HV-3 strain has no long-term effects, but precautions must be taken to prevent secondary infectionIn recent weeks, at least six cases of equine genital herpes have been reported at no fewer than three Kentucky farms, and the outbreak has prompted concerns over the diseases short-term and long-term effects on stallions and broodmares. The good news is that, unlike human genital herpes, the equine version is not a lifelong condition. It does, however, require immediate attention to prevent its spread and secondary infections.
Equine genital herpesvirus is a sexually transmitted disease that can be identified by the appearance of lesions on the shaft of the stallions penis. In the mare, it is commonly observed as a vaginal discharge. The disease is contracted by direct genital contact with an infected animal or contaminated breeding equipment.
Because it is a virus and not a bacteria, the disease is not detectable through a culture, so even a mare who comes to the breeding shed bearing a health certificate and clean culture may be carrying the virus.
Coital exanthema, its veterinary name, is classified as equine herpesvirus-3 (EHV-3). Unlike other strains of equine herpesvirus, genital herpes does not cause abortion or produce respiratory or neurological problems. Incubation period for the virus is five to seven days, with symptoms appearing about a week after exposure.
Small blisters first appear on the penis, which generally go unnoticed. The blisters progress to lesions, which then erode as sores, much like human cold sores, with a diameter of 2 millimeters (mm) to 3 mm. The lesions rapidly advance to ulcers or pustules between 5 mm to 10 mm in diameter, which are painful to the touch.
Contagious period
The stallion is contagious during the period of time when the lesions are visible, and the disease cannot be transmitted after the ulcers heal. In mares, lesions are obscure, and the vaginal discharge they produce is often presumed to be caused by a bacteria or fungus. When a culture comes back negative, the discharge is usually dismissed as inconsequential. This is typically the point when transmission occurs, with the mare sent to the breeding shed presumed to be clean.
As the virus progresses, the horses immune system develops a resistance to the disease, and symptoms begin to dissipate.
From the first exposure, the disease should fully run its course in two-to-three-weeks. However, secondary bacterial infections in the stallion can produce mucopurulent exudate (running sores) from the lesions, which complicates treatment and prolongs recovery time.
Veterinarians recommend application of a topical antibiotic to the emerging sores to prevent secondary bacterial infections in the stallion from setting in, but, because the disease is self-limiting and a virus, no other treatment is generally prescribed. Once called horse pox or spots, genital herpes leaves the stallion with telltale, unpigmented spots where the lesions occurred.
Laboratory testing is available to confirm the diagnosis of EHV-3 through cytological smears of affected skin cells of the penis but, because the virus is short-lived and inconsequential, the time and expense involved in testing is rarely warranted.
EHV-3 is different from human genital herpesvirus in that, once it runs its course, it leaves no lasting effects, nor is it a disease that infects the animal for life. Other than suspending the horses breeding activity during the period of contagion, the condition is little more than an inconvenience.
Nevertheless, barring a popular stallion from the breeding shed even for ten days at the height of the breeding season may have a considerable economic impact on the stallion station as well as the broodmare owner, who either has to short-cycle his mares estrus or wait another month to breed.
Equine genital herpesvirus is not a reportable disease, which means that veterinarians diagnosing the disease are not required by law to report it to the United States Department of Agriculture. For this reason, it is difficult to estimate how many cases of EHV-3 actually occur. News of the recent central Kentucky outbreak spread by word of mouth.
Typically, mares are only booked to one stallion per breeding season. It is conceivable that one infected stallion could have passed the virus on to numerous mares, but the question remains how it was spread among six stallions.
A different virus
Rhinopneumonitis, another form of equine herpesvirus classified as EHV-1 and EHV-4, can be deadly for the unborn foal. Rhinopneumonitis is a disease of the upper respiratory tract in young and adult horses that is characterized by a nasal discharge, fever, and coughing.
The virus tends to run its course the same as a human cold and, unless complications arise, is not cause for alarm. However, if a pregnant mare is exposed to the disease after her fifth month of gestation, rhino will attack the placenta at the point where it attaches to the mares uterus. Spontaneous abortion results when the placenta finally dislodges from the uterus, causing fetal death.
Abortion may occur months after exposure, with no symptoms present in the mare. Numerous vaccines have been developed to guard against EHV-1 and EHV-4, and are recommended for the fifth, seventh, and ninth months of gestation. Foals should be vaccinated every two months beginning at 16 weeks of age.
