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Acute Cases (acute + case)
Selected AbstractsNicotine replacement therapy in patients with cardiovascular disease: guidelines for health professionalsADDICTION, Issue 11 2001Hayden McRobbie The causal relationship between cigarette smoking and cardiovascular disease (CVD) is well known and it is of great importance that smokers with CVD are encouraged to stop. Nicotine replacement therapy (NRT) is an effective aid to smoking cessation. However, its use in patients with CVD is often avoided because of warnings on product labelling. This is not justified, as NRT use in dependent smokers is much safer than smoking. Arguments are presented for the following guidelines which may be used when recommending NRT to patients with CVD; (i) NRT can normally be recommended to smokers with CVD who tried and failed to quit without such help; (ii) in patients who have experienced a serious cardiovascular event within the past 4 weeks, involve the patient's consulting physician. In less acute cases this is not needed; (iii) ensure dosing does not exceed the manufacturer's recommendation; (iv) warn patients to stop using NRT if they relapse to smoking; and (v) target motivated smokers (i.e. those seeking help), and where possible provide or arrange intensive behavioural support to accompany NRT. This advice is conservative, but will hopefully remove some obstacles faced by smoking cessation counsellors and other health professionals when considering the use of NRT in people with history of CVD. [source] A quantitative study of epidermal Langerhans cells in cutaneous leishmaniasis caused by Leishmania tropicaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2004Simin Meymandi MD Objective, The purpose of this study was to characterize the number and distribution of epidermal Langerhans cells in different clinical forms of dry-type cutaneous leishmaniasis (CL). Methods, Sixteen cases of dry-type cutaneous leishmaniasis caused by Leishmania tropica were studied. These cases were classified clinically as five cases of acute leishmaniasis with indurated papules, nodules and plaques with central crust formation and duration < 2 years, six cases of lupoid leishmaniasis with characteristic papules around previous scars of cutaneous leishmaniasis with duration > 2 years, and five cases of chronic nonlupoid type with nonhealing lesions of duration > 2 years. Paraffin-embedded blocks were stained with hematoxylin and eosin (H&E) and stained immunohistochemically for CD1a. Results, The number of Langerhans cells per millimeter length of epidermis was increased in acute cases compared to chronic and lupoid cases. Conclusions, Lesions of acute leishmaniasis contain the greatest amounts of antigen for presentation, so Langerhans cells increase in number and in trafficking to present antigens derived from Leishman bodies to the cellular immune system. In chronic leishmaniasis, the Langerhans cell population is reduced, perhaps because of exhaustion of the source of Langerhans cells, or because of reduced response to modified antigen. [source] Humoral immunity in natural infection by tick-borne encephalitis virusJOURNAL OF MEDICAL VIROLOGY, Issue 4 2009Giulietta Venturi Abstract Tick-borne encephalitis (TBE) virus is one of the most important flaviviruses associated with neurological disease in Europe. Cross-reactive antibodies elicited by different flaviviruses can make difficult the interpretation of ELISA and hemagglutination-inhibition (HI) tests for the diagnosis of TBE. Neutralization tests, which are more specific, are not in common use because they are difficult to perform and standardize. A plaque reduction neutralization test (PRNT), optimized previously in vaccinated children, was evaluated in sera from acute cases of TBE, collected for diagnostic purposes, and from healthy human population and wild ruminants, collected for serosurvey purposes. The PRNT results were compared with the results of ELISA and HI tests. In acute TBE disease, most sera were positive for IgM antibodies by ELISA and with high HI antibody titers; neutralizing antibodies were detected in 71.4% of patients, at a very low titer (1:10 NT50) in almost all cases. Seroprevalences of 8% and 6.5% for anti-TBE ELISA antibodies were found in healthy subjects and wild ruminants, respectively. Among anti-TBE positive healthy subjects, a very low 1:10 NT50 titer was detected in 17.4% of cases, while NT80 titers ranging from 1:10 to 1:80 were detected in 65.2% of cases. Among wild ruminants, 90.9% of ELISA and HI positive samples showed a positive, ,1:10 NT80 titer. In conclusion, neutralization assays can be useful for the diagnosis and serosurveys of TBE. J. Med. Virol. 