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el Lun Ago 15, 2011 2:22 pm
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Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico.

National Institute of Respiratory Diseases, Mexico City, Mexico. perezpad@gmail.com
Abstract
BACKGROUND:

In late March 2009, an outbreak of a respiratory illness later proved to be caused by novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in Mexico. We describe the clinical and epidemiologic characteristics of persons hospitalized for pneumonia at the national tertiary hospital for respiratory illnesses in Mexico City who had laboratory-confirmed S-OIV infection, also known as swine flu.
METHODS:

We used retrospective medical chart reviews to collect data on the hospitalized patients. S-OIV infection was confirmed in specimens with the use of a real-time reverse-transcriptase-polymerase-chain-reaction assay.
RESULTS:

From March 24 through April 24, 2009, a total of 18 cases of pneumonia and confirmed S-OIV infection were identified among 98 patients hospitalized for acute respiratory illness at the National Institute of Respiratory Diseases in Mexico City. More than half of the 18 case patients were between 13 and 47 years of age, and only 8 had preexisting medical conditions. For 16 of the 18 patients, this was the first hospitalization for their illness; the other 2 patients were referred from other hospitals. All patients had fever, cough, dyspnea or respiratory distress, increased serum lactate dehydrogenase levels, and bilateral patchy pneumonia. Other common findings were an increased creatine kinase level (in 62% of patients) and lymphopenia (in 61%). Twelve patients required mechanical ventilation, and seven died. Within 7 days after contact with the initial case patients, a mild or moderate influenza-like illness developed in 22 health care workers; they were treated with oseltamivir, and none were hospitalized.
CONCLUSIONS:

S-OIV infection can cause severe illness, the acute respiratory distress syndrome, and death in previously healthy persons who are young to middle-aged. None of the secondary infections among health care workers were severe.


In this study it is referred that there were hospitalized with pneumonia and S-OIV

a) 18 cases
b) 98 cases
c) 116 cases
d) 8 cases



The age groups described in the article shows that:

a) The risk of infection was in young to mature persons
b) Some medical personnel were infected with influenza A (H1N1) virus (S-OIV)
c) The patients were treated in different hospitals
d) The patients were included in a retrospective study



How many patients were referred for a first treatment of their condition?

a) 18
b) 2
c) 16
d) 98
Which were the most significant laboratory findings?

a) Increased serum lactate dehydrogenase levels
b) Elevated leucocyte count
c) Increased lymphocyte count
d) Diminished creatinine kinase


Most deaths occurred in patients who required:

a) Treatment of pnemonia
b) Mechanical ventilation
c) Treatment for secondary infections
d) Hopitalilzation






Comparative efficacy of inactivated and live attenuated influenza vaccines.
Monto AS, Ohmit SE, Petrie JG, Johnson E, Truscon R, Teich E, Rotthoff J, Boulton M, Victor JC.
Source

Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA. asmonto@umich.edu
Abstract
BACKGROUND:

The efficacy of influenza vaccines may vary from year to year, depending on a variety of factors, and may differ for inactivated and live attenuated vaccines.
METHODS:

We carried out a randomized, double-blind, placebo-controlled trial of licensed inactivated and live attenuated influenza vaccines in healthy adults during the 2007-2008 influenza season and estimated the absolute and relative efficacies of the two vaccines.
RESULTS:

A total of 1952 subjects were enrolled and received study vaccines in the fall of 2007. Influenza activity occurred from January through April 2008, with the circulation of influenza types A (H3N2) (about 90%) and B (about 9%). Absolute efficacy against both types of influenza, as measured by isolating the virus in culture, identifying it on real-time polymerase-chain-reaction assay, or both, was 68% (95% confidence interval [CI], 46 to 81) for the inactivated vaccine and 36% (95% CI, 0 to 59) for the live attenuated vaccine. In terms of relative efficacy, there was a 50% (95% CI, 20 to 69) reduction in laboratory-confirmed influenza among subjects who received inactivated vaccine as compared with those given live attenuated vaccine. The absolute efficacy against the influenza A virus was 72% (95% CI, 49 to 84) for the inactivated vaccine and 29% (95% CI, -14 to 55) for the live attenuated vaccine, with a relative efficacy of 60% (95% CI, 33 to 77) for the inactivated vaccine.
CONCLUSIONS:

In the 2007-2008 season, the inactivated vaccine was efficacious in preventing laboratory-confirmed symptomatic influenza A (predominately H3N2) in healthy adults. The live attenuated vaccine also prevented influenza illnesses but was less efficacious. (ClinicalTrials.gov number, NCT00538512.)





