,000 population. Additional clinical data were available for 369 (46.8%) cases presenting to the selected sites. Among typhoid fever patients with known HIV status, 19.3% (29/150) were HIV-infected. In adult females, HIV prevalence in typhoid fever patients was 43.2% (19/44) versus 15.7% national HIV seroprevalence (P Typhoid fever incidence in South Africa was largely unchanged from 2003-2013. Typhoid fever mortality was associated disease severity. HIV infection may be a contributing factor. Interventions mandate improved health care access, including to HIV management programmes as well as patient education. Further studies are necessary to clarify relationships between HIV infection and typhoid fever in adults.

  12. Pontiac fever: an operational definition for epidemiological studies

    Directory of Open Access Journals (Sweden)

    Mathieu Laurence

    2006-04-01

    Full Text Available Abstract Background Pontiac fever is usually described in epidemic settings. Detection of Pontiac fever is a marker of an environmental contamination by Legionella and should thereby call for prevention measures in order to prevent outbreak of Legionnaire's disease. The objective of this study is to propose an operational definition of Pontiac fever that is amenable to epidemiological surveillance and investigation in a non epidemic setting. Methods A population of 560 elderly subjects residing in 25 nursing homes was followed during 4 months in order to assess the daily incidence of symptoms associated, in the literature, with Pontiac fever. The water and aerosol of one to 8 showers by nursing home were characterized combining conventional bacterial culture of Legionella and the Fluorescence In Situ Hybridization (FISH technique that used oligonucleotides probes specific for Legionellaceae. A definition of Pontiac fever was devised based on clinical symptoms described in epidemic investigations and on their timing after the exposure event. The association between incidence of Pontiac fever and shower contamination levels was evaluated to test the relevance of this definition. Results The proposed definition of Pontiac fever associated the following criteria: occurrence of at least one symptom among headache, myalgia, fever and shivers, possibly associated with other 'minor' symptoms, within three days after a shower contaminated by Legionella, during a maximum of 8 days (minimum 2 days. 23 such cases occurred during the study (incidence rate: 0.125 cases per person-year [95% CI: 0.122–0.127]. A concentration of Legionella in water equal to or greater than 104.L-1 (FISH method was associated with a significant increase of incidence of Pontiac fever (p = 0.04. Conclusion Once validated in other settings, the proposed definition of Pontiac fever might be used to develop epidemiological surveillance and help draw attention on sources of

  13. Haemorrhage control in severely injured patients.

    Science.gov (United States)

    Gruen, Russell L; Brohi, Karim; Schreiber, Martin; Balogh, Zsolt J; Pitt, Veronica; Narayan, Mayur; Maier, Ronald V

    2012-09-22

    Most surgeons have adopted damage control surgery for severely injured patients, in which the initial operation is abbreviated after control of bleeding and contamination to allow ongoing resuscitation in the intensive-care unit. Developments in early resuscitation that emphasise rapid control of bleeding, restrictive volume replacement, and prevention or early management of coagulopathy are making definitive surgery during the first operation possible for many patients. Improved topical haemostatic agents and interventional radiology are becoming increasingly useful adjuncts to surgical control of bleeding. Better understanding of trauma-induced coagulopathy is paving the way for the replacement of blind, unguided protocols for blood component therapy with systemic treatments targeting specific deficiencies in coagulation. Similarly, treatments targeting dysregulated inflammatory responses to severe injury are under investigation. As point-of-care diagnostics become more suited to emergency environments, timely targeted intervention for haemorrhage control will result in better patient outcomes and reduced demand for blood products. Our Series paper describes how our understanding of the roles of the microcirculation, inflammation, and coagulation has shaped new and emerging treatment strategies.

  14. Intracranial haemorrhage among a population of haemophilic patients in Brazil.

    Science.gov (United States)

    Antunes, S V; Vicari, P; Cavalheiro, S; Bordin, J O

    2003-09-01

    Intracranial haemorrhage (ICH) is a common cause of morbidity and mortality in haemophilic patients. The overall incidence of ICH has been reported to range from 2.2% to 7.5% in patients with haemophilia. From 1987 to 2001, 401 haemophilic patients from the Serviço de Hemofilia, Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo were evaluated. The episodes of ICH were documented by CT scan and the anatomic location, clinical presentation, relationship to trauma and clinical factors, including the presence of HIV infection and the presence of inhibitor, were reviewed. Among 401 haemophilic patients, 45 ICH episodes in 35 (8.7%) patients with age ranging from 4 days to 49 years (mean 10.6 years) were observed. A history of recent trauma was documented in 24 (53.3%) cases. Seventeen (37.8%) episodes occurred in more than one site of bleeding, 12 (26.7%) were subdural, seven (15.5%) subarachnoid, four (8.9%) epidural, two (4.4%) intracerebral and one (2.2%) intraventricular. The most frequent symptoms were headache and drowsiness. All patients were submitted to replacement therapy and neurosurgical intervention was performed in eight (17.8%) patients. Despite the treatment, three (8.6%) haemophilia A patients died due to the ICH event and three presented late sequelae. The most important aspect of ICH management is the early replacement therapy in haemophilic patients. This prompt treatment will increase the chances of a better prognosis. Another impact measure consists in the administration of the deficient coagulation factor after every head trauma, even when considered minor.

  15. Typhoid fever vaccination strategies.

    Science.gov (United States)

    Date, Kashmira A; Bentsi-Enchill, Adwoa; Marks, Florian; Fox, Kimberley

    2015-06-19

    Typhoid vaccination is an important component of typhoid fever prevention and control, and is recommended for public health programmatic use in both endemic and outbreak settings. We reviewed experiences with various vaccination strategies using the currently available typhoid vaccines (injectable Vi polysaccharide vaccine [ViPS], oral Ty21a vaccine, and injectable typhoid conjugate vaccine [TCV]). We assessed the rationale, acceptability, effectiveness, impact and implementation lessons of these strategies to inform effective typhoid vaccination strategies for the future. Vaccination strategies were categorized by vaccine disease control strategy (preemptive use for endemic disease or to prevent an outbreak, and reactive use for outbreak control) and vaccine delivery strategy (community-based routine, community-based campaign and school-based). Almost all public health typhoid vaccination programs used ViPS vaccine and have been in countries of Asia, with one example in the Pacific and one experience using the Ty21a vaccine in South America. All vaccination strategies were found to be acceptable, feasible and effective in the settings evaluated; evidence of impact, where available, was strongest in endemic settings and in the short- to medium-term. Vaccination was cost-effective in high-incidence but not low-incidence settings. Experience in disaster and outbreak settings remains limited. TCVs have recently become available and none are WHO-prequalified yet; no program experience with TCVs was found in published literature. Despite the demonstrated success of several typhoid vaccination strategies, typhoid vaccines remain underused. Implementation lessons should be applied to design optimal vaccination strategies using TCVs which have several anticipated advantages, such as potential for use in infant immunization programs and longer duration of protection, over the ViPS and Ty21a vaccines for typhoid prevention and control. Copyright © 2015. Published by

  16. Treatment of dengue fever

    Directory of Open Access Journals (Sweden)

    Rajapakse S

    2012-07-01

    Full Text Available Senaka Rajapakse,1,2 Chaturaka Rodrigo,1 Anoja Rajapakse31Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka; 2Lincoln County Hospital, United Lincolnshire NHS Trust, Lincoln, UK; 3Kings Mill Hospital, Sherwood Forest NHS Foundation Trust, Mansfield, UKAbstract: The endemic area for dengue fever extends over 60 countries, and approximately 2.5 billion people are at risk of infection. The incidence of dengue has multiplied many times over the last five decades at an alarming rate. In the endemic areas, waves of infection occur in epidemics, with thousands of individuals affected, creating a huge burden on the limited resources of a country's health care system. While the illness passes off as a simple febrile episode in many, a few have a severe illness marked by hypovolemic shock and bleeding. Iatrogenic fluid overload in the management may further complicate the picture. In this severe form dengue can be fatal. Tackling the burden of dengue is impeded by several issues, including a lack of understanding about the exact pathophysiology of the infection, inability to successfully control the vector population, lack of specific therapy against the virus, and the technical difficulties in developing a vaccine. This review provides an overview on the epidemiology, natural history, management strategies, and future directions for research on dengue, including the potential for development of a vaccine.Keywords: dengue, treatment, fluid resuscitation

  17. Dabigatran ameliorates post-haemorrhagic hydrocephalus development after germinal matrix haemorrhage in neonatal rat pups.

    Science.gov (United States)

    Klebe, Damon; Flores, Jerry J; McBride, Devin W; Krafft, Paul R; Rolland, William B; Lekic, Tim; Zhang, John H

    2016-01-01

    We aim to determine if direct thrombin inhibition by dabigatran will improve long-term brain morphological and neurofunctional outcomes and if potential therapeutic effects are dependent upon reduced PAR-1 stimulation and consequent mTOR activation. Germinal matrix haemorrhage was induced by stereotaxically injecting 0.3 U type VII-S collagenase into the germinal matrix of P7 rat pups. Animals were divided into five groups: sham, vehicle (5% DMSO), dabigatran intraperitoneal, dabigatran intraperitoneal + TFLLR-NH2 (PAR-1 agonist) intranasal, SCH79797 (PAR-1 antagonist) intraperitoneal, and dabigatran intranasal. Neurofunctional outcomes were determined by Morris water maze, rotarod, and foot fault evaluations at three weeks. Brain morphological outcomes were determined by histological Nissl staining at four weeks. Expression levels of p-mTOR/p-p70s6k at three days and vitronectin/fibronectin at 28 days were quantified. Intranasal and intraperitoneal dabigatran promoted long-term neurofunctional recovery, improved brain morphological outcomes, and reduced intracranial pressure at four weeks after GMH. PAR-1 stimulation tended to reverse dabigatran's effects on post-haemorrhagic hydrocephalus development. Dabigatran also reduced expression of short-term p-mTOR and long-term extracellular matrix proteins, which tended to be reversed by PAR-1 agonist co-administration. PAR-1 inhibition alone, however, did not achieve the same therapeutic effects as dabigatran administration.

  18. Rheumatic fever reappraised

    Institute of Scientific and Technical Information of China (English)

    Ulrik Baandrup

    2005-01-01

    @@ Rheumatic fever is a complication following an episode of group A streptococcal pharyngitis. It is an acute immunologically mediated, multisystem inflammatory disorder. Acute rheumatic heart disease during the active phase of rheumatic fever sometimes progresses to chronic rheumatic heart disease. Despite its declining importance in industrialised countries rheumatic fever remains the leading cause of death from heart disease in children and young adults in less developed regions. Fifteen to twenty million new cases emerge every year in developing countries.1

  19. Misoprostol for treating postpartum haemorrhage: a randomized controlled trial [ISRCTN72263357

    Directory of Open Access Journals (Sweden)

    Maholwana Babalwa

    2004-08-01

    Full Text Available Abstract Background Postpartum haemorrhage remains an important cause of maternal death despite treatment with conventional therapy. Uncontrolled studies and one randomised comparison with conventional oxytocics have reported dramatic effects with high-dose misoprostol, usually given rectally, for treatment of postpartum haemorrhage, but this has not been evaluated in a placebo-controlled trial. Methods The study was conducted at East London Hospital Complex, Tembisa and Chris Hani Baragwanath Hospitals, South Africa. Routine active management of the third stage of labour was practised. Women with more than usual postpartum bleeding thought to be related to inadequate uterine contraction were invited to participate, and to sign informed consent. All routine treatment was given from a special 'Postpartum Haemorrhage Trolley'. In addition, participants who consented were enrolled by drawing the next in a series of randomised treatment packs containing either misoprostol 5 × 200 μg or similar placebo, which were given 1 orally, 2 sublingually and 2 rectally. Results With misoprostol there was a trend to reduced blood loss ≥500 ml in 1 hour after enrolment measured in a flat plastic 'fracture bedpan', the primary outcome (6/117 vs 11/120, relative risk 0.56; 95% confidence interval 0.21 to 1.46. There was no difference in mean blood loss or haemoglobin level on day 1 after birth 38.5°C (11/114 vs 2/118; 5.69, 1.29 to 25. In the misoprostol group 3 women underwent hysterectomy of whom 1 died, and there were 2 further maternal deaths. Conclusions Because of a lower than expected incidence of the primary outcome in the placebo group, the study was underpowered. We could not confirm the dramatic effect of misoprostol reported in several unblinded studies, but the results do not exclude a clinically important effect. Larger studies are needed to assess substantive outcomes and risks before misoprostol enters routine use.

  20. Chronic haemorrhagic radiation proctitis: A review

    Institute of Scientific and Technical Information of China (English)

    Vishnu Prasad Nelamangala Ramakrishnaiah; Srinivasan Krishnamachari

    2016-01-01

    Chronic haemorrhagic radiation proctitis(CHRP) is a difficult problem faced by the patients following radiation for pelvic malignancy. There is no standardtreatment for this condition, but many methods of treatment are available. The aim of this study was to review the literature to see whether there is an improvement in the available evidence in comparison with previously published systematic reviews in treating patients with CHRP. The Pub Med/Medline database and Google Scholar search was selectively searched. Studies, which treated patients with rectal bleeding due to chronic radiation proctitis or CHRP, were included. Seventy studies were finally selected out of which 14 were randomized controlled clinical trials. Though these studies could not be compared, it could be seen that there was an improvement in the methodology of the studies. There was an objective assessment of symptoms, signs and an objective assessment of outcomes. But, still, there were only a few studies that looked into the quality of life following treatment of CHRP. To increase recruitment to trials, a national registry of cases with established late radiation toxicity would facilitate the further improvement of such studies. Some of the conclusions that could be reached based on the available evidence are 4% formalin should be the first line treatment for patients with CHRP. Formalin and argon plasma coagulation(APC) are equally effective, but formalin is better for severe disease. Refractory patients, not responding to formalin or APC, need to be referred for hyperbaric oxygen therapy or surgery. Radio-frequency ablation is a promising modality that needs to be studied further in randomized trials.

  1. Host biomarkers are associated with progression to dengue haemorrhagic fever: a nested case-control study

    Directory of Open Access Journals (Sweden)

    Andrea L. Conroy

    2015-11-01

    Conclusions: These results suggest that inflammation and endothelial activation are important pathways in the pathogenesis of dengue and sICAM-1 levels may identify individuals at risk of plasma leakage.

  2. The Utility of a Board Game for Dengue Haemorrhagic Fever Health Education

    Science.gov (United States)

    Lennon, Jeffrey L.; Coombs, David W.

    2007-01-01

    Purpose: The purpose of this study is to test the effectiveness of an educational board game for increasing knowledge, positive attitudes-beliefs, and self-efficacy for dengue prevention in a sample of Philippine school children and adolescents. Effective board games are more advantageous than lectures because they are adaptable, inexpensive and…

  3. The Utility of a Board Game for Dengue Haemorrhagic Fever Health Education

    Science.gov (United States)

    Lennon, Jeffrey L.; Coombs, David W.

    2007-01-01

    Purpose: The purpose of this study is to test the effectiveness of an educational board game for increasing knowledge, positive attitudes-beliefs, and self-efficacy for dengue prevention in a sample of Philippine school children and adolescents. Effective board games are more advantageous than lectures because they are adaptable, inexpensive and…

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

    Directory of Open Access Journals (Sweden)

    Talgat Nurmakhanov

    2015-09-01

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

  5. First serological evidence of Crimean-Congo haemorrhagic fever in febrile patients in Mozambique

    Directory of Open Access Journals (Sweden)

    Argentina Felisbela Muianga

    2017-09-01

    Conclusions: This study shows for the first time that humans are exposed to CCHFV in Mozambique. It highlights the need for further work to investigate the broader extent of circulating CCHFV in the country and its clinical implications.

  6. Hantaan Virus, Aetiological Agent of Korean Haemorrhagic Fever, Has Bunyaviridae-Like Morphology

    Science.gov (United States)

    1982-04-03

    properties. This led us to use buoyant density centrifugation to re-examine Hantaan virus. Materials and Methods Virus and Antisera All work was done with...The density of sucrose measured by refractometry is in g/nil ( - - A). Presence (+ )or absence (0) of virus particles by electron microscopy is

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-08-01

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

  8. Haemorrhagic cholecystitis: an unusual cause of upper gastrointestinal bleeding.

    Science.gov (United States)

    Hicks, Natalie

    2014-01-17

    Haemorrhagic cholecystitis is a rare cause of upper gastrointestinal bleeding and is a difficult diagnosis to make. This case report describes an orthopaedic patient, who developed deranged liver function tests and anaemia after a hemiarthroplasty of the hip. The patient had upper abdominal pain and black stools which clinically appeared to be melaena. An ultrasound scan of the abdomen was inconclusive, and therefore a CT was performed and the potential diagnosis of haemorrhagic cholecystitis was raised. An endoscopic evaluation of the upper gastrointestinal tract showed no evidence of other causes of upper gastrointestinal bleeding. Following an emergency laparotomy and cholecystectomy, she recovered well. This report aims to increase awareness about the uncommon condition of haemorrhagic cholecystitis, and to educate regarding clinical and radiological signs which lead to this diagnosis.

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

    LENUS (Irish Health Repository)

    Ogbodo, Elisha

    2012-01-01

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

  10. An outbreak of acute haemorrhagic conjunctivitis in Melaka, Malaysia.

    Science.gov (United States)

    Ghazali, O; Chua, K B; Ng, K P; Hooi, P S; Pallansch, M A; Oberste, M S; Chua, K H; Mak, J W

    2003-10-01

    This paper reports a second outbreak of acute haemorrhagic conjunctivitis due to coxsackievirus A24 in peninsular Malaysia. Between June 2002 and early October 2003, 10,327 patients, comprising 3,261 children and 7,066 adults, were treated for acute conjunctivitis in 11 government health clinics in the Melaka Tengah district of the state of Melaka. The figure grossly underestimates the size of the outbreak; as no patients treated in private clinics in the same district were included. Institution and household surveillance showed that the commonest presenting clinical feature of the illness was eye-discharge (91.2%), followed by foreign body sensation (81.8%), pain (78.3%) and subconjunctival haemorrhage (74.4%). The mean duration of illness was 6.5 and five days for patients with and without subconjunctival haemorrhage respectively.

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

    LENUS (Irish Health Repository)

    Ogbodo, Elisha

    2012-01-01

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

  12. Haemoragisk Rift Valley Fever

    DEFF Research Database (Denmark)

    Fabiansen, Christian; Thybo, Søren

    2007-01-01

    A case of fatal hemorrhagic Rift Valley fever during an epidemic in Kenya's North Eastern Province in January 2007 is described.......A case of fatal hemorrhagic Rift Valley fever during an epidemic in Kenya's North Eastern Province in January 2007 is described....

  13. Rift Valley Fever Virus

    Science.gov (United States)

    Rift Valley fever virus (RVFV) is a mosquito-transmitted virus or arbovirus that is endemic in sub-Saharan Africa. In the last decade, Rift Valley fever (RVF) outbreaks have resulted in loss of human and animal life, as well as had significant economic impact. The disease in livestock is primarily a...

  14. Neonatal typhoid fever.

    OpenAIRE

    Chin, K C; Simmonds, E J; Tarlow, M J

    1986-01-01

    Three infants of Pakistani immigrant mothers developed typhoid fever in the neonatal period. All three survived, but two became chronic excretors of Salmonella typhi. The risk of an outbreak of typhoid fever in a maternity unit or special care baby unit is emphasized.

  15. Rat bite fever.

    NARCIS (Netherlands)

    Gaastra, W.; Boot, R.G.A.; Ho, H.; Lipman, L.J.A.

    2009-01-01

    Rat bite fever (RBF) is a bacterial zoonosis for which two causal bacterial species have been identified: Streptobacillis moniliformis and Spirillum minus. Haverhill fever (HF) is a form of S. moniliformis infection believed to develop after ingestion of contaminated food or water. Here the

  16. Differences in cognitive and emotional outcomes between patients with perimesencephalic and aneurysmal subarachnoid haemorrhage

    NARCIS (Netherlands)

    W. Boerboom (Wendy); M.H. Heijenbrok-Kal (Majanka); L. Khajeh (Ladbon); F. van Kooten (Fop); G.M. Ribbers (Gerard)

    2014-01-01

    textabstractObjectives: To compare cognitive and emotional outcomes between patients with aneurysmal and perimesencephalic subarachnoid haemorrhage and norm scores. Design: First measurement in prospective cohort study. Patients: Sixty-seven patients with subarachnoid haemorrhage, were divided into

  17. Epistaxis related to exercise-induced pulmonary haemorrhage in South African Thoroughbreds

    Directory of Open Access Journals (Sweden)

    H. Weideman

    2003-07-01

    Full Text Available This study investigated if environmental factors had an effect on the incidence of epistaxis related to exercise-induced pulmonary haemorrhage (EIPH among racehorses in southern Africa. Data covering the period 1986-2001 and involving 778 532 race runs were analysed. This included the following information : date of race, age, sex, name of breeder, trainer, distance, jockey, state of going, weight carried, racing centre and altitude. Veterinarians employed by the Jockey Club suspended officially entered horses that presented with epistaxis (frank bleeding from the nostrils after racing. On-course endoscopy is not performedas a standard practice at any southern African racetrack. Epistaxis was identified in 1287 horses (0.165 %. More horses presented with EIPH-related epistaxis (a at sea level, (b from May to October, (c when older (> 3 years, (d after 1995, (e on Fridays and Sundays, and (f more in geldings than in mares or entire males. No association could be established between epistaxis and breeder, trainer, distance run, jockey, state of going and weight carried. It is concluded that the frequency of EIPH-related epistaxis is associated with altitude, winter and spring, sex and age. It is suggested that racing at lower altitudes may increase the probability of exercise-induced pulmonary haemorrhage.