81:665,671, 2009 © 2009 Wiley-Liss, Inc. [source] Serological response to hepatitis E virus genotype 3 infection: IgG quantitation, avidity, and IgM responseJOURNAL OF MEDICAL VIROLOGY, Issue 1 2008R. Bendall Abstract Sequential sera were collected from 18 acute cases of UK-acquired hepatitis E. The virus strains in all cases were of genotype 3. The IgM and IgG response to acute infection were documented over time using EIA kits based on a peptide antigen, pE2, which is derived from a genotype 1 strain of hepatitis E virus (HEV). Ninety-five percentage of acute sera were IgM positive; after 6 months or more only 12% remained positive. The kit was adapted to quantify the IgG response (in WHO U/ml) and to determine antibody avidity. Following acute infection, anti-HEV IgG concentrations rose between 6.9- and 90-fold. IgG avidity was low (<25%) in most acute sera. After 6 months IgG avidity was greater than 50% in all cases. One patient with a poor IgM response and high avidity antibody in acute sera may have had a second HEV infection. Taken together, these results confirm that the pE2-based EIA kits are suitable for diagnosing acute HEV genotype 3 infection. With simple modifications the IgG kit can measure anti-HEV concentration and avidity, which can be used to confirm acute infection. J. Med. Virol. 80:95,101, 2008. © 2007 Wiley-Liss, Inc. [source] Incremental detection of HIV infections by the HIV antigen/antibody combination assays: An Australian experience,JOURNAL OF MEDICAL VIROLOGY, Issue S1 2007Philip Cunningham Abstract Detection of acute cases of human immunodeficiency virus (HIV) infection by the direct detection of HIV antigen or HIV nucleic acid assays is well known with an estimated 5,9 days reduction in the pre-seroconversion ,window period' by the detection of HIV specific antibodies. The aim of this study was to observe the impact following routine introduction of a screening assay which simultaneously detects HIV (type 1 & 2) antigen and antibody on the yield of acute HIV infection in multiple sites servicing different patient populations with a varying range of risk factors associated with HIV acquisition. During the first year (2003,2004), a total of 27 cases of acute HIV-1 infection were identified by the HIV-1/2 Ab/Ag combo test which were confirmed to be detectable for HIV antigen only that may have gone undetected should an HIV-1/2 antibody only assay have been used. Specimens referred from higher HIV case load centers were more likely to have provided relevant clinical information consistent with acute retroviral syndrome and relevant history of risk however there were numerous cases where no clinical information was provided. This study shows that routine introduction of HIV-1/2 antigen/antibody screening assays increases the identification of acute cases of HIV infection in low prevalence setting and may represent an important tool for enhanced surveillance of incident HIV infection and opportunities for prevention. J. Med. Virol. 79:S16,S22, 2007. © 2007 Wiley-Liss, Inc. [source] Correlation of norovirus variants with epidemics of acute viral gastroenteritis in Hong KongJOURNAL OF MEDICAL VIROLOGY, Issue 11 2006Eric C.M. Ho Abstract Norovirus (NV) (formerly called Norwalk-like virus) is the most common etiological agent of acute viral gastroenteritis outbreaks worldwide. Recent reports have shown that two new GII.4 variants caused epidemics in Europe. To investigate if it is also the case in Hong Kong, a molecular epidemiological study was undertaken between January 2002 and June 2005. During this period, there was a substantial increase in acute cases of gastroenteritis caused by NV. Phylogenetic analysis showed that GII.2 and GII.4 are the major circulating genotypes. Two new GII.4 variants (variants C and D) were identified in 2002 and 2004, which quickly became the predominant strains. They were almost identical to the variants causing epidemics in Europe recently. Since geographically distinct areas were involved within a short period of time, it is possible that GII.4 has a particular propensity for causing pandemics. J. Med. Virol. 78:1473,1479, 2006. © 2006 Wiley-Liss, Inc. [source] Assessment of intraradicular bacterial composition by terminal restriction fragment length polymorphism analysisMOLECULAR ORAL MICROBIOLOGY, Issue 5 2009D. Saito Background:, The aim of the study was to assess the bacterial community structures associated with endodontic infections using terminal restriction fragment length polymorphism (T-RFLP), and to investigate the correlation of whole community profiles with the manifestation of particular clinical features. Methods:, Intraradicular samples were collected from 34 subjects and classified into three study groups based on the observed clinical symptoms: acute (n = 16), sub-acute (n = 8), and asymptomatic (n = 10). Genomic DNA was extracted from each sample, submitted to polymerase chain reaction using a fluorescently labeled 16S ribosomal DNA forward primer, and digested with two tetrameric endonucleases (HhaI and MspI). The terminal restriction fragments (T-RFs) were subsequently discriminated in an automated DNA sequencer, and the results were filtered using a statistics-based criterion. Results:, Totals of 138 (HhaI) and 145 (MspI) unique T-RFs were detected (means 13.1 and 11.9) and there was high inter-subject variability in the bacterial assemblages. Odds-ratio analysis unveiled the existence of higher