RESUMO
Colletotrichum cliviae is a fungal species reported both as pathogen and endophyte with broad geographical distribution. Some purported isolates of this species have been assigned to different taxa, including Colletotrichum aracearum, Colletotrichum orchidearum and Colletotrichum. sichuanensis, for which a preliminary analysis of extensive multilocus (ACT, GAPDH, ITS, TUB2) data in this study revealed high sequence similarity with C. cliviae. We further reassessed the species delineation by using the coalescent method of the generalized mixed Yule-coalescent (GMYC) and Poisson Tree Processes (PTP). Single and multilocus gene trees strongly supported a C. cliviae s. lat. clade including the four species. This clade unfolded eight subclades grouped into three distinct lineages, but no monophyly of any of the four species. GMYC and PTP analyses confidently supported the evolutionary independence of these lineages. C. sichuanensis and C. cliviae, except one isolate, formed the largest lineage. The second lineage was made up of isolates named C. aracearum and some of C. orchidearum sharing the haplotype and the third lineage accommodated two isolates named C. cliviae and C. orchidearum. This finding suggests the synonymization of C. sichuanensis with C. cliviae whereas the taxonomic status of C. aracearum and C. orchidearum still needs clarification. This study lays great stress upon the use of comprehensive data for sequence-based characterisation of species in the C. cliviae s. lat. It also presents the first report of C. cliviae in tropical Africa and on citrus host.
Assuntos
Biodiversidade , Colletotrichum/classificação , Técnicas de Tipagem Micológica , Colletotrichum/química , Colletotrichum/genética , DNA Ribossômico/genética , DNA Espaçador Ribossômico , Variação Genética , Haplótipos , FilogeniaRESUMO
Living with wildfires in an era of climate change requires adaptation and weaving together many forms of knowledge. Empirical evidence of knowledge co-production in wildfire management is lacking in Mediterranean European areas. We explored how local ecological knowledge can be leveraged to reduce wildfire risk through an adaptation pathways process in the Montseny massif and wider Tordera River watershed of Catalonia, Spain: an area stewarded through forestry and agriculture, tourism, nature conservation, and fire management. We combined different methods (e.g., a timeline and Three Horizons framework) throughout three workshops with agents of change to co-create adaptation pathways to reduce wildfire risk, integrating a historical perspective of the landscape while envisioning desirable futures. Our results showed that local ecological knowledge and other soft adaptation strategies contribute to innovative sustainable development initiatives that can also mitigate wildfire risk. The adaptation pathways approach holds much potential to inform local policies and support wildfire-based community initiatives in diverse contexts.
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Conservação dos Recursos Naturais , Incêndios Florestais , Espanha , Conservação dos Recursos Naturais/métodos , Agricultura Florestal/métodos , Mudança Climática , EcologiaRESUMO
Wood-inhabiting fungi (WIF), such as polypores, are extremely species-rich and play vital roles in the functioning of forest ecosystems as decomposers. Despite the importance of polypores, our knowledge of the diversity and distribution of these fungi is still poor in general and especially for West Africa. To advance our knowledge we here summarise results from field collections between 2017 and 2021 and present (i) a taxonomic overview, (ii) phylogenetic placements and (iii) an illustrated catalogue of wood-inhabiting polypore fungi with colour pictures. During the field sampling campaigns, we collected 647 specimens. Based on morphological characteristics and molecular barcode data, 76 polypore species belonging to six orders, 15 families and 39 genera were identified. Of the 76 species, 30 are new to the West Africa, 69 new to Benin, and two new combinations Fuscoporia beninensis and Megasporia minuta are proposed. With this summary, we provide new data for further research. Citation: Olou BA, Langer E, Ryvarden L, Krah F-S, Hounwanou GB, Piepenbring M, Yorou NS (2023). New records and barcode sequence data of wood-inhabiting polypores in Benin with notes on their phylogenetic placements and distribution. Fungal Systematics and Evolution 11: 11-42. doi: 10.3114/fuse.2023.11.02.
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Indigenous cultural fire practitioners proactively revitalise their stewardship/custodianship of their traditional territories to generate diverse social, cultural, economic, self-determination, and ecological benefits. Government, researchers, and natural resource managers can overcome ongoing colonial legacies by enabling Indigenous leadership, providing ongoing investment and removing imposed barriers that restrict cultural fire practices.
