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At least 145 records · Page 8Linked to original sources
PubMed1999

Familial fatal and near-fatal third ventricle colloid cysts.

BACKGROUND: Despite having a presumed congenital origin, familial cases of colloid cysts have been reported only rarely. The first case of a brother and sister with colloid cysts is reported here, and the relevant literature is reviewed. METHODS: A 25-year-old man presented with a 24-h history of headache and vomiting. He rapidly became unconscious and fulfilled the criteria for brain death on arrival at hospital. No surgical intervention was performed. RESULTS: The patient's sister presented at the age of 41 with headaches and rapidly became unconscious. The sister had urgent bilateral ventriculostomies. followed by transcallosal removal of a colloid cyst. CONCLUSIONS: These cases support the hypothesis that colloid cysts are congenital lesions and provide some evidence of a possible genetic predisposition to their formation. Sudden death remains a real risk for patients harbouring a colloid cyst.

Adult↗
PubMed1997

Immunoblot characterization of IgG, IgM and IgE antibodies elicited during the course of fatal and non-fatal infections of Plasmodium berghei in DBA/2 and Balb/c mice.

When infected with the CRS line of Plasmodium berghei ANKA, DBA/2 mice died of a fulminating infection around day 20 post-infection whereas Balb/c mice had crises around day 15 then low or subpatent parasitaemias until approximately day 73, when sterile immunity is believed to have supervened. Immunoblots for parasite-specific immunoglobulins G, M and E were made from the sera taken during the course of infection in each mouse strain. Although both strains elicited antibodies to a 128-kDa antigen by day 8, this was solely of the IgG class in the DBA/2 but of both IgG and IgM in the Balb/c. Crisis and subpatency were associated with the appearance of IgG and IgM antibodies to 74- and 80-kDa antigens. The most vigorous immune response was observed in sera from the Balb/c mice on day 73, with antibodies to many antigens of 19-180 kDa; IgE antibody (to antigens of 38 and 45 kDa) was then evident for the first time.

Animals↗
PubMed2002

Different proinflammatory reactions in fatal and non-fatal enterovirus 71 infections: implications for early recognition and therapy.

AIM: The mechanism of pulmonary oedema, a life-threatening manifestation of enterovirus 71 (EV71) encephalitis, is unclear. Our aim was to assess the relationship of proinflammatory cytokines to EV71-related pulmonary oedema. METHODS: Proinflammatory responses in 33 EV71 patients with various complications and 21 normal healthy children were measured using an enzyme-linked immunosorbent assay. RESULTS: EV71 patients with both encephalitis and pulmonary oedema were found to have much higher levels of blood interleukin-6 (IL-6) (947 +/- 1239 vs 4.9 +/- 3.1 pg/ml, p = 0.0003), tumour necrosis factor-alpha (TNF-alpha) (22.4 +/- 29.5 vs 5.3 +/- 1.0 pg/ml, p = 0.0035), interleukin Ibeta (IL-1beta) (48.4 +/- 85.2 vs 4.9 +/- 10.1 pg/ml, p = 0.01), white blood cell count (28.3 +/- 7.6 vs 15.5 +/- 6.8 10(9)/L, p > or = 0.0001) and blood glucose (501 +/- 186 vs 165 +/- 117 mg/dL, p = 0.0009) than patients with EV71 encephalitis alone. In fact, the cytokine levels in patients with encephalitis only or in those without complications were not significantly different from the levels found in normal children. The sensitivity, specificity, positive and negative predictive values of IL-6 > 70 pg/ml for EV71 encephalitis with pulmonary oedema were all 100%. CONCLUSION: Patients with EV71-related encephalitis combined with pulmonary oedema were found to have significantly elevated levels of proinflammatory cytokines and the best predictor for this complicated condition was found to be the level of serum IL-6.

Analysis of Variance↗
PubMed2004

Fatal and non-fatal injuries among U.S. Air Force personnel resulting from the terrorist bombing of the Khobar Towers.