  18. Investigating the effects of climatic variables and reservoir on the incidence of hemorrhagic fever with renal syndrome in Huludao City, China: a 17-year data analysis based on structure equation model

    Directory of Open Access Journals (Sweden)

    Shen Tiefeng

    2009-07-01

    Full Text Available Abstract Background HFRS is a serious public health problem in China and the study on HFRS is important in China for its large population. The present study aimed to explore the impact of climatic variables and reservoir on the incidence of HFRS in Huludao City, an epidemic focus of the disease in northeastern China. Methods Structure Equation Model (SEM, a statistical technique for testing and estimating causal relationships, was conducted based on climatic variables, virus-carrying index among rodents, and incidence of HFRS in the city during the period 1990 to 2006. The linear structural relationships (LISREL software (Scientific Software International, Lincolnwood, IL was used to fit SEMs. Results Temperature, precipitation, relative humidity and virus-carrying index among rodents have shown positive correlations with the monthly incidence of HFRS, while air pressure had a negative correlation with the incidence. The best-fit SEM model fitted well with the data-based correlation matrix, P value was more than 0.56, root mean square error of approximation (RMSEA equaled to 0, goodness-of-fit index (GFI was more than 0.99. Conclusion Climate and reservoirs have affected the incidence of HFRS in Huludao City, located in northeastern China. Climate affects HFRS incidence mainly through the effect on reservoir in the study area. HFRS prevention and control should give more consideration to rodent control and climate variations.

  19. Investigating the effects of climatic variables and reservoir on the incidence of hemorrhagic fever with renal syndrome in Huludao City, China: a 17-year data analysis based on structure equation model

    Science.gov (United States)

    2009-01-01

    Background HFRS is a serious public health problem in China and the study on HFRS is important in China for its large population. The present study aimed to explore the impact of climatic variables and reservoir on the incidence of HFRS in Huludao City, an epidemic focus of the disease in northeastern China. Methods Structure Equation Model (SEM), a statistical technique for testing and estimating causal relationships, was conducted based on climatic variables, virus-carrying index among rodents, and incidence of HFRS in the city during the period 1990 to 2006. The linear structural relationships (LISREL) software (Scientific Software International, Lincolnwood, IL) was used to fit SEMs. Results Temperature, precipitation, relative humidity and virus-carrying index among rodents have shown positive correlations with the monthly incidence of HFRS, while air pressure had a negative correlation with the incidence. The best-fit SEM model fitted well with the data-based correlation matrix, P value was more than 0.56, root mean square error of approximation (RMSEA) equaled to 0, goodness-of-fit index (GFI) was more than 0.99. Conclusion Climate and reservoirs have affected the incidence of HFRS in Huludao City, located in northeastern China. Climate affects HFRS incidence mainly through the effect on reservoir in the study area. HFRS prevention and control should give more consideration to rodent control and climate variations. PMID:19583875

  20. Haemorrhagic Lumbar Juxtafacet Cyst with Ligamentum Flavum Involvement

    Directory of Open Access Journals (Sweden)

    Finn Ghent

    2014-01-01

    Full Text Available Juxtafacet cysts are an uncommon cause of radiculopathy. They occur most frequently in the lumbar region, and their distribution across the spine correlates with mobility. Haemorrhagic complications are rare and may occur in the absence of any provocation, although there is some association with anticoagulation and trauma. We present a case of acute radiculopathy due to an L5/S1 juxtafacet cyst with unprovoked haemorrhage which was found to extend into ligamentum flavum. The patient underwent uncomplicated microscope assisted decompression with excellent results. The demographics, presentation, aetiology, and management of juxtafacet cysts are discussed.

  1. Eradication of viral haemorrhagic septicaemia in Danish aquaculture

    DEFF Research Database (Denmark)

    Olesen, Niels Jørgen; Skall, Helle Frank; Jensen, Britt Bang

    Eradication of viral haemorrhagic septicaemia in Danish aquaculture Olesen N.J.1, Skall H.F.1, Jensen B.B.2, Henriksen N.H.3, Mellergård S.4, H. Korsholm H.5 1National Veterinary Institute, Technical University of Denmark, Aarhus, Denmark 2Norwegian Veterinary Institute, Oslo, Norway 3Danish...... Aquaculture Association, Silkeborg, Denmark 4Danish Veterinary and Food Administration, Glostrup, Denmark 5Danish Veterinary and Food Administration, Vejle, Denmark Viral haemorrhagic septicaemia (VHS) virus was first isolated in Denmark in 1962, when more than half of the approximately 800 Danish fish farms...

  2. Bacterial endotoxins and liver haemorrhage in the oestrogenised chicken.

    Science.gov (United States)

    Curtis, M J; Pearson, A W; Butler, E J

    1980-11-01

    Hepatic steatosis and haemorrhage in oestrogenised chickens were not associated with any increase in the endotoxin content of the plasma. The haemorrhage was not ameliorated by suppressing enteric bacteria with neomycin or exacerbated by the repeated injection of Escherichia coli O111 endotoxin and there were no relevant changes in plasma enzyme activities that are indicators of liver damage. These results therefore do not support the hypothesis that, as in the choline deficient rat, hepatic steatosis impairs the ability of the oestrogenised chicken to dispose of bacterial endotoxins and that these then damage the liver.

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

    DEFF Research Database (Denmark)

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

    2004-01-01

    The nucleotide sequences of a specific region of the nucleoprotein gene were compared in order to investigate the genetic population structure of marine viral haemorrhagic septicaemia virus (VHSV). Analysis of the sequence from 128 isolates of diverse geographic and host origin renders this the m......The nucleotide sequences of a specific region of the nucleoprotein gene were compared in order to investigate the genetic population structure of marine viral haemorrhagic septicaemia virus (VHSV). Analysis of the sequence from 128 isolates of diverse geographic and host origin renders...

  4. Perforated ileal duplication cyst with haemorrhagic pseudocyst formation

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Im Kyung; Kim, Bong Soo; Kim, Heung Chul; Lee, In Sun; Hwang, Woo Chul [Department of Radiology, College of Medicine, Hallym University (Korea); Namkung, Sook [Department of Radiology, College of Medicine, Hallym University (Korea); Department of Radiology, Chuncheon Sacred Heart Hospital, 153 Kyo-dong, Chuncheon, Kangwon-do, 200-704 (Korea)

    2003-07-01

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

  5. Typhoid Fever Presenting With Acute Renal Failure And Hepatitis Simultaneously - A Rare Presentation

    Directory of Open Access Journals (Sweden)

    Rajput R.

    2016-05-01

    Full Text Available Typhoid fever is an important health problem worldwide but its incidence is more in developing countries. Hepatic involvement is common, but both hepatic and renal involvement is rare in typhoid fever. We report a case of typhoid fever presenting with hepatitis and acute renal failure. A 17 year old male presenting with fever and pain abdomen was found to have raised blood urea, creatinine, liver enzymes and bilirubin. Widal and typhidot (IgM,IgG test were positive. His symptoms subsided and deranged parameters resolved with treatment of typhoid fever.

  6. Spatial analysis of dengue fever in Guangdong Province, China, 2001-2006.

    Science.gov (United States)

    Liu, Chunxiao; Liu, Qiyong; Lin, Hualiang; Xin, Benqiang; Nie, Jun

    2014-01-01

    Guangdong Province is the area most seriously affected by dengue fever in China. In this study, we describe the spatial distribution of dengue fever in Guangdong Province from 2001 to 2006 with the objective of informing priority areas for public health planning and resource allocation. Annualized incidence at a county level was calculated and mapped to show crude incidence, excess hazard, and spatial smoothed incidence. Geographic information system-based spatial scan statistics was conducted to detect the spatial distribution pattern of dengue fever incidence at the county level. Spatial scan cluster analyses suggested that counties around Guangzhou City and Chaoshan Region were at increased risk for dengue fever (P dengue fever were found in Guangdong Province, which allowed intervention measures to be targeted for maximum effect.

  7. A case of pulmonary tuberculosis presenting as diffuse alveolar haemorrhage: is there a role for anticardiolipin antibodies?

    Directory of Open Access Journals (Sweden)

    Lauria Francesco N

    2010-02-01

    Full Text Available Abstract Background Diffuse alveolar haemorrhage (DAH has been rarely reported in association with pulmonary infections. Case Presentation We report the case of a 43 year old immunocompetent man presenting with dyspnoea, fever and haemoptysis. Chest imaging showed bilateral ground glass opacities. Microbiological and molecular tests were positive for Mycobacterium tuberculosis and treatment with isoniazid, rifampicin, ethambutol and pyrazinamide was successful. In this case the diagnosis of DAH relies on clinical, radiological and endoscopic findings. Routine blood tests documented the presence of anticardiolipin antibodies. In the reported case the diagnostic criteria of antiphospholipid syndrome were not fulfilled. Conclusions The transient presence of anticardiolipin antibodies in association with an unusual clinical presentation of pulmonary tuberculosis is intriguing although a causal relationship cannot be established.

  8. Epidural Analgesia and Fever at Labor

    Directory of Open Access Journals (Sweden)

    Ye. M. Shifman

    2008-01-01

    Full Text Available Objective: to study the incidence of labor fever under epidural analgesia (EA and to evaluate its impact on the courses of puerperium and early neonatality. Subjects and methods. The paper presents the data of a prospective study of the course of labor, puerperium, and early neonatality in 397 women in whom labors occurred at the Republican Peritoneal Center in 2006. A study group included 324 parturients in whom labor pain was relieved by EA. A comparison group comprised 55 parturients in whom no analgesics were used at labor. Results. There were no significant statistical differences between the groups in the incidence of labor fever and complicated puerperium and in that of neonatal pyoseptic diseases. Key words: labor hyperthermia, epidural analgesia, labor pain relief.

  9. Can radiological characteristics of preoperative cerebral lesions predict postoperative intracranial haemorrhage in endocarditis patients?

    Science.gov (United States)

    Diab, Mahmoud; Guenther, Albrecht; Scheffel, Philipp; Sponholz, Christoph; Lehmann, Thomas; Hedderich, Johannes; Faerber, Gloria; Brunkhorst, Frank; Pletz, Mathias W; Doenst, Torsten

    2016-05-01

    Infective endocarditis (IE) is associated with high mortality (20-40%) and neurological complications (20-50%). Postoperative intracranial haemorrhage (ICH) is a feared complication especially in patients with preoperative cerebral infarcts. The aim of this study was to determine the radiological characteristics of cerebral lesions that could predict the occurrence of postoperative ICH in IE patients. We retrospectively reviewed all charts, brain imaging and follow-up data from patients operated for left-sided endocarditis between January 2007 and April 2013. A total of 308 patients (age 62.0 ± 13.9) underwent surgery for IE. Preoperative cerebrovascular complications were present in 122 patients (39.6%), representing stroke in 87, silent cerebral infarctions in 31 patients and transient ischaemic attacks in 4 patients. Among 118 patients with cerebral lesions, the aetiological classification of the lesions was ischaemic in 63.6%, ischaemic with haemorrhagic transformation (HT) in 17.8%, ischaemic with concomitant microbleeds in 16.1% and intracerebral bleeding in 2.5%. Postoperative ICH occurred in 17 patients and its incidence was slightly higher in patients with preoperative cerebral infarcts compared with those without preoperative cerebral infarcts [7.6 vs 4.2%, respectively, odds ratio (OR) 1.88, 95% confidence interval (CI) 0.70-5.02, P = 0.21]. However, the difference was not statistically significant. Similarly, the incidence of postoperative ICH was higher in cases of HT of ischaemic infarcts than in cases of ischaemic infarcts not complicated with HT (19.0 vs 5.3%). However, the difference was not statistically significant (P = 0.24). The radiological pattern of preoperative cerebral lesions was single in 35.6% and multiple in 60.0% of cases. Multiple cerebral lesions were associated with a non-significantly lower incidence of postoperative ICH than single lesions (5.6 vs 11.9%, respectively, OR: 0.44, CI: 0.11-1.73, P = 0.29). The results suggest that

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  11. Subjective hearing impairment after subarachnoid haemorrhage : Prevalence and risk factors

    NARCIS (Netherlands)

    Vos, Erik M.; Greebe, Paut; Visser-Meily, J. M Anne|info:eu-repo/dai/nl/180428047; Rinkel, Gabriel J E|info:eu-repo/dai/nl/085712000; Vergouwen, Mervyn D I

    2017-01-01

    Background Sensorineural hearing impairment is a key symptom in patients with superficial siderosis of the central nervous system, a disease caused by chronic or intermittent haemorrhage into the subarachnoid space. We investigated the prevalence and risk factors of subjective hearing impairment

  12. Individual risk assessment for intracranial haemorrhage during thrombolytic therapy

    NARCIS (Netherlands)

    M.L. Simoons (Maarten); A.P. Maggioni; G. Knatterud; J.D. Leimberger; P.P.T. de Jaegere (Peter); R.T. van Domburg (Ron); H. Boersma (Eric); M. Grazia Franzosi (M.); R.M. Califf (Robert); R. Schroder; E. Braunwald (Eugene)

    1993-01-01

    textabstractThrombolytic therapy improves outcome in patients with myocardial infarction but is associated with an increased risk of intracranial haemorrhage. For some patients, this risk may outweigh the potential benefits of thrombolytic treatment. Using data from other studies, we developed a mod

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-06-01

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

  14. Eradication of viral haemorrhagic septicaemia in Danish aquaculture

    DEFF Research Database (Denmark)

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

    2013-01-01

    Viral haemorrhagic septicaemia (VHS) virus was first isolated in Denmark in 1962, when more than half of the approximately 800 Danish fish farms were considered to be infected. Today, 50 years later, the country obtained status as EU approved VHS free zone. In the years in between very significan...

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

    DEFF Research Database (Denmark)

    Bashir, Asma; Andresen, Morten; Bartek, Jiri

    2016-01-01

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

  16. Transfusion practice in major obstetric haemorrhage: lessons from trauma.

    Science.gov (United States)

    Saule, I; Hawkins, N

    2012-01-01

    The management of massive haemorrhage with blood products is changing as evidence arrives from civilian and military trauma. Rapid early replacement of coagulation factors and platelets is now becoming central to improving outcome, usually given in higher ratios with respect to red cell units than previously recommended and using empiric transfusion based on clinical rather than laboratory parameters. The management of three cases of major obstetric haemorrhage based on these principles is presented. Packed red blood cells, fresh frozen plasma, platelets and cryoprecipitate were transfused in the ratios 5:2:2:1, 4.5:1:1:1 and 4.5:2:1:1. Each patient had acceptable full blood count and coagulation results after surgery and all made an uneventful recovery. These outcomes support the opinion that major obstetric haemorrhage can be managed in a similar fashion to blood loss in trauma. Recommendations from the Association of Anaesthetists of Great Britain and Ireland, and the UK National Patient Safety Agency should be considered during major obstetric haemorrhage.

  17. Haemorrhage after home birth: audit of decision making and referral

    NARCIS (Netherlands)

    Smit, M. de; Dijkman, A.; Rijnders, M.; Bustraan, J.; Dillen, J. van; Middeldorp, J.; Havenith, B.; Roosmalen, J. van

    2013-01-01

    In the Netherlands, 20 per cent of women give birth at home. In 0.7 per cent, referral to secondary care because of postpartum haemorrhage (PPH) is indicated. Midwives are regularly trained in managing obstetric emergencies. A postgraduate training programme developed for Dutch community-based midwi

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  19. Intrauterine balloon tamponade for the control of postpartum haemorrhage.

    Science.gov (United States)

    Lohano, Rajni; Haq, Gulfishan; Kazi, Sarah; Sheikh, Saima

    2016-01-01

    To evaluate the effectiveness of balloon temponade in the management of postpartum haemorrhage. The study was conducted at the Dow University of Health Sciences and Civil Hospital Karachi from January to July 18, 2012, and comprised women aged 18-35 years, parity 1-6 and gestational age 31-41 weeks, who developed or were admitted with primary postpartum haemorrhage due to uterine atony in whom medical treatment had failed. SPSS 10 was used to analyse the data. The mean age, parity, gestational age of 139 women was 26.4±4.2 years, 3.4±1.3, 37.81±1.67 respectively. Mean estimated blood loss was 1155.8±350.6 ml, mean systolic blood pressure 90.96±18.1 mmHg, diastolic blood pressure 55±7.5 mmHg and mean pulse was 108.3±10.89 bpm. Balloon tamponade was effective in 126(90.4%) cases. Condom catheter balloon tamponade was an effective means of controlling postpartum haemorrhage. There should be a low threshold for use of balloon tamponade as it is effective, easy to use, easily available, has low complication rate, and an inexpensive modality to manage non-traumatic postpartum haemorrhage, especially in resource-limited settings, and still maintain reproductive ability.

  20. Breathing-Impaired Speech after Brain Haemorrhage: A Case Study

    Science.gov (United States)

    Heselwood, Barry

    2007-01-01

    Results are presented from an auditory and acoustic analysis of the speech of an adult male with impaired prosody and articulation due to brain haemorrhage. They show marked effects on phonation, speech rate and articulator velocity, and a speech rhythm disrupted by "intrusive" stresses. These effects are discussed in relation to the speaker's…

  1. A rare case of Weil’s disease with alveolar haemorrhage

    Institute of Scientific and Technical Information of China (English)

    Abhiram Chakrabarti; Manab Nandy; Dipankar Pal; Sudesna Mallik

    2014-01-01

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

  2. Risk factors for the incidence of dengue virus infection in preschool children.

    Science.gov (United States)

    Teixeira, Maria G; Morato, Vanessa; Barreto, Florisneide R; Mendes, Carlos M C; Barreto, Maurício L; Costa, Maria da Conceição N

    2012-11-01

    To estimate the seroincidence of dengue in children living in Salvador, Bahia, Brazil and to evaluate the factors associated.   A prospective serological survey was carried out in a sample of children 0-3 years of age. A multilevel logistic model was used to identify the determinants of seroincidence. The seroprevalence of dengue was 26.6% in the 625 children evaluated. A second survey detected an incidence of 33.2%. Multilevel logistic regression showed a statistically significant association between the seroincidence of dengue and age and the premises index. In Salvador, the dengue virus is in active circulation during early childhood; consequently, children have heterotypic antibodies and run a high risk of developing dengue haemorrhagic fever, because the sequence and intensity of the three dengue virus serotypes currently circulating in this city are very similar to those that were circulating in Rio de Janeiro, Brazil, in 2008. Therefore, the authors strongly recommend that the health authorities in cities with a similar epidemiological scenario be aware of this risk and implement improvements in health care, particularly targeting the paediatric age groups. In addition, information should be provided to the population and actions should be implemented to combat this vector. © 2012 Blackwell Publishing Ltd.

  3. STUDY OF ULTRASOUND FINDING IN DENGUE FEVER

    Directory of Open Access Journals (Sweden)

    Sunita Bajaj

    2016-10-01

    Full Text Available BACKGROUND Dengue fever (DF is a viral haemorrhagic fever causing severe morbidity and mortality in affected patients. The aim of the study is to describe the role of ultrasonography (USG in the assessment of patients with Dengue fever, and its complications and to prove ultrasound is useful in the diagnosis during an epidemic. MATERIALS AND METHODS It is a prospective study was conducted in 2016 comprising of 178 patients who were serologically positive for dengue, radiological investigations were conducted in all cases. RESULTS Out of 178 patients Males (N=117 are more effected subjects in the study. female: Male ratio is 1:2. Hepatomegaly 74.1% which is most common findings in study, 113 (63.4% had GB wall thickening 98 had ascites (55%, 32 had pleural effusion (17.9%. most commonly seen in the age group of 20-39 years. Hepatomegaly was the most common finding noted in 67 patients (37.6%, followed by GB wall thickening in 65 patients (36.1%. Hepatomegaly was more common in 0-19 is 56 patients with 31.4% years age group Ascites in >40 years age group (16.8%. Hepatomegaly was seen in most of the patients whose platelet count was <40,000. (94.7%. GB wall thickening (88.5% common findings seen in patients whose platelet count was <40,000. In patients with platelet count of 40,000-80,000, Ascites is most common finding (87.5%, followed by Splenomegaly (60.7%. In patients whose platelet count was 80,000-150,000, Ascites (50% was more common than Splenomegaly (45.8%. In three patients with platelet count more than 150,000, no sonological abnormality was detected. CONCLUSIONS Ultrasound findings of hepatic changes, GB wall oedema, splenomegaly, ascites and pleural effusion in patients presenting with signs and symptoms of Dengue fever during an epidemic are diagnostic. Contributing in the differential diagnosis with other causes of febrile disease.

  4. Cutting edge issues in rheumatic fever.

    Science.gov (United States)

    Chang, Christopher

    2012-04-01

    Although the incidence of acute rheumatic fever and rheumatic heart disease has decreased significantly in regions of the world where antibiotics are easily accessible, there remains a high incidence in developing nations as well as in certain regions where there is a high incidence of genetic susceptibility. These diseases are a function of poverty, low socioeconomic status, and barriers to healthcare access, and it is in the developing world that a comprehensive prevention program is most critically needed. Development of group A streptococcal vaccines has been under investigation since the 1960s and 50 years later, we still have no vaccine. Factors that contribute to this lack of success include a potential risk for developing vaccine-induced rheumatic heart disease, as well as difficulties in covering the many serological subtypes of M protein, a virulence factor found on the surface of the bacterium. Yet, development of a successful vaccine program for prevention of group A streptococcal infection still offers the best chance for eradication of rheumatic fever in the twenty-first century. Other useful approaches include continuation of primary and secondary prevention with antibiotics and implementation of health care policies that provide patients with easy access to antibiotics. Improved living conditions and better hygiene are also critical to the prevention of the spread of group A streptococcus, especially in impoverished regions of the world. The purpose of this article is to discuss current and recent developments in the diagnosis, pathogenesis, and management of rheumatic fever and rheumatic heart disease.

