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Joseph S Hudson, Kingsley Abode-Iyamah, Yasunori Nagahama, Chandan G Reddy
BACKGROUND: Ionic contrast, if accidentally injected into the intrathecal space during routine imaging studies or interventional procedures, may significantly interfere with neuronal activity, potentially causing ascending tonic-clonic seizure syndrome and even death. As a result, ionic contrast is strictly contraindicated for intrathecal use. Rapid recognition of the condition followed by prompt management, typically involving aggressive cerebrospinal fluid (CSF) drainage, is critical to improving patient outcome...
October 17, 2016: World Neurosurgery
Yuxiao Wang, Jingxin Li, Yuemei Hu, Qi Liang, Mingwei Wei, Fengcai Zhu
Ebola virus disease (EVD) has become a great threat to humans across the world in recent years. The 2014 Ebola epidemic in West Africa caused numerous deaths and attracted worldwide attentions. Since no specific drugs and treatments against EVD was available, vaccination was considered as the most promising and effective method of controlling this epidemic. So far, 7 vaccine candidates had been developed and evaluated through clinical trials. Among them, the recombinant vesicular stomatitis virus-based vaccine (rVSV-EBOV) is the most promising candidate, which demonstrated a significant protection against EVD in phase III clinical trial...
October 20, 2016: Human Vaccines & Immunotherapeutics
Rui Guo, Lu Ma, Bal Krishna Shrestha, Zhiyuan Yu, Hao Li, Chao You
The aim of the study is to define the clinical features, risk factors, treatment and prognosis of idiopathic primary intraventricular hemorrhage (IPIVH).We retrospectively collected the data of consecutively admitted patients who were diagnosed and treated for IPIVH in our hospital from January 2010 to December 2014. The clinical information, treatment, and prognosis at the 6-month follow-up were analyzed.Among the 3798 cases of spontaneous intracranial hemorrhage (ICH), 98 IPIVH (2.58%) patients were recruited for the study...
October 2016: Medicine (Baltimore)
Nophanan Chaikittisilpa, Abhijit V Lele, Vivian H Lyons, Bala G Nair, Shu-Fang Newman, Patricia A Blissitt, Monica S Vavilala
BACKGROUND: Current guidelines recommend routine clamping of external ventricular drains (EVD) for intrahospital transport (IHT). The aim of this project was to describe intracranial hemodynamic complications associated with routine EVD clamping for IHT in neurocritically ill cerebrovascular patients. METHODS: We conducted a retrospective review of cerebrovascular adult patients with indwelling EVD admitted to the neurocritical care unit (NICU) during the months of September to December 2015 at a tertiary care center...
October 18, 2016: Neurocritical Care
H Humphreys, P Jenks, J Wilson, V Weston, R Bayston, C Waterhouse, A Moore
BACKGROUND: The insertion of external ventricular drains (EVDs) is necessary in some neurosurgical patients, but increases the risk of meningitis/ventriculitis. While there are well-recognized risk factors, the proportion of patients who develop meningitis/ventriculitis varies partly due to differences in definitions. A multi-disciplinary working group was established to agree definitions for EVD-associated meningitis/ventriculitis, and a surveillance system was piloted in four centres in the UK and Ireland...
September 17, 2016: Journal of Hospital Infection
Samuel A Olowookere, Emmanuel A Abioye-Kuteyi, O Adekanle
BACKGROUND: Ebola viral disease (EVD) epidemic need to be contained through means which include vaccination of susceptible population. Vaccination has eradicated major killer diseases. OBJECTIVE: The study determined the health workers willingness to participate in EVD vaccine clinical trials and receive EVD vaccine. MATERIALS AND METHODS: A descriptive cross-sectional study design involving 370 consenting health workers of Obafemi Awolowo University, Ile-Ife that completed a self administered semi-structured questionnaire...
October 14, 2016: Vaccine
Alexey Martyushev, Shinji Nakaoka, Kei Sato, Takeshi Noda, Shingo Iwami
Ebola virus (EBOV) causes a severe, often fatal Ebola virus disease (EVD), for which no approved antivirals exist. Recently, some promising anti-EBOV drugs, which are experimentally potent in animal models, have been developed. However, because the quantitative dynamics of EBOV replication in humans is uncertain, it remains unclear how much antiviral suppression of viral replication affects EVD outcome in patients. Here, we developed a novel mathematical model to quantitatively analyse human viral load data obtained during the 2000/01 Uganda EBOV outbreak and evaluated the effects of different antivirals...
October 12, 2016: Antiviral Research
Cong Qian, Xiaobo Yu, Jingyin Chen, Chi Gu, Lin Wang, Gao Chen, Yuying Dai
BACKGROUND AND OBJECTIVES: Vasospasm-related injury such as delayed ischemic neurological defect (DIND) or cerebral infarction is an important prognostic factor for aneurismal subarachnoid hemorrhage (SAH). Whether cerebrospinal fluid (CSF) drainage can achieve a better outcome in aneurismal SAH patients after coiling or clipping remains the subject of debate. Here, we report a meta-analysis of the related available literature to assess the effect of continuous CSF drainage on clinical outcomes in patients with aneurismal SAH...