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Conservação dos Recursos Naturais , IncêndiosRESUMO
Biosolids management has been largely overlooked as an issue for environmental co-management, collaborative learning and public participation. This paper summarises four research projects on facilitating community involvement in biosolids management in New Zealand. The authors situate these studies both in relation to the New Zealand institutional and policy context for the management of biosolids and in relation to the themes of public participation and social learning in the literature on community involvement in environmental management. From the studies it can be concluded that: the incorporation of the knowledge and views of Maori is important from both public-participation and social-learning perspectives; both public-participation and social-learning approaches must consider the role of issue-definition in relation to willingness to participate; democratic accountability remains a challenge for both approaches; and locating biosolids management within an integrated water-and-wastewater or sustainable waste-management strategy may facilitate wider community participation as well as better-coordinated decision-making.
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Gerenciamento de Resíduos , Participação da Comunidade , Nova Zelândia , Características de ResidênciaRESUMO
Biological warfare is the intentional use of living organisms or their toxic products to cause death, disability, or damage in man, animals, or plants. The target is man, either by causing his sickness or death, or through limitation of his food supplies or other agricultural resources. Man must wage a continuous fight to maintain and defend himself, his animals, and his plants in competition with insects and microorganisms. The object of BW is to overcome these efforts by deliberately distributing large numbers of organisms of native or foreign origin, or their toxic products, taking full advantage of the ability to utilize more effective methods of dissemination and unusual portals of entry. BW has been aptly described as public health in reverse.-"Effects of Biological Warfare Agents," pamphlet published by Department of Health, Education, and Welfare, July 1959.
RESUMO
The first of two articles on chemical and biological warfare (Chemical and Biological Warfare (I): The Research Program, Science, 13 January 1967) incorrectly stated that the Illinois Insti tute of Technology is among institu tions conducting research on CBW. IIT is conducting no work on CBW and does not engage in classified research. The work in question is being per formed at the Illinois Institute of Tech nology Research Institute, a separate organization affiliated administratively with IIT.
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In respect to the actual discussion of new anticoagulants in secondary haemostasis, we will give a short review on established oral anticoagulation with vitamin K antagonists and parenteral anticoagulation by use of heparin. The different coumarin derivatives phenprocoumon, warfarin, and acenocoumarol are compared concerning to the management and influence of pharmacogenetic and pharmacokinetic factors. Studies to improve the safety of oral anticoagulation by vitamin K supplementation will be briefly discussed. The therapy with heparins include until now some problems of dose-response control. It is necessary to pay attention to contra-indications even for well known anticoagulants. Examples for that will be given.
Assuntos
Anticoagulantes/uso terapêutico , Hemostasia/efeitos dos fármacos , Heparina/uso terapêutico , Vitamina K/antagonistas & inibidores , HumanosRESUMO
During normal tumor growth and in response to some therapies, tumor cells experience acute or chronic deprivation of nutrients and oxygen and induce tumor vascularization. While this occurs predominately through sprouting angiogenesis, tumor cells have also been shown to directly contribute to vessel formation through vascular mimicry (VM) and/or endothelial transdifferentiation. The extrinsic and intrinsic mechanisms underlying tumor cell adoption of endothelial phenotypes, however, are not well understood. Here we show that serum withdrawal induces mesenchymal breast cancer cells to undergo VM and that knockdown of the epithelial-to-mesenchymal transition (EMT) regulator, Zinc finger E-box binding homeobox 1 (ZEB1), or overexpression of the ZEB1-repressed microRNAs (miRNAs), miR-200c, miR-183, miR-96 and miR-182 inhibits this process. We find that secreted proteins Fibronectin 1 (FN1) and serine protease inhibitor (serpin) family E member 2 (SERPINE2) are essential for VM in this system. These secreted factors are upregulated in mesenchymal cells in response to serum withdrawal, and overexpression of VM-inhibiting miRNAs abrogates this upregulation. Intriguingly, the receptors for these secreted proteins, low-density lipoprotein receptor-related protein 1 (LRP1) and Integrin beta 1 (ITGB1), are also targets of the VM-inhibiting miRNAs, suggesting that autocrine signaling stimulating VM is regulated by ZEB1-repressed miRNA clusters. Together, these data provide mechanistic insight into the regulation of VM and suggest that miRNAs repressed during EMT, in addition to suppressing migratory and stem-like properties of tumor cells, also inhibit endothelial phenotypes of breast cancer cells adopted in response to a nutrient-deficient microenvironment.
