Strategies for safe living following solid organ transplantation-Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.

The present AST-IDCOP guidelines update information on strategies for safe living after organ transplantation. While transplantation carries an increased risk for infection from the recipient's environment due to lifelong immunosuppression, the goal is for the recipient to be able to return to their home and live as normal a life as possible with a functioning graft. The current guideline provides updates to prior recommendations including additions on infections from water and food sources, exposures to animals, cannabis use as well as sexual exposures or those encountered with travel. Similar to the prior editions, many of the recommendations are based on good infection prevention standards, extrapolation from other immunocompromised hosts, and risks found from cases series in transplant patients. Enhanced education and attention to incorporating safe living strategies into daily life should help to accomplish successful transplant with recipients achieving a fulfilling life away from the hospital.

Infectious diseases in aquarium ornamental pet fish: prevention and control measures / Doenças infeciosas em peixes ornamentais de aquário: medidas de prevenção e controle

Aquarium ornamental pet fish constitute a major segment in the pet industry, with the United States, Europe, and Japan dominating the market. There are approximately 1,500 marine fish species and over 4,500 freshwater fish species commercialized as aquarium ornamental pet fish. Fish are the fourth most common pet present in Brazilian homes. In Brazil, aquarium ornamental pet fish can be marketed and distributed from different parts of the Brazilian territory and the world. Commercialization and circulation of living animals without the use of adequate prophylactic management procedures enables dissemination of a number of agents responsible for infectious diseases. Aquarium pet fish can also carry pathogenic agents, of bacterial, viral, fungal, or parasitic etiology, that may have a zoonotic feature endangering the persons handling the animals. This review presents the main pathogenic infectious agents of bacterial, viral, and fungal etiology that affect aquarium pet fish, as well as the prevention and control measures to ensure sanitary excellence in this segment.(AU)

Peixes ornamentais de aquário representam um grande segmento no mercado de animais de estimação, no qual Estados Unidos, Europa e Japão dominam. São aproximadamente 1.500 espécies de peixes marinhos e em torno de 4.500 de espécies de água doce comercializados com fins ornamentais. O peixe é a quarta espécie mais comum nos domicílios brasileiros. Peixes ornamentais de aquário são comercializados e distribuídos em diferentes partes do território nacional e do mundo. O comércio e circulação de animais vivos sem o uso de procedimentos de manejo profilático adequados possibilita a disseminação de inúmeros agentes patogênicos. Peixes ornamentais de aquário carreiam consigo agentes patogênicos de etiologia bacteriana, viral, fúngica e parasitária, sendo alguns de caráter zoonótico colocando em risco pessoas que os manipulam. O objetivo desta revisão é apresentar os principais agentes infeciosos patogênicos - de natureza bacteriana, viral e fúngica - que acometem peixes ornamentais de aquário, bem como os métodos de prevenção e controle que permitam excelência no segmento.(AU)

Interfacing brain with computer to improve communication and rehabilitation after brain damage.

Communication and control of the external environment can be provided via brain-computer interfaces (BCIs) to replace a lost function in persons with severe diseases and little or no chance of recovery of motor abilities (ie, amyotrophic lateral sclerosis, brainstem stroke). BCIs allow to intentionally modulate brain activity, to train specific brain functions, and to control prosthetic devices, and thus, this technology can also improve the outcome of rehabilitation programs in persons who have suffered from a central nervous system injury (ie, stroke leading to motor or cognitive impairment). Overall, the BCI researcher is challenged to interact with people with severe disabilities and professionals in the field of neurorehabilitation. This implies a deep understanding of the disabled condition on the one hand, and it requires extensive knowledge on the physiology and function of the human brain on the other. For these reasons, a multidisciplinary approach and the continuous involvement of BCI users in the design, development, and testing of new systems are desirable. In this chapter, we will focus on noninvasive EEG-based systems and their clinical applications, highlighting crucial issues to foster BCI translation outside laboratories to eventually become a technology usable in real-life realm.

Assistive technology-based programs to promote communication and leisure activities by three children emerged from a minimal conscious state.

This study proposed the use of assistive technology (AT) to promote communication and leisure opportunities by three children with traumatic brain injury (TBI). Furthermore, it assessed the effects of such technology on the indices of positive participation and provided a social validation procedure. Three children emerged from a minimal conscious state and presenting extensive motor disabilities were involved. The intervention program allowed the participants to request and to choice preferred items independently and to perform literacy through a keyboard emulator. A multiple probe design across behaviors with post-intervention check was employed. Outcome measures were correct requests, understandable words, intervals with positive participation, and scores of social validation assessment. Request and choice behaviors and literacy improved significantly during intervention phases. During post-intervention check, all participants consolidated their performance. Moreover, indices of positive participation increased during intervention phases. Scores of social validation assessment showed that the combination of both behaviors was preferable to the same considered separately. AT program showed to be suitable for promoting constructive engagement and literacy behaviors by children with TBI. Future research is needed to generalize this data to a larger sample and to develop new technology for people with different levels of disabilities due to TBI.

Psychological consequences in pediatric intensive care unit survivors: the neglected outcome.

