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Biomedical subjects

Henry Wilde

Publications and source records attributed to Henry Wilde.

At least 37 records · Page 2Linked to original sources
PubMed2005

Pathophysiology of human paralytic rabies.

Furious rabies is a well-recognized clinical disorder in humans but the paralytic form is not as easily identified. The mechanisms responsible for the weakness and longer survival periods are not clear. Several hypotheses have been proposed, including rabies virus variants associated with a particular vector, location of wounds, incubation period, influence of prior rabies vaccination, and virus localization in the central nervous system (CNS). However, none of these have been substantiated. Regarding molecular analyses of rabies viruses isolated from both furious and paralytic rabies patients, only minor genetic variations with no specific patterns in glyco- (G), phospho- (P), and nucleoprotein (N) sequences have been identified and arginine 333 in G protein was present in all samples. Regional distribution of rabies virus antigenin rabies patients whose survival periods were 7 days or less and magnetic resonance imaging (MRI) of the CNS indicated brainstem and spinal cord as predilection sites regardless of clinical presentations. There are clinical, electrophysiological, and pathological indications that peripheral nerve dysfunction is responsible for weakness in paralytic rabies whereas in furious rabies, even in the absence of clinical weakness, abundant denervation potentials with normal sensory nerve conduction studies and proximal motor latencies suggest anterior horn cell dysfunction. The lack of cellular immunity to rabies virus antigen accompanied by an absence of cerebrospinal fluid (CSF) rabies neutralizing antibody in most paralytic rabies patients may argue against role of an immune response against rabies virus-positive axons. Aberrant immune responses to peripheral nerve antigen, in particular those mediated by one or more cellular-dependent mechanisms, may be involved as is supported by the absence of putative anti-ganglioside antibodies commonly found in immune-mediated peripheral nerve diseases. Longer survival period in paralytic rabies may possibly be related to currently unidentified mechanism(s) on neuronal gene expression, required for virus transcription/replication and for maintaining neuronal survival.

Animals↗
PubMed2005

A study of Thai cobra (Naja kaouthia) bites in Thailand.

This study evaluated factors affecting the severity of bite site necrosis and systemic symptoms resulting from envenomation among patients bitten by Thai cobras (Naja kaouthia) in Thailand. We studied 45 victims prospectively. An additional 40 medical records were obtained for a retrospective study. Collected data included gender of the victims, anatomic locations of bites, where attacks took place, and predisposing factors and how they might have affected the clinical course. Most patients were asymptomatic or mildly symptomatic. Neurotoxic symptoms and respiratory failure developed in 31.11% and 12.50% in the prospective and retrospective groups, respectively. Only one patient died, from the effects of prolonged respiratory failure. There was some degree of tissue necrosis at the bite site for almost all victims. One victim required amputation of a digit in the retrospective study, and 33.60% of the prospective group and 20% of the retrospective group required minor surgical debridement. Snakebites in Thailand are still a public health problem, although rapid urbanization has decreased the number of victims because of degradation of the snake's habitat.

Animals↗
PubMed2005

A study of 225 Malayan pit viper bites in Thailand.

This study evaluated factors affecting the severity of bite site necrosis and systemic symptoms resulting from envenomation among patients bitten by Malayan pit vipers (Calloselasma rhodostoma) in Thailand. We studied 145 victims prospectively. An additional 80 medical records were obtained for a retrospective study. Collected data included gender of the victims, anatomic locations of bites, where attacks took place, and predisposing factors and how they might have affected the clinical course. Most patients presented with minimal to moderate symptoms. Only eight patients required surgical wound debridement. None required amputation. However, 27 subjects developed permanently swollen limbs, presumably because of lymphatic or vascular injury. Significant coagulopathies were common (52.48%), and the only two deaths were attributable to intracranial hemorrhage. The improved clinical outcomes in the prospective and retrospective groups, compared with older series, might have been attributable to better public education, improved road infrastructure, and more health care facilities. Less reliance on nonprofessional healers and fewer applications of tourniquets also might have influenced clinical outcomes. Malayan pit viper antivenin, manufactured in Thailand, appears to be effective in reversing dangerous coagulopathies.

Adult↗
PubMed2005

Six criteria for rabies diagnosis in living dogs.

