Erratum to "Measles outbreaks - potential threat for health care professionals" Infect Prev Pract, Volume 2, Issue 3, September 2020, 100074.

[This corrects the article DOI: 10.1016/j.infpip.2020.100074.].

Measles outbreaks - potential threat for health care professionals.

The ongoing spread of measles is a major concern for public health. Optimal vaccination coverage amongst health care professionals (HCP) is essential for individual protection. This is illustrated by our two cases of measles infection in HCP during the 2018 outbreak in Europe. We developed a questionnaire to assess protection against measles amongst HCP working in acute care of a tertiary hospital in The Netherlands. In total, 29% of these professionals were not protected against measles. During current worldwide measles outbreaks, it is paramount for employee health protection, patient protection and disease control to register and optimize employees' immunity.

[Incidence of ischemic lesions in diffusion-weighted imaging after transbrachial digital subtraction angiography]. / Inzidenz ischämischer Läsionen in der Diffusionsbildgebung nach transbrachialer digitaler Subtraktionsangiografie.

PURPOSE: To evaluate the frequency of ischemia after transbrachial digital subtraction angiography under ambulant conditions using diffusion-weighted imaging. MATERIALS AND METHODS: 200 patients were included in a prospective study design and received transbrachial digital subtraction angiography under ambulant conditions. Before and after digital subtraction angiography, diffusion-weighted imaging of the brain was performed. RESULTS: In our study population no new lesions were found in diffusion-weighted imaging after digital subtraction angiography during the 3-hour window after angiography. One new lesion was found 3 days after angiography as a late onset complication. Therefore, the frequency of neurological complications is at the level of the confidence interval of 0 - 1.5 %. CONCLUSION: The transbrachial approach under ambulant conditions is a safe method for digital subtraction angiography resulting in a low rate of ischemic lesions in diffusion-weighted imaging.

Infections in patients with immunodeficiency with thymoma (Good syndrome). Report of 5 cases and review of the literature.

Immunodeficiency with thymoma (Good syndrome, GS) is a rare, adult-onset condition that is characterized by thymoma, hypogammaglobulinemia, and low numbers of peripheral B cells. CD4+ T lymphopenia and an inverted CD4:CD8+ T-cell ratio may be present. Here we report 5 patients with GS and infectious complications who were seen at 3 institutions between 1983 and 1999. Three patients had recurrent sinopulmonary infections, 3 had severe cytomegalovirus (CMV) disease, and 1 had Pneumocystis carinii pneumonia. Review of the literature identified 46 other reports of infections in GS patients. The infections reported in all 51 patients included recurrent sinopulmonary infection (19 cases with documented respiratory pathogens), generally with encapsulated bacteria, most often Haemophilus influenzae (11 cases); CMV disease (5 cases); bacteremia (7 cases); oral or esophageal candidiasis (6 cases); persistent mucocutaneous candidiasis (5 cases); chronic diarrhea (5 cases with documented stool pathogens); urinary tract infections (4 cases); P. carinii pneumonia (3 cases); tuberculosis (2 cases); Kaposi sarcoma (1 case); disseminated varicella (1 case); candidemia (1 case); wound infection with Clostridium perfringens (1 case); Mycoplasma arthritis (1 case); and other infections. Patients with GS present with a spectrum of sinopulmonary infections and pathogens similar to common variable immunodeficiency (CVID). Compared with patients with CVID, opportunistic infections, including severe CMV disease, P. carinii pneumonia, and mucocutaneous candidiasis, appear to be more common in patients with GS, and patients with GS may have a worse prognosis. GS should be ruled out in patients with thymoma or CVID who develop severe, especially opportunistic, infections. Treatment with intravenous immune globulin is recommended for all patients with GS.

Immunologic study of systemic aspergillosis in German shepherd dogs.

Data are presented from a series of eight cases of disseminated canine aspergillosis (A. terreus) in German Shepherd dogs referred to Murdoch University Veterinary Hospital. Immunoglobulin determination revealed depression of serum IgA (cases 1 and 5) and IgM (case 2) levels and elevated levels of IgG in all cases. Total complement activity (CH50) and complement components tests, (C3, C4) were present in normal amounts in all cases. Using agar gel diffusion, serum antibody to A. terreus was found in only one case and aspergillus antigenaemia in two of the remainder. Lectin transformation of lymphocytes in two dogs was found to be depressed relative to normal controls in case 1 and initially in case 2. Two dogs failed to respond to the intradermal injection of A. terreus antigen.

