Neonatal CD8(+) T-cell activation is significantly impaired compared with that in adults. Recent studies have demonstrated that interleukin (IL)-12 is necessary as a third signal, in addition to antigen and co-stimulation, to authorize the differentiation of naive CD8(+) T cells. We examined whether human neonatal CD8(+) T cells, which possess an exclusively naive T-cell phenotype, required a third signal to authorize a productive T-cell response.
View Article and Find Full Text PDFJ Stroke Cerebrovasc Dis
November 2011
Bicuspid aortic valve (BAV) is a common condition but is only rarely associated with embolic complications. We describe a 42-year-old man with recurrent posterior circulatory ischemic strokes that resulted in ataxia and cognitive impairment. Transesophageal echocardiography demonstrated a BAV with mild stenosis, moderate calcification, and a dilated ascending aorta.
View Article and Find Full Text PDFClin Neurol Neurosurg
January 2010
Objective: Neurologists working in district general hospitals (DGHs) in the UK frequently rely on neuroimaging reports from general radiologists. Neuroradiologists and general radiologists may disagree in the interpretation of magnetic resonance imaging and computerized tomographs of brain and spine. We sought to analyse disagreements between reports from general radiologists and neuroradiologists in selected patients and to examine the impact of a four-point quality-improvement program in a DGH neuroimaging reporting service.
View Article and Find Full Text PDFThe emergence of a novel strain of influenza virus A (H1N1) in April 2009 focused attention on influenza surveillance capabilities worldwide. In consultations before the 2009 outbreak of influenza subtype H1N1, the World Health Organization had concluded that the world was unprepared to respond to an influenza pandemic, due in part to inadequate global surveillance and response capacity. We describe a sentinel surveillance system that could enhance the quality of influenza epidemiologic and laboratory data and strengthen a country's capacity for seasonal, novel, and pandemic influenza detection and prevention.
View Article and Find Full Text PDFBackground: An accurate estimate of the total number of cases and severity of illness of an emerging infectious disease is required both to define the burden of the epidemic and to determine the severity of disease. When a novel pathogen first appears, affected individuals with severe symptoms are more likely to be diagnosed. Accordingly, the total number of cases will be underestimated and disease severity overestimated.
View Article and Find Full Text PDFAim: This paper is a report of a literature review conducted to analyse data from published studies reporting nursing interventions targeted at older attendees of emergency departments (EDs), and to provide a critical appraisal of the evidence concerning their effectiveness.
Background: Attendance at hospital EDs by older persons presents opportunities for targeted interventions to address actual and potential problems associated with or in addition to the presenting problem. The evidence concerning the effectiveness of such interventions is mixed.
Highly pathogenic avian influenza H5N1 virus was detected in poultry seized at two ports of entry located in Lang Son Province, Vietnam. Sequence analysis of the hemagglutinin (HA) genes from five H5N1 virus isolates and ten PCR amplicons from chicken cloacal samples revealed their close phylogenetic relationship to clade 7 H5N1 HA genes. However, these HA genes exhibited extensive genetic divergence at both the nucleotide and amino acid levels in comparison to previously described clade 7 viruses; e.
View Article and Find Full Text PDFIn conditions of optimal priming, the neonate possesses competency to mount quantitatively adult-like responses. Vaccine formulations containing sufficiently potent adjuvants may overcome the neonate's natural tendency for immunosuppression and provoke a similarly robust immune response. TLR expression on T cells represents the possibility of directly enhancing T cell immunity.
View Article and Find Full Text PDFAim: This article presents the core concept of 'visible-ness' that emerged from an ethnographic study, which explored the nature of communication, for children (for ease of reading children refers to children and young people), admitted to a children's hospital in the Republic of Ireland.
Background: The importance of engaging with both child and family has been espoused as fundamental in promoting 'family'-centred care. To date, studies have almost exclusively explored parents' and nurses' perspectives of the nature of parent participation and nurse-parent interactions and relationships.
School closure is a proposed strategy for reducing influenza transmission during a pandemic. Few studies have assessed how families respond to closures, or whether other interactions during closure could reduce this strategy's effect. Questionnaires were administered to 220 households (438 adults and 355 children) with school-age children in a North Carolina county during an influenza B virus outbreak that resulted in school closure.
View Article and Find Full Text PDFThe frequency of adherence to the UK Driver and Vehicle Licensing Authority (DVLA) guidelines for patients referred to a neurovascular clinic is not known. Of 166 consecutive patients, 95 (57.2%) had a group 1 licence and 71 (42.
View Article and Find Full Text PDFPosterior reversible encephalopathy syndrome caused by hypertension is well recognized with magnetic resonance imaging. We report a patient in whom posterior reversible encephalopathy syndrome involved just the brainstem, caused a pontine stroke, and subsequently both clinically and radiologically improved with antihypertensive therapy.
View Article and Find Full Text PDFBackground: Stroke units and thrombolysis are evidence based treatments for stroke patients. Few studies have prospectively assessed the success of, and obstacles to implementation of such strategies in patients admitted to district general hospitals.
Objective: To document delays in admissions of acute stroke patients to hospital, failures in accessing a stroke unit and the clinical impact of missed opportunities for intervention in acute stroke patients.
Objective: To analyse outcome of surgical management of aneurysms unsuitable for endovascular intervention in a tertiary referral neurosurgical unit over a 5-year post-ISAT period. To compare secondary parameters such as operating time, number of clips required, and training over last 5 years with similar number of patients in the pre-ISAT period.
Methods: Consecutive 54 patients harbouring 62 uncoilable aneurysms admitted from May 2002 to April 2007 in a tertiary neurosurgical unit.
Objective: To compare high-resolution ultrasound (HRUS) with conventional radiography in the detection of erosions in the first metatarsophalangeal joints (1st MTPJs) of patients with gout and to identify the characteristic sonographic features of gout.
Methods: HRUS examination of the 1st MTPJs of both feet was performed by two independent sonographers. The presence of joint and soft-tissue pathology was recorded.
Background: The natural history and triggers of perihaematomal oedema (PHO) remain poorly understood. Cerebral amyloid angiopathy (a common cause of lobar haemorrhage) has localised anticoagulant and thrombolytic properties, which may influence PHO. We hypothesised that early (within 24 hours) oedema to haematoma volume ratios are smaller in patients with lobar intracerebral haemorrhage (ICH) than in patients with deep ICH.
View Article and Find Full Text PDFBackground: An increasing number of neurologists in District General Hospitals (DGHs) rely on local neuroimaging reports from general radiologists.
Aim: To determine the level of disagreement between general radiologists and neuroradiologists in reporting neuroimaging from patients referred to a neurologist.
Design: Prospective observational study.
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