BACKGROUND: Culminating with the events of September 11, 2001, U.S. civilian and military populations are vulnerable to terrorist attacks. Information about the patterns of injuries and their causes inform disaster management planning and can improve structural and architectural design. This report documents the injuries following an estimated 20K bomb at the Khobar Towers military compound in Dhahran, Saudi Arabia. METHODS: US Air Force personnel in the compound at the time of the bombing were evaluated. Data were collected through a mail survey, and a review of military medical records and autopsy reports. Outcome measures included injury types, treatment status, severity, and causes of injuries. RESULTS: The study identified 574 persons who were injured in the bombing; 19 persons died. A total of 420 (73%) persons were injured directly in the blast and 154 (27%) persons were injured during evacuation, search and rescue, during cleanup, or sustained only auditory or inhalation trauma. Sixteen percent of survivors injured directly in the blast were hospitalized; 6% were critical. Soft tissue and foreign body injuries of the lower extremities were the most common injuries among survivors, most often caused by glass. Persons who died suffered extensive, multiple injuries from blunt trauma and one death was caused by glass. CONCLUSIONS: All deaths were immediate and the majority of survivors suffered minor to moderate injuries. Injuries and deaths were consistent with extensive glass damage in the compound and fragmentation of building concrete. Improved building designs and retrofits such as blast-resistant glass and prevention of structural collapse or building fragmentation should be considered in building design and construction in high threat areas.

Adult↗
PubMed1981

Non-fatal healed transmural myocardial infarction and fatal non-cardiac disease. Qualification and quantification of coronary arterial narrowing and of left ventricular scarring in 18 necropsy patients.

A qualitative and quantitative analysis of the amount of myocardial scarring and the degree and extent of coronary arterial narrowing by atherosclerotic plaque in the entire lengths of each of the four major epicardial coronary arteries is described in 18 necropsy patients with healed transmural myocardial infarcts and death from a non-cardiac condition. An average of 30 per cent of the basal half and 38 per cent of the apical half of the left ventricular wall was scarred. The nine patients with clinical evidence of previous acute myocardial infarction tended to have larger left ventricular scars than the nine patients without such evidence but the difference was not significant. An average of 26 cm (51 5 mm segments) of coronary artery were examined from each patient ad 25 cm (49 5 mm segments) from each of 19 control subjects. Of 924 segments examined in the 18 patients, 292 (32%) were 76 to 100 per cent narrowed in cross-sectional area (controls = 5); 321 (35%) were 51 to 75 per cent narrowed (controls = 34%); 210 (23%) were 26 to 50 per cent narrowed (controls = 44%), and 101 (11%) were 0 to 25 per cent narrowed (controls = 17%). The extent of severe narrowing of 75 per cent or more was similar (25%) in the left anterior descending and left circumflex coronary arteries; the right was the most severely narrowed artery and the left main was not severely narrowed in any patient. Excluding, then, the left main artery, the amount of severe narrowing in the proximal and distal halves of the other three vessels was similar. The amount of severe narrowing was not related to the age at death or to heart weight, but was greater in patients with hypertension or with a history of acute myocardial infarction.

Aged↗
PubMed1997

Fatal and non-fatal farm injuries to children and adolescents in the United States, 1990-3.

