Ebola virus is transmitted to people as a result of direct contact with body fluids containing virus of an infected patient. The incubation period usually lasts 5 to 7 d and approximately95% of the patients appear sig...Ebola virus is transmitted to people as a result of direct contact with body fluids containing virus of an infected patient. The incubation period usually lasts 5 to 7 d and approximately95% of the patients appear signs within 21 d after exposure. Typical features include fever,profound weakness, diarrhea, abdominal pain, cramping, nausea and vomiting for 3-5days and maybe persisting for up to a week. Laboratory complications including elevated aminotransferase levels, marked lymphocytopenia, and thrombocytopenia may have occurred.Hemorrhagic fever occurs in less than half of patients and it takes place most commonly in the gastrointestinal tract. The symptoms progress over the time and patients suffer from dehydration, stupor, confusion, hypotension, multi-organ failure, leading to fulminant shock and eventually death. The most general assays used for antibody detection are direct IgG and IgM ELISAs and IgM capture ELISA. An IgM or rising IgG titer(four-fold) contributes to strong presumptive diagnosis. Currently neither a licensed vaccine nor an approved treatment is available for human use. Passive transfer of serum collected from survivors of Junin virus or Lassa virus, equine IgG product from horses hypervaccinated with Ebola virus, a "cocktail"of humanized-mouse antibodies(ZMapp), recombinant inhibitor of factor VIIa/tissue factor,activated protein C, RNA-polymerase inhibitors and small interfering RNA nano particles are among the therapies in development. Preclinical evaluation is also underway for various vaccine candidates. One is a chimpanzee adenovirus vector vaccine; other vaccines involve replication-defective adenovirus serotype 5 and recombinant vesicular stomatitis virus.展开更多
Background:Most children in need of cardiac pacemakers remain dependent on the function of the permanent from childhood to adulthood.We sought to evaluate and compare the function between epicardial and endocardial pa...Background:Most children in need of cardiac pacemakers remain dependent on the function of the permanent from childhood to adulthood.We sought to evaluate and compare the function between epicardial and endocardial pacemakers in pediatric groups with different conditions.Methods:Between 2012 and 2018,this single-canter study evaluated 44 pediatric patients with indications for epicardial or endocardial pacemakers.Results:The 2 groups,at a median age of 5(0.1–16)years,were compared concerning the characteristics of the leads used(n=80:bipolar,unipolar,steroid-eluting,and non–steroid-eluting),survival data,and complications.The reason for pacemaker implantation was congenital complete heart block in 11(25%)cases and postoperative heart block in 33(75%)cases.The commonest congenital heart disease accompanied by postoperative block was the ventricular septal defect.In the endocardial lead group,the mean ventricular pacing threshold immediately after the implantation and during the follow-up was less than that in the epicardial lead group(0.75 vs.0.81 V;P=0.01 and 0.8 vs.2.4 V;P=0.001).During the follow-up,the mean battery longevity was better in the endocardial group(last visit:6.7 endocardial vs.3.3 years epicardial).Lead failure was commoner in the epicardial pacemaker,and chronic high-pacing threshold pattern was seen in 14 patients in this group.After 3 years,freedom from lead failure was 94%and 63%in the endocardial and epicardial leads.Conclusions:Pacemakers with endocardial bipolar steroid-eluting leads showed better lead characteristics regarding survival and battery longevity than epicardial pacemakers without these lead characteristics.An appropriate pacemaker type should be selected based on the patient’s condition.展开更多
基金Supported by Iranian Research Center for HIV/AIDS(IRCHA)affiliated to Tehran University of Medical Sciences(Grant No.93-2-12)
文摘Ebola virus is transmitted to people as a result of direct contact with body fluids containing virus of an infected patient. The incubation period usually lasts 5 to 7 d and approximately95% of the patients appear signs within 21 d after exposure. Typical features include fever,profound weakness, diarrhea, abdominal pain, cramping, nausea and vomiting for 3-5days and maybe persisting for up to a week. Laboratory complications including elevated aminotransferase levels, marked lymphocytopenia, and thrombocytopenia may have occurred.Hemorrhagic fever occurs in less than half of patients and it takes place most commonly in the gastrointestinal tract. The symptoms progress over the time and patients suffer from dehydration, stupor, confusion, hypotension, multi-organ failure, leading to fulminant shock and eventually death. The most general assays used for antibody detection are direct IgG and IgM ELISAs and IgM capture ELISA. An IgM or rising IgG titer(four-fold) contributes to strong presumptive diagnosis. Currently neither a licensed vaccine nor an approved treatment is available for human use. Passive transfer of serum collected from survivors of Junin virus or Lassa virus, equine IgG product from horses hypervaccinated with Ebola virus, a "cocktail"of humanized-mouse antibodies(ZMapp), recombinant inhibitor of factor VIIa/tissue factor,activated protein C, RNA-polymerase inhibitors and small interfering RNA nano particles are among the therapies in development. Preclinical evaluation is also underway for various vaccine candidates. One is a chimpanzee adenovirus vector vaccine; other vaccines involve replication-defective adenovirus serotype 5 and recombinant vesicular stomatitis virus.
文摘Background:Most children in need of cardiac pacemakers remain dependent on the function of the permanent from childhood to adulthood.We sought to evaluate and compare the function between epicardial and endocardial pacemakers in pediatric groups with different conditions.Methods:Between 2012 and 2018,this single-canter study evaluated 44 pediatric patients with indications for epicardial or endocardial pacemakers.Results:The 2 groups,at a median age of 5(0.1–16)years,were compared concerning the characteristics of the leads used(n=80:bipolar,unipolar,steroid-eluting,and non–steroid-eluting),survival data,and complications.The reason for pacemaker implantation was congenital complete heart block in 11(25%)cases and postoperative heart block in 33(75%)cases.The commonest congenital heart disease accompanied by postoperative block was the ventricular septal defect.In the endocardial lead group,the mean ventricular pacing threshold immediately after the implantation and during the follow-up was less than that in the epicardial lead group(0.75 vs.0.81 V;P=0.01 and 0.8 vs.2.4 V;P=0.001).During the follow-up,the mean battery longevity was better in the endocardial group(last visit:6.7 endocardial vs.3.3 years epicardial).Lead failure was commoner in the epicardial pacemaker,and chronic high-pacing threshold pattern was seen in 14 patients in this group.After 3 years,freedom from lead failure was 94%and 63%in the endocardial and epicardial leads.Conclusions:Pacemakers with endocardial bipolar steroid-eluting leads showed better lead characteristics regarding survival and battery longevity than epicardial pacemakers without these lead characteristics.An appropriate pacemaker type should be selected based on the patient’s condition.