In adult horses, EHV-1 sometimes affects the nervous system producing incoordination, paralysis, and incontinence. Researchers theorize that the immune system in certain horses may overreact to the virus and congest the blood vessels nourishing the nerves to the hindquarters. Serious complications may develop from the horses inability to stand.
2011年4月20日星期三
2011年4月19日星期二
Don’t fear the flowers
London - Recently, the pollen count hit 220 in some parts of England - a dramatic rise from its normal level of 40 or so.
For millions of Britons with hay fever this alarming spike - measured in grains of pollen per cubic metre of air by the Met Office - will have triggered sneezing fits, runny noses, Cold Sore eyes and an itchy throat.
Indeed, on Monday my surgery was full of sufferers desperate for treatment.
Those who don’t get hay fever may think a lot of fuss is made over what can’t be much worse than a cold. But, unlike a cold, hay fever can last for weeks or even months without the right treatment. I see patients who dread spring and summer. One in ten suffers symptoms so bad they affect their ability to drive or even sleep. It is not uncommon for them to be signed off sick from work.
Hay fever, also known as seasonal allergic rhinitis, occurs when the immune system mistakes pollen for toxins, causing the body’s cells to release histamines: chemicals which inflame the lining of the nose, throat and eyes. In the UK at this time of year, tree pollen is the main culprit. From May to August, it’s pollen from grass. In autumn, hay fever may be caused by late-flowering plants, nettles, mould and fungal spores.
Sufferers can be sensitive to one or more of these but 90 percent are affected by grass pollen.
The amount of sunshine, rain or wind affects how much pollen plants release and how far grains spread. On rainy days, pollen may be cleared from the air, causing levels to fall, which is why there may have been a bit of light relief in midweek. On sunny days, the pollen count is highest in early evening.
The UK has one of the highest hay fever rates. There has been a fourfold increase in allergies since the Fifties. It’s not clear why: theories include dietary changes, an increase in air pollutants, and over-sterilised environments which deny our immune system a chance to learn which factors are harmful or harmless.
It used to be something that mostly affected youngsters - 38 percent of UK teenagers are sufferers, compared with a quarter of the general population. But many more patients are developing hay fever for the first time in middle age or later, according to the National Pollen and Aerobiology Research Unit at the University of Worcester. If trends continue, some estimate there could be 32million sufferers by 2030.
Fortunately, there is a wide range of treatment options. My advice is try all and any until you find one that works. As I tell my patients: Don’t despair, hay fever can be beaten.
How do I know I have hay fever, rather than other allergies or a cold?
Rhinitis is a condition in which the inside of the nose becomes inflamed, causing sneezing, itchiness and a persistent runny nose, plus symptoms in the sinuses and eyes. It is a common condition affecting at least one in five of us, and can be caused by various allergens such as animal fur or dust. Rhinitis caused by pollen is hay fever: it tends to be seasonal, not year-long.
It is possible to be tested for different pollen allergies to confirm the diagnosis but this is not commonly available on the NHS. Unlike a cold, with hay fever you never have a temperature and your nose runs clear.
I look out for the pollen count but I’m not sure I understand it.
The pollen-count prediction is intended to give hay fever sufferers a head start to prepare for a bad day. Less than 30 is low, more than 50 is high. Most people find their hay-fever symptoms start at a pollen count of 50 or more, so if that is predicted you need to have your treatment with you.
Can I use combinations of hay fever treatments?
It is safe and sensible to combine hay fever treatments for the best results. For example, it is reasonable to use a steroid nasal spray with a daily antihistamine. Check with your doctor or pharmacist, but it is not uncommon for a patient with severe hay fever to be on three treatments to control symptoms.
How do I know which antihistamine treatment is best?
Simply, trial and error. A once- a-day, non-drowsy tablet bought over the counter is a good place to start. Many different ones are available, such as cetirizine or loratadine. If after three or four days’ use these don’t work for you, ask your GP about prescription antihistamines or an antihistamine nasal spray. However, if a blocked nose is one of your main symptoms, antihistamines are unlikely to be helpful. You can also become tolerant to antihistamines, and after years of using one type you might find you need to switch.
What if antihistamines don’t work?
Steroid sprays such as beconase or flixonase are useful for hay fever, if a blocked nose is your main symptom, and also if you want to avoid antihistamines because you are pregnant or breastfeeding.