[Grading of carotid artery stenosis using high resolution dynamic magnetic resonance angiography in comparison to intraarterial digital subtraction angiography. Are stenoses over 70% reliably detectable?]. / Graduierung von Karotisstenosen mittels hochaufgelöster dynamischer MR-Angiographie im Vergleich zur intraarteriellen DSA. Können Stenosen über 70% zuverlässig erkannt werden?

PURPOSES: Evaluation of high resolution dynamic magnetic resonance angiography (ceMRA) in detection and graduation of carotid artery stenosis in comparison to intraarterial digital subtraction angiography. MATERIALS AND METHODS: Magnetic resonance angiography and intraarterial digital subtraction angiography was performed in 65 patients with suspected carotid artery stenosis by ultrasound examination. Detection and graduation of carotid artery stenosis by magnetic resonance angiography were compared to those of intraarterial digital subtraction angiography after stenosis grading according to NASCET criteria. RESULTS: All magnetic resonance angiographies were of excellent quality, with 46 stenoses type I and II and 12 stenoses type III NASCET correctly identified and classified by magnetic resonance angiography. Overestimation was found in 4 cases and underestimation in 2 cases. Both modalities detected 13 occlusions. Sensitivity and specificity of ceMRA were 92%. The positive predictive value was 86% and the negative predictive value 96%. CONCLUSION: High resolution dynamic magnetic resonance angiography is suitable in detecting and classifying carotid artery stenoses over 70% with high sensitivity and specificity in comparison to intraarterial digital subtraction angiography. Intraarterial digital subtraction angiography should only be performed in critical cases.

Stabilization of atlantoaxial subluxation in the dog, using the nuchal ligament.

A technique for the stabilization of atlantoaxial subluxation in the dog was developed. The technique involved use of the nuchal ligament as a means of securing the spinous process of the axis to the dorsal arch of the atlas. Two cases were typical atlantoaxial subluxation in toy-breed dogs, and 2 cases were traumatic subluxation secondary to fracture of the axis in dogs of large breeds. On the basis of the results in these cases, it was concluded that the technique has advantages over techniques in which wire or nonmetallic suture material is utilized for stabilization.

Transbrachial angiography: an effective and safe approach.

BACKGROUND: Description of the technique of the transbrachial catheter diagnostics, retrospective evaluation of the technical success rate and the complications. PATIENTS AND METHODS: In a period of 8 years the transbrachial approach was used in 2555 patients, 1734 men and 821 women with an average age of 62.9 years. The investigation was done with outpatients in approximately 90% of the cases. Usually, the preferred arm was not punctured. For the diagnostics F4 and F5-catheter sheaths and selective catheter and/or plain catheters were used. RESULTS: 12 times (0.47%) the investigation did not succeed technically. The image quality of the vascular representations was diagnostically sufficient. The total complication rate amounted to 0.47%. The following complications appeared: four dissections in the site of puncture, one embolism into arteries at the forearm, three transitory ischemic attacks, four haematoma at the site of puncture. CONCLUSIONS: The transbrachial catheter diagnostics is a little invasive, efficient and low-risk method, which is practicable in out-patients.

The brachial artery as approach for catheter interventions--indications, results, complications.

BACKGROUND: Evaluation of the technical practicability of the acute results and complications with transbrachial catheter interventions. PATIENTS AND METHODS: Retrospective investigation of 156 catheter interventions with 147 patients within the period of 4/2000 to 12/2003. Target vessel, technical success, complications and in- or out-patient' practicability received special consideration. RESULTS: The intervention was technically successful in 94%, 10 times segment obliterations of the distal femoral artery could not be recanalised. Renal arteries and mesenteric arteries going off steeply, processes of the femoral bifurcation, bypass stenosis, bilateral distal vascular processes as well as difficult puncturable or not puncturable inguinal arteries are particularly suitable for transbrachial procedure. Three complications arose, two haematoma, conservatively treated, and one cerebrovascular insult. CONCLUSIONS: Many vascular processes can be treated without any problem by transbrachial approach. The technical success rates are very high. The interventions can be realized without hospitalisation of the patient, except for some special cases (renal arteries and mesenteric arteries). The complication rate is low, condition is a large experience of the examiner.

[Veno-occlusive dysfunction as a cause of erectile impotence: therapy of venous leak with retrograde embolization of the internal pudendal vein]. / Venookklusive Dysfunktion als Ursache der erektilen Impotenz: Therapie des venösen Lecks durch retrograde Embolisation der V. pudenda interna.

