Comparison of clinical presentation and laboratory values at admission between PCR-confirmed influenza A H1N1 infection and influenza-like disease, South-East Austria.

PURPOSE: Reliable and rapid diagnosis of influenza A H1N1 is essential to initiate the appropriate antiviral therapy and preventive measures. As PCR assays are time-consuming and rapid antigen tests have a limited sensitivity, official influenza case definitions are used in many clinical settings. These, however, are based exclusively on clinical criteria and have only a moderate potential to differentiate between influenza and other febrile diseases. Only limited data on the differences in clinical and laboratory parameters between influenza and non-influenza febrile diseases are available to date. METHODS: This was a retrospective case-negative control series that was conducted in Styria, southeast Austria. We analyzed the differences in clinical presentation and laboratory admission parameters between patients with PCR-confirmed H1N1 influenza infection (n = 199) and those with influenza-like disease and negative influenza PCR results (ILD group; n = 252). RESULTS: In the multivariable analysis lower C-reactive protein (CRP) level, lower white blood cell (WBC) count, fever, wheezing, cough, and the absence of nausea or sudden onset remained significant predictors of H1N1 influenza in adult patients (n = 263). Lower CRP level, lower WBC count, and cough remained significant predictors in pediatric patients (<16 years; n = 188). CONCLUSION: Lower CRP level, lower WBC count, and cough were significant predictors of H1N1 in both the adult and pediatric patient group. These data may help to develop an improved case definition for suspected H1N1 infection which combines clinical findings and easily available laboratory parameters.

[The early enteral feeding in patients after the surgical treatment of duodenal ulcer].

The author has analyzed the data of 163 patients operated because of their duodenal ulcer disease. There were in existence 30% of the first degree, 53% of the second degree and 17% of third degree emaciated patients. The author developed a new scheme of the enteral feeding. This new scheme proved to be effective based on the analysis of biochemical indices in patients at the early postopeartive period.

[Use of fats in early enteral feeding]. / Ispol'zovanie zhirov pri provedenii rannego énteral'nogo zondovogo pitaniia.

It was established in experiments on dogs that tropism of the small intestine to proteins, fats, and carbohydrates is determined by the organism's requirements in them. Clinical studies showed the efficacy of enteral administration of fats in a highly dispersed form. Peripheral beta-adrenergic block was found to be a modulator of the functions of the small intestine which were disturbed by the operative trauma.

[Functional state of the pancreas and risks of occurrence of acute pancreatitis in early use of enteral tube feeding in surgery of bile ducts]. / Funktsional'noe sostoianie podzheludochnoi zhelezy i opasnost' vozniknoveniia ostrogo pankreatita pri rannem primenenii énteral'nogo zondovogo pitaniia v khirurgii zhelchevyvodiashchikh putei.

In experiment on 43 dogs while the loading with polysubstrate food mixtures it was established, that the food passage shunting and starvation enhances the incretory answer value, but cholestasis and starvation lowers the pancreatic secretory potency. The restorational operation conduction promotes elimination of the cholestasis influence, but aggravates the action of starvation. An acute pancreatitis was not noted.

[Membrane digestion in the early postoperative period during enteral tube feeding]. / Membrannoe pishchevarenie v rannem posleoperatsionnom periode pri énteral'nom zondovom pitanii.

The investigation of the membrane digestion has established that in the early postoperative period pronounced alterations of the hydrolytic system in the small intestine take place in all its links (synthesis, translocation and adsorption of enzymes). The main compensatory mechanism responsible for the hydrolytic processes in the early postoperative period is the membrane digestion, so the level of the amylolytic activity of the small intestine in the early postoperative period allows the enteral tube nutrition to be performed not only with mono- and oligosaccharides but also with polysaccharides.

[Pancreatic function and the danger of the occurrence of acute pancreatitis during the use of early enteral tube feeding after an operation on the bile ducts]. / Funktsional'noe sostoianie podzheludochnoi zhelezy i opasnost' vozniknoveniia ostrogo pankreatita pri primenenii rannego énteral'nogo zondovogo pitaniia posle operatsii na zhelchevyvodiashchikh putiakh.

The amylase and lipase activity dynamics was studied in experiment on 43 dogs using the method of loading with polysubstrate eatable mixtures while the jaundice simulation after a bile passage restoration. The amylase and lipase amplitude and yield increase as an answer to food introduction in the animals with the obturating jaundice simulation and after a bile diversion operation conduction was established. The fact that such possible dangerous complication as an acute pancreatitis did not occur witnesses the security of enteral probe nutrition.

Predictors of H1N1 influenza in the emergency department: proposition for a modified H1N1 case definition.

Reliable and rapid diagnosis of influenza A H1N1 is essential to initiate appropriate antiviral therapy and preventive measures. We analysed the differences in clinical presentation and laboratory parameters between emergency department patients with PCR-confirmed H1N1 influenza infection (n = 199) and those with PCR-negative influenza-like illness (ILI; n = 252). Cough, wheezing, leucopenia, eosinopenia and a lower C-reactive protein remained significant predictors of H1N1 influenza. Proposed combinations of clinical symptoms with simple laboratory parameters (e.g. reported or measured fever and either cough or leucocytes <8.5 × 10(9) /L) were clearly superior to currently used official ILI case definitions that use clinical criteria alone.