OBJECTIVE: Examine the current magnitude of the injury problem to children and adolescents on farms, and to compare these data to that from 1978-83. DATA SOURCES: US National Center for Health Statistics Mortality Multiple Cause of Death Tapes for the years 1991-3, and the US Consumer Product Safety Commission National Electronic Injury Surveillance System for data on emergency department visits for 1990-3. SUBJECTS: Children and adolescents 19 years and younger injured on farms. RESULTS: There were an average of 104 deaths per year due to injuries occurring on farms. The rate of 8.0 deaths per 100,000 child farm residents is 39% lower than in 1979-81. More of the deaths occurred in hospital than previously. There were an average of 22,288 emergency department treated injuries per year. The rate of 1717 injuries per 100,000 child farm residents is 10.7% higher than 1979-83. Males were injured more frequently than females. Tractors accounted for 20.9% of all injuries, followed by horses (8.4%), all terrain vehicles and minibikes (8.0%), and farm wagons (7.7%). CONCLUSIONS: Farm injuries continue to be a major problem to children living on farms. While improved medical care may have contributed to the reduction in mortality, the continued high rate of injuries warrants study of a variety of intervention strategies to reduce the injury toll. There is also a need for ongoing injury surveillance to provide accurate data on the farm injury problem.

Adolescent↗
PubMed1997

Mutation of a highly conserved residue of betaI spectrin associated with fatal and near-fatal neonatal hemolytic anemia.

We studied an infant with severe nonimmune hemolytic anemia and hydrops fetalis at birth. His neonatal course was marked by ongoing hemolysis of undetermined etiology requiring repeated erythrocyte transfusions. He has remained transfusion-dependent for more than 2 yr. A previous sibling born with hemolytic anemia and hydrops fetalis died on the second day of life. Peripheral blood smears from the parents revealed rare elliptocytes. Examination of their erythrocyte membranes revealed abnormal mechanical stability as well as structural and functional abnormalities in spectrin. Genetic studies revealed that the proband and his deceased sister were homozygous for a mutation of betaIsigma1 spectrin, L2025R, in a region of spectrin that is critical for normal function. The importance of leucine in this position of the proposed triple helical model of spectrin repeats is highlighted by its evolutionary conservation in all beta spectrins from Drosophila to humans. Molecular modeling demonstrated the disruption of hydrophobic interactions in the interior of the triple helix critical for spectrin function caused by the replacement of the hydrophobic, uncharged leucine by a hydrophilic, positively charged arginine. This mutation must also be expressed in the betaIsigma2 spectrin found in muscle, yet pathologic and immunohistochemical examination of skeletal muscle from the deceased sibling was unremarkable.

Anemia, Hemolytic, Congenital↗
PubMed2007

Total joint arthroplasty: When do fatal or near-fatal complications occur?

BACKGROUND: With the recent trend toward minimally invasive total joint arthroplasty and the increased emphasis on faster recovery and shorter hospital stays, it has become increasingly important to recognize the timing and severity of the various complications associated with elective total joint arthroplasty to ensure that early patient discharge is a safe practice. METHODS: We evaluated the systemic and local complications associated with primary unilateral lower-extremity arthroplasties performed during one year in 1636 patients. A total of 966 patients had a primary total hip arthroplasty, and 670 had a primary total knee arthroplasty. All complications that occurred in the hospital and for six weeks following the index surgery were recorded. The circumstances leading to the complications and the details of the therapeutic intervention for each complication were recorded. Analyses were performed to predict the factors that predispose patients to serious complications. RESULTS: One patient (0.06%) in the cohort died during the hospital stay. There were a total of 104 major (life-threatening) complications, including cardiac arrest (one), tachyarrhythmia (thirty-three), pulmonary edema or congestive heart failure (ten), myocardial infarction (six), hypotensive crisis (four), pulmonary embolus (twenty-five), acute renal failure (fourteen), stroke (six), bowel obstruction or perforation (three), and pneumothorax (one). There were seventeen major local complications. Ninety-four (90%) of the major complications occurred within four days after the index surgery. Although older age, increased body mass, and preexistent comorbidities were important predisposing factors for serious medical complications, 58% of the patients who had life-threatening complications develop had no identifiable predisposing factors. CONCLUSIONS: This study demonstrated that most of the complications of lower-extremity total joint replacement occur within the time-frame of the typical hospital stay. Given the serious nature of some of these complications and the inability to identify many of the patients who may be at risk, we caution against early discharge of patients from the hospital after elective total joint arthroplasty in the lower extremity.

Adolescent↗