Assuntos
Comunicação Autócrina , Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/irrigação sanguínea , Regulação Neoplásica da Expressão Gênica , MicroRNAs/genética , Neovascularização Patológica/patologia , Homeobox 1 de Ligação a E-box em Dedo de Zinco/metabolismo , Animais , Apoptose , Biomarcadores Tumorais/genética , Neoplasias da Mama/genética , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Movimento Celular , Proliferação de Células , Transição Epitelial-Mesenquimal , Feminino , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos SCID , Neovascularização Patológica/genética , Neovascularização Patológica/metabolismo , Prognóstico , Serpina E2/genética , Serpina E2/metabolismo , Células Tumorais Cultivadas , Ensaios Antitumorais Modelo de Xenoenxerto , Homeobox 1 de Ligação a E-box em Dedo de Zinco/genéticaRESUMO
Synovial sarcomas are aggressive soft-tissue malignancies that express chromosomal translocation-generated fusion genes, SS18-SSX1 or SS18-SSX2 in most cases. Here, we report a mouse sarcoma model expressing SS18-SSX1, complementing our prior model expressing SS18-SSX2. Exome sequencing identified no recurrent secondary mutations in tumors of either genotype. Most of the few mutations identified in single tumors were present in genes that were minimally or not expressed in any of the tumors. Chromosome 6, either entirely or around the fusion gene expression locus, demonstrated a copy number gain in a majority of tumors of both genotypes. Thus, by fusion oncogene coding sequence alone, SS18-SSX1 and SS18-SSX2 can each drive comparable synovial sarcomagenesis, independent from other genetic drivers. SS18-SSX1 and SS18-SSX2 tumor transcriptomes demonstrated very few consistent differences overall. In direct tumorigenesis comparisons, SS18-SSX2 was slightly more sarcomagenic than SS18-SSX1, but equivalent in its generation of biphasic histologic features. Meta-analysis of human synovial sarcoma patient series identified two tumor-gentoype-phenotype correlations that were not modeled by the mice, namely a scarcity of male hosts and biphasic histologic features among SS18-SSX2 tumors. Re-analysis of human SS18-SSX1 and SS18-SSX2 tumor transcriptomes demonstrated very few consistent differences, but highlighted increased native SSX2 expression in SS18-SSX1 tumors. This suggests that the translocated locus may drive genotype-phenotype differences more than the coding sequence of the fusion gene created. Two possible roles for native SSX2 in synovial sarcomagenesis are explored. Thus, even specific partial failures of mouse genetic modeling can be instructive to human tumor biology.
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Biomarcadores Tumorais/genética , Proteínas de Neoplasias/genética , Proteínas de Fusão Oncogênica/genética , Proteínas Proto-Oncogênicas/genética , Proteínas Repressoras/genética , Sarcoma Sinovial/genética , Animais , Carcinogênese/genética , Modelos Animais de Doenças , Genótipo , Humanos , Camundongos , Sarcoma Sinovial/patologia , Translocação Genética/genéticaRESUMO
We reviewed malpractice data from the state of Wisconsin for 1983 and 1984 to determine the frequency and the outcome of malpractice litigation by the elderly. Research data were obtained from court dockets filed with Wisconsin's Patients Compensation Panel and from 281 attorneys who provided the age for 431 claimants. The results showed that 10.0% of malpractice suits in Wisconsin were filed by the elderly during the study years. When we compared the frequency of litigation with the use of the health care system (number of hospitalizations and inpatient days), the elderly were significantly less likely than younger persons to initiate malpractice litigation despite greater exposure to potential negligence. However, once a malpractice suit was filed, there was no significant difference between older and younger litigants in the disposition of the case or in the likelihood of being the prevailing party when a finding or award was made. These findings suggest that the elderly are less likely to file malpractice claims against health care providers than would be expected given their use of the health care system. This finding may be related to social, economic, and legal barriers to malpractice litigation by older adults.