order groups of positively associated T-RFs, restating the concept that intricate ecological relationships may take place in the root canal space. A significantly greater T-RF prevalence was detected in acute cases, suggesting a straight correlation between species richness and spontaneous pain. Conclusion:, Overall, no T-RFLP profile representing a specific bacterial consortium could be associated with the manifestation of symptoms of endodontic origin. [source] Oral administration of a centrally acting ghrelin receptor agonist to conscious rats triggers defecationNEUROGASTROENTEROLOGY & MOTILITY, Issue 1 2009A. D. Shafton Abstract, Agonists of ghrelin receptors that cross the blood,brain barrier, but not ghrelin itself, administered peripherally (intravenous or subcutaneous), cause defecation by acting on centres in the lumbo-sacral spinal cord. It is not established whether orally administered ghrelin receptor agonists can have this action. We tested GSK894281 for its effectiveness at the ghrelin receptor and its ability to cross the blood,brain barrier. GSK894281 was effective at the human and rat ghrelin receptors at 1,10 nmol L,1, but was >1000-fold less potent at the motilin receptor. It achieved a similar blood concentration by oral or intravenous administration. Oral bioavailability was 74% and brain : blood ratio at steady state was 0.7 : 1. GSK894281 administered orally (1,100 mg kg,1) caused a prompt, dose-related production of faecal pellets; at 10 mg kg,1 faecal output was four times greater than after carrier. The output was the greatest in the first half hour and subsided over the next 90 min. At an oral dose of 10 mg kg,1, the compound was effective on eight successive days. Faecal output was, on average, increased threefold over control in the 2 h after administration on each of the 8 days. This dose also significantly increased food consumption. Rats showed no adverse behavioural effects to the drug on a single application, but at the end of a week of administration they avoided the gavaging pipette. Oral administration of ghrelin receptor agonists that enter the central nervous system could possibly be used to relieve acute cases of constipation or to clear the bowel for colonoscopy. [source] Review: Neuropathology of acute phase encephalitis lethargica: a review of cases from the epidemic periodNEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 5 2009L. L. Anderson Introduction: Encephalitis lethargica (EL), an epidemic disease of the early 20th century, has continued to be diagnosed sporadically since that time, including a report of 20 new cases in 2004. Many of the recent case reports state that the primary neuropathology of acute EL consists of inflammatory changes and lesions within the midbrain, basal ganglia and substantia nigra. However, the neuropathology of acute EL cases from the epidemic period was actually much more widespread. Methods: In order to characterize the neuropathology of acute phase EL, we developed a database of EL pathology based on 112 cases from the years 1915 to 1940, of which most died within 2 weeks of EL onset. Results: Our analysis revealed that cortical damage was prevalent in 75% of the 112 cases; damage to the meninges and brainstem occurred in approximately half of the cases; and the substantia nigra was damaged in only 13% of these acute cases. We also found that after 1921, damage to cranial nerve nuclei was not reported. An analysis of the neuropathology and clinical symptoms revealed little correlation. Conclusions: Based on these findings, putative modern cases of acute EL with MRI/CT indicated lesions confined solely to the midbrain, brainstem, and/or basal ganglia should not be considered, consistent with that reported during epidemic period. [source] Annotation: PANDAS: a model for human autoimmune diseaseTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 3 2005Susan E. Swedo Background:, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus infections (PANDAS) is a recently recognized syndrome in which pre-adolescent children have abrupt onsets of tics and/or obsessive-compulsive symptoms, a recurring and remitting course of illness temporally related to streptococcal infections, and associated neurologic findings including adventitious movements, hyperactivity and emotional lability. Methods:, Inspired by observations of similar symptoms in children with Sydenham's chorea, a search was undertaken for clinical and laboratory evidence in support of the new syndrome. Results:, Consistent and predictable clinical findings have been described in a large case series. Magnetic resonance imaging has supported the postulated pathobiology of the syndrome with evidence of inflammatory changes in basal ganglia. Antibasal ganglia antibodies have been found in some acute cases, mimicking streptococcal antigen epitopes. Conclusions:, While PANDAS remains a controversial diagnostic concept, it has stimulated new research endeavors into the possible links between bacterial pathogens, autoimmune reactions, and neuropsychiatric symptoms. [source] | ||||||||||