If you know the time of year you usually get affected, you can start with a steroid nasal spray a few weeks beforehand to reduce the severity, but you must be consistent in your use. The sprays can cause a dry nose or mouth, so don’t overuse them. For hay fever which is so bad it is interfering with normal day-to-day life, doctors will sometimes prescribe a short course of steroid tablets to dampen down the immune system.
Are alternative treatments effective?
Many sufferers find acupuncture effective, and even resolve symptoms completely in some cases. Research is under way to evaluate this properly. Herbal remedies should be avoided as they can cause liver or kidney problems. Salt-water sprays are useful to clean out the nose regularly to remove allergens, and can be used safely by adults and children along with conventional treatment.
Is desensitisation treatment an option?
Desensitisation treatment, or immunotherapy, is useful for those with persistent symptoms. It is offered in a few NHS specialist centres and many private ones. There is a small risk of an acute reaction. You are exposed to ever larger amounts of pollen which over time reduces symptoms.
For millions of Britons with hay fever this alarming spike - measured in grains of pollen per cubic metre of air by the Met Office - will have triggered sneezing fits, runny noses, Cold Sore eyes and an itchy throat.
Indeed, on Monday my surgery was full of sufferers desperate for treatment.
Those who don’t get hay fever may think a lot of fuss is made over what can’t be much worse than a cold. But, unlike a cold, hay fever can last for weeks or even months without the right treatment. I see patients who dread spring and summer. One in ten suffers symptoms so bad they affect their ability to drive or even sleep. It is not uncommon for them to be signed off sick from work.
Hay fever, also known as seasonal allergic rhinitis, occurs when the immune system mistakes pollen for toxins, causing the body’s cells to release histamines: chemicals which inflame the lining of the nose, throat and eyes. In the UK at this time of year, tree pollen is the main culprit. From May to August, it’s pollen from grass. In autumn, hay fever may be caused by late-flowering plants, nettles, mould and fungal spores.
Sufferers can be sensitive to one or more of these but 90 percent are affected by grass pollen.
The amount of sunshine, rain or wind affects how much pollen plants release and how far grains spread. On rainy days, pollen may be cleared from the air, causing levels to fall, which is why there may have been a bit of light relief in midweek. On sunny days, the pollen count is highest in early evening.
The UK has one of the highest hay fever rates. There has been a fourfold increase in allergies since the Fifties. It’s not clear why: theories include dietary changes, an increase in air pollutants, and over-sterilised environments which deny our immune system a chance to learn which factors are harmful or harmless.
It used to be something that mostly affected youngsters - 38 percent of UK teenagers are sufferers, compared with a quarter of the general population. But many more patients are developing hay fever for the first time in middle age or later, according to the National Pollen and Aerobiology Research Unit at the University of Worcester. If trends continue, some estimate there could be 32million sufferers by 2030.
Fortunately, there is a wide range of treatment options. My advice is try all and any until you find one that works. As I tell my patients: Don’t despair, hay fever can be beaten.
How do I know I have hay fever, rather than other allergies or a cold?
Rhinitis is a condition in which the inside of the nose becomes inflamed, causing sneezing, itchiness and a persistent runny nose, plus symptoms in the sinuses and eyes. It is a common condition affecting at least one in five of us, and can be caused by various allergens such as animal fur or dust. Rhinitis caused by pollen is hay fever: it tends to be seasonal, not year-long.
It is possible to be tested for different pollen allergies to confirm the diagnosis but this is not commonly available on the NHS. Unlike a cold, with hay fever you never have a temperature and your nose runs clear.
I look out for the pollen count but I’m not sure I understand it.
The pollen-count prediction is intended to give hay fever sufferers a head start to prepare for a bad day. Less than 30 is low, more than 50 is high. Most people find their hay-fever symptoms start at a pollen count of 50 or more, so if that is predicted you need to have your treatment with you.
Can I use combinations of hay fever treatments?
It is safe and sensible to combine hay fever treatments for the best results. For example, it is reasonable to use a steroid nasal spray with a daily antihistamine. Check with your doctor or pharmacist, but it is not uncommon for a patient with severe hay fever to be on three treatments to control symptoms.
How do I know which antihistamine treatment is best?
Simply, trial and error. A once- a-day, non-drowsy tablet bought over the counter is a good place to start. Many different ones are available, such as cetirizine or loratadine. If after three or four days’ use these don’t work for you, ask your GP about prescription antihistamines or an antihistamine nasal spray. However, if a blocked nose is one of your main symptoms, antihistamines are unlikely to be helpful. You can also become tolerant to antihistamines, and after years of using one type you might find you need to switch.
