Tetanus - A case report and literature review

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open Allur texti - Full textA 79 year old farmer was referred to the University Hospital with a three days history of difficulty in opening his mouth. On examination, both masseters were seen to be stiff, suggesting tetanus or jaw-subluxation. An attempt to reduce the joint was made, but failed. He subsequently developed progressive respiratory difficulties requiring intubation. The farmer had recently cut his finger on barbed wire. He had not received tetanus immunization for years and it was not clear whether primary immunization had been completed. Tetanus immunoglobulin and antibiotics were administered. He proceeded to develop autonomic instability and critical illness polyneuropathy requiring 45 days of ICU care. He was finally discharged eight months later. The farmer has gradually improved and is now living unaided at home. In this article we will review this case and the literature on tetanus. Correspondence: Albert Pall Sigurdsson, [email protected] Key words: Tetanus, case report.79 ára bónda var vísað á Landspítala þar sem hann hafði ekki getað opnað munninn í þrjá daga. Við skoðun voru tyggingarvöðvar spenntir. Talið var að þetta væri stífkrampi eða los á kjálkaliði. Reynt var að setja hann í lið án árangurs. Síðar bar á öndunarörðugleikum sem ágerðust. Bóndinn fór á gjörgæslu í öndunarvél. Hann hafði stungið sig í fingur á gaddavír við landbúnaðarstörf nokkru áður. Hann hafði ekki fengið stífkrampabólusetningu í mörg ár og óljóst var um grunnbólusetningu. Gefið var stífkrampa-ónæmisglóbúlín og sýklalyf. Síðar fékk hann truflun á ósjálfráða taugakerfinu auk gjörgæslu-úttaugameins. Hann lá 45 daga á gjörgæslu og útskrifaðist heim eftir 8 mánaða legu. Ástandið hefur lagast og er hann nú að mestu leyti sjálfbjarga. Í greininni er farið yfir tilfellið og gefið yfirlit yfir stífkrampa

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Histologic and bacteriologic findings in valvular endocarditis of slaughter-age pigs

Endocarditis lesions from 117 slaughter pigs were examined pathologically and etiologically in addition to 90 control hearts with cardiac valves. Lesions were located on the valves; however, the lesions had extended to the walls in 21 cases (18%). Lesions predominated on the mitral valve (59%). A total of 28 cases, from which no growth was obtained or a contamination flora was grown, were screened by fluorescence in situ hybridization (FISH) for bacteria (general bacterial probe) and probes specific for Streptococcus suis and Erysipelothrix rhusiopathiae, respectively. Using FISH, an additional 10 cases of endocarditis due to S. suis and E. rhusiopathiae were disclosed. Within lesions, streptococci predominated (53%) followed by E. rhusiopathiae (30%). Distinct features of both the lesions and the shape and localization of bacterial colonies were related to streptococci and E. rhusiopathiae. The propensity for streptococci to be localized on more than 1 valve in single hearts may be because S. suis–infected pigs tend to have been infected for a longer period compared with E. rhusiopathiae. Mineralization of endocarditis lesions was significantly associated with infection by streptococci, and was seen in 71% of the cases, whereas it was present in only 28% of lesions caused by E. rhusiopathiae. In addition, areas with mineralization were significantly correlated to the presence of a granulomatous reaction. Granulomatous endocarditis is likely a result of a foreign body reaction due to dystrophic mineralization. Local proliferation of valvular endothelial cells, found in 9 hearts in the current study, may increase the risk of developing thrombosing endocarditis in pigs. </jats:p

Tackling Exascale Software Challenges in Molecular Dynamics Simulations with GROMACS

GROMACS is a widely used package for biomolecular simulation, and over the last two decades it has evolved from small-scale efficiency to advanced heterogeneous acceleration and multi-level parallelism targeting some of the largest supercomputers in the world. Here, we describe some of the ways we have been able to realize this through the use of parallelization on all levels, combined with a constant focus on absolute performance. Release 4.6 of GROMACS uses SIMD acceleration on a wide range of architectures, GPU offloading acceleration, and both OpenMP and MPI parallelism within and between nodes, respectively. The recent work on acceleration made it necessary to revisit the fundamental algorithms of molecular simulation, including the concept of neighborsearching, and we discuss the present and future challenges we see for exascale simulation - in particular a very fine-grained task parallelism. We also discuss the software management, code peer review and continuous integration testing required for a project of this complexity.Comment: EASC 2014 conference proceedin

Phenotypic and genetic characterization of a novel phenotype in pigs characterized by juvenile hairlessness and age dependent emphysema

<p>Abstract</p> <p>Background</p> <p>A pig phenotype characterized by juvenile hairlessness, thin skin and age dependent lung emphysema has been discovered in a Danish pig herd. The trait shows autosomal co-dominant inheritance with all three genotypes distinguishable. Since the phenotype shows resemblance to the integrin β₆-/- knockout phenotype seen in mice, the two genes encoding the two subunits of integrin α_vβ₆, i.e. <it>ITGB6 </it>and <it>ITGAV</it>, were considered candidate genes for this trait.</p> <p>Results</p> <p>The mutated pig phenotype is characterized by hairlessness until puberty, thin skin with few hair follicles and absence of <it>musculi arrectores pili</it>, and at puberty or later localized areas of emphysema are seen in the lungs. Comparative mapping predicted that the porcine <it>ITGB6 </it>and<it>ITGAV </it>orthologs map to SSC15. In an experimental family (n = 113), showing segregation of the trait, the candidate region was confirmed by linkage analysis with four microsatellite markers. Mapping of the porcine <it>ITGB6 </it>and <it>ITGAV </it>in the IMpRH radiation hybrid panel confirmed the comparative mapping information. Sequencing of the <it>ITGB6 </it>and <it>ITGAV </it>coding sequences from affected and normal pigs revealed no evidence of a causative mutation, but alternative splicing of the <it>ITGB6 </it>pre-mRNA was detected. For both <it>ITGB6 </it>and <it>ITGAV </it>quantitative PCR revealed no significant difference in the expression levels in normal and affected animals. In a western blot, ITGB6 was detected in lung protein samples of all three genotypes. This result was supported by flow cytometric analyses which showed comparable reactions of kidney cells from affected and normal pigs with an integrin α_vβ₆monoclonal antibody. Also, immunohistochemical staining of lung tissue with an integrin β₆antibody showed immunoreaction in both normal and affected pigs.</p> <p>Conclusion</p> <p>A phenotype resembling the integrin β₆-/- knockout phenotype seen in mice has been characterized in the pig. The candidate region on SSC15 has been confirmed by linkage analysis but molecular and functional analyses have excluded that the mutated phenotype is caused by structural mutations in or ablation of any of the two candidate genes.</p