  5. Q fever - early

    Science.gov (United States)

    ... if untreated. Other complications can include: Bone infection ( osteomyelitis ) Brain infection ( encephalitis ) Liver infection (chronic hepatitis) Lung ... 2015:chap 190. Read More Encephalitis Endocarditis Flu Osteomyelitis Pneumonia - adults (community acquired) Q fever Tick bite ...

  6. Dengue hemorrhagic fever

    Science.gov (United States)

    ... that is infected with the virus. The mosquito Aedes aegypti is the main species that spreads this ... especially if you have had dengue fever before. Prevention Because there is no way to prevent dengue ...

  7. Familial Mediterranean Fever

    Science.gov (United States)

    ... don't use genetic tests as the sole method of diagnosing familial Mediterranean fever. There's no cure ... may be options, though these treatments are considered experimental. Other medications include rilonacept (Arcalyst) and anakinra (Kineret). ...

  8. Paracetamol and fever management.

    Science.gov (United States)

    Warwick, C

    2008-11-01

    Paracetamol is one of the most commonly used legal drugs in the western world. Its availability is good, cost is low, and its uses include 'over-the-counter' (OTC) distribution, primary care prescribed therapy, secondary care 'post-operative' application and emergency treatment. Stated benefits of paracetamol include: the drug's analgesic effects, preference to aspirin in avoidance of Reye's syndrome, good patient tolerance, and iatrogenic complications are infrequent and minor. Stated cautions include hepatotoxic effect following minor doses and short duration use and users may incur compromised immune integrity. This paper is concerned with paracetamol's role in fever management. Public concern regarding, in particular, childhood fever and febrile convulsions is largely unwarranted. Despite paracetamol's reputation as a popular fever-reducing agent the drug is poorly effective in the control of febrility and febrile convulsions showing no important advantage compared with placebo. Paracetamol is probably grossly over-prescribed for fever management and its value more perceived than real. Greater efforts are needed to inform patients of the natural benefits of the biological strategy of fever and of the highly limited and in some cases contraindicated use of paracetamol in fever management.

  9. Emergence of Q Fever

    Directory of Open Access Journals (Sweden)

    E Angelakis

    2011-09-01

    Full Text Available Q fever is a worldwide zoonosis with many acute and chronic manifestations caused by the pathogen Coxiella burnetii. Farm animals and pets are the main reservoirs of infection, and transmission to human beings is mainly accomplished through inhalation of contaminated aerosols. Persons at greatest risk are those in contact with farm animals and include farmers, abattoir workers, and veterinarians. The organs most commonly affected during Q fever are the heart, the arteries, the bones and the liver. The most common clinical presentation is an influenza-like illness with varying degrees of pneumonia and hepatitis. Although acute disease is usually self-limiting, people do occasionally die from this condition. Endocarditis is the most serious and most frequent clinical presentation of chronic Q fever. Vascular infection is the second most frequent presentation of Q fever. The diagnosis of Q fever is based on a significant increase in serum antibody titers. The treatment is effective and well tolerated, but must be adapted to the acute or chronic pattern with the tetracyclines to be considered the mainstay of antibiotic therapy. For the treatment of Q fever during pregnancy the use of long-term cotrimoxazole therapy is proposed.

  10. Typhoid fever in Ethiopia.

    Science.gov (United States)

    Beyene, Getenet; Asrat, Daniel; Mengistu, Yohannes; Aseffa, Abrham; Wain, John

    2008-12-01

    This review focuses on the reports of salmonellosis by investigators in different parts of Ethiopia, in particular focusing on the levels of typhoid fever. Many of the reports are published in local journals that are not available online. There have been seven studies which diagnosed typhoid fever by laboratory culture and there is no coordinated epidemiological surveillance. All conducted research and reports from different health institutions in Ethiopia indicate that typhoid fever was still a common problem up to the most recent study in 2000 and that the extensive use of first-line drugs has led to the development of multiple drug resistance. In the sites covered by this review, the total number of published cases of typhoid fever dropped over time reflecting the decline in research capacity in the country. Data on the proportion of patients infected by different serovars of Salmonella suggest that the non-Typhi serovars of Salmonella are increasing. The published evidence suggests that typhoid fever is a current public health problem in Ethiopia although population based surveys, based on good microbiological diagnosis, are urgently needed. Only then can the true burden of enteric fever be estimated and the benefit of public health control measures, such as health education, safe water provision, improved food hygienic practices and eventually vaccination, be properly assessed.

  11. Urinary tract infections and post-operative fever in percutaneous nephrolithotomy

    OpenAIRE

    Gutierrez, Jorge; Smith, Arthur; Geavlete, Petrisor; Shah, Hemendra; Kural, Ali Riza; De Sio, Marco; Amón Sesmero, José H.; Hoznek, András; de la Rosette, Jean; ,

    2012-01-01

    Purpose To review the incidence of UTIs, post-operative fever, and risk factors for post-operative fever in PCNL patients. Materials and methods Between 2007 and 2009, consecutive PCNL patients were enrolled from 96 centers participating in the PCNL Global Study. Only data from patients with pre-operative urine samples and who received antibiotic prophylaxis were included. Pre-operative bladder urine culture and post-operative fever (>38.5°C) were assessed. Relationship between various patien...

  12. Febres hemorrágicas por vírus no Brasil Viral hemorrhagic fevers in Brazil

    Directory of Open Access Journals (Sweden)

    Luiz Tadeu Moraes Figueiredo

    2006-04-01

    Full Text Available Chamando a atenção para as febres hemorrágicas por vírus, que em sua maioria tem escassa informação divulgada e provavelmente são subnotificadas, mostra-se neste artigo casos clínicos das 4 doenças deste tipo que ocorrem no Brasil: febre amarela, dengue hemorrágico/síndrome de choque do dengue, febre hemorrágica por arenavírus e síndrome pulmonar e cardiovascular por hantavírus. Também, relevantes aspectos clínicos, laboratoriais e epidemiológicos destas viroses são aqui abordados. São doenças que têm alta letalidade e induzem extravasamento capilar e coagulopatia, que podem ser evidenciados pela elevação do hematócrito e plaquetopenia. A suspeita clínica e o tratamento precoce são fundamentais à sobrevida dos pacientes.To call atention to viral hemorrhagic fevers, diseases that are mostly underdivulged and, probably, undereported, we present here case reports of the 4 diseases of this kind that occur in Brazil: yellow fever, dengue haemorrhagic fever/dengue shock syndrome, arenavirus haemorrhagic fever and hantavirus cardiopulmonary syndrome. Relevant clinical, epidemiological and laboratorial diagnostic aspects of these viral haemorrhagic fevers are also shown here. These diseases have a high case fatality rate, induce capillary leaking and blood coagulation disturbances that are evidenced by hemoconcentrantion and thrombocytopenia. An early clinical diagnosis and treatment is fundamental for patient survival.

  13. Behavioral fever in ectothermic vertebrates.

    Science.gov (United States)

    Rakus, Krzysztof; Ronsmans, Maygane; Vanderplasschen, Alain

    2017-01-01

    Fever is an evolutionary conserved defense mechanism which is present in both endothermic and ectothermic vertebrates. Ectotherms in response to infection can increase their body temperature by moving to warmer places. This process is known as behavioral fever. In this review, we summarize the current knowledge on the mechanisms of induction of fever in mammals. We further discuss the evolutionary conserved mechanisms existing between fever of mammals and behavioral fever of ectothermic vertebrates. Finally, the experimental evidences supporting an adaptive value of behavioral fever expressed by ectothermic vertebrates are summarized. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Recurrent Fever in Children.

    Science.gov (United States)

    Torreggiani, Sofia; Filocamo, Giovanni; Esposito, Susanna

    2016-03-25

    Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time.

  15. Recurrent Fever in Children

    Directory of Open Access Journals (Sweden)

    Sofia Torreggiani

    2016-03-01

    Full Text Available Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-04-15

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

  17. Rehabilitation following intracerebral haemorrhage secondary to extracorporeal membrane oxygenation (ECMO).

    Science.gov (United States)

    Kilsby, Amanda; Buddha, Sandeep

    2013-05-24

    Extracorporeal membrane oxygenation (ECMO) was first used in adults with severe respiratory failure in the 1970s. Its use has been steadily increasing since the 1990s after a trial demonstrated improved survival. There are currently seven centres in the UK offering ECMO to adults. Neurological complications are often picked up within the first few days of initiating ECMO. Intracerebral haemorrhage is a well recognised complication and it is the leading cause of death in infants on ECMO and rates of 9-18.9% in adults have been reported. We report a 52-year-old woman admitted in severe type 1 respiratory failure in January 2012. She was transferred to a tertiary centre and suffered bitemporal and right parietal haemorrhages on ECMO in late February. She was repatriated to our unit for rehabilitation in April 2012. Her rehabilitation needs represent the complexity of this patient group with multiple medical, behavioural and physical challenges.

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

    Directory of Open Access Journals (Sweden)

    Rowan Elise N

    2011-05-01

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

  19. Haemorrhagic enteritis seroconversion in turkey breeders: field observations

    Directory of Open Access Journals (Sweden)

    Raffaella Ceruti

    2010-01-01

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

  20. Nosocomial ventriculitis due to Roseomonas gilardii complicating subarachnoid haemorrhage.

    Science.gov (United States)

    Nolan, Jason S; Waites, Ken B

    2005-04-01

    Roseomonas gilardii is a pink-pigmented, non-fermentative, Gram-negative coccobacillus that has been recognized as a rare cause of human infections. We report the first case of ventriculitis caused by R. gilardii in a 54-year-old man with a subarachnoid haemorrhage secondary to a vertebral artery aneurysm; discuss previous reports of this organism as a nosocomial and community-acquired pathogen, laboratory diagnosis, and patient management.

  1. [Trends in yellow fever mortality in Colombia, 1998-2009].

    Science.gov (United States)

    Segura, Ángela María; Cardona, Doris; Garzón, María Osley

    2013-09-01

    Yellow fever is a neglected tropical disease, thus, knowing the trends in mortality from this disease in Colombia is an important source of information for decision making and identifying public health interventions. To analyze trends in yellow fever mortality in Colombia during the 1998-2009 period and the differences in the morbidity and mortality information sources for the country, which affect indicators such as the lethality one. This is a descriptive study of deaths by yellow fever according to the Departamento Administrativo Nacional de Estadística and the incidence of the disease according to the Instituto Nacional de Salud . We used secondary sources of information in the calculation of proportions of socio-demographic characteristics of the deceased and epidemiological measures of lethality, incidence and mortality from yellow fever by department of residence of the deceased. Yellow fever deaths occur primarily in men of working age residing in scattered rural areas, who were members of the regimen vinculado, and who were living in the eastern, southeastern, northern and central zones in the country. We observed inconsistencies in the reports that affect the comparative analysis. The inhabitants of the departments located in national territories and Norte de Santander have an increased risk of illness and death from yellow fever, but this information could be underestimated, according to the source of information used for its calculation.

  2. Pathogenesis of Lassa fever.

    Science.gov (United States)

    Yun, Nadezhda E; Walker, David H

    2012-10-09

    Lassa virus, an Old World arenavirus (family Arenaviridae), is the etiological agent of Lassa fever, a severe human disease that is reported in more than 100,000 patients annually in the endemic regions of West Africa with mortality rates for hospitalized patients varying between 5-10%. Currently, there are no approved vaccines against Lassa fever for use in humans. Here, we review the published literature on the life cycle of Lassa virus with the specific focus put on Lassa fever pathogenesis in humans and relevant animal models. Advancing knowledge significantly improves our understanding of Lassa virus biology, as well as of the mechanisms that allow the virus to evade the host's immune system. However, further investigations are required in order to design improved diagnostic tools, an effective vaccine, and therapeutic agents.

  3. Pathogenesis of Lassa Fever

    Directory of Open Access Journals (Sweden)

    David H. Walker

    2012-10-01

    Full Text Available Lassa virus, an Old World arenavirus (family Arenaviridae, is the etiological agent of Lassa fever, a severe human disease that is reported in more than 100,000 patients annually in the endemic regions of West Africa with mortality rates for hospitalized patients varying between 5-10%. Currently, there are no approved vaccines against Lassa fever for use in humans. Here, we review the published literature on the life cycle of Lassa virus with the specific focus put on Lassa fever pathogenesis in humans and relevant animal models. Advancing knowledge significantly improves our understanding of Lassa virus biology, as well as of the mechanisms that allow the virus to evade the host’s immune system. However, further investigations are required in order to design improved diagnostic tools, an effective vaccine, and therapeutic agents.

  4. Vaccines against typhoid fever.

    Science.gov (United States)

    Guzman, Carlos A; Borsutzky, Stefan; Griot-Wenk, Monika; Metcalfe, Ian C; Pearman, Jon; Collioud, Andre; Favre, Didier; Dietrich, Guido

    2006-05-01

    Because of high infectivity and significant disease burden, typhoid fever constitutes a major global health problem. Implementation of adequate food handling practices and establishment of safe water supplies are the cornerstone for the development of an effective prevention program. However, vaccination against typhoid fever remains an essential tool for the effective management of this disease. Currently, there are two well tolerated and effective licensed vaccines. One is based on defined subunit virulence (Vi) polysaccharide antigen and can be administered either intramuscularly or subcutaneously and the other is based on the use of live attenuated bacteria for oral administration. The advantages and disadvantages of the various approaches taken in the development of a vaccine against typhoid fever are discussed, along with the potential for future vaccine candidates.

  5. Adrenal crisis secondary to bilateral adrenal haemorrhage after hemicolectomy

    Directory of Open Access Journals (Sweden)

    Anthony Logaraj

    2016-10-01

    Full Text Available Adrenal haemorrhage is a rare cause of adrenal crisis, which requires rapid diagnosis, prompt initiation of parenteral hydrocortisone and haemodynamic monitoring to avoid hypotensive crises. We herein describe a case of bilateral adrenal haemorrhage after hemicolectomy in a 93-year-old female with high-grade colonic adenocarcinoma. This patient’s post-operative recovery was complicated by an acute hypotensive episode, hypoglycaemia and syncope, and subsequent computed tomography (CT scan of the abdomen revealed bilateral adrenal haemorrhage. Given her labile blood pressure, intravenous hydrocortisone was commenced with rapid improvement of blood pressure, which had incompletely responded with fluids. A provisional diagnosis of hypocortisolism was made. Initial heparin-induced thrombocytopenic screen (HITTS was positive, but platelet count and coagulation profile were both normal. The patient suffered a concurrent transient ischaemic attack with no neurological deficits. She was discharged on a reducing dose of oral steroids with normal serum cortisol levels at the time of discharge. She and her family were educated about lifelong steroids and the use of parenteral steroids should a hypoadrenal crisis eventuate.

  6. Control measures against Q fever in Dutch dairy goat herds: epidemiological and economical evaluation

    NARCIS (Netherlands)

    Bontje, D.M.; Backer, J.A.; Roest, H.I.J.; Asseldonk, van M.A.P.M.; Bergevoet, R.H.M.; Roermund, van H.J.W.

    2013-01-01

    To analyse the disease dynamics in goat herds and to study the effect of control measures, a Q fever transmission model was developed by CVI. With such a model we can study questions like ‘What strategy can lower the incidence of Q fever in goats or even lead to disease extinction?’ and ‘Is vaccinat

  7. Control measures against Q fever in Dutch dairy goat herds: epidemiological and economical evaluation

    NARCIS (Netherlands)

    Bontje, D.M.; Backer, J.A.; Roest, H.I.J.; Asseldonk, van M.A.P.M.; Bergevoet, R.H.M.; Roermund, van H.J.W.

    2013-01-01

    To analyse the disease dynamics in goat herds and to study the effect of control measures, a Q fever transmission model was developed by CVI. With such a model we can study questions like ‘What strategy can lower the incidence of Q fever in goats or even lead to disease extinction?’ and ‘Is vaccinat

  8. [Intraventricular haemorrhage in premature newborn babies].

    Science.gov (United States)

    Nazar, N

    This work is the product of the checking of the pathogenesis, incidence, treatment, and prognostic of the intraventricular hemorrhage in the premature newborn. In the revised publications, that include important series of following, this pathology is present in 25% of the infants weighing less than 1,500 g, in which the mortality and morbidity is greater than that of normal newborns, since the development of intraventricular hemorrhage can produce alterations of cerebral blood flow in the immature germinal matrix and in the microvascular net. In consequence the prevention of the intraventricular hemorrhage is directly related with its pathogenesis. It is said that the use of dexamethasone steroids in low doses in the prenatal period, and low doses of indomethacin in the postnatal period, can give better neuroprotection. The surgical treatment is exceptional and has very precise indications, when a progresive hydrocephalus of later apparition is proven. Therefore in premature newborns with intraventricular hemorrhage the best actual treatment is to use an appropiate pharmacological and medical following

  9. [Acute fever in children].

    Science.gov (United States)

    Gras-Le Guen, Christèle; Launay, Élise

    2015-05-01

    Fever in children is a very common symptom associated most of the time with a viral infection. However, in 7% of children, fever without source is the first symptom of a serious bacterial infection such as pneumonia, meningitis, pyelonephritis or bacteremia. The key point in clinical examination of these children is the early identification of toxic signs. Because SBI prevalence is higher in very young children (1-3 month-aged), they required a specific management with some systematic complementary investigations and a broad indication of probabilistic antibiotherapy treatment.

  10. [Fever of unknown origin].

    Science.gov (United States)

    Salzberger, B; Müller-Schilling, M; Fleck, M

    2013-04-01

    Fever of unknown origin (FUO) is defined as sustained unexplained fever despite intensive diagnostic evaluation and represents a particular diagnostic challenge. It can be classified into different categories, e.g. classical, nosocomial, neutropenic and HIV-associated FUO, which is based on the patient-specific clinical and immunological situation. Infections, malignant diseases and non-infectious inflammatory diseases have to be considered as the most important causes of FUO; however, no definitive diagnosis can be established in a substantial number of FUO patients despite an extensive diagnostic work-up. The present review focuses on the important diagnostic aspects as well as therapeutic options in FUO patients.

  11. Marburg Hemorrhagic Fever (Marburg HF)

    Science.gov (United States)

    ... CDC Cancel Submit Search The CDC Marburg hemorrhagic fever (Marburg HF) Note: Javascript is disabled or is ... first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, ...

  12. Typhoid Fever, Below the Belt

    National Research Council Canada - National Science Library

    Raveendran, Kamakshi Mahadevan; Viswanathan, Stalin

    2016-01-01

    ... (sexually transmitted infections) aetiologies. Typhoid fever is endemic in the tropics. Except "rose spots", skin manifestations in typhoid fever are unusual, and they are missed due to pigmented skin...

  13. Q Fever: Statistics and Epidemiology

    Science.gov (United States)

    ... Statistics Reporting and In-Depth Information Other Ricketssial Zoonosis Diseases Anaplasmosis Ehrlichiosis Other Spotted Fever Rocky Mountain ... 60–64 years. Top of Page Other Ricketssial Zoonosis Diseases Anaplasmosis Ehrlichiosis Other Spotted Fever Rocky Mountain ...

  14. Dengue Fever: An Emerging Infectious Disease in The Bahamas

    Directory of Open Access Journals (Sweden)

    Bain, Sherrie Valarie

    2011-10-01

    Full Text Available Dengue fever is an emerging infectious disease that is increasing in prevalence in many geographic regions, including the Caribbean. It is the most common arboviral (vector-borne disease in the world, and infects more that 50 million people annually worldwide. The etiological agent of dengue fever is one of four serotypes of the Dengue virus (DENV1 – DENV4. The infection is transmitted via a human-mosquito-human route, when one or more species of the Aedes mosquito takes a blood meal from an infected host and then feeds on a person who is uninfected. There is no vaccine or cure for dengue fever. Dengue fever is a growing cause for concern in The Bahamas. This year the incidence of dengue fever reached epidemic proportions in The Bahamas. This article will explore the etiology and epidemiology of dengue fever, and offer some insight into how future the Bahamas can begin to develop strategies for the eradication of dengue fever.

  15. Typhoid fever & vaccine development: a partially answered question.

    Science.gov (United States)

    Marathe, Sandhya A; Lahiri, Amit; Negi, Vidya Devi; Chakravortty, Dipshikha

    2012-01-01

    Typhoid fever is a systemic disease caused by the human specific Gram-negative pathogen Salmonella enterica serovar Typhi (S. Typhi). The extra-intestinal infections caused by Salmonella are very fatal. The incidence of typhoid fever remains very high in impoverished areas and the emergence of multidrug resistance has made the situation worse. To combat and to reduce the morbidity and mortality caused by typhoid fever, many preventive measures and strategies have been employed, the most important being vaccination. In recent years, many Salmonella vaccines have been developed including live attenuated as well as DNA vaccines and their clinical trials have shown encouraging results. But with the increasing antibiotic resistance, the development of potent vaccine candidate for typhoid fever is a need of the hour. This review discusses the latest trends in the typhoid vaccine development and the clinical trials which are underway.