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Idoso , Imperícia/tendências , Adulto , Fatores Etários , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade , WisconsinRESUMO
No mycoplasmas and no chlamydiae were found in cultures of 75 uninflamed comedones, 72 papulopustular lesions, and 7 cystic lesions from 14 subjects with acne. Chlamydial serologic tests were negative for 11 subjects and showed antibodies in 3 subjects to 3 different antigenic types of trachoma agent. These results are viewed as substantial evidence against the possibility that either mycoplasmas or chlamydiae play an important part in the pathogenesis of acne.
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Acne Vulgar/microbiologia , Chlamydia/isolamento & purificação , Mycoplasma/isolamento & purificação , Acne Vulgar/etiologia , Adulto , Chlamydia trachomatis/isolamento & purificação , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
This report describes the morphological changes observed in the brain of an untreated 27-year-old man with phenylketonuria, cortical blindness, and seizures. Golgi-Kopsch silver, cresyl violet, and hematoxylin and eosin stains were used to study cell structure and organization of the cerebellum, the lateral geniculate nuclei, the visual cortex, frontal cortex, and hippocampus. Extensive neuronal losses occurred in the right lateral geniculate nucleus (LGN), the visual cortex, and hippocampus. The left LGN, cerebellum, and frontal cortex retained neuronal components; there was a reduction in the number of dendritic processes on the Purkinje cells of the PKU subject. The loss of neurons in the LGN and occipital cortex is related to the blindness and the neuronal loss in the hippocampus is related to seizure activity.
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Cegueira/complicações , Encéfalo/patologia , Fenilcetonúrias/complicações , Convulsões/complicações , Cegueira/patologia , Humanos , Masculino , Neurônios/patologia , Fenilcetonúrias/patologiaRESUMO
Many performance deficits observed in institutionalized elderly patients may be the results of social and environmental factors rather than disease or the aging process. To test this hypothesis, 72 nursing home residents (mean age, 78 years) were randomly assigned to three groups for training in completion of a simple psychomotor task. In four training sessions, members of Group I ("helped") were given extensive assistance in completing the task; members of Group II ("encouraged only") were given verbal encouragement but minimal assistance; members of Group III ("no contact") received no training sessions and served as controls. All subjects were tested on proficiency in completion of the task (a simple jigsaw puzzle) before and after the intervention period. Completeness of performance by Group II improved during the study, but that of Group I deteriorated significantly (P = 0.04 between groups) to a level even below that of the control group (P = 0.03). Similar differences were found in speed of performance, with Group II performing best, Group I performing worst (P = 0.05), and the control group performing intermediately. Perception of task difficulty was greater (P = 0.02) and self-confidence was less (P = 0.06) for Group I than for Group II. The psychosocial environment of long-term facilities can have important effects on the competence of elderly patients. Excessive infantilization of residents and overly intrusive help in self-care beyond clinical requirements can lead to "learned helplessness," with further disability.
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Atividades Cotidianas , Pacientes Internados , Casas de Saúde , Pacientes , Idoso , Enfermagem Geriátrica , Comportamento de Ajuda , HumanosRESUMO
OBJECTIVES: To investigate the relationship between antithyroid antibody elevation and thyrotropin (TSH) elevation. SETTING: Large state veterans home. METHODS: Seven hundred seventy-six residents were screened for TSH elevation. Seventy-two residents with TSH elevation and no history of thyroid disease or recent iodine exposure later had determinations of antithyroglobulin and antimicrosomal antibodies. The relationship between TSH levels and antibody titers was explored. RESULTS: Eleven percent of the residents had TSH elevation. Thirty-two percent of men and 64% of women with TSH elevation had elevation of antithyroid antibodies. Those residents with the highest antithyroid antibody titers had significantly greater TSH elevation. CONCLUSION: Previous investigators have found similar percentages of individuals with TSH elevation who lack antithyroid antibody elevation. We hypothesize that TSH elevation without elevated antibody titers may be the result of a previously described involutional histologic lesion of the thyroid.
