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BACKGROUND: Seasonal influenza outbreaks are associated with increased mortality and hospitalisation rates. Herein we tried to identify predictors of mortality in hospitalised patients with influenza virus infection. MATERIALS/METHODS: In this exploratory retrospective observational single-centre-study we included all influenza-positive patients older than 18 years who were hospitalised and treated at the flu-isolation-ward during the influenza season 2017/18. Diagnosis was based on point-of-care-test with the Alere™ i. First we performed χ2 tests and Mann-Whitney U tests to identify predictors of mortality. Significant variables were used in a stepwise-forward-logistic-regression-model to predict in-hospital and 90-day mortality. RESULTS: Of the 396 patients who tested positive for influenza 96 (24.2%) had influenza A and 300 (75.8%) influenza B. Twenty-two (5.6%) died in hospital and the 90-day mortality rate was 9.4%. In the stepwise logistic regression older age (OR 1.1 per year 95% CI 1.03-1.17), history of atrial fibrillation (OR 5.91 95% CI 1.91-18.34), dementia (OR 3.98 95% CI 1.24-12.78), leucocyte count (OR 1.11 per G/L 95% CI 1.03-1.20), pneumonia (OR 4.39 95% CI 1.44-13.39) and acute heart failure (OR 23.15 95% CI 4.33-123.76) increased the risk of in-hospital mortality. The risk for 90-day mortality was increased by older age (OR 1.04 per year 95% CI 1.01-1.07), history of atrial fibrillation (OR 3.1, 95% CI 1.36-7.05), history of congestive heart failure (OR 4.7 95% CI 1.94-11.48), pneumonia (OR 3.2 95% CI 1.45-6.91) and decreased by statin use (OR 0.28 95% CI 0.10-0.78). CONCLUSIONS: Older age, history of atrial fibrillation and pneumonia are associated with increased risk of influenza-associated in-hospital and 90-day mortality. Statin use may decrease 90-day mortality.
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Mortalidad Hospitalaria , Gripe Humana/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Austria/epidemiología , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Orthomyxoviridae/fisiología , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Adulto JovenRESUMEN
We report the successful management of a patient with severe respiratory failure due to COVID-19 admitted to an intensive care unit complicated by secondary catheter-related infection of Candida glabrata. We are discussing some of the clinical challenges and the pitfalls in molecular diagnosis of SARS-CoV-2, including the fact that a positive PCR result may not always reflect infectiousness.
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Candidemia/tratamiento farmacológico , Infecciones por Coronavirus/terapia , Manejo de la Enfermedad , Neumonía Viral/terapia , Síndrome de Dificultad Respiratoria/virología , Anciano , Antifúngicos/uso terapéutico , Austria , Betacoronavirus , COVID-19 , Candidemia/virología , Coinfección/microbiología , Coinfección/virología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico por imagen , Humanos , Hipertensión/complicaciones , Unidades de Cuidados Intensivos , Masculino , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico por imagen , SARS-CoV-2 , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Backward-angle meson electroproduction above the resonance region, which was previously ignored, is anticipated to offer unique access to the three quark plus sea component of the nucleon wave function. In this Letter, we present the first complete separation of the four electromagnetic structure functions above the resonance region in exclusive ω electroproduction off the proton, epâe^{'}pω, at central Q^{2} values of 1.60, 2.45 GeV^{2}, at W=2.21 GeV. The results of our pioneering -u≈-u_{min} study demonstrate the existence of a unanticipated backward-angle cross section peak and the feasibility of full L/T/LT/TT separations in this never explored kinematic territory. At Q^{2}=2.45 GeV^{2}, the observed dominance of σ_{T} over σ_{L}, is qualitatively consistent with the collinear QCD description in the near-backward regime, in which the scattering amplitude factorizes into a hard subprocess amplitude and baryon to meson transition distribution amplitudes: universal nonperturbative objects only accessible through backward-angle kinematics.
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We have extracted QCD matrix elements from our data on doubly polarized inelastic scattering of electrons on nuclei. We find the higher twist matrix element dË2, which arises strictly from quark-gluon interactions, to be unambiguously nonzero. The data also reveal an isospin dependence of higher twist effects if we assume that the Burkhardt-Cottingham sum rule is valid. The fundamental Bjorken sum rule obtained from the a0 matrix element is satisfied at our low momentum transfer.
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Neurologic findings are being increasingly recognized in coronavirus disease 2019. We present a patient with a unique involvement of the corpus callosum that we relate to the cytokine storm seen in patients with Severe Acute Respiratory Syndrome coronavirus 2 infection. As the infection is increasingly seen around the world, recognition of these unique patterns may facilitate early identification of the progression of this disease and potentially facilitate appropriate management.