  16. Fever in acute pulmonary embolism.

    Science.gov (United States)

    Stein, P D; Afzal, A; Henry, J W; Villareal, C G

    2000-01-01

    Although fever has been reported in several case series of acute pulmonary embolism (PE), the extent to which fever may be caused by PE, and not associated disease, has not been adequately sorted out. Clarification of the frequency and severity of fever in acute PE may assist in achieving an accurate clinical impression, and perhaps avoid an inadvertent exclusion of the diagnosis. The purpose of this investigation is to evaluate the extent to which fever is caused by acute PE. Patients participated in the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED). Temperature was evaluated among patients with angiographically proven PE. A determination of whether other causes of fever were present was based on a retrospective analysis of discharge summaries, PIOPED summaries, and a computerized list of all discharge diagnoses. Among patients with PE and no other source of fever, fever was present in 43 of 311 patients (14%). Fever in patients with pulmonary hemorrhage or infarction was not more frequent than among those with no pulmonary hemorrhage or infarction, 39 of 267 patients (15%) vs 4 of 44 patients (9%; not significant). Clinical evidence of deep venous thrombosis was often present in patients with PE and otherwise unexplained fever. Low-grade fever is not uncommon in PE, and high fever, although rare, may occur. Fever need not be accompanied by pulmonary hemorrhage or infarction.

  17. A possible case of caprine-associated malignant catarrhal fever in a domestic water buffalo (Bubalus bubalis in Switzerland

    Directory of Open Access Journals (Sweden)

    Dettwiler Martina

    2011-12-01

    Full Text Available Abstract Background Malignant catarrhal fever (MCF is a fatal herpesvirus infection, affecting various wild and domestic ruminants all over the world. Water buffaloes were reported to be particularly susceptible for the ovine herpesvirus-2 (OvHV-2 causing the sheep-associated form of MCF (SA-MCF. This report describes the first case of possibly caprine-associated malignant catarrhal fever symptoms in a domestic water buffalo in Switzerland. Case presentation The buffalo cow presented with persistent fever, dyspnoea, nasal bleeding and haematuria. Despite symptomatic therapy, the buffalo died and was submitted to post mortem examination. Major findings were an abomasal ulceration, a mild haemorrhagic cystitis and multifocal haemorrhages on the epicardium and on serosal and mucosal surfaces. Eyes and oral cavity were not affected. Histopathology revealed a mild to moderate lymphohistiocytic vasculitis limited to the brain and the urinary bladder. Although these findings are typical for MCF, OvHV-2 DNA was not detected in peripheral blood lymphocytes or in paraffin-embedded brain, using an OvHV-2 specific real time PCR. With the aid of a panherpesvirus PCR, a caprine herpesvirus-2 (CpHV-2 sequence could be amplified from both samples. Conclusions To our knowledge, this is the first report of malignant catarrhal fever in the subfamily Bovinae, where the presence of CpHV-2 could be demonstrated. The etiological context has yet to be evaluated.

  18. Predicting postoperative fever and bacterial colonization on packing material following endoscopic endonasal surgery.

    Science.gov (United States)

    Nomura, Kazuhiro; Yamanaka, Yurika; Sekine, Yasuhiro; Yamamoto, Hiroki; Esu, Yoshihiko; Hara, Mariko; Hasegawa, Masayo; Shinnabe, Akihiro; Kanazawa, Hiromi; Kakuta, Risako; Ozawa, Daiki; Hidaka, Hiroshi; Katori, Yukio; Yoshida, Naohiro

    2017-01-01

    Postoperative fever following endoscopic endonasal surgery is a rare occurrence of concern to surgeons. To elucidate preoperative and operative predictors of postoperative fever, we analyzed the characteristics of patients and their perioperative background in association with postoperative fever. A retrospective review of 371 patients who had undergone endoscopic endonasal surgery was conducted. Predictors, including intake of antibiotics, steroids, history of asthma, preoperative nasal bacterial culture, duration of operation, duration of packing and intraoperative intravenous antibiotics on the occurrence of postoperative fever, and bacterial colonization on the packing material, were analyzed retrospectively. Fever (≥38 °C) occurred in 63 (17 %) patients. Most incidences of fever occurred on postoperative day one. In majority of these cases, the fever subsided after removal of the packing material without further antibiotic administration. However, one patient who experienced persistent fever after the removal of packing material developed meningitis. History of asthma, prolonged operation time (≥108 min), and intravenous cefazolin administration instead of cefmetazole were associated with postoperative fever. Odds ratios (ORs) for each were 2.3, 4.6, and 2.0, respectively. Positive preoperative bacterial colonization was associated with postoperative bacterial colonization on the packing material (OR 2.3). Postoperative fever subsided in most patients after removal of the packing material. When this postoperative fever persists, its underlying cause should be examined.

  19. Pre-Eclampsia Increases the Risk of Postpartum Haemorrhage: A Nationwide Cohort Study in The Netherlands

    OpenAIRE

    Joost F von Schmidt auf Altenstadt; Hukkelhoven, Chantal W. P. M.; Jos van Roosmalen; Bloemenkamp, Kitty W. M.

    2013-01-01

    BACKGROUND: Postpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide. Identifying risk indicators for postpartum haemorrhage is crucial to predict this life threatening condition. Another major contributor to maternal morbidity and mortality is pre-eclampsia. Previous studies show conflicting results in the association between pre-eclampsia and postpartum haemorrhage. The primary objective of this study was to investigate the association between pre-eclampsia an...

  20. A probabilistic risk assessment for dengue fever by a threshold based-quantile regression

    Science.gov (United States)

    Chiu, Chuan-Hung; Tan, Yih-Chi; Wen, Tzai-Hung; Chien, Lung-Chang; Yu, Hwa-Lung

    2014-05-01

    This article introduces an important concept "return period" to analyze potential incident rate of dengue fever by bringing together two models: the quantile regression model and the threshold-based method. The return period provided the frequency of incidence of dengue fever, and established the risk maps for potential incidence of dengue fever to point out highest risk in certain areas. A threshold-based linear quantile regression model was constructed to find significantly main effects and interactions based on collinearity test and stepwise selection, and also showed the performance of our model via pseudo R2. Finally, the spatial risk maps of the specified return periods and average incident rates were given, and indicated that high population density place (e.g., residential area), water conservancy facilities, and corresponding interactions could lead to a positive influence on dengue fever. These factors would be the key point to disease protection in a given study area.

  1. Comparison between emerging Q fever in French Guiana and endemic Q fever in Marseille, France.

    Science.gov (United States)

    Edouard, Sophie; Mahamat, Aba; Demar, Magalie; Abboud, Philippe; Djossou, Felix; Raoult, Didier

    2014-05-01

    Q fever is an emergent disease in French Guiana. We compared the incidence clinical and serologic profiles between patients from Cayenne, French Guiana and Marseille in metropolitan France during a four-year period. The annual incidence of diagnosed acute Q fever was significantly higher in Cayenne (17.5/100,000) than in Marseille (1.9/100,000) (P = 0.0004), but not the annual incidence of endocarditis (1.29 versus 0.34/100,000). Most patients had fever (97%) and pneumonia (83%) in Cayenne versus 81% and 8% in Marseille (P < 0.0001 and P < 0.0001, respectively) but transaminitis was more common in patients from Marseille (54% versus 32%; P < 0.0001). The proportion of patients with cardiovascular infections was significantly lower in Cayenne (7%) than in Marseille (17%) (P = 0.017), although they showed a stronger immune response with higher levels of phase I IgG (P = 0.024). The differing epidemiology, clinical, and serologic responses of patients from Cayenne and Marseille suggest a different source of infection and a different strain of Coxiella burnetii.

  2. Association of Mean Platelet Volume with Severity, Serology & Treatment Outcome in Dengue Fever: Prognostic Utility.

    Science.gov (United States)

    Sharma, Kritika; Yadav, Ajay

    2015-11-01

    Dengue is the most rapidly spreading mosquito-borne viral disease in the world. Dengue fever (DF) with its severe manifestations such as dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) has emerged as a major public health problem of international concern. Thrombocytopenia and bleeding are common complications of dengue fever, hence besides platelet counts, there is a need to assess the role of mean platelet volume. Studying association of mean platelet volume (MPV) with severity, serology & treatment outcome to assess its prognostic utility, which can be of great help in limiting morbidity & mortality associated with dengue fever. The present study was conducted in Central Pathology Lab of SMS Medical College & Hospital, Jaipur, Rajasthan from the period of March 2013 till October 2013. Blood samples were collected from 200 patients with NS 1 Antigen positivity experiencing febrile illness, clinically consistent with dengue infection. Evaluation of platelet counts, MPV, IgM and IgG antibodies was done in all these cases. Categorical data were presented as numbers (percent) and were compared among groups using Chi-square test. Groups compared for demographic data were presented as mean and standard deviation and were compared using student t-test, ANOVA and Post-Hoc Test, Tukey Test using SPSS, version 20 for Windows. A total of 200 Dengue fever cases were studied. Out of which, 68% cases were of DF, 23% DHF & 9% DSS i.e. classical dengue fever was most common presentation. Maximum (44%) cases were in age group of 15-24 years. Fever was the presenting complaint in all cases (100%). 98% cases of dengue had thrombocytopenia. MPV showed no significant correlation with severity, serology & treatment outcome, thus excluding its role in dengue cases. Mean platelet volume is not important as prognostic parameter in dengue fever.

  3. Hereditary periodic fever syndromes

    NARCIS (Netherlands)

    McDermott, MF; Frenkel, J

    Hereditary periodic fever syndromes are defined by recurrent attacks of generalised inflammation for which no infectious or auto-immune cause can be identified. For most of these disorders, the molecular basis has recently been elucidated. This has opened the prospect of novel therapeutic

  4. Fever of unknown origin

    NARCIS (Netherlands)

    Mulders-Manders, C.; Simon, A.; Bleeker-Rovers, C.P.

    2015-01-01

    More than 50 years after the first definition of fever of unknown origin (FUO), it still remains a diagnostic challenge. Evaluation starts with the identification of potential diagnostic clues (PDCs), which should guide further investigations. In the absence of PDCs a standardised diagnostic

  5. Breathing Valley Fever

    Centers for Disease Control (CDC) Podcasts

    2014-02-04

    Dr. Duc Vugia, chief of the Infectious Diseases Branch in the California Department of Public Health, discusses Valley Fever.  Created: 2/4/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/5/2014.

  6. Lithotrites and postoperative fever

    DEFF Research Database (Denmark)

    Chu, David I; Lipkin, Michael E; Wang, Agnes J

    2013-01-01

    OBJECTIVE: To compare the risks of fever from different lithotrites after percutaneous nephrolithotomy (PNL). MATERIALS AND METHODS: The Clinical Research Office of the Endourological Society (CROES) PNL database is a prospective, multi-institutional, international PNL registry. Of 5,803 total pa...

  7. [Fever without focus and fever of unknown origin in childhood].

    Science.gov (United States)

    Ritz, Nicole

    2013-01-30

    Fever is one of the most common presenting symptoms in children. In the majority of cases the underlying cause is easily diagnosed and if necessary a treatment initiated. In case of absent localising symptoms and signs (fever without a focus) investigations rapidly need to be undertaken in particular in newborns and infants. Persisting daily fever for more than two weeks are called fever of unknown origin. Diagnosis of etiology of fever of unknown origin is challenging. In approximately half of the cases an infectious cause is found; inflammatory and mailgnant diseases account for 5 to 10% of the cases. Despite a systematic and interdisciplinary approach the etiology remains unknown in up to a quarter of cases. This review discusses differential diagnoses, suggested investigations and treatment for fever without a focus and fever of unknown origin.

  8. [Coexistence of acute appendicitis and dengue fever: A case report].

    Science.gov (United States)

    Osuna-Ramos, Juan Fidel; Silva-Gracia, Carlos; Maya-Vacio, Gerardo Joel; Romero-Utrilla, Alejandra; Ríos-Burgueño, Efrén Rafael; Velarde-Félix, Jesús Salvador

    2017-01-03

    Dengue is the most important human viral disease transmitted by mosquitoes. It can be asymptomatic or it can present in any of its 3clinical forms: Dengue fever, dengue haemorrhagic fever and dengue shock syndrome. However, some atypical manifestations have been reported in surgical emergencies caused by acute appendicitis in patients with dengue fever. We report the case of an 18-year-old Mexican male who presented to the emergency department of the General Hospital of Culiacan, Sinaloa, with symptoms of dengue fever, accompanied by crampy abdominal pain with positive Rovsing and Dunphy signs. Dengue infection was confirmed by a positive NS1 antigen test performed by enzyme-linked immunosorbent assay. An abdominal ultrasound revealed an appendicular process; as the abdominal pain in the right side kept increasing, an open appendectomy was performed. Abundant inflammatory liquid was observed during the surgery, and the pathology laboratory reported an oedematous appendix with fibrinopurulent plaques, which agreed with acute ulcerative appendicitis. The patient was discharged fully recovered without complications during the follow-up period. Acute abdominal pain can be caused in some cases by dengue infection. This can be confusing, which can lead to unnecessary surgical interventions, creating additional morbidities and costs for the patient. This unusual and coincident acute appendicitis with dengue highlights the importance of performing careful clinical studies for appropriate decision making, especially in dengue endemic regions during an outbreak of this disease. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  9. Thrombocytopenia in Paediatric ICU: Incidence, Transfusion Requirement and Role as Prognostic Indicator

    Science.gov (United States)

    Sethi, Gurmeet Kaur; Goyal, Ram Kumar; Kaur, Avneet; Kaur, Rupinderjeet; Dhir, Shashi Kant; Gupta, Harshvardhan

    2015-01-01

    Introduction Thrombocytopenia is defined as platelet count less than 150×109/L, it has a greater incidence in Intensive Care Units (ICUs) compared to wards and its most common cause is increased platelet consumption. Aims To investigate incidence of thrombocytopenia, platelet transfusions requirement, associated diseases and relationship between thrombocytopenia and mortality. Materials and Methods Eleven months hospital records between October 2013 and August 2014 of the PICU in a tertiary care teaching hospital was investigated retrospectively and 275 critically ill children formed the sample. Statistical analysis Odds ratio with 95% confidence interval was used. Probability value (p-value) of less than 0.05 was considered statistically significant. Results were confirmed using χ2 test. Results Out of 275 patients {168 males (61.09%) and 107 females (38.91%)}, 89 patients had thrombocytopenia. Out of these 89 patients, 43 patients (48.31%) had severe, 24 patients (27.91%) had moderate and 22 patients (24.72%) had mild thrombocytopenia. The 43 patients having severe thrombocytopenia received platelet transfusion and out of these 43 patients 24 (55.81%) received more than one transfusion and 18 (41.86%) of the transfused patients expired. Among thrombocytopaenic patients, Sepsis (25.84%) was the most common diagnosis followed by Pneumonia (19.10%), Meningitis (13.48%), Diabetic Ketoacidosis (5.62%), Enteric fever (7.86%), Tubercular Meningitis (3.37%), Infantile Tremor Syndrome (2.25%), Congenital heart disease (5.62%), Burns(3.37%), Brain Haemorrhage (2.25%%), Hepatic abscess (1.12%), Chronic Renal Failure (3.37%), Malaria (2.25%) and Hepatitis (4.49%). There is a statistically significant association between thrombocytopenia and mortality. A significant association was established between mortality in thrombocytopenic patients of sepsis. Conclusion Thrombocytopenia is commonly associated with sepsis. Mortality rate is higher in thrombocytopenic patients. PMID

  10. Skull fracture and haemorrhage pattern among fatal and nonfatal head injury assault victims – a critical analysis

    Science.gov (United States)

    Chattopadhyay, Saurabh; Tripathi, Chandrabhal

    2010-01-01

    Abstract: Background: The global incidence of fatal head injuries as the result of assault is greater than the number of non-fatal cases. The important factors that determine the outcome in terms of survival of such head injury cases include the type of weapon used, type and site of skull fracture, intra cranial haemorrhage and the brain injury. The present study aims to highlight the role of skull fractures as an indirect indicator of force of impact and the intra cranial haemorrhage by a comparative study of assault victims with fatal and nonfatal head injuries. Methods: 91 head injury cases resulting from assault were studied in the Department of Forensic Medicine, IMS, BHU Varanasi over a period of 2 years from which 18 patients survived and 73 cases had a lethal outcome. Details of the fatal cases were obtained from the police inquest and an autopsy while examination of the surviving patients was done after obtaining an informed consent. The data so obtained were analyzed and presented in the study. Results: Assault with firearms often led to fatality whereas with assault involving blunt weapons the survival rate was higher. Multiple cranial bones were involved in 69.3% cases while comminuted fracture of the skull was common among the fatal cases. Fracture of the base of the skull was noted only in the fatal cases and a combination of subdural and subarachnoid haemorrhage was found in the majority of the fatal cases. Conclusions: The present study shows skull fractures to be an important indicator of severity of trauma in attacks to the head. Multiple bone fracture, comminuted fracture and base fractures may be considered as high risk factors in attempted homicide cases. PMID:21483205

  11. Is fever a predictive factor in the autism spectrum disorders?

    Science.gov (United States)

    Megremi, Amalia S F

    2013-04-01

    Autism spectrum disorders (ASD) display such a marked increase in recent decades that researchers speak of "epidemic outbreak" of the disease. Although the diagnostic framework has been expanded and thus more disorders now fall within the autistic spectrum, no one disputes the increased incidence of autism in modern societies, making it a major public health problem. On the other hand, heterogeneity is a major feature of the disorder, both in terms of the etiopathogenesis as well as to the phenotypic expression, natural history and evolution. Consequently, there is considerable research interest in determining factors which are etiopathogenetically, prognostically, preventively or/and therapeutically associated with the disorder. Literature data indicate that probably there are differences in susceptibility to various infections between normal and autistic children. In addition, some autistic children show improvement in the characteristics of their autistic behavior during febrile incident and repression of fever (through antipyretics) might be associated with the onset of autistic disorder. Since fever has been associated with mental illness since the time of Hippocrates already and the presence of fever is associated with a favorable outcome in various pathologic conditions, it is assumed that there are probably two subgroups of autistic children: those who have the possibility to develop acute febrile incidents and those who develop acute incidents without fever. If this is the case, it is important to know whether there are differences between the two subgroups in various biological markers (cytokines/chemokines, autoantibodies), neuroimaging findings, personal and family history of these children (use of drugs, vaccinations, history of autoimmunity, etc.) and, if the first subgroup consists of autistic people of higher functionality and better outcome, or not. If such a classification is real, is there a possibility for the fever to be used as a predictor of

  12. 282 REVIEW ARTICLE

    African Journals Online (AJOL)

    boaz

    A REVIEW OF LASSA FEVER, AN EMERGING OLD WORLD HAEMORRHAGIC VIRAL .... countries where the disease is endemic (including ... low incidence of Lassa fever in advanced countries of ..... in mobilizing logistics and necessary.

  13. [Incidence and preventability of haemorrhagic strokes. Results of the Ebrictus register].

    Science.gov (United States)

    Gonzalez-Henares, A; Clua-Espuny, J L; Gil-Guillen, V F; Panisello-Tafalla, A; Queralt-Tomas, M L; Ripolles-Vicente, R; Lopez-Pablo, C; Lucas-Noll, J; Equipo de Investigacion Ebrictus, Equipo de Investigacion Ebrictus

    2016-05-01

    Objetivo. Conocer la incidencia poblacional de la hemorragia intracerebral y su incidencia evitable, factores de riesgo asociados y pronostico de muerte y discapacidad. Sujetos y metodos. Muestra de 240 pacientes consecutivos con un primer episodio de hemorragia intracerebral entre el 1 de abril de 2006 y el 30 de junio de 2015. Las variables principales son: escala NIHSS, comorbilidad, informacion farmacologica, indice de Barthel, escala de Rankin, tiempo en rango terapeutico, pronostico y destino al alta hospitalaria. Se aplico la clasificacion 'mortalidad innecesariamente prematura y sanitariamente evitable' (MIPSE) para definir los casos como 'incidencia evitable'. Resultados. La tasa de incidencia poblacional de enfermedad cerebrovascular hemorragica fue de 23,5 casos por 100.000 habitantes/año; se produjo un incremento exponencial a partir de los 55 años en hombres y 75 años en mujeres. La razon de tasas fue de 0,682. La incidencia evitable significaria el 66,6% de todos los casos en los menores de 75 años y el 22,7% en aquellos con 75 o mas años. La probabilidad de supervivencia y la autonomia funcional fueron significativamente inferiores en las mujeres, y la edad, el tratamiento anticoagulante, la presencia de polimedicacion y el tratamiento con antidepresivos inhibidores de la recaptacion de serotonina fueron factores independientes del pronostico. Conclusiones. No parece que se modifique la incidencia de enfermedad cerebrovascular hemorragica en el periodo, pero si los factores asociados segun sexo y edad. Segun la clasificacion MIPSE, la evitabilidad de la enfermedad cerebrovascular hemorragica seria de hasta un 36%.