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Anticorpos/análise , Glândula Tireoide/imunologia , Tireotropina/sangue , Idoso , Idoso de 80 Anos ou mais , Feminino , Instituição de Longa Permanência para Idosos , Humanos , Masculino , Pessoa de Meia-Idade , Casas de Saúde , Valores de Referência , Veteranos , WisconsinRESUMO
OBJECTIVE: To compare mortality following isolation of influenza A to mortality following isolation of other respiratory viruses in a nursing home. SETTING: The Wisconsin Veterans Home, a 688-bed skilled nursing facility for veterans and their spouses. PARTICIPANTS: All residents with respiratory viral isolates obtained between 1988 and 1999. DESIGN: Thirty-day mortality was determined following each culture-proven illness. RESULTS: Thirty-day mortality following isolation of viral respiratory pathogens was 4.7% (15/322) for influenza A; 5.4% (7/129) for influenza B; 6.1% (3/49) for parainfluenza type 1; 0% (0/26) for parainfluenza types 2, 3, and 4; 0% (0/26) for respiratory syncytial virus (RSV); and 1.6% (1/61) for rhinovirus. CONCLUSIONS: Mortality following isolation of certain other respiratory viruses may be comparable to that following influenza A (although influenza A mortality might be higher without vaccination and antiviral agents). The use of uniform secretion precautions for all viral respiratory illness deserves consideration in nursing homes.
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Casas de Saúde , Infecções Respiratórias/mortalidade , Idoso , Feminino , Humanos , Vírus da Influenza A/isolamento & purificação , Masculino , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/virologia , Wisconsin/epidemiologiaRESUMO
The course of untreated mild hypothyroidism was followed in 67 nursing home residents (mean age 78 years). The diagnosis was based on a normal free thyroxine index (FTI) and elevated thyrotropin concentration (TSH 4.6 to 15.0 microIU/mL, nl less than or equal to 4.5 microIU/mL. FTI and FSH were measured in follow-up 42-378 (mean 161) days after the diagnosis of mild hypothyroidism had been made. In 45 patients initial TSH was less than 6.8 microIU/mL; in 23 of these subjects TSH returned to normal during the observation period, whereas in 22 TSH remained elevated. In all 22 residents whose initial TSH was greater than 6.8 microIU/mL, TSH remained elevated at follow-up. In 4 subjects whose initial TSH concentrations ranged from 5.0 to 9.6 microIU/mL, FTI fell below normal 91-141 days after the diagnosis of mild hypothyroidism was made. Clinical progression of the signs or symptoms of hypothyroidism was not detected in the 4 patients who developed hypothyroxinemia. Three demonstrated positive thyroid antibody titers, and 1 had myasthenia gravis. These observations suggest a need for replacement therapy in debilitated patients with mild hypothyroidism and evidence of thyroid autoimmunity.
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Instituição de Longa Permanência para Idosos , Hipotireoidismo/sangue , Programas de Rastreamento , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Hipotireoidismo/diagnóstico , Hipotireoidismo/terapia , Masculino , Pessoa de Meia-Idade , Tireotropina/sangue , Tiroxina/sangue , WisconsinRESUMO
One hundred ninety-eight nursing home admissions underwent audiometric assessment and answered questions regarding hearing difficulty in common listening situations. Twenty-four percent demonstrated normal thresholds (0-25 dB) in the speech frequencies with only mild losses at 4000 Hz. Fifty-four percent had normal thresholds through the speech frequencies with moderate to profound losses at higher frequencies, or mild losses (26-40 dB) in the speech frequencies. Such persons would be at risk in daily listening situations. Twenty-two percent had moderate or greater losses (greater than 40 dB) through the entire frequency range. Sixteen percent of this significantly impaired group were not identified as having a hearing loss by either the admitting RN or physician. Sixty percent of residents reported trouble in a group if they could not see the speaker's face, when watching television, and/or when using the telephone. The data indicate that a systematic hearing screening program is the most reliable means of identifying hearing loss and functional hearing handicap on an individual basis. The high prevalence of hearing problems suggests that this handicap also needs to be addressed from the perspective of institutional policy. Staff training and environmental modification should be undertaken to give hearing support to the entire nursing home population.