October 2016: Medicine (Baltimore)
(no author information available yet)
Background Data from studies in nonhuman primates suggest that the triple monoclonal antibody cocktail ZMapp is a promising immune-based treatment for Ebola virus disease (EVD). Methods Beginning in March 2015, we conducted a randomized, controlled trial of ZMapp plus the current standard of care as compared with the current standard of care alone in patients with EVD that was diagnosed in West Africa by polymerase-chain-reaction (PCR) assay. Eligible patients of any age were randomly assigned in a 1:1 ratio to receive either the current standard of care or the current standard of care plus three intravenous infusions of ZMapp (50 mg per kilogram of body weight, administered every third day)...
October 13, 2016: New England Journal of Medicine
Linda Valeri, Oscar Patterson-Lomba, Yared Gurmu, Akweley Ablorh, Jennifer Bobb, F William Townes, Guy Harling
BACKGROUND: The recent Ebola virus disease (EVD) outbreak in West Africa has spread wider than any previous human EVD epidemic. While individual-level risk factors that contribute to the spread of EVD have been studied, the population-level attributes of subnational regions associated with outbreak severity have not yet been considered. METHODS: To investigate the area-level predictors of EVD dynamics, we integrated time series data on cumulative reported cases of EVD from the World Health Organization and covariate data from the Demographic and Health Surveys...
2016: PloS One
Vianney Gilard, Ben Ousmanou Djoubairou, Arnaud Lepetit, Thomas Metayer, Clement Gakuba, Charlotte Gourio, Stephane Derey, François Proust, Evelyne Emery, Thomas Gaberel
OBJECTIVE: intraventricular hemorrhage (IVH) often requires the insertion of an external ventricular drain (EVD), but blood clots could occlude the catheters. Large EVD catheters may help to reduce the risk of catheter occlusion. Here, we compared small catheters with large catheters for ventriculostomy in patients suffering from IVH. METHODS: We conducted a retrospective cohort study. Patients were included if they had IVH requiring EVD insertion. We then compared baseline characteristics and outcomes of patients treated with large catheters to patients treated with small catheters...
October 8, 2016: World Neurosurgery
Keith Burghardt, Christopher Verzijl, Junming Huang, Matthew Ingram, Binyang Song, Marie-Pierre Hasne
The Ebola virus in West Africa has infected almost 30,000 and killed over 11,000 people. Recent models of Ebola Virus Disease (EVD) have often made assumptions about how the disease spreads, such as uniform transmissibility and homogeneous mixing within a population. In this paper, we test whether these assumptions are necessarily correct, and offer simple solutions that may improve disease model accuracy. First, we use data and models of West African migration to show that EVD does not homogeneously mix, but spreads in a predictable manner...
October 10, 2016: Scientific Reports
M Aletti, H Savini, C Ficko, J Bordes, A Cambon, M Billhot, G Velut, H Granier, T De Greslan, T Carmoi
The clinical spectrum of Ebola virus disease (EVD) ranges from very serious forms with organ failure and death within days to paucisymptomatic forms and perhaps even asymptomatic. The authors propose a focus on the clinical manifestations of EVD, on prognosis and on therapeutic aspects (excluding resuscitation). This work extracts from the literature the main data gathered during the 2014-2015 epidemic that raged in Guinea Conakry and Sierra Leone. These two countries, even if they are separated by a border, are one and the same population base...
October 4, 2016: La Revue de Médecine Interne
P Msellati, A Touré, M S Sow, K Cécé, B Taverne, A Desclaux, M Barry, J-F Etard, E Delaporte
Ebola virus disease (EVD) epidemic that spread in West Africa from the end of 2013 to early 2016 has reached more people than all past epidemics. Beyond care management of acute phase ill patients and measures for the control of the epidemic, the outcome of Ebola survivors became an important question as their number increased and raised new issues. A multidisciplinary prospective cohort of survivors in Guinea has been launched by IRD UMI 233 and Donka National Hospital, Conakry, Guinea, to assess the longterm clinical, psychological, sociological, immunological, and viral outcomes potentially related to EVD...
October 3, 2016: Bulletin de la Société de Pathologie Exotique
Amanda Tiffany, Faya Pascal Moundekeno, Alexis Traoré, Melat Haile, Esther Sterk, Timothé Guilavogui, Micaela Serafini, Blaise Genton, Rebecca F Grais
Multiple community-based approaches can aid in quantifying mortality in the absence of reliable health facility data. Community-based sentinel site surveillance that was used to document mortality and the systems utility for outbreak detection was evaluated. We retrospectively analyzed data from 46 sentinel sites in three sous-préfectures with a reinforced malaria control program and one sous-préfecture without (Koundou) in Guinea. Deaths were recorded by key informants and classified as due to malaria or another cause...
