RESUMO
Highly pathogenic avian influenza (HPAI) viruses of the H5N1 subtype are enzootic in poultry populations in different parts of the world, and have caused numerous human infections in recent years, particularly in Egypt. However, no sustained human-to-human transmission of these viruses has yet been reported. We tested nine naturally occurring Egyptian H5N1 viruses (isolated in 2014-2015) in ferrets and found that three of them transmitted via respiratory droplets, causing a fatal infection in one of the exposed animals. All isolates were sensitive to neuraminidase inhibitors. However, these viruses were not transmitted via respiratory droplets in three additional transmission experiments in ferrets. Currently, we do not know if the efficiency of transmission is very low or if subtle differences in experimental parameters contributed to these inconsistent results. Nonetheless, our findings heighten concern regarding the pandemic potential of recent Egyptian H5N1 influenza viruses.
Assuntos
Virus da Influenza A Subtipo H5N1/genética , Infecções por Orthomyxoviridae/epidemiologia , Infecções por Orthomyxoviridae/veterinária , Animais , Antivirais/farmacologia , Bioensaio , Cães , Egito/epidemiologia , Inibidores Enzimáticos/farmacologia , Furões , Expressão Gênica , Células HeLa , Humanos , Virus da Influenza A Subtipo H5N1/classificação , Virus da Influenza A Subtipo H5N1/efeitos dos fármacos , Virus da Influenza A Subtipo H5N1/isolamento & purificação , Células Madin Darby de Rim Canino , Neuraminidase/antagonistas & inibidores , Neuraminidase/genética , Neuraminidase/metabolismo , Infecções por Orthomyxoviridae/tratamento farmacológico , Infecções por Orthomyxoviridae/transmissão , Filogenia , Medição de Risco , Carga Viral/efeitos dos fármacos , Proteínas Virais/antagonistas & inibidores , Proteínas Virais/genética , Proteínas Virais/metabolismoRESUMO
Blood pressure and flow in the ascending aorta were measured in 16 patients undergoing coronary artery bypass grafting. The analog records were digitized and the data used to compute total hemodynamic power and aortic input impedance, which may be considered to be direct indices of cardiac performance and the state of the cardiovascular system. Various indirect indices were also computed from the same data and statistically compared with the two direct indices. The results showed that it is necessary to measure both pressure and flow to achieve statistically significant correlations, and that none of the indirect indices was capable of describing either cardiac performance or the state of the cardiovascular system comprehensively, or unambiguously, in these patients.
Assuntos
Ponte de Artéria Coronária , Hemodinâmica , Adulto , Aorta/fisiopatologia , Pressão Sanguínea , Débito Cardíaco , Frequência Cardíaca , Humanos , Período Intraoperatório , Pessoa de Meia-Idade , Resistência VascularRESUMO
Vecuronium is an intermediate duration, non-depolarising muscle relaxant. When used during prolonged procedures, it may be given by intermittent injection, by continuous infusion or by a single very large dose at the start of anaesthesia. It may also be used to maintain relaxation after the initial use of a long-acting agent, such as pancuronium. This study demonstrates that the effect of a dose of vecuronium used in this fashion is increased when interaction with pancuronium takes place. The clinical and theoretical implications of this observation are discussed.