Assuntos
Perda Auditiva , Casas de Saúde/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Comunicação , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Perda Auditiva/fisiopatologia , Testes Auditivos , Humanos , Decoração de Interiores e Mobiliário , Masculino , Pessoa de Meia-Idade , Estados Unidos , Veteranos , Wisconsin/epidemiologiaRESUMO
OBJECTIVE: To compare the efficacy of an influenza hemagglutinin-diphtheria toxoid conjugate vaccine with the commercially available influenza hemagglutinin-subunit vaccine in preventing influenza in older adults living in a nursing home. DESIGN: A prospective, randomized, double-blind vaccine trial with 5 months of follow-up after vaccination. SETTING: Fourteen Wisconsin nursing homes. PARTICIPANTS: Nursing home residents at least 65 years old who were able to give informed consent and were free of malignancy and not receiving immunosuppressive therapy. INTERVENTIONS: Participants received, by intramuscular injection, 0.5 mL of a trivalent influenza vaccine containing 15 micrograms each of A/Leningrad/360/86 (H3N2), A/Taiwan/1/86 (H1N1), and B/Ann Arbor/1/86 (HA) or 0.5 mL of an influenza vaccine containing the same antigens conjugated to diphtheria toxoid (HA-D). MEASUREMENTS: Blood was obtained pre- and 1 month post-vaccination to assess for any vaccine-induced antibody titer change. Clinical surveillance for respiratory illness was performed twice weekly for 5 months. A record was kept of all signs and symptoms of new respiratory illness, and a viral culture and acute and convalescent sera were obtained. RESULTS: 204 participants received HA and 204 received HA-D. Both groups had similar baseline antibody levels to all influenza antigens. HA-D recipients seroconverted more frequently based on serum neutralizing activity (P < 0.05), had a greater increase in geometric mean titer (GMT), and sustained the increase in antibody titer longer than HA recipients. Vaccine hemagglutinin recall was greater in a subset of HA-D recipients as measured by lymphocyte proliferative assays (P < 0.05). During an outbreak of influenza A (H3N2 A/Shanghai/11/87-like and A/Victoria/7/87-like), fewer HA-D (29/195) than HA (43/204) recipients had laboratory-confirmed infection (P = 0.053), and, of these, fewer HA-D-treated subjects had lower respiratory tract involvement (5/29 HA-D and 17/43 HA) (P = 0.022). CONCLUSIONS: HA-D was more immunogenic in institutionalized elderly recipients and produced greater protection from influenza infection. Superior protection may be due to HA-D's ability to stimulate and recruit antigen-presenting cells, thus enabling the recipient to achieve and maintain functional antibody titers.
Assuntos
Infecção Hospitalar/prevenção & controle , Toxoide Diftérico/administração & dosagem , Surtos de Doenças , Hemaglutininas Virais/imunologia , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Casas de Saúde , Idoso , Formação de Anticorpos , Toxoide Diftérico/imunologia , Método Duplo-Cego , Feminino , Glicoproteínas de Hemaglutininação de Vírus da Influenza , Humanos , Vacinas contra Influenza/imunologia , Influenza Humana/epidemiologia , Ativação Linfocitária , Masculino , Estudos Prospectivos , Vacinas Conjugadas/administração & dosagem , Vacinas Conjugadas/imunologiaRESUMO
OBJECTIVE: To report the number and timing of influenza A isolates, as well as overlapping respiratory viruses. Co-circulating respiratory viruses may obscure the determination of influenza activity. DESIGN: Prospective clinical surveillance for the new onset of respiratory illness followed by viral cultures during seven separate influenza seasons. SETTING: The Wisconsin Veterans Home, a skilled nursing facility for veterans and their spouses. RESULTS: Influenza A isolates were encountered in greater numbers than non-influenza A isolates during three seasons. Seasonal variability is striking. In December 1992, we identified a large outbreak of respiratory illness. Influenza type B was cultured from 102 residents. In December 1995, influenza A was cultured from 285 people in Wisconsin. At that time, we identified outbreaks of respiratory illness in two of our four buildings. Based on statewide data, we suspected an influenza outbreak; however, 26 isolates of parainfluenza virus type 1 were cultured with no influenza. The potential importance of culturing at the end of the season was demonstrated in 1991-1992 when an outbreak of respiratory syncytial virus (RSV) overlapped and extended beyond influenza A activity. CONCLUSIONS: When interpreting new clinical respiratory illnesses as a basis for declaring an outbreak of influenza A, clinicians should realize that co-circulating respiratory viruses can account for clinical illnesses. Clinicians might utilize healthcare dollars efficiently by performing cultures to focus the timing of influenza A chemoprophylaxis. Cultures could be performed when clinical outbreak criteria are approached to confirm an outbreak. Culturing of new respiratory illness could begin again before the anticipated discontinuation of prophylaxis (approximately 2 weeks).