  14. Application of Elman feedback neural network model to predict the incidence of hemorrhagic fever with renal syndrome%基于Elman反馈型神经网络的肾综合征出血热发病率预测模型

    Institute of Scientific and Technical Information of China (English)

    吴伟; 郭军巧; 安淑一; 关鹏; 周宝森

    2015-01-01

    Objective To describe the procedure of building Elman neural network model, and explore the value of potential application of the above model. Methods Monthly incidence of hemorrhagic fever with renal syndrome(HFRS) in China from 2004 to 2013 was used to build Elman neural network model and SARIMA model and forecasted the monthly incidence of HFRS in China from January 2014 to September 2014. The fitting and prediction effects of the two models were compared. Results For training sample, MAE, MAPE and RMSE of Elman neural network were 0.0088, 0.1191 and 0.0127 respectively; MAE, MAPE and RMSE of SARIMA model were 0.0111, 0.1268 and 0.0206 respectively. For predicting sample, MAE, RMSE and MAPE of Elman neural network were 0.0079, 0.1180 and 0.0096 respectively;MAE, RMSE and MAPE of SARIMA model were 0.0178, 0.2778 and 0.1861 respectively. Conclusion Elman neural network fits and forecasts the HFRS incidence trend in China well, and the fitting and prediction effect is superior to the SARIMA model, which is of great application value for the prevention and control of hemorrhagic fever with renal syndrome.%目的:阐述建立Elman神经网络模型预测肾综合征出血热(HFRS)发病率的方法和步骤,探讨其应用前景。方法使用全国2004-2013年HFRS的月发病率资料,建立Elman神经网络预测模型和SARIMA模型,对2014年1-9月HFRS的月发病率进行预测,比较2个模型的拟合和预测效果。结果对于训练样本,Elman神经网络的平均绝对误差(MAE)、平均绝对误差百分比(MAPE)以及均方误差平方根(RMSE)分别为0.0088、0.1191和0.0127;SARIMA模型的MAE、MAPE和RMSE分别为0.0111、0.1268和0.0206。对于预测样本,Elman神经网络的MAE、MAPE和RMSE分别为0.0079、0.1180和0.0096;SARIMA模型的MAE、MAPE和RMSE分别为0.0178、0.2778和0.1861。结论 Elman神经网络较好地拟合和预测了全国HFRS的发病趋势,并且其拟合和预测效果优

  15. Pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands.

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    Joost F von Schmidt auf Altenstadt

    Full Text Available BACKGROUND: Postpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide. Identifying risk indicators for postpartum haemorrhage is crucial to predict this life threatening condition. Another major contributor to maternal morbidity and mortality is pre-eclampsia. Previous studies show conflicting results in the association between pre-eclampsia and postpartum haemorrhage. The primary objective of this study was to investigate the association between pre-eclampsia and postpartum haemorrhage. Our secondary objective was to identify other risk indicators for postpartum haemorrhage in the Netherlands. METHODS: A nationwide cohort was used, containing prospectively collected data of women giving birth after 19 completed weeks of gestation from January 2000 until January 2008 (n =  1,457,576. Data were extracted from the Netherlands Perinatal Registry, covering 96% of all deliveries in the Netherlands. The main outcome measure, postpartum haemorrhage, was defined as blood loss of ≥1000 ml in the 24 hours following delivery. The association between pre-eclampsia and postpartum haemorrhage was investigated with uni- and multivariable logistic regression analyses. RESULTS: Overall prevalence of postpartum haemorrhage was 4.3% and of pre-eclampsia 2.2%. From the 31 560 women with pre-eclampsia 2 347 (7.4% developed postpartum haemorrhage, compared to 60 517 (4.2% from the 1 426 016 women without pre-eclampsia (odds ratio 1.81; 95% CI 1.74 to 1.89. Risk of postpartum haemorrhage in women with pre-eclampsia remained increased after adjusting for confounders (adjusted odds ratio 1.53; 95% CI 1.46 to 1.60. CONCLUSION: Women with pre-eclampsia have a 1.53 fold increased risk for postpartum haemorrhage. Clinicians should be aware of this and use this knowledge in the management of pre-eclampsia and the third stage of labour in order to reach the fifth Millenium Developmental Goal of reducing maternal mortality ratios with 75% by

  16. A Case of Haemorrhagic Constrictive Pericarditis with Bilateral Pleural Effusions

    Science.gov (United States)

    Islam, Julie; Talebi, Soheila; Cativo, Eder; Mushiyev, Savi; Pekler, Gerald; Visco, Ferdinand

    2016-01-01

    Presentation of pericardial disease is diverse, with the viral aetiology being the most common cause; however, when haemorrhagic pericardial effusion is present, these causes are narrowed to few aetiologies. We present a case of a young female of African descent who presented with diffuse abdominal pain and vomiting. Initial work-up showed pericardial effusion with impending echocardiographic findings of cardiac tamponade and bilateral pleural effusions. Procedures included a left video-assisted thoracoscopic surgery (VATS) with pericardial window. We consider that it is important for all physicians to be aware of not only typical presentation but also atypical and unusual clinical picture of pericardial disease.

  17. Hemorragia en la gestación Haemorrhage in gestation

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    I. Gómez Gutiérrez-Solana

    2009-01-01

    Full Text Available La hemorragia es una de las causas más frecuentes y potencialmente más graves en la consulta de urgencias durante la gestación. En esta revisión hemos realizado un enfoque global para el manejo de una gestante que acude a urgencias por un sangrado vaginal, y posteriormente de manera más específica el manejo de algunas de las entidades más frecuentes de la hemorragia obstétrica. En cuanto a las hemorragias del primer trimestre se ha hecho mayor hincapié en el manejo del aborto, puesto que otras entidades que también son frecuentes se valoran de manera específica en otros capítulos. En el segundo trimestre se ha realizado una revisión de tres entidades que abarcan el mayor porcentaje de hemorragias en ese periodo, como son la placenta previa, el desprendimiento prematuro de placenta normalmente inserta y la rotura uterina. Hemos valorado en cada una de ellas la etiopatogenia, la actitud diagnóstica y el manejo de la forma más sistemática posible.A haemorrhage is one of the most frequent, and potentially most serious, causes for emergency consultation during gestation. In this review we offer an overall approach to managing a pregnant woman who attends Accidents and Emergencies due to vaginal bleeding and then, in a more specific way, we consider how to manage some of the most frequent entities of the obstetric haemorrhage. With respect to haemorrhages in the second trimester, we give greater attention to how to manage a miscarriage, since other entities that are also frequent receive a specific evaluation in other chapters. In the second trimester three entities account for the greatest percentage of haemorrhages, such as placenta praevia, the premature detachment of the normally inserted placenta and uterine rupture. In each case we have evaluated the etiopathology, diagnostic attitude and management in the most systematic way possible.

  18. A Case of Haemorrhagic Constrictive Pericarditis with Bilateral Pleural Effusions

    Directory of Open Access Journals (Sweden)

    Hans A. Reyes

    2016-01-01

    Full Text Available Presentation of pericardial disease is diverse, with the viral aetiology being the most common cause; however, when haemorrhagic pericardial effusion is present, these causes are narrowed to few aetiologies. We present a case of a young female of African descent who presented with diffuse abdominal pain and vomiting. Initial work-up showed pericardial effusion with impending echocardiographic findings of cardiac tamponade and bilateral pleural effusions. Procedures included a left video-assisted thoracoscopic surgery (VATS with pericardial window. We consider that it is important for all physicians to be aware of not only typical presentation but also atypical and unusual clinical picture of pericardial disease.

  19. Pathogenesis of African swine fever in domestic pigs and European wild boar.

    Science.gov (United States)

    Blome, Sandra; Gabriel, Claudia; Beer, Martin

    2013-04-01

    African swine fever (ASF) is among the most important viral diseases that can affect domestic and feral pigs. Both clinical signs and pathomorphological changes vary considerably depending on strain virulence and host factors. Acute infections with highly virulent virus strains lead to a clinical course that resembles a viral haemorrhagic fever that is characterized by pronounced depletion of lymphoid tissues, apoptosis of lymphocyte subsets, and impairment of haemostasis and immune functions. It is generally accepted that most lesions can be attributed to cytokine-mediated interactions triggered by infected and activated monocytes and macrophages, rather than by virus-induced direct cell damage. Nevertheless, most pathogenetic mechanisms are far from being understood. This review summarizes the current knowledge and discusses implications and research gaps.

  20. Fever of unknown origin.

    Science.gov (United States)

    Mulders-Manders, Catharina; Simon, Anna; Bleeker-Rovers, Chantal

    2015-06-01

    More than 50 years after the first definition of fever of unknown origin (FUO), it still remains a diagnostic challenge. Evaluation starts with the identification of potential diagnostic clues (PDCs), which should guide further investigations. In the absence of PDCs a standardised diagnostic protocol should be followed with PET-CT as the imaging technique of first choice. Even with a standardised protocol, in a large proportion of patients from western countries the cause for FUO cannot be identified. The treatment of FUO is guided by the final diagnosis, but when no cause is found, antipyretic drugs can be prescribed. Corticosteroids should be avoided in the absence of a diagnosis, especially at an early stage. The prognosis of FUO is determined by the underlying cause. The majority of patients with unexplained FUO will eventually show spontaneous remission of fever. We describe the definition, diagnostic workup, causes and treatment of FUO. © Royal College of Physicians 2015. All rights reserved.

  1. Risk maps of Lassa fever in West Africa.

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    Elisabeth Fichet-Calvet

    Full Text Available BACKGROUND: Lassa fever is caused by a viral haemorrhagic arenavirus that affects two to three million people in West Africa, causing a mortality of between 5,000 and 10,000 each year. The natural reservoir of Lassa virus is the multi-mammate rat Mastomys natalensis, which lives in houses and surrounding fields. With the aim of gaining more information to control this disease, we here carry out a spatial analysis of Lassa fever data from human cases and infected rodent hosts covering the period 1965-2007. Information on contemporary environmental conditions (temperature, rainfall, vegetation was derived from NASA Terra MODIS satellite sensor data and other sources and for elevation from the GTOPO30 surface for the region from Senegal to the Congo. All multi-temporal data were analysed using temporal Fourier techniques to generate images of means, amplitudes and phases which were used as the predictor variables in the models. In addition, meteorological rainfall data collected between 1951 and 1989 were used to generate a synoptic rainfall surface for the same region. METHODOLOGY/PRINCIPAL FINDINGS: Three different analyses (models are presented, one superimposing Lassa fever outbreaks on the mean rainfall surface (Model 1 and the other two using non-linear discriminant analytical techniques. Model 2 selected variables in a step-wise inclusive fashion, and Model 3 used an information-theoretic approach in which many different random combinations of 10 variables were fitted to the Lassa fever data. Three combinations of absenceratiopresence clusters were used in each of Models 2 and 3, the 2 absenceratio1 presence cluster combination giving what appeared to be the best result. Model 1 showed that the recorded outbreaks of Lassa fever in human populations occurred in zones receiving between 1,500 and 3,000 mm rainfall annually. Rainfall, and to a much lesser extent temperature variables, were most strongly selected in both Models 2 and 3, and

  2. Understanding rheumatic fever.

    Science.gov (United States)

    Azevedo, Pedro Ming; Pereira, Rosa Rodrigues; Guilherme, Luiza

    2012-05-01

    Through a comprehensive review of the recent findings on rheumatic fever, we intend to propose a new physiopathologic model for this disease. A Medline search was performed for all articles containing the terms rheumatic fever or rheumatic heart disease in title or abstract from 1970 to 2011. Best evidence qualitative technique was used to select the most relevant. The scientific interest on rheumatic fever has notably diminished throughout the twentieth century as evidenced by the comparison of the proportion of articles in which RF was a subject in 1950 (0.26%) and today (0.03%) [Pubmed]. However, RF remains a major medical and social problem in the developing world and in the so-called hotspots, where it still causes around 500.000 deaths each year, not too different from the pre-antibiotic era. The role of genetic factors in RF susceptibility is discussed. Familiar aggregation, similarity of disease patterns between siblings, identical twin, and HLA correlation studies are evidence for a genetic influence on RF susceptibility. The suspect-involved genes fall mainly into those capable of immunologic mediation. Molecular mimicry explains the triggering of RF, but an intense and sustained inflammation is needed to cause sequels. Also, RF patients vary greatly in terms of symptoms. It is likely that a genetic background directing immune response towards a predominantly Th1 or Th2 pattern contributes to these features. The recent findings on rheumatic fever provide important insight on its physiopathology that helps understanding this prototype post-infectious autoimmune disease giving insights on other autoimmune conditions.

  3. STUDY OF SIGNIFICANCE OF PLATELET COUNT IN FEVER CASES

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    Vasavilatha

    2015-01-01

    Full Text Available AIM: To study the significance of platelet count in various fevers and also identify the common causes of fever with thrombocytopenia . MATERIALS AND METHODS: 69 patients who were admitted with fever over 2 months of period from 15th October to15th December 2014 in King George Hospital AMC Visakhapatnam studied retrospectively. RESULTS: INCIDENCE: More than half of the cases (52.2% admitted with fever have thrombocytopenia. SEX: The study reveals that irrespective of sex and size of the sample the presentation of fever with/ without thromb ocytopenia could not found any significant difference . Degree of thrombocytopenia in various etiologies: in the present study it is found that out of 15 cases of falciparum malaria 10 cases had thrombocytopenia. Out of 12 undiagnosed cases 8 cases had thro mbocytopenia. Out of 4 cases of gastro intestinal system 3 cases had thrombocytopenia. In the present study it is significantly found that the highest difference is noticed in the presentation of dengue cases. Out of total sample (69 cases it is found tha t 5cases (7.2% of thrombocytopenia with dengue fever were found against 1case (1.4% of dengue fever with normal plate let count. The present study reveals that there is significant difference among various diseases such as malaria 14 (16.6%, dengue feve r 5 (13.9%, Urinary tract infection 2 (5.6%, undiagnosed cases 8 (22.2%. However severe thrombocytopenia (platelets less than 50,000 is seen in14 cases (38.8%out of 36 cases of fever with thrombocytopenia. Further this study reveals that in the cases of malaria 50% of cases reported as severe thrombocytopenia 7cases (19.4% followed by dengue fever3 cases (8.3%. CONCLUSION: Not only malaria, dengue fever and urinary tract infection can also cause severe thrombocytopenia. Fever cases especially with th rombocytopenia show seasonal variations, they are seen commonly in early winter. Febrile thrombocytopenia still presents as atypical and occult forms making

  4. EpiReview: Typhoid fever, NSW, 2005-2011.

    Science.gov (United States)

    Gunaratnam, Praveena; Tobin, Sean; Seale, Holly; Musto, Jennie

    2013-11-01

    To examine trends in the incidence of typhoid fever in NSW to inform the development of prevention strategies. Typhoid fever case notification data for the period 2005-2011 were extracted from the NSW Notifiable Conditions Information Management System. Population incidence rates were calculated and analysed by demographic variables. There were 250 case notifications of typhoid fever in NSW from 2005 to 2011, of which 240 are likely to have been acquired overseas. Case notifications remained relatively stable over the review period with the highest rates in Western Sydney Local Health District (10.9 per 100,000 population). Two-thirds (66.4%) of all case notifications are likely to have been acquired in South Asia, and about half of overseas-acquired case notifications were most likely to have been associated with travel to visit friends and relatives. Hospitalisation was required for 79.6% of cases where hospitalisation status was known. Prior typhoid vaccination was reported in 7% of cases in 2010 and 2011 where vaccination status was known. While typhoid fever rates remain low in NSW, case notifications of this preventable infection continue to be reported, particularly in travellers visiting friends and relatives in South Asia. Further research to better understand barriers to the use of preventive measures may be useful in targeting typhoid fever prevention messages in high-risk groups, particularly South Asian communities in NSW.

  5. Meteorological factors and dengue fever transmission in South Taiwan

    Science.gov (United States)

    Chien, Lung-Chang; Lin, Yuan-Chien; Cheng, Ming-Hung; Yu, Hwa-Lung

    2013-04-01

    The variations in meteorological conditions induced by climate change causes the diffusion pattern of infectious disease and serious epidemic situation. The objective of this study is to investigate the impact of meteorological variables to the temporal variation of dengue fever epidemic in weekly basis in south Taiwan. Several extreme and average index of meteorological variables, i.e. temperature and humidity, were used for this analysis, including averaged, maximum and minimum temperature, and average rainfall, maximum 1-hr rainfall, and maximum 24-hr rainfall. This study applies the distributed lag nonlinear model (DLNM) to reveal the significant meteorological variables and their temporal lag effects to the dengue fever epidemic by analyzing the dengue fever records from 1998-2011. Results show that the weekly minimum temperature (minT) and 1-hr maximum rainfall (maxR) are significantly important to the dengue fever spread. Among them, once minT is higher than 20°C, the relative risk of dengue fever of nine-fourteen week later will be significantly elevated. On the other hand, the incidences of maxR higher than 80mm can also increase the relative risk of dengue fever occurrences around nine-fourteen weeks afterwards.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-10-01

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

  7. Management of a delayed post-pancreatoduodenectomy haemorrhage using endovascular techniques

    Science.gov (United States)

    Asai, Kengo; Zaydfudim, Victor; Truty, Mark; Reid-Lombardo, KMarie; Kendrick, Michael; Que, Florencia; Nagorney, David; Andrews, James; Farnell, Michael

    2015-01-01

    Background A delayed post-pancreatoduodenectomy haemorrhage is associated with a significant increase in peri-operative mortality. Endovascular techniques are frequently used for a delayed haemorrhage. However, limited data exists on the short- and long-term outcomes of this approach. A retrospective review over a 10-year period at a quaternary-referral pancreatic centre was performed. Methods Between 2002–2012, 1430 pancreatoduodenectomies were performed, and 32 patients had a delayed haemorrhage (occurring >24 h post-operatively) managed by endovascular techniques. The clinicopathological variables related to a haemorrhage were investigated. Results A total of 42 endovascular procedures were performed at a median of 25 days, with the majority of delayed haemorrhages occurring after 7 days. There were four deaths (13%) with three occurring in patients with a grade C haemorrhage. Seven patients (22%) experienced rebleeding, and two patients developed hepatic abscesses. Conclusion A delayed haemorrhage post-pancreaticoduodenectomy can be managed by endovascular techniques with acceptable morbidity and mortality. Rebleeding and hepatic abscesses may occur and can be managed non-operatively in most cases. The association of a delayed haemorrhage with a pancreatic fistula makes this a challenging clinical problem. PMID:26235930

  8. Haemostatic effect and tissue reactions of methods and agents used for haemorrhage control in apical surgery

    DEFF Research Database (Denmark)

    Jensen, Simon Storgaard; Yazdi, P M; Hjørting-Hansen, Erik

    2010-01-01

    To compare the haemostatic effect and tissue reactions of different agents and methods used for haemorrhage control in apical surgery.......To compare the haemostatic effect and tissue reactions of different agents and methods used for haemorrhage control in apical surgery....

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

    Science.gov (United States)

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

    2017-01-01

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

  10. Surgical trial in intracerebral haemorrhage (S.T.I.C.H).

    Science.gov (United States)

    Mendelow, A D

    2000-01-01

    The International Surgical Trial in Intracerebral haemorrhage has been set up to determine the role of surgery in spontaneous supratentorial intracerebral haemorrhage. This is an interim report as the results will remain blinded until all patients have been recruited and followed up.

  11. Prospects for development of African swine fever virus vaccines.

    Science.gov (United States)

    Dixon, L K; Abrams, C C; Chapman, D D G; Goatley, L C; Netherton, C L; Taylor, G; Takamatsu, H H

    2013-01-01

    African swine fever virus is a large DNA virus which can cause an acute haemorrhagic fever in pigs resulting in high mortality. No vaccine is available, limiting options for control. The virus encodes up to 165 genes and virus particles are multi-layered and contain more than 50 proteins. Pigs immunised with natural low virulence isolates or attenuated viruses produced by passage in tissue culture and by targeted gene deletions can be protected against challenge with virulent viruses. CD8+ cells are required for protection induced by attenuated strain OURT88/3. Passive transfer of antibodies from immune to naïve pigs can also induce protection. Knowledge of the genome sequences of attenuated and virulent strains and targeted gene deletions from virulent strains have identified a number of virus genes involved in virulence and immune evasion. This information can be used to produce rationally attenuated vaccine strains. Virus antigens that are targets for neutralising antibodies have been identified and immunisation with these recombinant proteins has been shown to induce partial protection. However knowledge of antigens which encode the dominant protective epitopes recognised by CD8+ T cells is lacking.

  12. Capacity building permitting comprehensive monitoring of a severe case of Lassa hemorrhagic fever in Sierra Leone with a positive outcome: case report.

    Science.gov (United States)

    Grove, Jessica N; Branco, Luis M; Boisen, Matt L; Muncy, Ivana J; Henderson, Lee A; Schieffellin, John S; Robinson, James E; Bangura, James J; Fonnie, Mbalu; Schoepp, Randal J; Hensley, Lisa E; Seisay, Alhassan; Fair, Joseph N; Garry, Robert F

    2011-06-20

    Lassa fever is a neglected tropical disease with a significant impact on the health care system of endemic West African nations. To date, case reports of Lassa fever have focused on laboratory characterisation of serological, biochemical and molecular aspects of the disease imported by infected individuals from Western Africa to the United States, Canada, Europe, Japan and Israel. Our report presents the first comprehensive real time diagnosis and characterization of a severe, hemorrhagic Lassa fever case in a Sierra Leonean individual admitted to the Kenema Government Hospital Lassa Fever Ward. Fever, malaise, unresponsiveness to anti-malarial and antibiotic drugs, followed by worsening symptoms and onset of haemorrhaging prompted medical officials to suspect Lassa fever. A recombinant Lassa virus protein based diagnostic was employed in diagnosing Lassa fever upon admission. This patient experienced a severe case of Lassa hemorrhagic fever with dysregulation of overall homeostasis, significant liver and renal system involvement, the interplay of pro- and anti-inflammatory cytokines during the course of hospitalization and an eventual successful outcome. These studies provide new insights into the pathophysiology and management of this viral illness and outline the improved infrastructure, research and real-time diagnostic capabilities within LASV endemic areas.