What if antihistamines don’t work?
Steroid sprays such as beconase or flixonase are useful for hay fever, if a blocked nose is your main symptom, and also if you want to avoid antihistamines because you are pregnant or breastfeeding.
If you know the time of year you usually get affected, you can start with a steroid nasal spray a few weeks beforehand to reduce the severity, but you must be consistent in your use. The sprays can cause a dry nose or mouth, so don’t overuse them. For hay fever which is so bad it is interfering with normal day-to-day life, doctors will sometimes prescribe a short course of steroid tablets to dampen down the immune system.
Are alternative treatments effective?
Many sufferers find acupuncture effective, and even resolve symptoms completely in some cases. Research is under way to evaluate this properly. Herbal remedies should be avoided as they can cause liver or kidney problems. Salt-water sprays are useful to clean out the nose regularly to remove allergens, and can be used safely by adults and children along with conventional treatment.
Is desensitisation treatment an option?
Desensitisation treatment, or immunotherapy, is useful for those with persistent symptoms. It is offered in a few NHS specialist centres and many private ones. There is a small risk of an acute reaction. You are exposed to ever larger amounts of pollen which over time reduces symptoms.
2011年4月18日星期一
ASK DR B: Natural Treatments for Genital Herpes
When Donna felt the itching and burning come back for a third time in 2 months, she started to realize that she needed to see her doctor–and fast. Though it felt like the symptoms of a yeast infection at first, by the third time it came back, the itching and burning came along with high fever and painful sores in her genital area. She also had pain in her legs and buttocks and noticeable discharge. What was also worse this time was that it seemed her urinary tract was also affected, because she had considerable pain while urinating. Though she was terribly uncomfortable and very tired, she made that visit to see the doctor right away, and he confirmed what she already knew deep inside to be true—she had a case of genital herpes.
Understanding Genital Herpes
Though it is seldom discussed and carries a longstanding social stigma, at least 45 million Americans contract the genital herpes virus every year, with approximately one million new infections occurring yearly. As many as 80%-90% of those infected fail to recognize the symptoms or show no symptoms at all and carriers can transmit the disease without having any symptoms of an active infection.[1] The reality is that genital herpes is a common and highly infectious disease that is caused by a virus. It is transmitted during sexual activity and causes blisters or groups of small ulcers (open sores) on and around the genitals in men and women. Though genital herpes is not curable, there are natural medications that can be used to treat outbreaks and minimize the symptoms.
Causes of Genital Herpes
Two types of herpes simplex virus infections can cause genital herpes. The first is HSV type 1 (HSV-1) which usually causes cold sores or fever blisters around the mouth, but can be spread to the genital area during oral sex. The second type, HSV type 2 (HSV-1), is the one that commonly causes genital herpes and spreads through sexual and skin-to-skin contact. This type is very common and is very contagious whether one has a visible open sore or not. The virus dies quickly outside of the body, so it’s almost impossible to get the infection through toilets, towels or other objects used by an infected person.
Understanding Genital Herpes
Though it is seldom discussed and carries a longstanding social stigma, at least 45 million Americans contract the genital herpes virus every year, with approximately one million new infections occurring yearly. As many as 80%-90% of those infected fail to recognize the symptoms or show no symptoms at all and carriers can transmit the disease without having any symptoms of an active infection.[1] The reality is that genital herpes is a common and highly infectious disease that is caused by a virus. It is transmitted during sexual activity and causes blisters or groups of small ulcers (open sores) on and around the genitals in men and women. Though genital herpes is not curable, there are natural medications that can be used to treat outbreaks and minimize the symptoms.
Causes of Genital Herpes
Two types of herpes simplex virus infections can cause genital herpes. The first is HSV type 1 (HSV-1) which usually causes cold sores or fever blisters around the mouth, but can be spread to the genital area during oral sex. The second type, HSV type 2 (HSV-1), is the one that commonly causes genital herpes and spreads through sexual and skin-to-skin contact. This type is very common and is very contagious whether one has a visible open sore or not. The virus dies quickly outside of the body, so it’s almost impossible to get the infection through toilets, towels or other objects used by an infected person.
2011年4月17日星期日
That cry in the wilderness is coming from Labor
Today will be one of those character forming days for the government.
The welfare sector, unions, industry and manufacturing all variously crying foul over the carbon tax and another poll showing the government still as popular as cold sores.
