Anti-HIV antibodies in patients receiving intravenous immunoglobulin

Until recently, donors of serum for intravenous immunoglobulin (IVIG) were not screened for the presence of antibodies to the human immunodeficiency virus (HIV). We detected anti-HIV antibodies (Ab) in the sera of seven patients following IVIG infusions. In addition, enzyme immunoassay values increased and/or Western blot converted from negative to positive in all patients following infusions and declined again over time confirming passive acquisition. Patients who received IVIG manufactured after the screening of donors was initiated may still test positive for anti-HIV Ab due to antibodies to human T-lymphocyte cell lines in which viral antigen was prepared. Such false positives must be excluded when testing IVIG recipients. Despite the presence of antibodies to HIV, IVIG has never been documented to transmit the virus.     

HLA antigens in schistosomal hepatic fibrosis patients with haematemesis

20 patients of schistosomal hepatic fibrosis and splenomegaly (SHF) with and without haematemesis were examined. Typing for HLA-A, B and C antigens in these patients were compared with those of a group of 100 Egyptian controls. The study showed the presence of an association between HLA-A1 and B5 antigens in SHF cases. However, there was no significant association between HLA antigens and SHF cases with haematemesis.     

Proliferation and differentiation of transplanted embryonic diencephalon in the brain of adult rats

The survival, proliferation potential, differentiation, and host tissue reaction of allografts of undifferentiated embryonal diencephalic tissue (E12.5, E17.5) transplanted into or around the third ventricle of adult rats were investigated. Rats harboring grafts were sacrificed at three, six, and nine weeks after transplantation. The proliferative activity of the grafts was assessed by injection of 5'-bromo-2'-deoxyuridine (BrdU) into pregnant rats before the removal of fetuses for transplantation, and staining the grafts using an anti-BrdU antibody. The proliferative activity of the transplanted grafts was evaluated by immunostaining using an anti-proliferating cell nuclear antigen (PCNA) antibody. The differentiation of the grafts into neurons was estimated by double immunostaining using anti-BrdU and anti-neuron-specific enolase (NSE) antibodies. The survival rate of the grafts was strongly related to the proliferative activity of the graft. Surviving E17.5 grafts contained immunoreactive BrdU cells. E12.5 grafts could survive without immunoreactive BrdU cells. Undifferentiated El2.5 grafts proliferated up to six weeks after transplantation. Thereafter, most graft cells differentiated into mature neurons. E12.5 diencephalic allografts survived well with minimal rejection reactions and resulted in substantial neurite ingrowth into the host brain, while El7.5 allografts caused substantial reactive gliosis and little ingrowth.     

Asphyxia homicides in Denmark 1992–2016

In this retrospective study , we present the findings in 250 homicides by asphyxia in Denmark in a 25-year period, with a particular focus on the autopsy findings in strangulation. Our intention is for the results to be used in future death investigations, where difficulties in interpretation of findings in potential asphyxial deaths arise. Asphyxia homicides showed a strong bias with respect to sex, age, and homicide type. The frequent female victim was typically an adult, whereas the rarer male victim was most often a child. Female offenders most often killed their children, and male offenders most often killed their female partner. Generally, most asphyxia homicides took place in a domestic setting. Manual strangulation and ligature strangulation were the most common mechanisms of asphyxia homicides (81.6%). A lack of petechial hemorrhages, especially in the conjunctiva, was rare in homicidal strangulation, but there were exceptions, especially when there was postmortem decomposition, making it impossible to verify them. Most victims of strangulation had skin lesions in the face (including the jawline) or on the neck, with accompanying hemorrhages in muscle and connective tissue, but the findings could be subtle or compounded by decomposition. Fractures of the laryngo-hyoid complex were common in strangulation, particularly in manual strangulation (chi-sq = 4.0993, df = 1, P < 0.05) and were clearly related to the age of the victim (chi-sq = 82.193, df = 4, P < 0.001). In children and young adults dying from homicidal strangulation, a lack of fractures is to be expected, while a lack of fractures is unusual, but not entirely unexpected, for adults and aged people.