  13. Capacity building permitting comprehensive monitoring of a severe case of Lassa hemorrhagic fever in Sierra Leone with a positive outcome: Case Report

    Directory of Open Access Journals (Sweden)

    Fonnie Mbalu

    2011-06-01

    Full Text Available Abstract Lassa fever is a neglected tropical disease with a significant impact on the health care system of endemic West African nations. To date, case reports of Lassa fever have focused on laboratory characterisation of serological, biochemical and molecular aspects of the disease imported by infected individuals from Western Africa to the United States, Canada, Europe, Japan and Israel. Our report presents the first comprehensive real time diagnosis and characterization of a severe, hemorrhagic Lassa fever case in a Sierra Leonean individual admitted to the Kenema Government Hospital Lassa Fever Ward. Fever, malaise, unresponsiveness to anti-malarial and antibiotic drugs, followed by worsening symptoms and onset of haemorrhaging prompted medical officials to suspect Lassa fever. A recombinant Lassa virus protein based diagnostic was employed in diagnosing Lassa fever upon admission. This patient experienced a severe case of Lassa hemorrhagic fever with dysregulation of overall homeostasis, significant liver and renal system involvement, the interplay of pro- and anti-inflammatory cytokines during the course of hospitalization and an eventual successful outcome. These studies provide new insights into the pathophysiology and management of this viral illness and outline the improved infrastructure, research and real-time diagnostic capabilities within LASV endemic areas.

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

    Science.gov (United States)

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

    2015-09-01

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

  15. Postinterventional subarachnoid haemorrhage after endovascular stroke treatment with stent retrievers

    Energy Technology Data Exchange (ETDEWEB)

    Nikoubashman, Omid [Uniklinik Aachen, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Aachen (Germany); Institute for Neuroscience and Medicine 4, Juelich (Germany); Reich, Arno; Jungbluth, Michael [Uniklinik Aachen, Klinik fuer Neurologie, Aachen (Germany); Pjontek, Rastislav; Wiesmann, Martin [Uniklinik Aachen, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Aachen (Germany)

    2014-12-15

    The purpose of this paper is to investigate the clinical significance of postinterventional subarachnoid hyperdensities (PSH) after endovascular mechanical thrombectomy in acute ischemic stroke. We analysed clinical and radiological data of 113 consecutive patients who received postinterventional CT scans within 4.5 h after mechanical thrombectomy. PSH was present in 27 of 113 patients (24 %). Extravasation of contrast agent was observed during intervention in only 6 of 27 cases (22 %). There was consecutive haemorrhagic transformation in four patients with PSH (p = 0.209, Fisher's exact test). Preinterventional predictors for the occurrence of PSH in our series were a long interval between clinical onset and recanalization (p = 0.028), a long procedure time (p = 0.010), and a high number of recanalization attempts (p = 0.001). PSH had no significant impact on clinical outcome (modified Rankin Scale) at discharge (p = 0.419) or at 3 months (p = 0.396). There were no significant correlations between PSH and thrombectomy devices (Solitaire: p = 0.433, Trevo Pro: p = 0.124). PSH after endovascular mechanical thrombectomy in acute ischemic stroke are likely to occur in complicated cases in which more than one revascularisation attempt is performed. PSH per se do not appear to be associated with an impaired clinical outcome or an elevated risk for consecutive haemorrhage. (orig.)

  16. Recombinant activated factor VII in post partum haemorrhage

    Directory of Open Access Journals (Sweden)

    Navneet Magon

    2013-01-01

    Full Text Available Post-partum haemorrhage (PPH is a life-threatening obstetric complication and the leading cause of maternal death. Any bleeding that results in or could result in haemodynamic instability, if untreated, must be considered as PPH. There is no controversy about the need for prevention and treatment of PPH. The keystone of management of PPH entails first, non-invasive and nonsurgical methods and then invasive and surgical methods. However, mortality remains high. Therefore, new advancements in the treatment are most crucial. One such advancement has been the use of recombinant activated factor VII (rFVIIa in PPH. First used 12 years back in PPH, this universal haemostatic agent has been effectively used in controlling PPH. The best available indicator of rFVIIa efficacy is the arrest of haemorrhage, which is judged by visual evidence and haemodynamic stabilization. It also reduces costs of therapy and the use of blood components in massive PPH. In cases of intractable PPH with no other obvious indications for hysterectomy, administration of rFVIIa should be considered before surgery. We share our experience in a series of cases of PPH, successfully managed using rFVIIa.

  17. Haemorrhagic and thrombotic diatheses in mouse models with thrombocytosis.

    Science.gov (United States)

    Strassel, Catherine; Kubovcakova, Lucia; Mangin, Pierre H; Ravanat, Catherine; Freund, Monique; Skoda, Radek C; Denis, Cécile V; Dupuis, Arnaud; Herbrecht, Raoul; Gachet, Christian; Lanza, François

    2015-02-01

    We studied haemostasis in two mouse models with thrombocytosis caused by different pathogenic mechanisms. In one strain (Yall;Mpl-/-) thrombocytosis is driven by a misbalance between thrombopoietin and its receptor, whereas in the other strain, thrombocytosis is caused by expressing a human JAK2-V617F transgene (FF1) that depends on activation by Cre-recombinase (VavCre;FF1, MxCre;FF1). Thrombotic responses were increased following some, but not all types of challenges. In a vaso-occlusive thrombotic model following collagen-adrenaline injection we found increased mortality in both strains. Arterial thrombosis, examined after ferric chloride-induced carotid injury, was accelerated but with little impact on maximal thrombus size. In a vena cava stasis model, clots were of similar size as in wild-type controls, but exhibited a different composition with a higher platelet to fibrin ratio. Both thrombocytosis strains displayed increased haemorrhagic tendency in a tail bleeding assay. Yall;Mpl and VavCre;FF1 displayed a lower proportion of the more reactive high-molecular-weight forms of von Willebrand factor in their plasma, mimicking essential thrombocythaemia with very high platelet counts. Bleeding could not be explained by clear defects in platelet activation, which were normal or only weakly decreased. In conclusion, these models of thrombocytosis recapitulate several features of the haemorrhagic and thrombotic diatheses in ET and PV demonstrating potentials but also some limitations to study these major complications.

  18. Sadfly fever: two case reports.

    Science.gov (United States)

    Özkale, Yasemin; Özkale, Murat; Kiper, Pinar; Çetinkaya, Bilin; Erol, İlknur

    2016-06-01

    Sandfly fever, also known as 'three-day fever' or 'pappataci fever' or 'Phlebotomus fever' is a viral infection that causes self-limited influenza-like symptoms and characterized by a rapid onset. The disease occurs commonly in endemic areas in summer months and especially in August during which sandflies are active. In this article, two siblings who presented with high fever, redness in the eyes, headache, weakness, malaise and inability to walk, who were found to have increased liver function tests and creatine kinase levels and who were diagnosed with sadfly fever with positive sadfly IgM and IgG antibodies are reported because of the rarity of this disease.

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

    Directory of Open Access Journals (Sweden)

    C Lahariya

    2012-01-01

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

  20. Chikungunya fever presenting with protracted severe pruritus.

    Science.gov (United States)

    Cunha, Burke A; Leonichev, Victoria B; Raza, Muhammad

    2016-01-01

    Travelers returning from the tropics often present with rash/fever. Those with rash/fever and myalgias/arthralgias are most likely due to chikungunya fever, dengue fever, or Zika virus. In these arthropod viral transmitted infections, the rash may be pruritic. The case presented here is that of chikungunya fever remarkable for the intensity and duration of her pruritis.

  1. Churg-Strauss Syndrome as an Unusual Aetiology of Stroke with Haemorrhagic Transformation in a Patient with No Cardiovascular Risk Factors

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    Tiina Sairanen

    2011-01-01

    Full Text Available Background: We present here a case of haemorrhagic brain infarction in a middle-aged and physically active male, who had never smoked. This case report aims to remind the internist and neurologist to bear in mind unusual aetiologies of brain infarcts in patients without classical cardiovascular risk factors. Case Description: A 49-year-old male with pulmonary asthma and a prior history of nasal polyps had a wake-up stroke with left-sided symptoms and speech disturbance. A head MRI and MR angiography revealed a recent haemorrhagic infarct in the right putamen and corona radiata. The left hemiparesis progressed to sensory-motor hemiplegia on the 4th day. In the head CT, it was shown that the haemorrhagic infarct had progressed to a large haematoma. A pansinusitis was also diagnosed. The aetiological investigations revealed a minor atrial septal defect (ASD with shunting and a heterozygotic clotting factor V R506Q mutation. A remarkable blood eosinophilia of 9.80 E9/l (42% together with fever, sinusitis, wide-spread bilateral nodular pulmonary infiltrates that did not respond to wide-spectrum antimicrobial treatment, positive anti-neutrophilic cytoplasmic antibodies, a high myeloperoxidase antibody level and slightly positive anti-proteinase 3 antibodies suggested the diagnosis of Churg-Strauss syndrome. These inflammatory symptoms and findings promptly responded to treatment with corticosteroids and cyclophosphamide. Conclusions: Even after the concomitant findings of the low risk factors, i.e. small ASD and heterozygotic clotting factor mutation, continued search for the final aetiology of stroke revealed Churg-Strauss syndrome, which was the key to the treatment.

  2. Typhoid fever cases in the U.S. military.

    Science.gov (United States)

    Sorrell, Tia; Selig, Daniel J; Riddle, Mark S; Porter, Chad K

    2015-10-14

    Salmonella enterica, serovar Typhi (S. Typhi), a causative agent of enteric fever (typhoid fever), predominately affects populations in developing regions with poor access to clean food and water. In addition, travelers to these regions are at risk of exposure. We report the epidemiological characteristics of S. Typhi cases among active duty United States military personnel from 1998 to 2011 using data obtained from the Defense Medical Surveillance System. Cases were identified based on International Classification for Disease Ninth Edition - Clinical Modification codes. We identified a total of 205 cases S. Typhi for an incidence of 1.09 per 100,000 person-years. Cases were on average 31.7 years old, predominately married (n = 129, 62.9 %), Caucasian (n = 142, 69.3 %), male (n = 176, 85.9 %), and had a high school education (n = 101, 49.3 %). Of the identified cases, 122 had received a Typhoid vaccination within 4 years of diagnosis. This study provides an overview of enteric fever in the United States military. The incidence was similar to the general U.S. population except for increased incidence from 1998 to 2000, perhaps attributable to operational deployments in that period. Given that vaccination is an effective primary prevention measure against typhoid fever, active monitoring of pre-deployment vaccine history is warranted.

  3. Typhoid Fever, Below the Belt.

    Science.gov (United States)

    Raveendran, Kamakshi Mahadevan; Viswanathan, Stalin

    2016-01-01

    Genital ulcers occur due to infective, inflammatory, malignant and drug-related causes. In tropical countries such as India, such ulcers are due to parasitic, tubercular, rickettsial and bacterial (sexually transmitted infections) aetiologies. Typhoid fever is endemic in the tropics. Except "rose spots", skin manifestations in typhoid fever are unusual, and they are missed due to pigmented skin. Patients do not often complain of genital ulcers due to shame or fear. Genital examination is not routinely performed in typhoid fever. We describe scrotal ulcers as the presenting symptom of typhoid fever, which subsided with appropriate therapy.

  4. Fever in the pediatric patient.

    Science.gov (United States)

    Wing, Robyn; Dor, Maya R; McQuilkin, Patricia A

    2013-11-01

    Fever is the most common reason that children and infants are brought to emergency departments. Emergency physicians face the challenge of quickly distinguishing benign from life-threatening conditions. The management of fever in children is guided by the patient's age, immunization status, and immune status as well as the results of a careful physical examination and appropriate laboratory tests and radiographic views. In this article, the evaluation and treatment of children with fevers of known and unknown origin are described. Causes of common and dangerous conditions that include fever in their manifestation are also discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. A RELOOK INTO THE CLINICO - PATHOLOGICAL ASPECTS OF LEPTOSPIRA INFECTION IN PATIENTS PRESENTING WITH FEVER IN A TERTIARY CARE HOSPITAL

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    Dwijen

    2015-10-01

    Full Text Available BACKGROUND: Leptospirosis is a bacterial disease affecting humans and animals alike. It is caused by bacteria of the genus Leptospira . In humans, it can lead to a wide range of presentations, some of which may be mistaken for other diseases commonly occurring in the community. Some infe cted persons, however, may be entirely asymptomatic. Without treatment, Leptospirosis can be fatal leading to kidney damage, meningitis, liver failure, respiratory distress, and even death. AIM OF THE STUDY : 1 T o find out the positive cases of Leptospira infection among patients attending with fever in Silchar Medical College and Hospital, department of Medicine. 2 To evaluate the clinical profile of leptospirosis. MATERIALS AND METHODS : A total of consecutive 100 cases of acute febrile illness with features suggestive of leptospira infection like conjunctival suffusion or sub - conjunctival haemorrhage, myalgia and headache with or without jaundice and/or oliguria were selected for serological test for leptospira. INCLUSION CRITERIA: Leptospira seropo sitive cases presenting with acute febrile illne ss were included in the study. RESULTS: 38 cases (23 males and 15 females in the series were found seropositive for Leptospira and formed the study group. Maximum incidence 15(39.5% were in the age group 30 - 39 years. Occupational distribution included businessman 13 (34.2%, students 10(26.4%, housewives 7(19.4% and farmers 8 (21% respectively. Other than fever, symptoms on presentation included headache 31 (81.5%, myalgia 20 (52.6% and jaundice 25 (6 5.78% respectively. Laboratory investigations revealed Hemoglobin 12000/mm 3 in 26 (68.42% and low platelet count <1.2 lac/mm 3 in 19 (50% of cases. 3 cases (7.89% had associated uremia and underwent hemodialysis. In present study, 2 (5.2% patients died. CONCLUSION: Leptospirosis is quiet common in this part of the world and all patients presenting with acute febrile illness, particularly during the monsoon season

  6. Fever's glass ceiling.

    Science.gov (United States)

    Mackowiak, P A; Boulant, J A

    1996-03-01

    The importance of an upper limit of the febrile response has been recognized since the time of Hippocrates. Although the precise temperature defining this limit varies according to the site at which body temperature is measured, human core temperature is almost never permitted to rise above 41 degrees C-42 degrees C during fever. There are compelling physiological reasons for such an upper limit of regulated body temperature. The mechanisms by which the limit is maintained are most likely complex and involve special properties of thermoregulatory neurons themselves, circulating endogenous antipyretics (such as arginine vasopressin and alpha-melanocyte-stimulating hormone), and soluble receptors for the (pyrogenic) cytokine mediators of the febrile response.

  7. Familial Mediterranean Fever (FMF

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    Onur Albayrak

    2009-08-01

    Full Text Available Familial Mediterranean Fever (FMF is an autosomal recessive genetic disease that affects males and females. FMF gene is on the short arm of chromosome 16. It is most often found in Jews, Arabs, Turks, and Armenians. Amyloidosis is charecterized by the deposition of a particular protein between the cells in the tissue. It is a potentially serious complication of FMF. The kidney is a prime target for the amyloid. [Archives Medical Review Journal 2009; 18(4.000: 260-267

  8. Ebola hemorrhagic Fever.

    Science.gov (United States)

    Burnett, Mark W

    2014-01-01

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

  9. Pharmacological manipulation of gastric juice: thrombelastographic assessment and implications for treatment of gastrointestinal haemorrhage.

    Science.gov (United States)

    Patchett, S E; O'Donoghue, D P

    1995-03-01

    The impairment of formation and maintenance of a formed fibrin clot contributes to the prolonged bleeding and high incidence of rebleeding in upper gastrointestinal haemorrhage. To investigate the basis for the use of drug therapy in gastric bleeding, this study used thrombelastography to determine the effects of pharmacological manipulation of gastric juice on coagulation and fibrinolysis. The thrombelastograph is a mechanical device that provides a visual assessment of all stages of coagulation and fibrinolysis. The effects of fresh and pharmacologically changed gastric juice was assessed after its addition to fresh whole blood in the thrombelastograph cuvette. Pharmacological manipulation was achieved through alkalisation or through addition of tranexamic acid, aprotinin, or sucralfate. Fresh gastric juice delayed clot formation, decreased maximum clot amplitude, and stimulated clot lysis. Alkalisation inhibited the lytic effects of fresh gastric juice and improved the induced abnormalities in coagulation. Tranexamic acid partially inhibited gastric juice induced clot lysis but did not exhibit a beneficial effect on coagulation. Sucralfate, and to a lesser extent aprotinin significantly inhibited fibrinolysis but exacerbated the detrimental effect of gastric juice on the parameters of coagulation. Alkalisation of gastric juice reduces the adverse effect on coagulation and fibrinolysis. Tranexamic acid, aprotinin, and sucralfate can all reduce or inhibit clot lysis, but the adverse effects on clot formation may outweigh any potential benefit in the treatment of gastrointestinal bleeding.

  10. Cerebral microbleeds on magnetic resonance imaging (MRI and anticoagulant-associated intracerebral haemorrhage risk

    Directory of Open Access Journals (Sweden)

    Andreas eCharidimou

    2012-09-01

    Full Text Available The increasing use of antithrombotic drugs in an ageing population (including anticoagulants to prevent future ischaemic stroke in individuals with atrial fibrillation has been associated with a dramatic increase in the incidence of intracerebral haemorrhage (ICH in users of antithrombotic drugs. Several lines of evidence suggest that cerebral small vessel disease (particularly sporadic cerebral amyloid angiopathy is a risk factor for this rare but devastating complication of these commonly used treatments. Cerebral microbleeds (CMBs have emerged as a key MRI marker of small vessel disease and a potentially powerful marker of future ICH risk, but adequately powered, high quality prospective studies of CMBs and ICH risk on anticoagulation are not available. Further data are urgently needed to determine how neuroimaging and other biomarkers may contribute to individualised risk prediction to make anticoagulation as safe and effective as possible. In this review we discuss the available evidence on cerebral small vessel disease and CMBs in the context of antithrombotic treatments, especially regarding their role as a predictor of future ICH risk after ischaemic stroke, where risk-benefit judgements can be a major challenge for physicians. We will focus on patients with atrial fibrillation because these are frequently treated with anticoagulation. We briefly describe the rationale and design of a new prospective observational inception cohort study (Clinical Relevance of Microbleeds in Stroke; CROMIS-2 which investigates the value of MRI markers of small vessel disease (including CMBs and genetic factors in assessing the risk of oral anticoagulation-associated ICH.

  11. Hemorrhagic Fever with Renal Syndrome (HFRS)

    Science.gov (United States)

    ... this page: About CDC.gov . Share Compartir Hemorrhagic Fever with Renal Syndrome (HFRS) On this Page What ... is HFRS prevented? Suggested Reading What is hemorrhagic fever with renal syndrome? Hemorrhagic fever with renal syndrome ( ...

  12. What about My Child and Rheumatic Fever?

    Science.gov (United States)

    ... Cardiovascular Conditions What About My Child and Rheumatic Fever? Rheumatic fever is an inflammatory reaction that can occur after ... strep throat infections don’t lead to rheumatic fever. When they do, the time between the strep ...

  13. Genetics Home Reference: familial Mediterranean fever

    Science.gov (United States)

    ... Facebook Twitter Home Health Conditions familial Mediterranean fever familial Mediterranean fever Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Familial Mediterranean fever is an inherited condition characterized by recurrent episodes ...

  14. Travelers' Health: Typhoid and Paratyphoid Fever

    Science.gov (United States)

    ... in an Area with Zika? Find a Clinic Yellow Fever Vaccinations Clinics FAQ Disease Directory Resources Resources for ... CE Courses and Training Presentations for Health Professionals Yellow Fever Vaccine Course About the Yellow Fever Vaccine Course ...

  15. Dengue fever presenting as acute acalculus cholecystitis.

    Science.gov (United States)

    Joshipura, Vismit P; Soni, Harshad N; Patel, Nitin R; Haribhakti, Sanjiv P

    2007-06-01

    Classically dengue fever presents as fever with myalgia. A patient of dengue fever presented with classical symptoms and signs of acute acalculous cholecystitis. Serology and ultrasound examination identified dengue as the aetiology. Patient was treated successfully by conservative measures.

  16. Comparisons of predictors for typhoid and paratyphoid fever in Kolkata, India

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    Deen Jacqueline L

    2007-10-01

    Full Text Available Abstract Background: Exposure of the individual to contaminated food or water correlates closely with the risk for enteric fever. Since public health interventions such as water improvement or vaccination campaigns are implemented for groups of individuals we were interested whether risk factors not only for the individual but for households, neighbourhoods and larger areas can be recognised? Methods: We conducted a large enteric fever surveillance study and analyzed factors which correlate with enteric fever on an individual level and factors associated with high and low risk areas with enteric fever incidence. Individual level data were linked to a population based geographic information systems. Individual and household level variables were fitted in Generalized Estimating Equations (GEE with the logit link function to take into account the likelihood that household factors correlated within household members. Results: Over a 12-month period 80 typhoid fever cases and 47 paratyphoid fever cases were detected among 56,946 residents in two bustees (slums of Kolkata, India. The incidence of paratyphoid fever was lower (0.8/1000/year, and the mean age of paratyphoid patients was older (17.1 years than for typhoid fever (incidence 1.4/1000/year, mean age 14.7 years. Residents in areas with a high risk for typhoid fever had lower literacy rates and economic status, bigger household size, and resided closer to waterbodies and study treatment centers than residents in low risk areas. Conclusion: There was a close correlation between the characteristics detected based on individual cases and characteristics associated with high incidence areas. Because the comparison of risk factors of populations living in high versus low risk areas is statistically very powerful this methodology holds promise to detect risk factors associated with diseases using geographic information systems.

