The Experts below are selected from a list of 57 Experts worldwide ranked by ideXlab platform
Laura E Riley - One of the best experts on this subject based on the ideXlab platform.
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ebola virus Disease and Marburg Disease in pregnancy a review and management considerations for filovirus infection
Obstetrics & Gynecology, 2015Co-Authors: Lisa M Bebell, Laura E RileyAbstract:The largest-ever recorded outbreak of viral hemorrhagic fever is ongoing. Due to the epidemic and rural nature of outbreaks, little is published about the Filovirus infections Ebola virus Disease and Marburg Disease in pregnancy. This review of viral hemorrhagic fever focusing on Marburg and Ebola uses knowledge of Disease in non-pregnant individuals and pregnancy-specific data to inform management for pregnant women. Filovirus infection presentation is similar between pregnant and non-pregnant patients, though infections may be more severe in pregnancy. Although labeled as hemorrhagic fevers, Marburg and Ebola do not commonly cause gross bleeding and should be conceptualized as Diseases of high gastrointestinal losses. Early, aggressive supportive care is the mainstay of Filovirus infection management with massive fluid resuscitation as the key management principle. Patients often require 5–10 liters or more per day of intravenous or oral fluid to maintain circulating blood volume in the setting of ongoing gastrointestinal loss. Fluid shifts warrant aggressive monitoring and correction of potassium levels and acid-base disturbances to prevent life-threatening arrhythmias and metabolic complications. Regardless of maternal survival, fetal loss rates are nearly 100% in Filovirus infection, likely resulting from unchecked transplacental and hematogenous viral spread. High fetal loss rates support the placenta as a difficult-to-eradicate Filovirus infection reservoir. In conclusion, the management of Filovirus infection in pregnancy should focus on stabilizing the mother with intensive monitoring and aggressive fluid and electrolyte repletion, as well as maintaining strict infection control to minimize transmission to others.
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Ebola virus Disease and Marburg Disease in pregnancy: a review and management considerations for filovirus infection.
Obstetrics and gynecology, 2015Co-Authors: Lisa M Bebell, Laura E RileyAbstract:The largest-ever recorded outbreak of viral hemorrhagic fever is ongoing. As a result of the epidemic and rural nature of outbreaks, little is published about the Filovirus infections Ebola virus Disease and Marburg Disease in pregnancy. This review of viral hemorrhagic fever focusing on Marburg and Ebola uses knowledge of Disease in nonpregnant individuals and pregnancy-specific data to inform management for pregnant women. Filovirus infection presentation is similar between pregnant and nonpregnant patients, although infections may be more severe in pregnancy. Although labeled as hemorrhagic fevers, Marburg and Ebola do not commonly cause gross bleeding and should be conceptualized as Diseases of high gastrointestinal losses. Early, aggressive supportive care is the mainstay of Filovirus infection management with massive fluid resuscitation as the key management principle. Patients often require 5-10 L or more per day of intravenous or oral fluid to maintain circulating blood volume in the setting of ongoing gastrointestinal loss. Fluid shifts warrant aggressive monitoring and correction of potassium levels and acid-base disturbances to prevent life-threatening arrhythmias and metabolic complications. Regardless of maternal survival, fetal loss rates are nearly 100% in Filovirus infection, likely resulting from unchecked transplacental and hematogenous viral spread. High fetal loss rates support the placenta as a difficult-to-eradicate Filovirus infection reservoir. In conclusion, the management of Filovirus infection in pregnancy should focus on stabilizing the mother with intensive monitoring and aggressive fluid and electrolyte repletion as well as maintaining strict infection control to minimize transmission to others.
Lisa M Bebell - One of the best experts on this subject based on the ideXlab platform.
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ebola virus Disease and Marburg Disease in pregnancy a review and management considerations for filovirus infection
Obstetrics & Gynecology, 2015Co-Authors: Lisa M Bebell, Laura E RileyAbstract:The largest-ever recorded outbreak of viral hemorrhagic fever is ongoing. Due to the epidemic and rural nature of outbreaks, little is published about the Filovirus infections Ebola virus Disease and Marburg Disease in pregnancy. This review of viral hemorrhagic fever focusing on Marburg and Ebola uses knowledge of Disease in non-pregnant individuals and pregnancy-specific data to inform management for pregnant women. Filovirus infection presentation is similar between pregnant and non-pregnant patients, though infections may be more severe in pregnancy. Although labeled as hemorrhagic fevers, Marburg and Ebola do not commonly cause gross bleeding and should be conceptualized as Diseases of high gastrointestinal losses. Early, aggressive supportive care is the mainstay of Filovirus infection management with massive fluid resuscitation as the key management principle. Patients often require 5–10 liters or more per day of intravenous or oral fluid to maintain circulating blood volume in the setting of ongoing gastrointestinal loss. Fluid shifts warrant aggressive monitoring and correction of potassium levels and acid-base disturbances to prevent life-threatening arrhythmias and metabolic complications. Regardless of maternal survival, fetal loss rates are nearly 100% in Filovirus infection, likely resulting from unchecked transplacental and hematogenous viral spread. High fetal loss rates support the placenta as a difficult-to-eradicate Filovirus infection reservoir. In conclusion, the management of Filovirus infection in pregnancy should focus on stabilizing the mother with intensive monitoring and aggressive fluid and electrolyte repletion, as well as maintaining strict infection control to minimize transmission to others.