Greg Combet's announcement last week that compensation for the carbon tax would be so generous that some people would actually be better off has done nothing to lift support for a price on carbon. If anything, opposition has hardened.
Advertisement: Story continues below
Even the government's admirable drive to balance the budget by 2012-13 is not lighting up the world.
The poll shows 61 per cent think it an important objective ''but it can wait a couple of years''.
And despite his treachery on Q&A two weeks ago, Kevin Rudd, himself as popular as cold sores this time last year, is now preferred by 55 per cent of voters as prime minister, compared with 38 per cent for Julia Gillard.
On the other side of the fence, Malcolm Turnbull is streets ahead of Joe Hockey and Tony Abbott as preferred Coalition leader.
Turnbull is vastly more popular among Labor and Green voters than Coalition voters. In a three-horse race against Hockey and Abbott, Turnbull has the support of 54 per cent of Labor voters.
In a two-horse race against each other, Gillard and Rudd have 49 per cent of the Labor vote apiece. Labor voters want Turnbull, something which will be handy for Turnbull should the Coalition find itself battling to win the soft Labor vote as the next election nears.
At the moment, however, Abbott would win in a canter based on these figures.
The great hope in Labor was that after the voters took their baseball bats to the Keneally government at the NSW election, the hostility towards federal Labor would ease. Instead, voters still have their bats in hand and are keen for another swing.
In NSW the poll shows primary support for the Coalition at 51 per cent and 27 per cent for Labor, results almost identical to the state election. That's called brand damage.
Labor sages have warned since the last federal election that turning the polls around will be a long haul and they will remain this miserable for the ALP until at least next year.
The danger in the interim is that the damage will become irreversible because people will stop listening.
The welfare sector, unions, industry and manufacturing all variously crying foul over the carbon tax and another poll showing the government still as popular as cold sores.
Greg Combet's announcement last week that compensation for the carbon tax would be so generous that some people would actually be better off has done nothing to lift support for a price on carbon. If anything, opposition has hardened.
Advertisement: Story continues below
Even the government's admirable drive to balance the budget by 2012-13 is not lighting up the world.
The poll shows 61 per cent think it an important objective ''but it can wait a couple of years''.
And despite his treachery on Q&A two weeks ago, Kevin Rudd, himself as popular as cold sores this time last year, is now preferred by 55 per cent of voters as prime minister, compared with 38 per cent for Julia Gillard.
On the other side of the fence, Malcolm Turnbull is streets ahead of Joe Hockey and Tony Abbott as preferred Coalition leader.
Turnbull is vastly more popular among Labor and Green voters than Coalition voters. In a three-horse race against Hockey and Abbott, Turnbull has the support of 54 per cent of Labor voters.
In a two-horse race against each other, Gillard and Rudd have 49 per cent of the Labor vote apiece. Labor voters want Turnbull, something which will be handy for Turnbull should the Coalition find itself battling to win the soft Labor vote as the next election nears.
At the moment, however, Abbott would win in a canter based on these figures.
The great hope in Labor was that after the voters took their baseball bats to the Keneally government at the NSW election, the hostility towards federal Labor would ease. Instead, voters still have their bats in hand and are keen for another swing.
In NSW the poll shows primary support for the Coalition at 51 per cent and 27 per cent for Labor, results almost identical to the state election. That's called brand damage.
Labor sages have warned since the last federal election that turning the polls around will be a long haul and they will remain this miserable for the ALP until at least next year.
The danger in the interim is that the damage will become irreversible because people will stop listening.
2011年4月14日星期四
Tansy May Be Used to Treat Herpes, Study Suggests
Tansy, Tanacetum Vulgare, is a flowering plant found across mainland Europe and Asia. From the Middle Ages onwards the plant, whose folk names include Golden Buttons and Mugwort, has been used as a remedy for various conditions, from fevers to rheumatism. However, its supposed medical benefits have always been questioned.
Joint work between research groups led by Dr Habtemariam from the School of Science at the University of Greenwich at Medway and Professor Francisco Parra at the Universidad de Oviedo in Spain, published in Phytotherapy Research, has revealed the clear potential of tansy as a treatment for herpes.
Dr Solomon Habtemariam says: "We have identified several compounds in the plant with strong antioxidant potential. Antioxidants are important for healing wounds and can be used to treat the skin eruptions and blister-like lesions or cold sores that are the symptoms of herpes. The drugs currently available to treat the disease are becoming less effective as the virus is developing resistance to them. Diseases such as genital herpes are also increasing due to immunosuppressive illnesses such as AIDS.