  17. Fever in trauma patients: evaluation of risk factors, including traumatic brain injury.

    Science.gov (United States)

    Bengualid, Victoria; Talari, Goutham; Rubin, David; Albaeni, Aiham; Ciubotaru, Ronald L; Berger, Judith

    2015-03-01

    The role of fever in trauma patients remains unclear. Fever occurs as a response to release of cytokines and prostaglandins by white blood cells. Many factors, including trauma, can trigger release of these factors. To determine whether (1) fever in the first 48 hours is related to a favorable outcome in trauma patients and (2) fever is more common in patients with head trauma. Retrospective study of trauma patients admitted to the intensive care unit for at least 2 days. Data were analyzed by using multivariate analysis. Of 162 patients studied, 40% had fever during the first 48 hours. Febrile patients had higher mortality rates than did afebrile patients. When adjusted for severity of injuries, fever did not correlate with mortality. Neither the incidence of fever in the first 48 hours after admission to the intensive care unit nor the number of days febrile in the unit differed between patients with and patients without head trauma (traumatic brain injury). About 70% of febrile patients did not have a source found for their fever. Febrile patients without an identified source of infection had lower peak white blood cell counts, lower maximum body temperature, and higher minimum platelet counts than did febrile patients who had an infectious source identified. The most common infection was pneumonia. No relationship was found between the presence of fever during the first 48 hours and mortality. Patients with traumatic brain injury did not have a higher incidence of fever than did patients without traumatic brain injury. About 30% of febrile patients had an identifiable source of infection. Further studies are needed to understand the origin and role of fever in trauma patients. ©2015 American Association of Critical-Care Nurses.

  18. Yellow fever virus: genetic and phenotypic diversity and implications for detection, prevention and therapy.

    Science.gov (United States)

    Beasley, David W C; McAuley, Alexander J; Bente, Dennis A

    2015-03-01

    Yellow fever virus (YFV) is the prototypical hemorrhagic fever virus, yet our understanding of its phenotypic diversity and any molecular basis for observed differences in disease severity and epidemiology is lacking, when compared to other arthropod-borne and haemorrhagic fever viruses. This is, in part, due to the availability of safe and effective vaccines resulting in basic YFV research taking a back seat to those viruses for which no effective vaccine occurs. However, regular outbreaks occur in endemic areas, and the spread of the virus to new, previously unaffected, areas is possible. Analysis of isolates from endemic areas reveals a strong geographic association for major genotypes, and recent epidemics have demonstrated the emergence of novel sequence variants. This review aims to outline the current understanding of YFV genetic and phenotypic diversity and its sources, as well as the available animal models for characterizing these differences in vivo. The consequences of genetic diversity for detection and diagnosis of yellow fever and development of new vaccines and therapeutics are discussed.

  19. The prevalence of maternal F cells in a pregnant population and potential overestimation of foeto-maternal haemorrhage as a consequence.

    LENUS (Irish Health Repository)

    Corcoran, Deirdre

    2014-06-12

    Acid elution (AE) is used to estimate foeto-maternal haemorrhage (FMH). However AE cannot differentiate between cells containing foetal or adult haemoglobin F (F cells), potentially leading to false positive results or an overestimate of the amount of FMH. The prevalence of F cells in pregnant populations remains poorly characterised. The purpose of this study was to ascertain the incidence of HbF-containing red cells in our pregnant population using anti-HbF-fluorescein isothiocyanate flow cytometry (anti-HbF FC) and to assess whether its presence leads to a significant overestimate of FMH.

  20. STUDY OF RENAL FUNCTION TESTS IN PATIEN TS OF ACUTE HAEMORRHAGIC STROKE

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    Aditya Vardhan

    2015-05-01

    Full Text Available OBJECTIVE: To study renal function tests in patients with acute haemorrhagic stroke and to find association of abnormal renal function with adverse outcome in patients with acute haemorrhagic stroke . MATERIAL AND METHODS: The study was conducted at Darbhanga Medical College & Hospital , Laheriasarai , Darbhanga during the period from January 2012 to September 2013 . This was an observational study . A total of 100 patients presenting with acute haemorrhagic stroke admitted to the hospital or reporting in OPD/Emergency for stroke were included in this study after having taken written informed consent . Cases were selected by random sampling . OBSERVATION: Out of 100 patients with acute haemorrhagic stroke 92 patients had intracerebral haemorrhage and 8 patie nts had subarachnoid haemorrhage . Patients were divided into two groups on the basis of estimated glomerular filtration rate ( eGFR . Group A ( eGFR > 60 ml/min/1 . 73 m 2 BSA comprised of 71% of total stroke patients and group B ( eGFR 98umol/L and 15 ( 68 . 60% patients had blood urea >6 . 8mmol/L . CONCLUSION: This study clearly indicated that renal dysfunction as evidenced by ( a eGFR 98umol/L & c Blood urea >6 . 8mmol/L , are not only an important risk factor for acute haemorrhagic stroke but are also an independent predictor of mortality within 30 days of presentation .

  1. Mayaro fever virus, Brazilian Amazon.

    Science.gov (United States)

    Azevedo, Raimunda S S; Silva, Eliana V P; Carvalho, Valéria L; Rodrigues, Sueli G; Nunes-Neto, Joaquim P; Monteiro, Hamilton; Peixoto, Victor S; Chiang, Jannifer O; Nunes, Márcio R T; Vasconcelos, Pedro F C

    2009-11-01

    In February 2008, a Mayaro fever virus (MAYV) outbreak occurred in a settlement in Santa Barbara municipality, northern Brazil. Patients had rash, fever, and severe arthralgia lasting up to 7 days. Immunoglobulin M against MAYV was detected by ELISA in 36 persons; 3 MAYV isolates sequenced were characterized as genotype D.

  2. Mayaro Fever Virus, Brazilian Amazon

    Science.gov (United States)

    Azevedo, Raimunda S.S.; Silva, Eliana V.P.; Carvalho, Valéria L.; Rodrigues, Sueli G.; Neto, Joaquim P. Nunes; Monteiro, Hamilton A.O.; Peixoto, Victor S.; Chiang, Jannifer O.; Nunes, Márcio R.T.

    2009-01-01

    In February 2008, a Mayaro fever virus (MAYV) outbreak occurred in a settlement in Santa Barbara municipality, northern Brazil. Patients had rash, fever, and severe arthralgia lasting up to 7 days. Immunoglobulin M against MAYV was detected by ELISA in 36 persons; 3 MAYV isolates sequenced were characterized as genotype D. PMID:19891877

  3. Q fever: The Dutch Policy

    NARCIS (Netherlands)

    Bruschke, C.J.M.; Roest, H.I.J.; Coutinho, R.A.

    2016-01-01

    Between 2007 and 2010, the Netherlands experienced an unprecedented outbreak of Q fever of more than 4000 human cases. Q fever infections of dairy goats, leading to abortion waves, were considered to be the cause of this outbreak. Measures to combat the outbreak had to be taken based on limited scie

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

    LENUS (Irish Health Repository)

    Brady, A P

    2012-01-31

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

  5. Study of foetomaternal outcome of antepartum haemorrhage in pregnancy

    Directory of Open Access Journals (Sweden)

    Siddhartha Majumder

    2015-12-01

    Conclusions: Educating pregnant mothers about the importance of antenatal care and easy accessibility to quality antenatal services would go a long way in bringing down the maternal and perinatal morbidity and mortality related with antepartum haemorrhage. The morbidity associated with placenta previa can be reduced by detecting the condition in the antenatal period by ultrasound, before it becomes symptomatic. Intensive family planning program and awareness of small family norm helps in decreasing cases of APH in relation with age and parity. Efforts should be made to reduce the rates of operative deliveries, because there is a greater likelihood of placenta previa in a scarred uterus. There is a lot of scope on further research in the field of APH for further reduction in foetal and maternal morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1936-1939

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: In early postpartum haemorrhage (PPH), a low concentration of fibrinogen is associated with excessive subsequent bleeding and blood transfusion. We hypothesized that pre-emptive treatment with fibrinogen concentrate reduces the need for red blood cell (RBC) transfusion in patients...... with PPH. METHODS: In this investigator-initiated, multicentre, double-blinded, parallel randomized controlled trial, we assigned subjects with severe PPH to a single dose of fibrinogen concentrate or placebo (saline). A dose of 2 g or equivalent was given to all subjects independent of body weight...... and the fibrinogen concentration at inclusion. The primary outcome was RBC transfusion up to 6 weeks postpartum. Secondary outcomes were total blood loss, total amount of blood transfused, occurrence of rebleeding, haemoglobin

  7. A near-miss case of obstetric haemorrhage managed successfully

    Directory of Open Access Journals (Sweden)

    Meena N. Satia

    2016-12-01

    Full Text Available Functioning of health systems with respect to maternal health were previously audited using indicators like maternal mortality ratio. However, maternal morbidity as a consequence of pregnancy-related complications is not accounted for in these indicators. Thus, the World Health Organization (WHO has formulated a maternal near-miss approach to pregnancy complications for a more thorough evaluation of health care systems across the world. In practical terms, women are said to be maternal near-miss cases when they survive lethal conditions during pregnancy or in the postpartum period. We report one such case of traumatic variety of postpartum haemorrhage subsequent to a lower segment caesarean section with immediate post-operative removal of cervical cerclage threads that resulted in a maternal near-miss case.

  8. The need for repeat angiography in subarachnoid haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-01-01

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

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

    DEFF Research Database (Denmark)

    Wikkelsø, Anne Juul

    2015-01-01

    Pregnancy is a state of hypercoagulobility that might be an evolutionary way of protecting parturients from exsanguination following child birth. Observational studies suggest an association between a low level of fibrinogen (coagulation factor I) at the start of postpartum haemorrhage (PPH....... Paper III was based on two national Danish registries evaluating the predictability of postpartum blood transfusion. Prediction was found difficult. However, retained placental parts seemed to be the strongest predictor. Since this diagnosis is made very late and often in association with the onset...... of bleeding, tools to perform an early diagnosis is highly warranted. Paper IV includes recommendations of the European Society of Anaesthesiology regarding the use of fibrinogen concentrate in PPH, and is based on very weak (GRADE 2) evidence and low confidence in estimates of effect (GRADE C). Paper V...

  10. Febre amarela Yellow fever

    Directory of Open Access Journals (Sweden)

    Pedro Fernando da Costa Vasconcelos

    2003-04-01

    Full Text Available A febre amarela é doenca infecciosa não-contagiosa causada por um arbovírus mantido em ciclos silvestres em que macacos atuam como hospedeiros amplificadores e mosquitos dos gêneros Aedes na África, e Haemagogus e Sabethes na América, são os transmissores. Cerca de 90% dos casos da doença apresentam-se com formas clínicas benignas que evoluem para a cura, enquanto 10% desenvolvem quadros dramáticos com mortalidade em torno de 50%. O problema mostra-se mais grave em África onde ainda há casos urbanos. Nas Américas, no período de 1970-2001, descreveram-se 4.543 casos. Os países que mais diagnosticaram a doença foram o Peru (51,5%, a Bolívia (20,1% e o Brasil (18,7%. Os métodos diagnósticos utilizados incluem a sorologia (IgM, isolamento viral, imunohistoquímica e RT-PCR. A zoonose não pode ser erradicada, mas, a doença humana é prevenível mediante a vacinação com a amostra 17D do vírus amarílico. A OMS recomenda nova vacinação a cada 10 anos. Neste artigo são revistos os principais conceitos da doença e os casos de mortes associados à vacina.Yellow fever is an infectious and non-contagious disease caused by an arbovirus, the yellow fever virus. The agent is maintained in jungle cycles among primates as vertebrate hosts and mosquitoes, especially Aedes in Africa, and Haemagogus and Sabethes in America. Approximately 90% of the infections are mild or asymptomatic, while 10% course to a severe clinical picture with 50% case-fatality rate. Yellow fever is largely distributed in Africa where urban epidemics are still reported. In South America, between 1970-2001, 4,543 cases were reported, mostly from Peru (51.5%, Bolivia (20.1% and Brazil (18.7%. The disease is diagnosed by serology (detection of IgM, virus isolation, immunohistochemistry and RT-PCR. Yellow fever is a zoonosis and cannot be eradicated, but it is preventable in man by using the 17D vaccine. A single dose is enough to protect an individual for at least

  11. A risk scoring system for prediction of haemorrhagic stroke.

    Science.gov (United States)

    Zodpey, S P; Tiwari, R R

    2005-01-01

    The present pair-matched case control study was carried out at Government Medical College Hospital, Nagpur, India, a tertiary care hospital with the objective to devise and validate a risk scoring system for prediction of hemorrhagic stroke. The study consisted of 166 hospitalized CT scan proved cases of hemorrhagic stroke (ICD 9, 431-432), and a age and sex matched control per case. The controls were selected from patients who attended the study hospital for conditions other than stroke. On conditional multiple logistic regression five risk factors- hypertension (OR = 1.9. 95% Cl = 1.5-2.5). raised scrum total cholesterol (OR = 2.3, 95% Cl = 1.1-4.9). use of anticoagulants and antiplatelet agents (OR = 3.4, 95% Cl =1.1-10.4). past history of transient ischaemic attack (OR = 8.4, 95% Cl = 2.1- 33.6) and alcohol intake (OR = 2.1, 95% Cl = 1.3-3.6) were significant. These factors were ascribed statistical weights (based on regression coefficients) of 6, 8, 12, 21 and 8 respectively. The nonsignificant factors (diabetes mellitus, physical inactivity, obesity, smoking, type A personality, history of claudication, family history of stroke, history of cardiac diseases and oral contraceptive use in females) were not included in the development of scoring system. ROC curve suggested a total score of 21 to be the best cut-off for predicting haemorrhag stroke. At this cut-off the sensitivity, specificity, positive predictivity and Cohen's kappa were 0.74, 0.74, 0.74 and 0.48 respectively. The overall predictive accuracy of this additive risk scoring system (area under ROC curve by Wilcoxon statistic) was 0.79 (95% Cl = 0.73-0.84). Thus to conclude, if substantiated by further validation, this scorincy system can be used to predict haemorrhagic stroke, thereby helping to devise effective risk factor intervention strategy.

  12. Prevention and treatment of variceal haemorrhage in 2017.

    Science.gov (United States)

    Brunner, Felix; Berzigotti, Annalisa; Bosch, Jaime

    2017-01-01

    Variceal haemorrhage is a major complication of portal hypertension that still causes high mortality in patients with cirrhosis. Improved knowledge of the pathophysiology of portal hypertension has recently led to a more comprehensive approach to prevent all the complications of this condition. Thus, optimal treatment of portal hypertension requires a strategy that takes into account the clinical stage of the disease and all the major variables that affect the risk of progression to the next stage and death. In patients with compensated liver disease, the correction of factors influencing the progression of fibrosis, in particular aetiologic factors, is now feasible in many cases and should be achieved to prevent the development or progression of gastroesophageal varices and hepatic decompensation. Once gastroesophageal varices have developed, non-selective beta-blockers remain the cornerstone of therapy. Carvedilol provides a greater decrease in portal pressure and is currently indicated as a first-choice therapy for primary prophylaxis. The treatment of acute variceal haemorrhage includes a combination of vasoactive drugs, antibiotics and endoscopic variceal band ligation. In high-risk patients, the early use of transjugular intrahepatic portosystemic shunt (TIPS) lowers the risk of re-bleeding and improves survival. Transjugular intrahepatic portosystemic shunt is the choice for uncontrolled variceal bleeding; a self-expandable metal stent or balloon tamponade can be used as a bridging measure. The combination of non-selective beta-blockers and endoscopic variceal band ligation reduces the risk of recurrent variceal bleeding and improves survival. In these cases, statins seem to further improve survival. Transjugular intrahepatic portosystemic shunt is indicated in patients who rebleed during secondary prophylaxis.

  13. Helical CT in the diagnosis of acute lower gastrointestinal haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Sabharwal, Rohan [Department of Radiology, Westmead Hospital, Sydney, NSW (Australia); Vladica, Philip [Department of Radiology, Westmead Hospital, Sydney, NSW (Australia)]. E-mail: rpvl@imag.wsahs.nsw.gov.au; Chou, Roger [Department of Radiology, Westmead Hospital, Sydney, NSW (Australia); Law, W. Phillip [Department of Radiology, Westmead Hospital, Sydney, NSW (Australia)

    2006-05-15

    Introduction: A pilot study to evaluate helical computer tomography (CT) as a diagnostic tool for acute lower gastrointestinal tract (GIT) bleeding. CT was compared to conventional angiography (CA) and colonoscopy for the diagnosis and detection of bleeding site in suspected cases of acute lower GIT bleeding. Methods: Seven patients presenting with acute lower GIT bleeding, between June and November 2002, underwent CT examinations. All of these seven patients underwent CA following CT. Emergency colonoscopies were performed on five patients investigated with both CT and CA. Median delay from the most recent episode of hematochezia to CT was two and a half hours, to CA was 3 h, and to colonoscopy was 4 h. None of the patients underwent nuclear medicine (NM) bleeding studies. Results: Haemoglobin drop in all patients was greater than 15 g/L in the first 24 h of presentation. The mean age was 68.86 years (range, 49-83 years). Comparing CT and CA, there were four concordant and three discordant results. Both modalities had concordant findings of two active bleeding sites, one non-bleeding rectal tumour, and one negative case result. In three patients, the source of bleeding was found on CT whereas CA was negative. Emergency colonoscopies performed in all of these three patients confirmed blood in the colon/ileum. Conclusion: Early experience suggests that CT is a safe, convenient and accurate diagnostic tool for acute lower GIT haemorrhage. It raises questions regarding the sensitivity of CA. A new management algorithm for acute lower GIT haemorrhage using CT as the pre-CA screening tool is being proposed based on the preliminary findings. Positive CT will allow directed therapeutic angiography, while negative CT will triage patients into alternative management pathways.

  14. Delayed ischaemic neurological deficits after subarachnoid haemorrhage are associated with clusters of spreading depolarizations.

    Science.gov (United States)

    Dreier, Jens P; Woitzik, Johannes; Fabricius, Martin; Bhatia, Robin; Major, Sebastian; Drenckhahn, Chistoph; Lehmann, Thomas-Nicolas; Sarrafzadeh, Asita; Willumsen, Lisette; Hartings, Jed A; Sakowitz, Oliver W; Seemann, Jörg H; Thieme, Anja; Lauritzen, Martin; Strong, Anthony J

    2006-12-01

    Progressive ischaemic damage in animals is associated with spreading mass depolarizations of neurons and astrocytes, detected as spreading negative slow voltage variations. Speculation on whether spreading depolarizations occur in human ischaemic stroke has continued for the past 60 years. Therefore, we performed a prospective multicentre study assessing incidence and timing of spreading depolarizations and delayed ischaemic neurological deficit (DIND) in patients with major subarachnoid haemorrhage (SAH) requiring aneurysm surgery. Spreading depolarizations were recorded by electrocorticography with a subdural electrode strip placed on cerebral cortex for up to 10 days. A total of 2110 h recording time was analysed. The clinical state was monitored every 6 h. Delayed infarcts after SAH were verified by serial CT scans and/or MRI. Electrocorticography revealed 298 spreading depolarizations in 13 of the 18 patients (72%). A clinical DIND was observed in seven patients 7.8 days (7.3, 8.2) after SAH. DIND was time-locked to a sequence of recurrent spreading depolarizations in every single case (positive and negative predictive values: 86 and 100%, respectively). In four patients delayed infarcts developed in the recording area. As in the ischaemic penumbra of animals, delayed infarction was preceded by progressive prolongation of the electrocorticographic depression periods associated with spreading depolarizations to >60 min in each case. This study demonstrates that spreading depolarizations have a high incidence in major SAH and occur in ischaemic stroke. Repeated spreading depolarizations with prolonged depression periods are an early indicator of delayed ischaemic brain damage after SAH. In view of experimental evidence and the present clinical results, we suggest that spreading depolarizations with prolonged depressions are a promising target for treatment development in SAH and ischaemic stroke.

  15. A Novel SMAD4 Mutation Causing Severe Juvenile Polyposis Syndrome with Protein Losing Enteropathy, Immunodeficiency, and Hereditary Haemorrhagic Telangiectasia

    Directory of Open Access Journals (Sweden)

    Joel Johansson

    2015-01-01

    Full Text Available Juvenile polyposis syndrome (JPS is a rare genetic disorder characterized by juvenile polyps of the gastrointestinal tract. We present a new pathogenic mutation of the SMAD4 gene and illustrate the need for a multidisciplinary health care approach to facilitate the correct diagnosis. The patient, a 47-year-old Caucasian woman, was diagnosed with anaemia at the age of 12. During the following 30 years, she developed numerous gastrointestinal polyps. The patient underwent several operations, and suffered chronic abdominal pain, malnutrition, and multiple infections. Screening of the SMAD4 gene revealed a novel, disease-causing mutation. In 2012, the patient suffered hypoalbuminemia and a large polyp in the small bowel was found. Gamma globulin was given but the patient responded with fever and influenza-like symptoms and refused more treatment. The patient underwent surgery in 2014 and made an uneventful recovery. At follow-up two months later albumin was 38 g/L and IgG was 6.9 g/L. Accurate diagnosis is essential for medical care. For patients with complex symptomatology, often with rare diseases, this is best provided by multidisciplinary teams including representatives from clinical genetics. Patients with a SMAD4 mutation should be followed up both for JPS and haemorrhagic hereditary telangiectasia and may develop protein loosing enteropathy and immunodeficiency.