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Ebola virus Disease and Marburg Disease in pregnancy: a review and management considerations for filovirus infection.
Obstetrics and gynecology, 2015Co-Authors: Lisa M Bebell, Laura E RileyAbstract:The largest-ever recorded outbreak of viral hemorrhagic fever is ongoing. As a result of the epidemic and rural nature of outbreaks, little is published about the Filovirus infections Ebola virus Disease and Marburg Disease in pregnancy. This review of viral hemorrhagic fever focusing on Marburg and Ebola uses knowledge of Disease in nonpregnant individuals and pregnancy-specific data to inform management for pregnant women. Filovirus infection presentation is similar between pregnant and nonpregnant patients, although infections may be more severe in pregnancy. Although labeled as hemorrhagic fevers, Marburg and Ebola do not commonly cause gross bleeding and should be conceptualized as Diseases of high gastrointestinal losses. Early, aggressive supportive care is the mainstay of Filovirus infection management with massive fluid resuscitation as the key management principle. Patients often require 5-10 L or more per day of intravenous or oral fluid to maintain circulating blood volume in the setting of ongoing gastrointestinal loss. Fluid shifts warrant aggressive monitoring and correction of potassium levels and acid-base disturbances to prevent life-threatening arrhythmias and metabolic complications. Regardless of maternal survival, fetal loss rates are nearly 100% in Filovirus infection, likely resulting from unchecked transplacental and hematogenous viral spread. High fetal loss rates support the placenta as a difficult-to-eradicate Filovirus infection reservoir. In conclusion, the management of Filovirus infection in pregnancy should focus on stabilizing the mother with intensive monitoring and aggressive fluid and electrolyte repletion as well as maintaining strict infection control to minimize transmission to others.
Franchesca Fiorito Torres - One of the best experts on this subject based on the ideXlab platform.
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an extremely aggressive case of Marburg s Disease p2 373
Neurology, 2018Co-Authors: Jose Avilaornelas, Eduardo J Labat, Gishlaine Alfonso, Laura Surillo Dahdah, Carmen Serrano Ramos, Franchesca Fiorito TorresAbstract:Objective: To describe an extremely aggressive case of Marburg’s Disease Background: Marburg Disease is considered an aggressive variant of Multiple Sclerois(MS). Common symptoms include seizures, headache, ataxia and cortical signs. Brain MRI typically shows multifocal demyelinating lesions in typical MS locations but usually extensive with surrounding edema and contrast enhancement. Cerebrospinal fluid(CSF) is frequently negative. Mortality is high. Acute treatment is with IV steroids, plasma exchange and some cases were treated with immunosupressors. Design/Methods: 20 y/o post partum female with no prior medical history developed left sided hemiparesis, bilateral papilledema, headache and visual field defects. Brain MRI showed multiple foci of T2 signal intensity throughout the bilateral periventricular and subcortical white matter, more on the right some with incomplete peripheral enhancement, the largest measuring 1.7cm. CSF, MS panel and workup for differentials were negative, opening pressure was 22 cm/H20. She was treated with IV solumedrol for 5 days and discharged to start a Disease modifying therapy. 4 weeks later she worsened clinically; Brain MRI showed extensive short-term progression of lesions with confluence of active and inactive lesions and development of black holes, some lesions with Balo’s like aspect. Marburg variant of MS was considered. Now treated with IV solumedrol and 5 Plasma exchanges and started on levetiracetam due to seizures. She was started in Cyclophosphamide at dose of 15mg/kg every 2 months and discharged. She missed her second infusion and worsened clinically 2 weeks later. Brain MRI showed significant enlargement and development of confluence of lesions with right sided mass effect and persistent peripheral contrast enhancement. In view of aggressiveness of Disease she was started on higher dose Cyclophosphamide 1000mg/m2 with IV methylprednisolone monthly for 12 to 24 months. Results: NA Conclusions: This is a highly aggressive case with very fast progression in comparison to few published cases of Marburg’s Disease in a young female. Study Supported by: NA Disclosure: Dr. Avila-Ornelas has nothing to disclose. Dr. Surillo Dahdah has nothing to disclose. Dr. Labat has nothing to disclose. Dr. Alfonso has nothing to disclose. Dr. Serrano has nothing to disclose. Dr. Fiorito Torres has nothing to disclose.
Innocent B Rwego - One of the best experts on this subject based on the ideXlab platform.
