Behaviour of the pandemic H1N1 influenza virus in Andalusia, Spain, at the onset of the 2009-10 season.

In Andalusia, Spain, the pandemic influenza A(H1N1)v virus has spread throughout the community, being the dominant influenza strain in the season so far. The current objective of the Andalusia Health Service is focussed on the mitigation of the health and social impact by appropriate care of the patients at home or in health centres. The 2009-10 seasonal influenza epidemic started early compared with to previous seasons. This article analyses the influenza A(H1N1)v situation in Andalusia until the week 39/2009.

A comparison of two constant-dose continuous infusions of remifentanil for severe postoperative pain.

UNLABELLED: We evaluated the analgesic efficacy and safety of two continuous constant-dose infusions of IV remifentanil, without infusion rate increments or the addition of boluses, in patients with severe postoperative pain during the first 4 h after general anesthesia with IV propofol-remifentanil. Thirty patients were randomly assigned to two groups of 15 subjects each according to the remifentanil dose administered: 0.1 microg. kg(-1). min(-1) IV (Group A) or 0.05 microg. kg(-1). min(-1) IV (Group B). Rescue analgesia was provided with meperidine (0.5 mg/kg IV) when pain intensity on the simple verbal scale (SVS) > or =2. The criteria for adequate analgesia (SVS 0-1, respiratory frequency >8/min. and SpO(2) >90%) after 4 h were met by 78% and 75% of the patients in Groups A and B, respectively (P = ns). "Meperidine rescue" analgesia was significantly more in Group B (26%) than in Group A (6%) (P < 0.05). There were no cases of respiratory depression, and nausea and emesis occurred in one patient in each group (6.5%). We conclude that IV remifentanil is an effective and safe opioid for the treatment of postoperative pain at a constant dose of 0.1 microg. kg(-1). min(-1) with a need for rescue analgesia 4 times less than a constant dose of 0.05 microg. kg(-1). min(-1). IMPLICATIONS: Our study suggests that the use of a constant continuous infusion of remifentanil 0.1 microg.kg(-1).min(-1)IV is an effective alternative in the treatment of severe postoperative pain.

[Comparative study of inhalation induction by vital capacity breath in adults using 6% sevoflurane with oxygen or 4.5%sevoflurane in 50% nitrous oxide]. / Estudio comparativo en la inducción inhalatoria a capacidad vital en adultos entre sevoflurano al 6% con oxígeno y sevoflurano al 4,5% con óxido nitroso al 50%.

OBJECTIVE: To evaluate the efficacy, side effects and hemodynamic characteristics of induction by vital capacity breath in adults using 6% sevoflurane and oxygen versus 4.5% sevoflurane and 50% nitrous oxide. PATIENTS AND METHODS: We assigned 50 ASA I-II patients aged 20 to 70 years old randomly to two groups of 25 to receive either 6% sevoflurane in oxygen or 4.5% sevoflurane in nitrous oxide. All patients were premedicated with oral bromazepam (1.5 to 3 mg). Induction was by vital capacity breath using a Mapleson A circuit (8 l. min-1) for 5 min. We recorded induction time, side effects, hemodynamic variables and patient opinion after surgery. RESULTS: Induction time was significantly faster for the sevoflurane-oxygen group (60 +/- 10 s) than for the sevoflurane-nitrous oxide group (71 +/- 8 s) (p < 0.001). Complications were minor and hemodynamic variables stable in both groups, with no statistically significant differences. The patients expressed satisfaction with both induction techniques. CONCLUSIONS: A vital capacity breath of 6% sevoflurane provided rapid induction. Induction was no more rapid when 50% nitrous oxide was added and the incidence of side effects did not decrease. Hemodynamic variables are stable during induction with sevoflurane with or without nitrous oxide, making this a well-tolerated alternative technique that is positively evaluated by patients.

[Immunologic situation of hepatitis B in immigrants. Strategy for vaccination]. / Situación inmunológica de la hepatitis B en inmigrates. Estrategias de vacunación.

BACKGROUND: The aim of this study was to know the prevalence of the hepatitis B virus markers of infection in immigrants, to explain the demographic factors determinant for the convenience of hepatitis B immunization and to evaluate the usefulness of previous screening based on the prevalence of infection. SUBJECTS AND METHODS: Transversal descriptive study including 1,226 immigrants. Age, sex, birth place, serologic virus markers and vaccine convenience were analyzed. A logit model for each sex, the vaccination probabilities, contrasts related with a reference category and the odds ratios (OR) were estimated. RESULTS: 73.25% of immigrants were men. The mean of age was 29.57 (SD = 9.31) in men and 29.98 (SD = 13.89) in women. Men were mostly born in South Asia (32%) and women were in sub-Saharian Africa (35%). The probability of hepatitis B immunization convenience in both sex were 29.1% in those born in sub-Saharian Africa, and higher than 91.5% in those from America. This probability was higher than 85.8% up to twenty years old, and higher than 55.7% in older than forty. All zones showed a percentage of patients with hepatitis B immunization convenience greater than sub-Saharian Africa (OR +/- 2.4). CONCLUSIONS: Age and birth place explain the convenience of hepatitis B immunization. In the American immigrants it would result more efficient the massive immunization, while in the sub-Saharian population it would be better a previous screening because the prevalence of hepatitis B virus markers of infection is very high. Probability of hepatitis B immunization convenience decreases as age increases.