"Our studies have proved the scientific basis for many traditional medicinal plants. We are now able to identify even more structurally complex natural products and those that are present in plants in minute concentrations with our state-of-the-art analytical facilities. In collaboration with our international partners, we are searching for novel antidiabetic, antimicrobial, anticancer, anti-inflammatory and neuroprotective agents from natural sources."
Joint work between research groups led by Dr Habtemariam from the School of Science at the University of Greenwich at Medway and Professor Francisco Parra at the Universidad de Oviedo in Spain, published in Phytotherapy Research, has revealed the clear potential of tansy as a treatment for herpes.
Dr Solomon Habtemariam says: "We have identified several compounds in the plant with strong antioxidant potential. Antioxidants are important for healing wounds and can be used to treat the skin eruptions and blister-like lesions or cold sores that are the symptoms of herpes. The drugs currently available to treat the disease are becoming less effective as the virus is developing resistance to them. Diseases such as genital herpes are also increasing due to immunosuppressive illnesses such as AIDS.
"Our studies have proved the scientific basis for many traditional medicinal plants. We are now able to identify even more structurally complex natural products and those that are present in plants in minute concentrations with our state-of-the-art analytical facilities. In collaboration with our international partners, we are searching for novel antidiabetic, antimicrobial, anticancer, anti-inflammatory and neuroprotective agents from natural sources."
2011年4月13日星期三
Call for new inquest into Carmel Bloom's hospital death
Carmel Bloom, 54, died in 2002 at the private Roding Hospital in Ilford after a kidney stone operation. She worked as a health controller there at the time.
Bernard Bloom called for a new inquest after a recording of a 999 call made and a list of phone calls emerged following the second inquest in 2005.
Hospital staff involved in Ms Bloom's care declined to comment to the BBC.
At the time of Ms Bloom's death the hospital was run by Bupa.
The first inquest in 2003 found she died of natural causes.
But the 2005 inquest at West London Coroners' Court found lack of post-operative care contributed to her death.
'Coughing up blood'
She was transferred to Whipps Cross Hospital in east London after the diagnosis of septicaemia which caused organ failure, the jury heard.
Ms Bloom's case was mainly handled by anaesthetist Dr Paul Timmis, consultant urological surgeon John Hines and night nurse Bridget Matthews.
Bernard Bloom said: "We have certain views which we feel are fully supported by the evidence, but they are not even vaguely compatible with the evidence or the verdict that was reached at the last inquest."
Continue reading the main story
“Start Quote
It showed that she'd been allowed to deteriorate into a fatal condition”
End Quote Bernard Bloom Carmel Bloom's brother
He said details have changed over the years for instance at the 2005 inquest Ms Matthews said she could not call an ambulance "until Dr Timmis had assessed the patient".
Mr Hines also told the court he did not ask anyone to phone an ambulance because "I had to wait for Dr Timmis to arrive".
But a list of phone calls made from the hospital on 29 August 2002 shows the ambulance was called before Dr Timmis could have reached the hospital.
In the emergency call to London Ambulance Service Ms Matthews can be heard saying: "She's now got pulmonary oedema, she's coughing up a lot of blood and she is very unstable actually."
But at the 2005 inquest she said: "It had not got to the stage where there was visible pulmonary oedema."
Mr Bloom believes the new evidence will show that the jury was misled.
He said: "It showed that she'd been allowed to deteriorate into a fatal condition."
Medical staff involved in the case declined to comment to the BBC.
Bernard Bloom called for a new inquest after a recording of a 999 call made and a list of phone calls emerged following the second inquest in 2005.
Hospital staff involved in Ms Bloom's care declined to comment to the BBC.
At the time of Ms Bloom's death the hospital was run by Bupa.
The first inquest in 2003 found she died of natural causes.
But the 2005 inquest at West London Coroners' Court found lack of post-operative care contributed to her death.
'Coughing up blood'
She was transferred to Whipps Cross Hospital in east London after the diagnosis of septicaemia which caused organ failure, the jury heard.
Ms Bloom's case was mainly handled by anaesthetist Dr Paul Timmis, consultant urological surgeon John Hines and night nurse Bridget Matthews.
Bernard Bloom said: "We have certain views which we feel are fully supported by the evidence, but they are not even vaguely compatible with the evidence or the verdict that was reached at the last inquest."