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lowland grazing and Marburg virus Disease mvd outbreak in kween district eastern uganda
BMC Public Health, 2019Co-Authors: Aggrey Siya, D R Kugonza, William Bazeyo, Doreen Tuhebwe, Gabriel Tumwine, Arnold Ezama, Leonard Manirakiza, Innocent B RwegoAbstract:Uganda is one of the few countries in Africa that has been experiencing outbreaks of viral hemorrhagic fevers such as Ebola, Marburg and Crimean-Congo Hemorrhagic fevers. In 2017 Uganda experienced a Marburg Virus Disease (MVD) outbreak with case fatality rate of 100% in Kween district. Although hunting for wild meat was linked to the MVD outbreak in Kween district, less was reported on the land use changes, especially the changing animal grazing practices in Kween district. Through Makerere University One Health graduate fellowship program with attachment to Uganda Red Cross Society, a study was conducted among the agricultural communities to elucidate the risk behaviors in Kween district that can be linked to the 2017 Marburg Disease outbreak. Results show that although a few elderly participants ascribed fatal causes (disobedience to gods, ancestors, and evil spirits) to the MVD outbreak during FGDs, majority of participants linked MVD to settling in caves (inhabited by Fruit Bats) during wet season as upper belts are extensively used for crop production leaving little space for animal grazing. Members also noted side activities like hunting for wild meat during this grazing period that could have predisposed them to Marburg Virus. There is need to integrate One Health concepts within agricultural extension service provision in Uganda so as to enhance the management of such infectious Diseases.
Jose Avilaornelas - One of the best experts on this subject based on the ideXlab platform.
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an extremely aggressive case of Marburg s Disease treated with high dose cyclophosphamide a case report
Multiple sclerosis and related disorders, 2019Co-Authors: Jose Avilaornelas, Eduardo J Labat, Gishlaine Alfonso, Carmen Serrano, Franchesca FioritoAbstract:Background The acute, fulminant type of Multiple Sclerosis (MS), known as Marburg Disease, has been shown to have poor response to conventional acute treatments typically used for demyelinating Diseases. Methods We report a 20 y/o postpartum female who was consulted to the Neurology service given findings of subacute left sided hemiparesis, left homonymous hemianopsia and bilateral papilledema. Extensive workup, including Brain and Cervical spine MRI with and without gadolinium, blood work, CSF studies, in addition to her rapid clinical decline, were highly suggestive of the demyelinating variant of Multiple Sclerosis known as Marburg Disease. After excluding other possible diagnosis, she was treated with IV corticosteroids and plasma exchange therapy with poor response. She was then started on monthly high dose cyclophosphamide therapy. Results Clinical and radiological improvement was present with initiation of cyclophosphamide therapy in this refractory variant of MS. Conclusion Our findings suggest that cyclophosphamide may be a therapeutic alternative to induce clinical and radiological improvement in Marburg Disease.
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an extremely aggressive case of Marburg s Disease p2 373
Neurology, 2018Co-Authors: Jose Avilaornelas, Eduardo J Labat, Gishlaine Alfonso, Laura Surillo Dahdah, Carmen Serrano Ramos, Franchesca Fiorito TorresAbstract:Objective: To describe an extremely aggressive case of Marburg’s Disease Background: Marburg Disease is considered an aggressive variant of Multiple Sclerois(MS). Common symptoms include seizures, headache, ataxia and cortical signs. Brain MRI typically shows multifocal demyelinating lesions in typical MS locations but usually extensive with surrounding edema and contrast enhancement. Cerebrospinal fluid(CSF) is frequently negative. Mortality is high. Acute treatment is with IV steroids, plasma exchange and some cases were treated with immunosupressors. Design/Methods: 20 y/o post partum female with no prior medical history developed left sided hemiparesis, bilateral papilledema, headache and visual field defects. Brain MRI showed multiple foci of T2 signal intensity throughout the bilateral periventricular and subcortical white matter, more on the right some with incomplete peripheral enhancement, the largest measuring 1.7cm. CSF, MS panel and workup for differentials were negative, opening pressure was 22 cm/H20. She was treated with IV solumedrol for 5 days and discharged to start a Disease modifying therapy. 4 weeks later she worsened clinically; Brain MRI showed extensive short-term progression of lesions with confluence of active and inactive lesions and development of black holes, some lesions with Balo’s like aspect. Marburg variant of MS was considered. Now treated with IV solumedrol and 5 Plasma exchanges and started on levetiracetam due to seizures. She was started in Cyclophosphamide at dose of 15mg/kg every 2 months and discharged. She missed her second infusion and worsened clinically 2 weeks later. Brain MRI showed significant enlargement and development of confluence of lesions with right sided mass effect and persistent peripheral contrast enhancement. In view of aggressiveness of Disease she was started on higher dose Cyclophosphamide 1000mg/m2 with IV methylprednisolone monthly for 12 to 24 months. Results: NA Conclusions: This is a highly aggressive case with very fast progression in comparison to few published cases of Marburg’s Disease in a young female. Study Supported by: NA Disclosure: Dr. Avila-Ornelas has nothing to disclose. Dr. Surillo Dahdah has nothing to disclose. Dr. Labat has nothing to disclose. Dr. Alfonso has nothing to disclose. Dr. Serrano has nothing to disclose. Dr. Fiorito Torres has nothing to disclose.