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Am J Kidney Dis. 2002 Jun;39(6):1162-7.
Goodpasture's disease in the absence of circulating anti-glomerular basement membrane antibodies as detected by standard techniques.
Salama AD, Dougan T, Levy JB, Cook HT, Morgan SH, Naudeer S, Maidment G, George AJ, Evans D, Lightstone L, Pusey CD.
Renal Section, Faculty of Medicine, Imperial College, Hammersmith Hospital, London, UK. asalamics.bwh.harvard.edu
Goodpasture's disease is characterized by rapidly progressive glomerulonephritis, often accompanied by pulmonary hemorrhage, in association with deposition of antibodies in a linear pattern on the glomerular basement membrane (GBM). The diagnosis of Goodpasture's disease in patients with acute renal failure often relies on the use of immunoassays to detect circulating anti-GBM antibodies in serum samples. We describe three cases of Goodpasture's disease in which no circulating anti-GBM antibodies were detectable in serum by well-established enzyme-linked immunosorbent assay or Western blotting techniques. The diagnosis of Goodpasture's disease was confirmed by renal biopsy, with linear deposition of immunoglobulin along the GBM and crescentic glomerulonephritis. In addition, an alternative method of antibody detection using a highly sensitive biosensor system confirmed that circulating antibodies were present in sera from both patients tested. Because this technique is not routinely available for the detection of anti-GBM antibodies, we suggest that diagnosis always be confirmed with a renal biopsy, and despite negative serological test results using immunoassay, the diagnosis of Goodpasture's disease should still be considered in the correct clinical context. 2002 by the National Kidney Foundation, Inc.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12046026&dopt=Abstract hemorrhage
Rozhl Chir. 2002 May;81(5):259-61.
[Bouveret's syndrome: biliary ileus manifested by acute upper gastrointestinal hemorrhage and impaired gastric emptying]
[Article in Czech]
Simonek J, Lischke R, Drabek J, Pafko P.
III. chirurgicka klinika 1, LF UK, FN Motol, Praha.
The authors present a very rare case of impaired gastric evacuation, known as Bouveret's syndrome, caused by a large biliary concrement wedged in the duodenum as a result of the development of a cholecystoduodenal fistula in a 77-year-old man. The condition was manifested clinically by developed high ileus and subsequent haemorrhage into the upper GIT. The diagnosis was established on the background of the clinical picture, passage through the upper GIT and endoscopy. As the attempt to remove the concrement endoscopically failed, laparotomy had to be used. In the conclusion of this case-record the authors discuss the method of assessment of the correct diagnosis endoscopically and possibilities of therapeutic strategy.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12046431&dopt=Abstract hemorrhage
Neurol Neurochir Pol. 2002 Mar-Apr;36(2):403-11.
[Posttraumatic visual agnosia and epilepsy as a consequence of gunshot injury to the head. Case report]
[Article in Polish]
Mandat T, Potakiewicz Z, Bolewski J, Matuszewska A, Podgorski JK.
Kliniki Neurochirurgii Centralnego Szpitala Klinicznego Wojskowej Akademii Medycznej w Warszawie.
Half million people in the world, each year have a gunshot injury to the head and eighty thousand of them are hospitalized. Gunshot injuries to the head have became in Poland second most frequent cause of death from head trauma, and in some countries during peace became the most frequent cause of death among patient with head injury. Glasgow Coma Scale (GCS) is a useful prognostic factor for patients with gunshot injury to the head. Injury to the eloquent regions of the brain, commotion and contusion of the brain, intracranial hematomas, subarachnoid hemorrhage, cerebro-vascular spasm, injuries to the major vessels, liquorrhea, infections, coagulopathies and epilepsy are the most important and influential factors in the clinical status of the patient with gunshot injury to the head. The operation is the preferred treatment to all patient, no matter of their clinical status at the moment of the admission. The report presents the history of treatment of a patient with gunshot injury to the head. During the treatment extremely infrequently occurring posttraumatic visual agnosia and posttraumatic epilepsy were observed. Twenty-two months after operation the patient is independent and professionally active.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12046516&dopt=Abstract hemorrhage
Rev Lat Am Enfermagem. 2001 May;9(3):70-6.
[Analysis of maternal mortality in the municipality of Ribeirao Preto -- SP-- in 1991-1995]
[Article in Portuguese]
Oba MD, Tavares MS.
Enfermeira da Secretaria Municipal da Saude de Ribeirao Preto. mariadasdoreol.com.br
This study aims at learning about and identifying the causes leading to maternal death. Data were obtained from the Ribeirao Preto Committee for Studies and Prevention of Maternal Death and from obituaries. It is an exploratory study in which 72 maternal deaths occurring in Ribeirao Preto were analyzed from 1991 to 1995. In 1995, the maternal death rate was 60.3 in 100,000 births, with the predominance of avoidable causes, such as hemorrhage (33.3%), other causes (26.4%), hypertension (15.3%), abortion (11.1%), infection (8.3%) and puerperium (5.6%). Maternal death is a public health problem which must be faced by government authorities.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12046569&dopt=Abstract hemorrhage
Jpn J Physiol. 2002 Feb;52(1):21-9.
Estimation of baroreflex gain using a baroreflex equilibrium diagram.
Kawada T, Shishido T, Inagaki M, Zheng C, Yanagiya Y, Uemura K, Sugimachi M, Sunagawa K.
Department of Cardiovascular Dynamics, National Cardiovascular Center Research Institute, Suita, 565-8565 Japan. torukawes.ncvc.go.jp
Two types of closed-loop perturbations can be applied to the arterial baroreflex system. The first (P(D1)) is introduced into the baroreceptors without a direct effect on arterial pressure (AP), whereas the second (P(D2)) initially affects AP. Neck suction and hemorrhage are examples of P(D1) and P(D2), respectively. To estimate the baroreflex open-loop gain (G(Baro)) without knowing the absolute magnitudes of P(D1) and P(D2), we explored a new strategy to estimate G(Baro) by combining P(D1) and P(D2) in a baroreflex equilibrium diagram. In this diagram, the neural arc presents the input-output relationship between baroreceptor pressure input and sympathetic nerve activity (SNA). The peripheral arc presents the input-output relationship between SNA and AP. In 8 anesthetized rabbits, we estimated G(Baro) by multiplying the slopes of the peripheral arc determined from P(D1) and the neural arc determined from P(D2). We also estimated G(Baro) by a conventional open-loop analysis. The G(Baro) values estimated by the equilibrium diagram and the open-loop analysis showed a positive correlation (y = 0.80x + 0.22, r(2) = 0.95) and a standard error of estimate of 0.21 across the animals. We conclude that G(Baro) was estimated well by combining P(D1) and P(D2) in the equilibrium diagram.
Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12047799&dopt=Abstract hemorrhage
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