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Betacoronavirus , Infecciones por Coronavirus , Cuerpo Calloso/diagnóstico por imagen , Citocinas/inmunología , Pandemias , Neumonía Viral , Anciano , COVID-19 , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/inmunología , Cuerpo Calloso/inmunología , Femenino , Humanos , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/inmunología , SARS-CoV-2 , Tomografía Computarizada por Rayos XRESUMEN
New Jefferson Lab data are presented on the nuclear dependence of the inclusive cross section from (2)H, (3)He, (4)He, (9)Be and (12)C for 0.3 < x < 0.9, Q(2) approximately 3-6 GeV(2). These data represent the first measurement of the EMC effect for (3)He at large x and a significant improvement for (4)He. The data do not support previous A-dependent or density-dependent fits to the EMC effect and suggest that the nuclear dependence of the quark distributions may depend on the local nuclear environment.
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A newly obtained data sample of inclusive electron-nucleon scattering from both hydrogen and deuterium targets is analyzed. These JLab data span the nucleon resonance region up to four-momentum transfers of 5 (GeV/c)(2). The data are found to follow an average scaling curve. The inclusion of low-momentum transfer data yields a scaling curve resembling deep inelastic neutrino-nucleus scattering data, suggesting a sensitivity to valencelike structure only.
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A newly obtained sample of inclusive electron-nucleon scattering data has been analyzed for precision tests of quark-hadron duality. The data are in the nucleon resonance region, and span the range 0. 3
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Infecciones por Orthomyxoviridae/veterinaria , Orthomyxoviridae , Enfermedades de los Porcinos/microbiología , Amnios , Animales , Antígenos Virales/análisis , Embrión de Pollo , Reservorios de Enfermedades , Pruebas de Inhibición de Hemaglutinación , Orthomyxoviridae/inmunología , Orthomyxoviridae/aislamiento & purificación , Infecciones por Orthomyxoviridae/inmunología , Infecciones por Orthomyxoviridae/microbiología , Neumonía/microbiología , Neumonía/veterinaria , Rumanía , Porcinos , Enfermedades de los Porcinos/inmunología , Cultivo de Virus , ZoonosisRESUMEN
We have measured the nuclear transparency of the A(e,e'pi+) process in 2H, 12C, 27Al, 63Cu, and 197Au targets. These measurements were performed at the Jefferson Laboratory over a four momentum transfer squared range Q2=1.1 to 4.7 (GeV/c)2. The nuclear transparency was extracted as the super-ratio of (sigmaA/sigmaH) from data to a model of pion-electroproduction from nuclei without pi-N final-state interactions. The Q2 and atomic number dependence of the nuclear transparency both show deviations from traditional nuclear physics expectations and are consistent with calculations that include the quantum chromodynamical phenomenon of color transparency.
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We have examined the spin structure of the proton in the region of the nucleon resonances (1.085 GeV
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We report on a study of the longitudinal to transverse cross section ratio, R=sigmaL/sigmaT, at low values of x and Q2, as determined from inclusive inelastic electron-hydrogen and electron-deuterium scattering data from Jefferson Laboratory Hall C spanning the four-momentum transfer range 0.06
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The 1H(e,e'pi+)n cross section was measured at four-momentum transfers of Q2=1.60 and 2.45 GeV2 at an invariant mass of the photon nucleon system of W=2.22 GeV. The charged pion form factor (F(pi)) was extracted from the data by comparing the separated longitudinal pion electroproduction cross section to a Regge model prediction in which F(pi) is a free parameter. The results indicate that the pion form factor deviates from the charge-radius constrained monopole form at these values of Q2 by one sigma, but is still far from its perturbative quantum chromodynamics prediction.
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We study the Q2 dependence of large x F2 nucleon structure function data, with the aim of providing a perturbative QCD based, quantitative analysis of parton-hadron duality. As opposed to previous analyses at fixed x, we use a framework in fixed W2. We uncover a breakdown of the twist-4 approximation with a renormalon type improvement at O(1/Q(4)) which affects the initial evolution of parton distributions.
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The present paper deals with the conditions that influenza vaccines must comply with, their efficiency in terms of the route of administration, the major antigenic changes of influenza viruses, that has to be known from beforehand, a basic problem for the efficient control of a pandemic. Vaccination must have in view reduction of the mortality and morbidity rate, a major criterion in establishing a programme for the prevention of influenza by vaccination.
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Vacunas contra la Influenza , Gripe Humana/prevención & control , Adolescente , Adulto , Antígenos Virales/análisis , Niño , Preescolar , Humanos , Lactante , Vacunas contra la Influenza/normas , Rumanía , VacunaciónRESUMEN
The paper reports on the casuistics of the colon cancer in the Clinic of Surgery of the "Grivita" Clinical Hospital, for 21 years (1966-1986) with emphasis on the situs peculiarities on the right and left colon. Whereas the left colon cancer (LCC) started in 32% of cases with subocclusive and occlusive syndromes having special implications on the treatment and prognosis, in the right colon cancer (RCC) only in 3.5% of cases the diagnosis was established in the stage of subocclusive syndrome. During surgery the metastatic adenopathy was met in 57% in LCC and only in 37% in RCC, and the hepatic metastases in 17.7% in LCC and in 10.9% in the RCC cases. The immediate postsurgery mortality was present in 12% of the LCC cases and in only 9.3% of the RCC cases. In the last 10 years of the period studied, the patients were periodically readmitted into the hospital, reinvestigated, and monochemotherapy with 5-fluorouracil was applied in sequential cures. In this last period, the survival at 5 years was of 25 (45.4%) in the 55 patients operated for RCC and of 41 (37.6%) in the 109 patients operated for LCC.