  16. A Novel SMAD4 Mutation Causing Severe Juvenile Polyposis Syndrome with Protein Losing Enteropathy, Immunodeficiency, and Hereditary Haemorrhagic Telangiectasia

    Science.gov (United States)

    Johansson, Joel; Sahin, Christofer; Pestoff, Rebecka; Ignatova, Simone; Forsberg, Pia; Edsjö, Anders; Ekstedt, Mattias; Stenmark Askmalm, Marie

    2015-01-01

    Juvenile polyposis syndrome (JPS) is a rare genetic disorder characterized by juvenile polyps of the gastrointestinal tract. We present a new pathogenic mutation of the SMAD4 gene and illustrate the need for a multidisciplinary health care approach to facilitate the correct diagnosis. The patient, a 47-year-old Caucasian woman, was diagnosed with anaemia at the age of 12. During the following 30 years, she developed numerous gastrointestinal polyps. The patient underwent several operations, and suffered chronic abdominal pain, malnutrition, and multiple infections. Screening of the SMAD4 gene revealed a novel, disease-causing mutation. In 2012, the patient suffered hypoalbuminemia and a large polyp in the small bowel was found. Gamma globulin was given but the patient responded with fever and influenza-like symptoms and refused more treatment. The patient underwent surgery in 2014 and made an uneventful recovery. At follow-up two months later albumin was 38 g/L and IgG was 6.9 g/L. Accurate diagnosis is essential for medical care. For patients with complex symptomatology, often with rare diseases, this is best provided by multidisciplinary teams including representatives from clinical genetics. Patients with a SMAD4 mutation should be followed up both for JPS and haemorrhagic hereditary telangiectasia and may develop protein loosing enteropathy and immunodeficiency. PMID:25705527

  17. Yellow Fever Vaccine: What You Need to Know

    Science.gov (United States)

    ... www. immunize. org/ vis 1 What is yellow fever? Yellow fever is a serious disease caused by the ... serious cases) 2 How can I prevent yellow fever? Yellow fever vaccine Yellow fever vaccine can prevent yellow ...

  18. 非线性自回归神经网络在肾综合征出血热流行趋势预测中的应用%Application of nonlinear autoregressive neural network in predicting incidence tendency of hemorrhagic fever with renal syndrome

    Institute of Scientific and Technical Information of China (English)

    吴伟; 安淑一; 郭军巧; 关鹏; 任仰武; 夏玲姿; 周宝森

    2015-01-01

    目的 探讨非线性自回归(NAR)神经网络拟合及预测我国HFRS流行趋势的应用.方法 使用2004-2013年全国HFRS月报告发病数序列建立ARIMA模型和NAR神经网络模型,预测2014年HFRS月发病数,并比较两模型的拟合和预测效果.结果 对于拟合集,ARIMA模型的平均绝对误差(MAE)、均方误差平方根(RMSE)和平均绝对误差百分比(MAPE)分别为148.058、272.077和12.678%,NAR神经网络分别为119.436、186.671和11.778%;对于预测集,ARIMA模型的MAE、RMSE和MAPE分别为189.088、221.133和21.296%,NAR神经网络分别为119.733、151.329和11.431%.结论 NAR神经网络对于全国HFRS流行趋势拟合及预测效果优于传统的ARIMA模型,具有良好推广应用价值.%Objective To explore the prospect of nonlinear autoregressive neural network in fitting and predicting the incidence tendency of hemorrhagic fever with renal syndrome (HFRS),in the mainland of China.Methods Monthly reported case series of HFRS in China from 2004 to 2013 were used to build both ARIMA and NAR neural network models,in order to predict the monthly incidence of HFRS in China in 2014.Fitness and prediction on the effects of these two models were compared.Results For the Fitting dataset,MAE,RMSE and MAPE of the ARIMA model were 148.058,272.077 and 12.678% respectively,while the MAE,RMSE and MAPE of NAR neural network appeared as 119.436,186.671 and 11.778% respectively.For the Predicting dataset,MAE,RMSE and MAPE of the ARIMA model appeared as 189.088,221.133 and 21.296%,while the MAE,RMSE and MAPE of the NAR neural network as 119.733,151.329 and 11.431% respectively.Conclusion The NAR neural network showed better effects in fitting and predicting the incidence tendency of HFRS than using the traditional ARIMA model,in China.NAR neural network seemed to have strong application value in the prevention and control of HFRS.

  19. [Dengue fever--not just a tropical infectious disease].

    Science.gov (United States)

    Stock, Ingo

    2016-03-01

    Dengue fever is a viral disease that is transmitted primarily by Aedes mosquitoes, i. e., A. aegypti and A. albopictus. Other species are rarely involved. The disease is caused by dengue virus, an enveloped RNA virus which belongs to the family of flaviviridae. Although most infections are asymptomatic, in 20 to 30 percentages all cases infections are accompanied with high fever and other influenza-like signs of illness. Serious medical conditions with lethal complications also occur. During the last decades, the incidence of dengue fever rose sharply in many tropical and subtropical countries. In some of these regions, dengue is one of the leading causes of death in children. In Europe, since a few years a strong clustering of dengue fever cases has been registered in travelers returning from certain tropical or subtropical regions. Recently, autochthonous outbreaks have been observed on the Atlantic island of Madeira and in a few other regions of South Europe. Treatment of dengue fever is supportive and symptomatic, a specific therapy does not exist. For prevention of disease, vector control is of crucial importance.

  20. Dengue fever presenting with acute cerebellitis: a case report.

    Science.gov (United States)

    Withana, Milinda; Rodrigo, Chaturaka; Chang, Thashi; Karunanayake, Panduka; Rajapakse, Senaka

    2014-03-05

    The incidence of dengue fever is on the rise in tropical countries. In Sri Lanka, nearly 45,000 patients were reported in 2012. With the increasing numbers, rare manifestations of dengue are occasionally encountered. We report a patient who presented with bilateral cerebellar signs as the presenting feature of dengue. A 45-year-old previously healthy female from the suburbs of Colombo, Sri Lanka presented with an acute febrile illness associated with unsteadiness of gait. Clinical examination revealed a scanning dysarthria and marked horizontal nystagmus with bilateral dysmetria, dysdiadokokinesia and incordination more prominent on the right. Her gait was wide-based and ataxic with a tendency to fall to the right more than to the left. Dengue nonstructural protein antigen 1 test and IgM antibody testing both became positive indicating acute dengue infection. She recovered from the febrile episode within 9 days since the onset of fever but cerebellar symptoms outlasted the fever by one week. The magnetic resonance imaging of brain was normal and cerebellar signs resolved spontaneously by day 17 of the illness. Cerebellar syndrome in association with dengue fever has been reported in only four instances and our patient is the first reported case of dengue fever presenting with cerebellitis as the first manifestation of disease. This case report is intended to highlight the occurrence of acute cerebellitis as a presenting syndrome of the expanding list of unusual neurological manifestations of dengue infection.

  1. Guillain-Barre syndrome following dengue fever and literature review.

    Science.gov (United States)

    Ralapanawa, Dissanayake Mudiyanselage Priyantha Udaya Kumara; Kularatne, Senanayake Abeysinghe Mudiyanselage; Jayalath, Widana Arachilage Thilak Ananda

    2015-11-27

    Dengue is an arboviral infection that classically presents with fever, joint pain, headaches, skin flush and morbilliform rashes. The incidence of neurological symptoms and complications in dengue varies from 1 to 25% that include encephalopathy, Guillain-Barre syndrome (GBS), acute motor weakness, seizures, neuritis, hypokalaemic paralysis, pyramidal tract signs, and a few more. Dengue fever as an antecedent infection in GBS is uncommon. A 34-years-old Sri Lankan Sinhalese male presented with fever, headache and myalgia of 3 days and developed leucopenia and thrombocytopenia without evidence of haemoconcentration. The diagnosis of dengue fever was confirmed as he had positive dengue NS1 antigen test on the third day of fever. He made full recovery and was discharged after 4 days of hospital stay. Six days later, he presented with history of acute flaccid weakness of both lower limbs and upper limbs which was of progressive ascending nature. The electromyography had evidence of demyelinating neuropathy and cerebrospinal fluid showed albuminocytological dissociation. Subsequently, IgM for dengue virus was positive. Dengue is endemic in Sri Lanka. Post dengue Guillain-Barre syndrome is a potential neurological complications of this infection.

  2. EXAMINATION OF THE IMMUNOGLOBULIN M ANTI SALMONELLA IN DIAGNOSIS OF THYPOID FEVER

    Directory of Open Access Journals (Sweden)

    I Kadek Septiawan

    2013-05-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Typhoid fever is an acute systemic infectious disease caused by Salmonella typhi, that can be found all over the world. According to the world health organization ( WHO 2003, is predicted there are about 17 million cases of typhoid fever in the entire world with incidence 600,000 cases of deaths every year. The diagnosis of typhoid fever is done clinically and by laboratory examination. Laboratory examination can be an examination of the blood test, serological test, and culture. Examination of the IgM anti Salmonella (TUBEX® test is one of the new serological test which more quickly and accurately in diagnose typhoid fever. This examination is competitive agglutination test, semi quantitative, simple, quick and very accurate in the diagnosis acute infection of typhoid fever as it only detects the antibodies IgM Anti-Salmonella in a few minutes.

  3. Dengue Fever-induced Thrombotic Microangiopathy: An Unusual Cause of Renal Failure.

    Science.gov (United States)

    Bhargava, V; Gupta, P; Kauntia, R; Bajpai, G

    2017-01-01

    Dengue fever is a tropical infection, which is mosquito-borne disease, caused by dengue virus and spread by Aedes mosquitoes. The incidence of dengue fever has risen rapidly over the past few years. About half of dengue infections are asymptomatic, and a great majority present with fever and body ache. However, the occurrence of complications is well known, including acute kidney injury (AKI). AKI in dengue is usually attributable to a pre-renal cause. Thrombotic microangiopathy is an extremely rare complication of dengue fever, with only a few published case reports in medical literature. This case intends to highlight the importance of recognizing dengue fever-induced thrombotic microangiopathy by physicians and pathologists, enabling better diagnosis and management of this life-threatening condition.

  4. ETIOLOGY OF YELLOW FEVER

    Science.gov (United States)

    Noguchi, Hideyo

    1922-01-01

    Analysis of the records of instances in which non-immune persons contracted yellow fever notwithstanding vaccination shows that the onset of disease occurs soon after vaccination, the longest period being 13 days. Since the average incubation period in yellow fever is 6 days, it seems that infection must have taken place in some instances during the period while protection was developing. These instances led to a study of the possibility of immediate protection by means of the anti-icteroides serum. It had already been shown that the immune serum protects at once against experimental Leptospira icteroides infection, but it remained to determine how long the protection would last. Guinea pigs were given different quantities of the immune serum and subsequently injected, at various intervals, with a virulent strain of Leptospira icteroides. Complete protection enduring 5 days was obtained with as minute a quantity of serum as 0.002 cc. per 1,000 gm. of body weight. After 5 days, however, the immune substance rapidly diminished, and to keep the animal protected for as long as 10 days it was necessary to give 100 times as much, or 0.2 cc. For a man weighing 80 kilos, 0.16 cc. (0.002 x 80) would theoretically be sufficient to protect for at least 5 days, 1.6 cc. for 7 days, and 16 cc. for 10 days. This temporary protection may be a valuable antecedent to that furnished by vaccination, since the final effect of the latter cannot be expected until at least 9 to 10 days have passed. PMID:19868677

  5. Dengue fever activates the L-arginine-nitric oxide pathway: an explanation for reduced aggregation of human platelets.

    Science.gov (United States)

    Mendes-Ribeiro, Antonio C; Moss, Monique B; Siqueira, Mariana As; Moraes, Thalyta L; Ellory, J Clive; Mann, Giovanni E; Brunini, Tatiana Mc

    2008-10-01

    In patients with Dengue fever, a viral inflammatory syndrome, haemorrhage is a significant pathological feature, yet the underlying mechanisms remain unclear. Nitric oxide (NO) is an important regulator of platelet function, inhibiting aggregation, recruitment and adhesion to the vascular endothelium. We have investigated whether changes in the activity of the L-arginine-NO pathway in human platelets may account for increased bleeding in patients with Dengue fever. A total of 16 patients with Dengue fever and 18 age-matched healthy volunteers participated in the study. Collagen induced platelet aggregation in a dose-dependent manner in both Dengue patients and controls, but the degree of platelet aggregation was significantly reduced in the patient group. Elevated rates of L-arginine transport in Dengue fever patients were associated with enhanced NO synthase activity and elevated plasma fibrinogen levels. The present study provides the first evidence that Dengue fever is associated with increased L-arginine transport and NO generation and reduced platelet aggregation.

  6. Hereditary haemorrhagic telangiectasia: a population-based study of prevalence and mortality in Danish patients

    DEFF Research Database (Denmark)

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

    1999-01-01

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

  7. Impaired endothelial function after aneurysmal subarachnoid haemorrhage correlates with arginine:asymmetric dimethylarginine ratio

    DEFF Research Database (Denmark)

    Bergström, A; Staalsø, J M; Romner, B

    2014-01-01

    BACKGROUND: Endothelial dysfunction might be involved in the development of cerebral vasospasm after aneurysmal subarachnoid haemorrhage (SAH). METHODS: This prospective observational study of 48 SAH subjects and 23 control subjects examined associations between reactive hyperaemia index (RHI...

  8. Successfull management of a life threatening cerebellar haemorrhage following spine surgery - a case report -.

    Science.gov (United States)

    Pallud, Johan; Belaïd, Hayat; Aldea, Sorin

    2009-06-01

    Cerebellar haemorrhages are rare life-threatening complications following spine surgery that present challenges for their diagnostic and their therapeutic management. Their patho-physiology remains unclear.We report a case of a life-threatening cerebellar haemorrhage secondary to an occult dural tear following a planned L5-S1 laminectomy. The patient was treated with emergent external ventriculostomy following by a posterior fossa decompressive craniectomy. Cerebellar haemorrhages have to be suspected systematically when unexpected neurological signs occur after spine surgery since their rapid management lead to favourable outcomes. The present imaging findings allow us proposing that cerebellar haemorrhages result primarily from superior cerebellar venous stretching and tearing, and that cerebellar infarction and swelling occur secondarily.

  9. Rhombencephalitis associated with Dengue fever.

    Science.gov (United States)

    Verma, Rajesh; Bharti, Kavita; Mehta, Mannan; Bansod, Amrit

    2016-05-01

    Dengue infection is gradually disseminating throughout the world in alarming proportions. It is a arbovirus infection,transmitted by aedes mosquitoes. It is a multi-systemic disorder associated with varied neurological complications. There is increased trend of development of neurological complications in dengue fever. The neurological complications arising due to dengue infection can be categorized into central and neuromuscular complications. The central nervous system disorders reported with dengue fever are encephalopathy,encephalitis and myelitis.Here we report a case of rhombencephalitis associated with dengue fever. The literature does not mention rhombencephalitis occurring with dengue illness.

  10. Genetic detection of Dobrava/Belgrade virus in a Czech patient with Haemorrhagic fever with renal syndrome.

    Science.gov (United States)

    Papa, A; Zelená, H; Barnetová, D; Petrousová, L

    2010-08-01

    In the summer of 2008, a 15-year-old boy was hospitalized in a paediatric intensive care unit in the Czech Republic. Laboratory diagnosis of hantavirus infection was established by serological and molecular methods. Sequence and phylogenetic analyses showed that the causative strain was Dobrava/Belgrade virus, which is genetically closer to strains associated with Apodemus flavicollis rodents.

  11. Postexposure Protection Against Marburg Haemorrhagic Fever with Recombinant Vesicular Stomatitis Virus Vectors in Non-Human Primates: An Efficacy Assessment

    Science.gov (United States)

    2006-04-29

    virus (MARV). We aimed to test the effi cacy of a replication -competent vaccine based on attenuated recombinant vesicular stomatitis virus (rVSV...including vaccines based on recombinant adenoviruses12,13 and recombinant alphaviruses .8 We previously described the generation and assessment of a live...such as Marburg virus (MARV). We aimed to test the efficacy of a replication -competent vaccine based on attenuated recombinant vesicular stomatitis

  12. Acute suprachoroidal haemorrhage post-tenecteplase thrombolysis for myocardial infarction: management considerations.

    Science.gov (United States)

    Trikha, Sameer; Lockwood, Alastair; Puvanachandra, Narman; Kirwan, James

    2010-05-13

    We report a case of a 63-year-old man who received intravenous tenecteplase as thrombolytic therapy for an inferior ST elevation myocardial infarction. Three hours later he complained of blurred vision in the right eye and on examination had sustained a suprachoroidal haemorrhage. With conservative treatment the haemorrhage resolved, leading to a normalisation of visual acuity. To the authors' knowledge, no case reports exist of this rare complication following intravenous tenecteplase. We discuss implications for further thrombolysis and anticoagulation.

  13. Acute suprachoroidal haemorrhage post-tenecteplase thrombolysis for myocardial infarction: management considerations

    OpenAIRE

    2010-01-01

    We report a case of a 63-year-old man who received intravenous tenecteplase as thrombolytic therapy for an inferior ST elevation myocardial infarction. Three hours later he complained of blurred vision in the right eye and on examination had sustained a suprachoroidal haemorrhage. With conservative treatment the haemorrhage resolved, leading to a normalisation of visual acuity. To the authors’ knowledge, no case reports exist of this rare complication following intravenous tenecteplase. We di...

  14. Two cases of extrapulmonary onset granulomatosis with polyangiitis which caused diffuse alveolar haemorrhage

    Directory of Open Access Journals (Sweden)

    Halide Kaya

    2014-01-01

    Full Text Available Granulomatosis with polyangiitis (GPA is a rare form of vasculitis. Multidisciplinary therapeutic approach and early diagnosis assume vital importance in management of patients with diffuse alveolar haemorrhage caused by GPA, which is a rare complication. The purpose of this study was to present the diagnostic and therapeutic challenges experienced by clinicians in management of two severe cases of GPA with insidious extrapulmonary manifestations which rapidly progressed into acute kidney injury, alveolar haemorrhage and acute respiratory failure.

  15. Evaluating condom catheter balloon tamponade in non-traumatic postpartum haemorrhage resistant to medical management

    OpenAIRE

    Syed Nawaz Ahmad; Sunita Seth; Shefali Agarwal; Swati Choudhary

    2016-01-01

    Background: Obstetric haemorrhage remains the most important cause of maternal mortality worldwide accounting for 25% of maternal deaths annually. The aim of the study was to evaluate efficacy of a condom catheter assembly for uterine tamponade in the management of non-traumatic postpartum haemorrhage (PPH). Methods: It was a prospective interventional study done in a tertiary care hospital in New Delhi, India. Thirty three women with intractable PPH unresponsive to medical management were...

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

    DEFF Research Database (Denmark)

    Driessen, Annemariek; Schäfer, N; Albrecht, V

    2015-01-01

    PURPOSE: Early detection and management of post-traumatic haemorrhage and coagulopathy have been associated with improved outcomes, but local infrastructures, logistics and clinical strategies may differ. METHODS: To assess local differences in infrastructure, logistics and clinical management...... intake of anticoagulants including "new oral anticoagulants" and platelet inhibitors as an increasing threat to bleeding trauma patients. CONCLUSIONS: This study confirms differences in infrastructure, logistics and clinical practice for the detection and management of trauma-haemorrhage and trauma...

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

    DEFF Research Database (Denmark)

    Bonnici, Mia; Markauskas, Algirdas; Munk, Torben

    2014-01-01

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

  18. Fever in pregnancy and risk of fetal death: a cohort study

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Vastrup, Pernille; Wohlfart, Jan

    2002-01-01

    BACKGROUND: Hyperthermia acts as a teratogen in some animals where it can induce resorption of the fetus and fetal death. Fever during pregnancy, especially in the period of embryogenesis, is also suspected as being a risk factor for fetal death in human beings. We did a large cohort study...... in Denmark to investigate this possibility. METHODS: We interviewed 24040 women who were recruited in the first half of pregnancy to the Danish National Birth Cohort Study, and obtained information on the number of fever incidents during the first 16 weeks of pregnancy. For each fever episode, the highest...

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

    Directory of Open Access Journals (Sweden)

    Dijkgraaf Marcel G

    2010-03-01

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

  20. Systolic blood pressure contributes to intracerebral haemorrhage after thrombolysis for ischemic stroke.

    Science.gov (United States)

    Perini, Francesco; De Boni, Antonella; Marcon, Michela; Bolgan, Irene; Pellizzari, Michele; Dionisio, Laura Di

    2010-10-15

    The frequency and risk factors for intracerebral haemorrhage (ICH) after ischemic stroke are well-known. ICH frequency is increased by the use of antithrombotic or thrombolytic drugs. Several experimental studies have demonstrated a relationship between ICH and hypertension after fibrinolysis, but the optimal blood pressure levels in patients treated with recombinant tissue plasminogen activator (rTPA) are as yet unknown. We evaluated the role of blood pressure in patients with ischemic stroke treated with rTPA within 3h of symptom onset. We treated 86 consecutive patients admitted to our stroke unit between 2002 and 2008 and prospectively recorded the clinical and instrumental data in our stroke registry. We evaluated haemorrhagic complications by reviewing imaging findings. Blood pressure was recorded before rTPA and at 6, 12, 18, and 32h. Total cerebral haemorrhage occurred in eleven (12.7%) patients, and symptomatic intracerebral haemorrhage occurred in seven (8.1%). We failed to find a correlation between blood pressure levels and stroke severity at admission. High blood pressure levels correlated with a worse outcome. Systolic blood pressure was significantly higher in ICH patients relative to rTPA-treated patients without haemorrhagic complications (p<0.03). This study indicates that rTPA-induced haemorrhage is influenced by systolic blood pressure. More aggressive pharmacological reduction of hypertension during fibrinolysis and the subsequent 32h may reduce this complication. Copyright 2010 Elsevier B.V. All rights reserved.