OBJECTIVES: To determine whether Pediatric Intensive Care Unit (PICU) hospitalization results in adverse psychological effects and to identify the contributory factors. SETTING: Level III PICU of a tertiary center. DESIGN: Prospective cohort study. METHODS: Consecutive patients 5 years or older admitted to PICU for at least 48 hours constituted the study population. Controls were age and sex matched children hospitalized in the pediatric wards for at least 48 hours. Severity of illness was assessed by the Pediatric Risk of Mortality (PRISM) score. Level of therapeutic intervention was determined by the Therapeutic Interventions Scoring System (TISS--76 score). Temperament Measurement Schedule was used to assess the premorbid temperament. Psychological assessment was performed using Impact of Event Scale (IES), Birleson Depression Scale and the Self-Esteem Scale. Follow-up evaluation was done one month after discharge. RESULTS: There were 30 children each in the study and control groups. They had comparable pre-morbid temperament as well as scores on the self-esteem and depression scales. Significantly higher proportion of patients in PICU had intrusive thoughts (43%) as compared to controls (6.7%). Development of intrusive thoughts correlated significantly with the degree of intervention. Demographic parameters, nature of the disease, duration of hospitalization and severity of illness did not correlate with the psychological outcome. One month after discharge, scores in both groups were comparable. CONCLUSIONS: Children subjected to therapeutic interventions in the PICU develop transient psychological impairment manifested by experiencing intrusive thoughts that resolve within a month.

[Season and age related structure of acute intestinal infections morbidity in the Russian Federation].

AIM: To study seasonal and age features of etiological structure of acute intestinal infections (AII) in the territory of the RF. MATERIAL AND METHODS: A total of 7388 AII inpatients aged from 1 day to 90 years from 7 cities (Moscow, St-Petersburg, Nizhniy Novgorod, Chelyabinsk, Tyumen, Makhachkala and Khabarovsk) of the RF participated in a trial conducted from December 2001 to September 2006 The patients were examined with diagnostic tests based on polymerase chain reaction (PCR) for detection of rotaviruses of group A (RVA), noroviruses, astroviruses, adenoviruses, salmonella, termophilic campilobacteria, shigella and enteroinvasive Escherichia coli (EIEC). RESULTS: The above agents were detected in 72% children and 52% adults. In children RVA and noroviruses occurred most frequently (29.5% and 11%, respectively). The adults carried most often salmonella (9.3%), noroviruses (8.4%), RVA (7.8%) and Schigella in combination with EIEC (7.0%). CONCLUSION: Viral agents are essential or prevailing causative agents of AII at different ages. Seasonal and age-related trends of AII morbidity are characterized.

Medical outreach to homeless substance users in New York City: preliminary results.

An innovative, experimental, medical out-reach initiative, using a fully-equipped mobile medical van with a staff of 2 part-time physicians, a physician assistant, a social worker, and a driver/medical aid serving the needs of 1048, mostly male, minority group, high-level, homeless New York City substance users with infectious diseases is described. The study sample (N = 250) was divided into experimental S's who received Intensive case management and a control group who could choose to refer themselves to the SW. Biological tests revealed high rates of cocaine use and infectious diseases. Preliminary 4-month outcomes (N = 128) showed reductions in drug use, homelessness and health complaints in both groups; experimental subjects compared with controls received more Public Assistance and had fewer emergency room visits.

[Cytokines in the immunorehabilitation of infectious patients]. / Tsitokiny v immunoreabilitatsii infektsionnykh bol'nykh.

For the first time in Russia the authors have defined an infectious process of Astrakhan rickettsiosis hemorrhagic fever attended by hyper- and hypoproduction of interferon g and its aftereffects. Reaferon and gammaferon therapy have proved to be very effective in fast normalisation of the immunology index. Enthalferon pills greatly reduced the morbidity rate in servicemen in rotaviral infections.

[The health status and morbidity in the crew members of submarines at different periods of combat training activity]. / Sostoianie zdorov'ia i zabolevaemost' chlenov ékipazhei podvodnykh lodok v razlichnye periody uchebno-boevoi deiatel'nosti.

It was found out in the result of complex examination of health status of 2020 enlisted men from 65 submarine crews of the North Fleet, that the inflammatory and infectious morbidity during the post-cruise period was considerably higher than during seagoing period. This morbidity was characterized by seasonal outbreaks. As for the types of the immune dependency, there were no seasonal changes. The peak of infectious morbidity coincides with the pre-cruise preparative period and post-cruise recreation due to "mixing" of the crews and diminishing of the non-specific resistance of an organism.

[The organization of the rehabilitation of infectious disease patients in multiple hospital overcrowding]. / Organizatsiia reabilitatsii infektsionnykh bol'nykh pri mnogokratnoi peregruzke gospitalei.

The Bagram Rehabilitation Centre was deployed to meet the requirements in equal postinfectious management of patients. Its organic structure was as following: command, 8 companies, aid post and supply units. Each company had in its structure 6 combined-arms officers and warrant officers. Rehabilitation measures included protection regimen with a two-hour after-dinner rest, 5 meals a day, therapeutic physical training, vitamin therapy, psychotherapy and occupational therapy. Convalescents were discharged from the Centre after a complete rehabilitation of their performance and combat capabilities.