     

Health telematics/telemedicine in the republic of Estonia

The people of Estonia, who until their independence had been systematically deprived of all forms of information, have shown a ready acceptance of the use of information technology in all areas of life. This environment and an excellent IT infrastructure have since the beginning of the new century provided favourable conditions for developing various individual projects in telemedicine. At the core of current telemedical applications in Estonia is the BITNET Project (in neurology, general medicine), built up with Swedish cooperation, and three German-Estonian projects (in telecardiology and telepathology). These projects are accompanied by studies of their cost-effectiveness. They constitute the basis for the plan that routine telemedical services be taken over by the Estonian health insurance. Differing from the situation in the Scandinavian countries, which have had an effective national telemedical service for over ten years, the special feature of telematrics in Estonia is its international networking with foreign centres of excellence. This has its origin in the aim of Estonian health policy to ensure medical services within its own country in all branches of medicine.     

Emotional health and quality of life after aneurysmal subarachnoid hemorrhage

Background

Emotional disorders and decrease in health-related quality of life (HRQoL) are well-documented sequelae of aneurysmal subarachnoid hemorrhage (SAH). The aim of this study was to analyze the impact of emotional disorders on HRQoL in survivors of SAH.

Methods

This was a retrospective study enrolling 114 SAH-survivors at 1–10 years (mean 4,5 years) after the disease. Emotional State Questionnaire (EST-Q) was used to measure emotional health and the Short Form Health Survey (SF-36) was used to assess HRQoL of the patients.

Results

Most of the patients reported good recovery, but EST-Q results revealed high prevalence of emotional disorders after SAH. Almost half of the patients had higher than cut-off values indicating fatigue (47 %) and insomnia (46 %). About one third of SAH-patients had higher than cut-off scores demonstrating depression (30 %) and anxiety (31 %). The patients scored significantly lower in all scales of SF-36 as compared to age-matched general population. All EST-Q subscale results were significantly and negatively correlated with SF-36 scores. Fatigue was independently related to all SF-36 subscales and depression to most of the mental health component scores. Emotional symptoms alone were demonstrated to explain 23–47 % of the SF-36 subscale values, and more than half of the variance of mental health component score values were found to be explained by emotional disorders (53 %).

Conclusions

Emotional disorders are frequent after SAH and significantly associated with impairment of HRQOL. Proper and timely screening tests are important to reveal development of emotional problems and improve QoL for the SAH-patients.     

Anatomic guide and sonography for surgical repair of leg muscle lacerations

Background

There were over 110,000 leg laceration cases reported in the United States in 2011. Currently, muscle laceration is repaired by suturing epimysium to epimysium. Tendon-to-tendon repair is stronger, restores the muscle's resting length, and leads to a better functional recovery. Tendons retract into the muscle belly following laceration and surgeons have a difficult time finding them. Many surgeons are unfamiliar with leg muscle anatomy and the fact that the leg muscles have long intramuscular tendons that are not visible in situ. A surgical anatomic guide exists to help surgeons locate forearm tendons; no such guide exists for tendons in the leg.

Materials and methods

The leg tendon ends of 11 cadavers were dissected, measured, and recorded as percentages of leg length. High-frequency ultrasound was used to locate tendon ends in three additional cadavers. These locations were compared with the actual tendon ends located via dissection.

Results

There was little variation in tendon end position within the cadaver group, between men and women or right and left legs. The data are presented as an anatomic guide to inform surgeons of the tendon ends' likely locations in the leg.

Conclusion

The location of leg intramuscular tendon ends is predictable and the anatomic guide will help surgeons locate tendon ends and perform tendon-to-tendon repairs. Ultrasound is a potentially effective tool for detection of accurate location of repairable tendon ends in leg muscle lacerations.     

The Effect of Type of Femoral Component Fixation on Mortality and Morbidity after Hip Hemiarthroplasty: A Systematic Review and Meta-Analysis

HSS Journal ® - Hip hemiarthroplasty is a well-established treatment of displaced femoral neck fracture, although debate exists over whether cemented or uncemented fixation is superior....     

Prevalence of Parkinson's disease in Estonia

OBJECTIVES: To investigate the prevalence of idiopathic Parkinson's disease (PD) in Tartu district of South Estonia, with a population of 153,240 on prevalence day, 1 January 1996. METHODS: The community-based method of case ascertainment was used, followed by neurologic examination. RESULTS: The age-adjusted prevalence was 152 per 100,000 population, 159 for urban and 139 for the rural group, 154 for men and 153 for women. The age-specific prevalence increased from 22 per 100,000 population in the age group 40-49 years up to 1232 per 100,000 population in the age group 70-79 years. The mean age of PD patients was 71.4 years, the mean age at onset of the symptoms - 66.9 years. CONCLUSIONS: When comparing the prevalence rates with other studies of Caucasian populations in Europe, the results are similar except for slightly but not significantly higher prevalence rates in the urban population in Estonia.