Continue reading the main story
“Start Quote
It showed that she'd been allowed to deteriorate into a fatal condition”
End Quote Bernard Bloom Carmel Bloom's brother
He said details have changed over the years for instance at the 2005 inquest Ms Matthews said she could not call an ambulance "until Dr Timmis had assessed the patient".
Mr Hines also told the court he did not ask anyone to phone an ambulance because "I had to wait for Dr Timmis to arrive".
But a list of phone calls made from the hospital on 29 August 2002 shows the ambulance was called before Dr Timmis could have reached the hospital.
In the emergency call to London Ambulance Service Ms Matthews can be heard saying: "She's now got pulmonary oedema, she's coughing up a lot of blood and she is very unstable actually."
But at the 2005 inquest she said: "It had not got to the stage where there was visible pulmonary oedema."
Mr Bloom believes the new evidence will show that the jury was misled.
He said: "It showed that she'd been allowed to deteriorate into a fatal condition."
Medical staff involved in the case declined to comment to the BBC.
2011年4月12日星期二
Don’t let herpes hamper your sex life
Dear Dr. Peg,
Recently my girlfriend was diagnosed with genital herpes. I have been with her for three years and neither of us has ever had herpes. Does this mean she cheated on me? And if I wear a condom, can I keep from getting it from her?
Dear sir,
No, it doesn’t mean she cheated on you. And no, a condom probably won’t protect you.
When someone comes down with a sexually transmitted infection, the first thing they usually want to know is who gave it to them. Sometimes that question has an answer, and sometimes it doesn’t. With herpes, there is no playing the blame game.
Herpes is a sneaky little bugger that can hide out for years, unknown and unnoticed. When it finally rears its ugly little head, it can wreak havoc on relationships with suspicion and mistrust.
A little knowledge can go a long way toward mending strained romances, so here goes:
The word “herpes” comes from a Greek word pronounced (roughly) “herpestes,” which is an adjective meaning “creeping.”
In the first century, it was thought to be the result of the body attempting to get rid of “acrid waste matter” by pushing it to the surface in blisters which would then burst and drain out the nastiness.
We now know that these blisters are, in fact, caused by a virus, which has been named after that Greek adjective.
There are two types of herpes simplex viruses, Type 1 (HSV1) and Type 2 (HSV2). Usually HSV1 lives on the face and HSV2 lives on the genitals. However, herpes viruses are flexible and can take up residence in either location.
HSV1 is extremely common, affecting about one in four Americans.
It usually comes out as a cold sore, that oozing crusty thing people get at the edge of their lip. Many of us get exposed to this virus type as children, from other children or from smooching adults.
HSV2 is usually contracted sexually, through direct skin-to-skin contact with someone who has it. The problem is they might not know they have it. HSV can be a silent, symptom-free disease. This goes for Type 1 and Type 2. The other problem is that condoms don’t provide complete protection. Since the virus lives in the nerves, it can be passed through the skin wherever the nerves go.
Once you catch HSV, it either causes sores or it doesn’t. In either case, it proceeds to move in to your spinal nerves, where it lives happily ever after. It might emerge from time to time and cause a sore, or it might not.
You can pass it along when you have a sore, but you can also pass it along when you don’t. That’s the mystery and frustration of herpes.
After the first outbreak, further outbreaks tend to be much milder, and once you have one established herpes site on your body, it’s rare to develop another, probably because your immune system makes antibodies to the virus. Also, if you do have HSV1, you are less likely to catch HSV2.
There appears to be some cross-protection in the antibodies that are formed.
Another issue this brings up is how to handle herpes as a couple.
What do you do if one of you has it and the other doesn’t? How do you talk about this with a prospective partner?
The couples I’ve known who deal with herpes in the healthiest way are those who tell me, “We have herpes.” In other words, they see it as a shared problem. They don’t expend a lot of energy trying to prevent passing it to each other, or let it put a crimp in their sex life. Their love for each other and their desire to express that love sexually overrides their worry about contagion.
I’m not suggesting anyone blithely rub open sores all over their partner. It still makes sense to avoid contact with open sores, for comfort’s sake if nothing else. I’m just pointing out that, for the sake of your relationship, it makes sense not to obsess about it. And medically speaking, herpes is rarely a big deal.
If you have herpes and are starting a new relationship, I think it’s only fair to inform your prospective partner before you have sex.
Ideally, this won’t be on your first date, but when you are close enough emotionally to can talk freely about such things and figure out how you as a couple want to handle the situation.