OBJECTIVE: The authors studied the predictive value of six criteria for clinical diagnosis of rabies in living dogs. DESIGN: Identify and test the criteria in a retrospective and prospective study. MATERIAL AND METHOD: Both studies were conducted at the Rabies Diagnostic Unit, Queen Saovabha Memorial Institute, Thai Red Cross Society, Bangkok. The authors reviewed 1,170 dogs that were kept under observation for 10 days after they exhibited abnormal behavior. To test the predictive value of the six criteria, a prospective study involving 450 rabies suspected dogs was also performed. RESULTS AND CONCLUSION: The six criteria demonstrated 90.2% sensitivity, 96.2% specificity and 94.6% accuracy for the clinical diagnosis of rabies. They can be used for a presumptive diagnosis and may help in prioritizing post-exposure treatments and institute urgent rabies control measures.

Animals↗
PubMed2005

Enteric fever-like illness caused by infection with citrobacter amalonaticus.

'Enteric fever' is a potentially fatal, severe systemic disease, which is encountered worldwide. Traditionally, enteric fever refers to a bacteremic illness caused by members of certain Salmonella serotypes, notably: Salmonella typhi, a Gram-negative bacterium, and to a lesser extent, Salmonella paratyphi A, B and C. In addition, other non-salmonella organisms may produce a syndrome clinically indistinguishable from "enteric fever". Brucella sp., Campylobacter sp., Edwardsiella tarda, Enterobacter Cloacae, Escherichia coli, Klebsiella pneumoniae, Providencia alcalifaciens, Pseudomonas sp., Serratia marcescens, Francisella sp. and Yersinia pp have been identified in enteric fever This is, to the best of the authors' knowledge, the first case of Citrobacter to be reported presenting as enteric fever in a normal host in Thailand.

Citrobacter↗
PubMed2005

Intratesticular injection of a balanced zinc solution for permanent sterilization of dogs.

Five male mature dogs with normal sex organs and normal pre-study semen evaluation received intratesticular injections of a sterile solution of balanced zinc gluconate. Semen without sperm could be collected on days 26, 30, 35 and 51 from 4 dogs. The dogs achieved penile erection but no ejaculation before these days. There were no significant adverse effects and no change in the dog behavior during the time that they were observed. Histopathological findings documented virtually complete fibrosis of seminiferous tubules and Leydig cells on days 60 and 75. This preliminary study concludes that balanced zinc gluconate may be used to sterilize dogs.

Animals↗
PubMed2004

Survival of naturally infected rabid dogs and cats.

A total of 1820 dogs and 332 cats that appeared ill or had bitten humans or animals were observed for >or=10 days. Of these, 957 dogs and 94 cats that were confirmed to be rabid survived <10 days after admission to our institution. This study supports current recommendations that dogs and cats that are suspected of being rabid should be euthanized and examined or, if this is inappropriate, confined and observed for 10 days.

Animals↗
PubMed2004

Balamuthia mandrillaris meningoencephalitis: the first case in southeast Asia.

We present a case of 23-year-old man with acute meningoencephalitis, accompanied by inflammation of a nasal ulcer. He had been healthy until six months prior to admission to the hospital when he had a motorcycle accident. A star-shaped wound at his nose was incurred after falling into a swamp. A computed tomogram of the brain showed two nonenhancing hypodense lesions at the left caudate nucleus and the right parietal lobe, ependymitis and leptomeningeal enhancement. A skin biopsy showed chronic noncaseous granulomatous inflammation without demonstrated microorganisms. The patient did not respond to the empirical treatment with cloxacillin, ceftriaxone, and amphotericin B, and eventually died on the thirteenth day of hospitalization. At autopsy, hematoxylin and eosin-stained brain sections showed a chronic necrotizing inflammation with numerous amebic trophozoites and rare cysts. Definitive identification of Balamuthia mandrillaris was made by fluorescent immunohistochemical analysis. There were 10 Naegleria fowleri primary amebic meningoencephalitis, eight Acanthamoeba granulomatous amebic encephalitis, and three Acanthamoeba meningitis in Thailand. To our knowledge, this case is the first reported case of B. mandrillaris in Southeast Asia.

Adult↗
PubMed2004

Hydatid disease of the liver: the first indigenous case in Thailand and review of the literature.

