Articles: human.
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WHO South East Asia J Public Health · Jan 2014
ReviewExpediency of dengue illness classification: the Sri Lankan perspective Highly infectious tick-borne viral diseases: Kyasanur forest disease and Crimean-Congo haemorrhagic fever in India.
Ticks are distributed worldwide and can harbourand transmit a range of pathogenic microorganisms that affect livestock and humans. Most tick-borne diseases are caused by tick-borne viruses. Two major tick-borne virus zoonotic diseases, Kyasanur forest disease (KFD) and Crimean-Congo haemorrhagic fever (CCHF), are notifiable in India and are associated with highmortality rates. ⋯ In 2013, a non-nosocomial CCHF outbreak in Amreli district, as well as positive tick, animal and human samples in various areas of Gujarat state, suggested that the virus is widespread in Gujarat state, India. The emergence of KFDand CCHF in various Indian states emphasizes the need for nationwide surveillance among animals and humans. There is a need for improved diagnostic facilities, more containment laboratories, better public awareness, and implementation ofthorough tick control in affected areas during epidemics.
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Stud Health Technol Inform · Jan 2014
Validation of a computerized technique for automatically tracking and measuring the inferior vena cava in ultrasound imagery.
Accurate resuscitation of the critically-ill patient using intravenous fluids and blood products is a challenging, time sensitive task. Ultrasound of the inferior vena cava (IVC) is a non-invasive technique currently used to guide fluid administration, though multiple factors such as variable image quality, time, and operator skill challenge mainstream acceptance. ⋯ Addressing problems such as gaps in the vessel wall and intra-lumen speckle should result in improved performance in average and poor quality videos. Semi-automated measurement of the IVC for the purposes of non-invasive estimation of circulating blood volume poses challenges however is feasible.
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Editorial Comment
The role of thoracic epidural anesthesia in severe acute pancreatitis.
In animal studies of severe acute pancreatitis, thoracic epidural anesthesia appears to enhance the splanchnic circulation, improve end-organ perfusion, and favorably influence mortality. The application of thoracic epidurals in the critically ill human patient is less clear. Methodological difficulties in reliably assessing mesenteric flow have hampered progress, and clinical concerns surrounding this potentially attractive therapeutic modality remain unanswered. Future research needs to focus on the impact of epidural anesthesia on basic human physiological parameters to help direct further randomized studies in human disease.
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Multiple clinical studies show that arterial stiffness, measured as pulse wave velocity (PWV), precedes hypertension and is an independent predictor of hypertension end organ diseases including stroke, cardiovascular disease and chronic kidney disease. Risk factor studies for arterial stiffness implicate age, hypertension and sodium. However, causal mechanisms linking risk factor to arterial stiffness remain to be elucidated. ⋯ Immunostaining testing histone modifiers Ep300, HDAC3, and PRMT5 levels confirmed carotid artery-upregulation in all three layers: endothelial, smooth muscle and adventitial cells. Our study recapitulates observations in humans that given salt-sensitivity, increased Na-intake induced arterial stiffness before hypertension, increased pulse pressure, and structural vessel wall changes. Differential gene expression changes associated with arterial stiffness suggest a molecular mechanism linking sodium to full-vessel wall response affecting gene-networks involved in vascular ECM structure-function, apoptosis balance, and epigenetic regulation.
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Observational Study
Increased plasma levels of endozepines, endogenous ligands of benzodiazepine receptors, during systemic inflammation: a prospective observational study.
Recent work has shown that benzodiazepines interact with the immune system and exhibit anti-inflammatory effects. By using in vitro models, researchers in several studies have shown that the peptidergic endogenous ligands of benzodiazepine receptors, named endozepines, are involved in the immune response. All endozepines identified so far derive from diazepam-binding inhibitor (DBI), which generates several biologically active fragments. The aim of the present study was to measure plasma levels of DBI-like immunoreactivity (DBI-LI) in a rat model of sepsis and in patients with systemic inflammation from septic or non-septic origin. ⋯ Endozepines might be involved in the inflammatory response in patients with systemic inflammation.