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Neoplasias del Colon/cirugía , Anciano , Anciano de 80 o más Años , Colectomía/métodos , Neoplasias del Colon/diagnóstico , Neoplasias del Colon/mortalidad , Colostomía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiologíaRESUMEN
Over a period of 14 years a total of 1,996 surgical procedures have been performed on extrahepatic biliary pathways. In 182 cases (9.11%) biliodigestive anastomoses have been done for a therapeutical solution of mechanical jaundice. Biliodigestive anastomoses have been mandatory in 76 cases (41.76%) because of mechanical jaundice induced by biliary stones. In 106 cases the anastomosis was carried out in an attempt to solve mechanical jaundice that was not induced by biliary stones but by other causes. In 45 cases the lesions that had determined the jaundice were benign, and in 61 of the cases malignancy was at the origin of the jaundice. The following types of anastomosis were employed: choledochoduodenal anastomoses were done in 120 cases (65.93%); hepatic duct-duodenal anastomoses in 15 cases (19.23%); hepatojejunal anastomoses in 7 cases (3.84%); recalibration of previous anastomoses in 5 cases (2.74%). These surgical methods, applied in cases of various etiologies, most of them quite severe, in debilitated patients, with iterative surgery, were associated with early postoperative mortality of 8% (13 cases), and a general morbidity of 35% (65 cases), which included: fistulae, anastomotic stenoses, acute postoperative pancreatitis, angiocholitis and suppuration. The late results were good, depending on the etiology of the mechanical jaundice. The authors preferred choledochoduodenal anastomosis for benign lesions, and anastomoses with the diverticular apparatus, or the main biliary pathway in palliative surgery.
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Procedimientos Quirúrgicos del Sistema Biliar/métodos , Colestasis Extrahepática/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo , Anciano , Anastomosis Quirúrgica/métodos , Colelitiasis/complicaciones , Colelitiasis/cirugía , Colestasis Extrahepática/etiología , Colestasis Extrahepática/mortalidad , Femenino , Humanos , Enfermedad Iatrogénica , Complicaciones Intraoperatorias/etiología , Complicaciones Intraoperatorias/cirugía , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiologíaRESUMEN
The distribution per age groups of antibodies to influenza viruses A/Hong Kong/1/68, A/England/837/69 and A/England/42/72 in the sera collected in 1970 demonstrates that antigenically similar strains also dominated the epidemiologic picture of influenza in the past century. The results suggest that the pandemic of 1893 and infection in persons born before 1885 were caused by a strain similar to A/Hong Kong/1/68 and in those born in 1895-1897 by the antigenic variant A/England/42/72. The anamnestic response to the A/England/69 variant, following upon vaccination with the Hong Kong strain shows that the primary infection in persons born before 1900 was caused by a strain antigenically similar to the first variant. The data obtained lend support to the hypothesis of antigenic recycling of influenza virus and of the finite character of the antigenic variation of influenza viruses.
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Gripe Humana/inmunología , Orthomyxoviridae , Factores de Edad , Anciano , Anticuerpos Antivirales/análisis , Antígenos Virales/análisis , Humanos , Virus de la Influenza A , Persona de Mediana EdadRESUMEN
Spectrophotometric assays have been used to determine FA concentration in tissue homogenates from various organs (liver, kidneys, brain, spleen) in white rats; these studies were undertaken to test the age--and organ--dependent variations of FA concentrations in tissue homogenates. The results showed a marked decrease of FA concentration in the adult group of rats when related to the young group, and in the aged group when compared to the adults respectively. Analysing the determined values of folates in tissue homogenates of various organs (in rats belonging to the same group of age), the highest concentration has been found in the liver homogenate, followed in decreasing order by kidneys and to a much greater distance, by the brain and spleen.
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Envejecimiento/metabolismo , Ácido Fólico/análisis , Especificidad de Órganos/fisiología , Animales , Química Encefálica/fisiología , Riñón/química , Hígado/química , Masculino , Ratas , Espectrofotometría , Bazo/químicaRESUMEN
Virological and bacteriological investigations were performed in 85 patients with acute pneumonias and virus isolation or serological evidence of virus infection were obtained in 37.6% of the cases. Influenza A2 and B viruses were incriminated in 14.1% of the patients; parainfluenza viruses in 7% and adenoviruses in 17.2% of the cases. Coxsackie virus was isolated from one patient's blood, and poliovirus 3 was recovered in 3 cases. In 5 cases associated virus infections were detected.