This isn’t always easy, because our society still has lots of judgment and stigma around sex-related topics of any kind, and having a sexually transmitted infection can be emotionally upsetting.
If you need help, the medical practitioners and/or the counselors at the Student Health Center would be happy to meet with you and your partner to answer questions and help you discuss it together. Call 277-3136 for an appointment.
Peggy Spencer has been a UNM Student Health physician for 20 years. E-mail your questions to her directly at pspencer@unm.edu. All questions will be considered, and all questioners will remain anonymous. This column has general health information only and cannot replace a visit to a health provider.
Recently my girlfriend was diagnosed with genital herpes. I have been with her for three years and neither of us has ever had herpes. Does this mean she cheated on me? And if I wear a condom, can I keep from getting it from her?
Dear sir,
No, it doesn’t mean she cheated on you. And no, a condom probably won’t protect you.
When someone comes down with a sexually transmitted infection, the first thing they usually want to know is who gave it to them. Sometimes that question has an answer, and sometimes it doesn’t. With herpes, there is no playing the blame game.
Herpes is a sneaky little bugger that can hide out for years, unknown and unnoticed. When it finally rears its ugly little head, it can wreak havoc on relationships with suspicion and mistrust.
A little knowledge can go a long way toward mending strained romances, so here goes:
The word “herpes” comes from a Greek word pronounced (roughly) “herpestes,” which is an adjective meaning “creeping.”
In the first century, it was thought to be the result of the body attempting to get rid of “acrid waste matter” by pushing it to the surface in blisters which would then burst and drain out the nastiness.
We now know that these blisters are, in fact, caused by a virus, which has been named after that Greek adjective.
There are two types of herpes simplex viruses, Type 1 (HSV1) and Type 2 (HSV2). Usually HSV1 lives on the face and HSV2 lives on the genitals. However, herpes viruses are flexible and can take up residence in either location.
HSV1 is extremely common, affecting about one in four Americans.
It usually comes out as a cold sore, that oozing crusty thing people get at the edge of their lip. Many of us get exposed to this virus type as children, from other children or from smooching adults.
HSV2 is usually contracted sexually, through direct skin-to-skin contact with someone who has it. The problem is they might not know they have it. HSV can be a silent, symptom-free disease. This goes for Type 1 and Type 2. The other problem is that condoms don’t provide complete protection. Since the virus lives in the nerves, it can be passed through the skin wherever the nerves go.
Once you catch HSV, it either causes sores or it doesn’t. In either case, it proceeds to move in to your spinal nerves, where it lives happily ever after. It might emerge from time to time and cause a sore, or it might not.
You can pass it along when you have a sore, but you can also pass it along when you don’t. That’s the mystery and frustration of herpes.
After the first outbreak, further outbreaks tend to be much milder, and once you have one established herpes site on your body, it’s rare to develop another, probably because your immune system makes antibodies to the virus. Also, if you do have HSV1, you are less likely to catch HSV2.
There appears to be some cross-protection in the antibodies that are formed.
Another issue this brings up is how to handle herpes as a couple.
What do you do if one of you has it and the other doesn’t? How do you talk about this with a prospective partner?
The couples I’ve known who deal with herpes in the healthiest way are those who tell me, “We have herpes.” In other words, they see it as a shared problem. They don’t expend a lot of energy trying to prevent passing it to each other, or let it put a crimp in their sex life. Their love for each other and their desire to express that love sexually overrides their worry about contagion.
I’m not suggesting anyone blithely rub open sores all over their partner. It still makes sense to avoid contact with open sores, for comfort’s sake if nothing else. I’m just pointing out that, for the sake of your relationship, it makes sense not to obsess about it. And medically speaking, herpes is rarely a big deal.
If you have herpes and are starting a new relationship, I think it’s only fair to inform your prospective partner before you have sex.
Ideally, this won’t be on your first date, but when you are close enough emotionally to can talk freely about such things and figure out how you as a couple want to handle the situation.
This isn’t always easy, because our society still has lots of judgment and stigma around sex-related topics of any kind, and having a sexually transmitted infection can be emotionally upsetting.
If you need help, the medical practitioners and/or the counselors at the Student Health Center would be happy to meet with you and your partner to answer questions and help you discuss it together. Call 277-3136 for an appointment.
Peggy Spencer has been a UNM Student Health physician for 20 years. E-mail your questions to her directly at pspencer@unm.edu. All questions will be considered, and all questioners will remain anonymous. This column has general health information only and cannot replace a visit to a health provider.
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