October 3, 2016: American Journal of Tropical Medicine and Hygiene
Reshma Roshania, Michaela Mallow, Nelson Dunbar, David Mansary, Pranav Shetty, Taralyn Lyon, Kacey Pham, Matthew Abad, Erin Shedd, Anh-Minh A Tran, Sarah Cundy, Adam C Levine
BACKGROUND: The 2014 outbreak of Ebola virus disease (EVD) in West Africa was the largest ever recorded. Starting in September 2014, International Medical Corps (IMC) managed 5 Ebola treatment units (ETUs) in Liberia and Sierra Leone, which cumulatively cared for about 2,500 patients. We conducted a retrospective cohort study of patient data collected at the 5 ETUs over 1 year of operations. METHODS: To collect clinical and epidemiological data from the patient care areas, each chart was either manually copied across the fence between the high-risk zone and low-risk zone, imaged across the fence, or imaged in the high-risk zone...
September 28, 2016: Global Health, Science and Practice
Corrado Cancedda, Sheila M Davis, Kerry L Dierberg, Jonathan Lascher, J Daniel Kelly, Mohammed Bailor Barrie, Alimamy Philip Koroma, Peter George, Adikali Alpha Kamara, Ronald Marsh, Manso S Sumbuya, Cameron T Nutt, Kirstin W Scott, Edgar Thomas, Katherine Bollbach, Andrew Sesay, Ahmidu Barrie, Elizabeth Barrera, Kathryn Barron, John Welch, Nahid Bhadelia, Raphael G Frankfurter, Ophelia M Dahl, Sarthak Das, Rebecca E Rollins, Bryan Eustis, Amanda Schwartz, Piero Pertile, Ilias Pavlopoulos, Allan Mayfield, Regan H Marsh, Yusupha Dibba, Danielle Kloepper, Andrew Hall, Karin Huster, Michael Grady, Kimberly Spray, David A Walton, Fodei Daboh, Cora Nally, Sahr James, Gabriel S Warren, Joyce Chang, Michael Drasher, Gina Lamin, Sherry Bangura, Ann C Miller, Annie P Michaelis, Ryan McBain, M Jana Broadhurst, Megan Murray, Eugene T Richardson, Ted Philip, Gary L Gottlieb, Joia S Mukherjee, Paul E Farmer
An epidemic of Ebola virus disease (EVD) beginning in 2013 has claimed an estimated 11 310 lives in West Africa. As the EVD epidemic subsides, it is important for all who participated in the emergency Ebola response to reflect on strengths and weaknesses of the response. Such reflections should take into account perspectives not usually included in peer-reviewed publications and after-action reports, including those from the public sector, nongovernmental organizations (NGOs), survivors of Ebola, and Ebola-affected households and communities...
October 15, 2016: Journal of Infectious Diseases
Naveen Kumar, Wisam Al-Faiadh, Jignesh Tailor, Conor Mallucci, Chris Chandler, Sanj Bassi, Benedetta Pettorini, Bassel Zebian
OBJECTIVES: The management of neonatal post-haemorrhagic hydrocephalus (nPHH) varies considerably between centres and even between neurosurgeons in the same centre. We performed a nationwide survey to evaluate current practice in the UK and reviewed the evidence for each intervention. METHODS: An online semi-structured questionnaire was emailed to all units registered on the British Paediatric Neurosurgery Group Mailing List. The survey consisted of 18 questions designed to establish the status quo in the management of nPHH, including preferred temporising procedure, factors guiding the timing of intervention and willingness to participate in a prospective study...
September 30, 2016: British Journal of Neurosurgery
Dattaraj Paramanand Sawarkar, Satish Varma, Pankaj Kumar Singh, Ramesh Doddamani, Amandeep Jagdevan, Bhawani Shanker Sharma
INTRODUCTION: Cerebral venous sinus thrombosis (CVST) is a rare condition with the potential to cause severe morbidity and mortality. CVST can also occur after vestibular schwannoma (VS) surgery with the thrombosis of transverse and sigmoid sinus. However, there is not a single report of superior sagittal sinus (SSS) thrombosis after VS surgery reported in the literature. CASE REPORT: A 45-year-old lady presented to our centre with large left sided solid cystic VS...
September 26, 2016: World Neurosurgery
A L Moekotte, M A M Huson, A J van der Ende, S T Agnandji, E Huizenga, A Goorhuis, M P Grobusch
To date, the management of patients with suspected or confirmed Ebolavirus disease (EVD) depends on quarantine, symptomatic management and supportive care, as there are no approved vaccines or treatments available for human use. However, accelerated by the recent large outbreak in West Africa, significant progress has been made towards vaccine development but also towards specific treatment with convalescent plasma and monoclonal antibodies. Areas covered: We describe recent developments in monoclonal antibody treatment for EVD, encompassing mAb114 and the MB-003, ZMAb, ZMapp™ and MIL-77E cocktails...
October 8, 2016: Expert Opinion on Investigational Drugs
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