The authors describe the first indigenous case of hepatic hydatid disease in Thailand. A 58-year-old female presented with progressive right upper quadrant abdominal discomfort over a 6-month period. Ultrasonography and computed tomography showed a solitary cystic lesion 11 x 12 x 13 centimeter in size at the left lobe of the liver. She had never been abroad and had no livestock exposure. The first operation was complicated by spillage of the parasite which required a combination of albendazole and praziquantel and a second operation for intracystic instillation of hypertonic saline solution. Unfortunately, uncontrolled generalized seizures developed due to severe hypernatremia. She never regained consciousness and expired 3 weeks after admission. In addition, the authors also reviewed previous reports of hydatid disease in Thailand. To date, only 9 cases have been reported since 1932.

Echinococcosis, Hepatic↗
PubMed2004

Paradigm shift in rabies control: a system approach.

Government centered approach in rabies prevention and control has not led to rabies safe community, both in urban and rural areas. Government services and organizations should recognize that only joint collaboration among households and community can lead to a successful rabies control mission. Dog owners should have been more actively involved in the prevention and solving of rabies problem. Promotion and support of government organizations should aim to strengthen the communities to become self reliance in diseases control and health care services. Only by strengthening community roles result in a more sustainable community disease control program.

Animals↗
PubMed2004

The rabies epidemic on Flores Island, Indonesia (1998-2003).

Flores is an isolated previously rabies-free Indonesian island which has been experiencing a canine rabies outbreak which resulted in at least 113 human deaths. It started with the importation of three dogs from rabies endemic Sulawesi in September of 1997. Local authorities responded with massive killing of dogs starting in early 1998. Approximately 70% of the dogs, in the district where rabies had been introduced, were killed during that year, yet canine rabies still exists on Flores at this time (June 2004). Approximately 50 percent of dog bite cases and human deaths were in children under 15 years of age. Between 1998 and the end of 2002, 3,389 post-exposure rabies treatments were provided and none of the treated subjects died. Almost all patients were given the Thai Red Cross intradermal rabies postexposure treatment regimen using tissue culture rabies vaccine. A small but unknown number of patients with very severe exposures also received equine rabies immune globulin. This occurrence indicates that even massive culling of the dog population, without an intensive vaccination campaign of the survivors, will not arrest an outbreak even if it occurs on a small island.

Animals↗
PubMed2004

Streptococcus suis meningitis in Thailand.

Streptococcus suis may be the second most common cause of adult streptococcal meningitis. The clinical and epidemiological data of S. suis meningitis are occasionally reviewed. To date, there have been only two large case series from Hong Kong and the Netherlands. We describe twelve cases of S. suis meningitis who were admitted to Chulalongkorn University Hospital, Bangkok, during a 6-year period between 1997 and 2002. A comparative review of case reports of S. suis meningitis in Thailand, Hong Kong, and the Netherlands is presented and revealed no significant differences between the three series. However, the cases from Thailand and Hong Kong had a significantly greater number of associated skin and soft tissue infections. Clinically, S. suis meningitis may appear acute or with a more chronic course.

Adult↗
PubMed2003

Rabies in a Thai child treated with the eight-site post-exposure regimen without rabies immune globulin.

We report the case of a 7-year-old Thai girl that was bitten by a dog. She received prompt wound care followed by eight-site intradermal post-exposure rabies schedule using purified chick embryo vaccine. Treatment followed WHO recommendations for desperate situations where no rabies immune globulin (RIG) is available. The patient died 15 days later with classical symptoms and signs of encephalitic rabies.

Animals↗
PubMed2003

Rabies update for travel medicine advisors.

Rabies is a neglected disease in many developing countries. It is preventable, and the tools to prevent it are known. There is urgent need for more funding, for study of innovative dog population-control measures, and for sustainable canine immunization. Safe and effective tissue-culture rabies vaccines and human and equine rabies immunoglobulins (HRIG and ERIG) are not readily available in many regions where rabies is endemic. This and the continuing presence and spread of rabies have increased the risk for travelers, who cannot rely on being able to receive optimal postexposure treatment in many parts of the world. Alternatives to HRIG or ERIG are not available. Travelers who leave the safe environments of tourist hotels and buses in regions of Asia, Russia, Africa, and Latin America where canine rabies is endemic may be at risk of life-threatening exposure to rabies.

Animals↗