Articles: human.
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Hepatitis E is a worldwide health problem, especially in developing countries. The virus genome contains three different open reading frames (ORFs): ORF-1, which is believed to encode nonstructural proteins, and ORF-2 and ORF-3, which are believed to encode structural proteins. Presently, serologic tests for the detection of human antibodies to hepatitis E virus (HEV) infection are primarily based on the ORF-2 structural protein expressed in Escherichia coli, insect cells or synthetic peptides. ⋯ These results suggest that the recombinant ORF-2 protein is more sensitive as a diagnostic antigen for detecting antibodies to HEV in both acute-phase and convalescent-phase sera than ORF-3 protein. Copyright 1996 S. Karger AG, Basel
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The HIV/AIDS pandemic can truly be described as an infectious disease that has recently emerged and judging from its rapid global spread, it leaves no doubt that it is one of the greatest health threats mankind has to contend with. This pandemic has alerted and stimulated the international scientific community to seriously reflect oa other recent episodes of emerging and re-emerging infections. The examples that have recently been observed and addressed include new emerging infectious diseases, unusual manifestations of previously known diseases and unusual eruption of known diseases in unusual geographic foci or unusual altitudes. ⋯ Setting up rapid reaction forces to respond to specific outbreak situations in order to control the spread of an emerging infectious disease. In this area of rapid trans not continental travel, the world is viewed as a "global village" and the relevance of the current International Sanitary Regulations requires a re-appraisal. Global sensitisation of the international community to the importance of this programme will ease and facilitate efforts at mobilisation resources needed and the training of the manpower required to make the above activities operational on a global scale.
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We report a case of a parturient with documented chronic Chagas' disease with cardiac manifestations presenting for labor management and complicated by the need for emergent hysterectomy after delivery. Chagas' disease is a common human hematogenous trypanosomiasis in Central and South America which is now, because of population migration, appearing in the USA. This disease predominantly affects the heart and the gastrointestinal system. This report discusses the parasite, the acute and chronic phases of Chagas' disease and highlights its medical implications, including maternal-fetal transfer of Trypanosoma cruzi.
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Journal of anesthesia · Mar 1996
Oral clonidine reduces thiamylal requirement for induction of anesthesia in adult patients.
Although preanesthetic clonidine, an α-2 agonist, is known to reduce anesthetic requirements, the effect of preanesthetic oral clonidine medication per se on the requirement of thiamylal in adult humans has not yet been examined. One hundred and sixty-one adult patients (14-78 years of age) were randomly assigned to groups that received oral clonidine (5μg·kg(-1) (n=51), 2.5μg·kg(-1) (n=55), or none (n=55)) in addition to 20mg oral famotidine 90min before anesthesia induction. ⋯ Thiamylal requirements were significantly less in both clonidine groups (2.95±0.09 and 3.14±0.10 mg·kg(-1) (mean±SE) for patients receiving 5μg·kg(-1) and 2.5μg·kg(-1) clonidine, respectively) than in the control group (3.81±0.11 mg·kg(-1),P<0.05); however, no difference was found between the two clonidine groups. Although mean blood pressure and heart rate during the study period were significantly lower in both clonidine groups than in the control group, no profound hypotension or marked bradycardia were noted in the clonidine groups.
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The effects of combined spinal administration of alpha(2)-adrenoceptor agonists, local anaesthetics, and opioids have been extensively studied. The motor and the sensory block of spinal and epidural anaesthesia is enhanced and prolonged by the combination of clonidine with the local anaesthetics lidocaine, tetracaine and bupivacaine. Because higher plasma levels of local anaesthetics were measured when clonidine was injected epidurally, the enhancement of the local anaesthetic's effect by clonidine is not due to slowed resorption, but rather to direct spinal and supraspinal effects of clonidine. ⋯ Despite the sedative properties of clonidine, there is no increased risk of respiratory depression when clonidine is given in combination with opioids. The inhibiting effect on the sympathetic nervous system activity regularly observed during spinal administration of clonidine supports the value of this therapy and will support its use in the future. Therefore, the combination of alpha(2)-adrenoceptor agonists with local anaesthetics or opioids is reasonable and may improve anaesthetic practice.