"Venous leak impotence" remains a therapeutic challenge as long term success rates with all interventions are only 50%. Surgical venous ligation is a well established procedure, yet not all pathological venous groups can always be occluded. Retrograde embolisation of angiographically identified pathological venous groups represent a promising alternative to surgical isolation and antegrad embolisation of deep dorsal penile veins. Four young men (19-42 years) presented with complete loss of erection. Vaginal intercourse was impossible. Pharmaco-duplex sonography with Prostaglandin E, 10-20 micrograms demonstrated normal arterial flow in all 4 penile arteries but even after intra-cavernosoal injection of Prostaglandin E, 20 micrograms no complete erection was achieved. Dynamic infusion cavernosometry showed increased maintenance flow. Cavernosography showed a venous leak involving the deep dorsal penile vein in all four cases. Embolisation was carried out via the femoral vein by coaxial technique using Histoacryl-Lipiodol solution in order to embolise all angiographically identified insufficient veins. At one year follow up all 4 patients still achieved spontaneous erections without any additional medical treatment.

[Stent PTA in secondary symptomatic proximal subclavian artery obstruction]. / Stent-PTA bei sekundär symptomatischen proximalen Subclaviaobstruktionen.

Stent-PTA of secondary symptomatic proximal subclavian artery stenosis In comparison with conventional surgical revascularisation, percutaneous transluminal angioplasty (PTA) is an alternative treatment for short stenoses or occlusions involving the origin of the subclavian artery. If there is clinical suspicion of subclavian artery obstruction (e.g. blood pressure difference in both arms), digital subtraction angiography of the aortic arch and upper limb should be performed prior to creating radial haemodialysis shunts or coronary bypass crafting involving the internal mammary artery. PTA and stenting can be successfully carried out in symptomatic secondary proximal subclavian artery stenosis, e.g. in radial haemodialysis fistulas with distal ischaemia.

Progressive tetraparesis and laryngeal paralysis in a young rottweiler with neuronal vacuolation and axonal degeneration: an Australian case.

A 5-month-old female Rottweiler dog was diagnosed to have a neurodegenerative disease that has been recently reported in Rottweilers from North America and Europe. The dog was presented with progressive signs of ataxia, tetraparesis and inspiratory stridor. The clinical investigation included analysis of CSF, radiography, myelography and electrophysiological testing. No evidence of vertebral malformation or inflammatory CNS disease was identified. Bilateral laryngeal paralysis was identified in the lightly anaesthetised dog. Electromyography showed abnormal spontaneous activity from the intrinsic musculature of the larynx. At necropsy there were no gross abnormalities of the nervous system but there was atrophy of the dorsal cricoarytenoid muscles of the larynx. There were widespread histological abnormalities throughout the nervous system including neuronal vacuolation, spongiform changes in the neuropil and axonal degeneration which was most prominent in the spinal cord. These clinical and pathological findings are consistent with the diagnosis of a new neurodegenerative disease reported from North America and Europe. This diagnosis is of particular significance in Australia where transmissible spongiform encephalopathies have not been identified.

Disseminated aspergillosis in dogs.

Clinical and pathological findings are reported from a series of 12 cases of disseminated aspergillosis (A. terreus) in 11 German Shepherd dogs and one Dalmatian referred to Murdoch University Veterinary Hospital (MUVH) over the period 1980 to 1984. A preliminary study of humoral and cell mediated immune components and complement levels revealed no consistent abnormality in 9 dogs tested apart from raised IgG levels. Serum IgA levels were depressed in 30% of cases. Serial data from one extensively monitored case is presented. The unusual epidemiological and pathogenetic features of the disease are discussed.

Effects of otitis on hearing in dogs characterised by brainstem auditory evoked response testing.

Hearing function was measured in normal dogs and in dogs with otitis using brainstem auditory evoked response testing. Data were obtained from 86 normal ears and from 105 ears with otitis, categorised into four degrees of severity. The data were analysed to illustrate the differences between the hearing function in the normal and abnormal ears and to estimate the degree of impairment associated with differing degrees of pathology. While severe hearing loss seemed to be present in the dogs with more severe otitis, only two individuals were identified as being totally deaf in the affected ears and no dogs were identified in which the cleaning and examination processes had caused damage to hearing function. Cleaning the ear canal produced measurable improvements in hearing in several dogs, indicating the profound effect of physical obstruction of the external ear canal by debris. It is concluded that most dogs with chronic otitis externa are not totally deaf and that the hearing impairment that does occur has the characteristics of conductive hearing loss.

Management of a femoral fracture complicated by clostridial myositis.

A clinical case of clostridial myositis secondary to a comminuted femoral fracture is described. This case is unusual because, despite the severe degree of obvious muscle necrosis and gas production, the dog had minimal signs of systemic toxicity. Union of the fracture was achieved but six months postoperatively muscular contracture had resulted in permanent stifle extension.