Evolutionary changes of nonlinear reaction norms according to thermal adaptation: a comparison of two Drosophila species.

While the adaptive significance of discontinuous reaction norms is generally accepted, the evolutionary interpretation of continuous response curves remains speculative, and the occurrence of internal constraints is often suggested as an explanation of experimental observations. In Drosophila melanogaster, various morphometrical traits exhibit convex reaction norms to growth temperature, with a maximum value within the developmental thermal range. We compared a cold-adapted species (D. subobscura) with a mid thermal range at 16 degrees C, to the warm-adapted D. melanogaster (mid thermal range at 22 degrees C) for three different morphometrical traits: wing and thorax length in both sexes and ovariole number in females. Maximum value temperatures were ordered in the same way for the three traits in both species: ovariole number > thorax length > wing length. Significant differences were also observed between the two species for the curvature parameter of the quadratic adjustment. The major observation was a significant lateral shift in the reaction norms: maximum values were observed at much lower temperatures in the cold-adapted species than in the warm-adapted one. The parallelism between mid thermal range variation and the position of the maximum value strongly suggests an adaptive displacement of the response curves. Natural selection may thus act not only on trait mean values but also on phenotypic plasticity and on the shape of reaction norms.

Genetic basis of some morphological differences between temperate and equatorial populations of Drosophila melanogaster.

The genetic basis of three morphological traits (ovariole number, sternopleural bristle number and wing length) of Drosophila melanogaster has been investigated in natural populations that show great differences in these traits, i.e. Bordeaux (France) and Loua (Congo). F1 and F2 crosses, and chromosome substitutions between these two populations, were analysed. Maternal and/or X chromosome effects were found for sternopleural bristle number and wing length. For all traits, significant effects from each of the three chromosomes were found, but in general only one or two chromosomes had a major effect. Moreover, in all cases significant interactions between chromosomes were observed, suggesting the existence of epistatic effects. Our results are discussed and compared to those obtained from the analysis of selected laboratory strains.

Adaptation to alcoholic fermentation in Drosophila: a parallel selection imposed by environmental ethanol and acetic acid.

Besides ethanol, acetic acid is produced in naturally fermenting sweet resources and is a significant environmental stress for fruit-breeding Drosophila populations and species. Although not related to the presence of an active alcohol dehydrogenase, adult acetic acid tolerance was found to correlate with ethanol tolerance when sensitive (Afrotropical) and resistant (European) natural populations of Drosophila melanogaster were compared. The same correlation was found when comparing various Drosophila species. Tolerance to acetic acid also correlated with the tolerance to longer aliphatic acids of three, four, or five carbons but did not correlate with the tolerance to inorganic acids (i.e., hydrochloric and sulfuric acids). These observations suggest that acetic acid is detoxified by the conversion of acetate into acetyl-CoA, a metabolic step also involved in ethanol detoxification. Future investigations on the adaptation of Drosophila to fermenting resources should consider selective effects of both ethanol and acetic acid.

Short-range genetic structure of Drosophila melanogaster populations in an Afrotropical urban area and its significance.

Alcohol dehydrogenase (Adh) (alcohol:NAD+ oxidoreductase, EC 1.1.1.1) gene frequencies and ethanol tolerance in Drosophila melanogaster are known to exhibit long-range latitudinal variations on different continents; this has led to the argument that the clines are adaptive. Accordingly, tropical populations are characterized both by a low frequency of Adh-F and by a low ethanol tolerance. In the urban area of Brazzaville (Congo) under an equatorial African climate, an original genetic structure of local populations has been found: Adh-F frequency varies from 3% to 90% when countryside and brewery populations are compared. This variation is accompanied by an increase of ethanol tolerance (from 6% to 13% alcohol). Such differences, which have remained stable for the past 3 years, were observed between collection sites less than 1 km apart. Two other enzyme loci exhibited a correlated variation with Adh-F--i.e., an increase of the S allele of glycerol-3-phosphate dehydrogenase (NAD+) (sn-glycerol-3-phosphate:NAD+ 2-oxidoreductase, EC 1.1.1.8) and of the F allele of glucose-6-phosphate dehydrogenase (D-glucose-6-phosphate:NADP+ 1-oxidoreductase, EC 1.1.1.49). Such observations suggest very strong selective pressures exerted by environmental ethanol that oppose the gene flow due to adult dispersal between contiguous habitats. A functional relationship between the polymorphisms of the three enzyme loci seems likely, and a metabolic interaction involving NAD and NADP cofactors is proposed.