The primary objective of this study is to estimate the efficacy of two types of vaccines taking into account:

a) History of individual hypersensitivity to other vaccines component
b) The age and health status of elegibility
c) Randomization of vaccines
d) The study was performed from January throughout April


When do the vaccines under research were administered?

a) In the autumn season
b) When viruses A and B were present
c) The study was carried out in Massachusetts
d) The authors concern was about the f identification of the real-time polymerase-chain-reaction assay


How was determined the absolute efficacy in opposition of type A virus?

a) When the viruses were circulating during the influenza activity
b) When influenza virus A was 95 per cent CI
c) When the cultured virus was separated in culture
d) By the results of both vaccines



The conclusion of the study was as follows:

a) When one vaccine was effective and the other not as much as the other
b) That the efficacy of the vaccines were administered during the influenza season
c) The efficacy improved only in healthy male patients
d) The efficacy of influenza vaccines may vary from year to year, depending on a variety of factors



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el Lun Ago 22, 2011 3:43 pm
Legionella pneumophila monoclonal antibody subgroups and DNA sequence types isolated in Canada between 1981 and 2009: Laboratory Component of National Surveillance.
Reimer AR, Au S, Schindle S, Bernard KA.
Source

Special Bacteriology, Emerging Bacterial Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg R3E 3R2, Canada. aleisha_reimer@phac-aspc.gc.ca
Abstract

Legionella pneumophila (Lp) is a significant cause of nosocomial, community-acquired, and travel-associated pneumonia in industrialized regions. Legionellosis has been a nationally notifiable disease in Canada since 1986, with an average of 75 cases reported annually; however, only the most severe, and often fatal, cases are reported or investigated. Here, epidemiological relationships, types, and distribution of Lp referrals to the Canadian national reference center were studied. Lp strains from different years, sources, and geographic locations were subtyped using a sequence-based typing (SBT) scheme and by the 'Joly' and/or 'Dresden' monoclonal antibody panels. Included were 128 epidemiologically unrelated clinical and 86 unrelated environmental strains. Sixty-four (index of diversity [IOD] = 0.964) and 45 (IOD = 0.888) sequence types (STs) were observed among clinical and environmental sources, respectively. Serogroup (sg) 1 was represented by 60.2% (77/128) and 52.3% (45/86) of clinical and environmental strains, respectively, and 63.6% (49/77) and 15.6% (7/45) of those were mAb2-positive, respectively. Serogroup 1, ST1 accounted for 14.1% (18/128) and 30.2% (26/86) of unrelated clinical and environmental isolates, respectively. This database will serve as a basis for Canadian epidemiological surveillance efforts and is linked to global surveillance initiatives curated by the European Working Group for Legionella Infections (EWGLI) network.



Besides the epidemiological study of Lp and other aspects, which cases are reported?

a) Chlorination
b) Urease
c) Severe and fatal cases
d) Effector proteins


Where in Canada is Legionella associated and detected?

a) In northern Canada
b) Is related to travel in industrialized places
c) In Vancouver
d) In bus driver


How were subtyped the different strains of Lp?

a) Using hydrolised gelatin
b) Using electron photography
c) By sequence analysis
d) Using a sequence-based typing


One important point in this study is that…

a) The relationship between serotypes
b) The data base accumulated will be useful for future observation
c) Geographical locations
d) Types of subjects infected


RESP
1.C
2.B
3.D
4.B







Out-of-hospital cardiac arrest due to drowning: An Utstein Style report of 10 years of experience from St. Mary's Hospital.
Youn CS, Choi SP, Yim HW, Park KN.
Source

Department of Emergency Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Abstract
BACKGROUND:

Drowning is a unique form of cardiac arrest and is often preventable. "Utstein Style for Drowning" was published in 2003 by the International Liaison Committee on Resuscitation (ILCOR) to improve the knowledge-base, to provide epidemiological stratification, to recommend appropriate treatments and to ultimately save lives. We report on the largest single-center study of the Utstein Style resuscitation for drowning.
METHODS:

All patients with out-of-hospital cardiac arrest (OHCA) due to drowning admitted to St. Mary's Hospital between 1998 and 2007 were included. Utstein Style variables and other time intervals not included in the Utstein Style guidelines were evaluated for their ability to predict survival. The primary end point of this study was survival to discharge.
RESULTS:

We enrolled 131 patients with OHCA due to drowning; 21 patients (16.03%) had survival to discharge and 9 patients (6.87%) were discharged with a good neurologic outcome, i.e., cerebral performance categories (CPC) of 1 or 2. For the Utstein Style variables witnessed, the duration of submersion and the time of first emergency medical systems (EMS) resuscitation attempt influenced survival. For other time intervals, the transportation time (i.e., time interval from witnessing of the drowning to EMS arrival at the hospital, or if events were not witnessed, the time interval from calling the EMS to EMS arrival at the hospital), the duration of advanced cardiovascular life support (ACLS) and the duration of total arrest time were associated with survival.
CONCLUSIONS:

Our report is the largest single-center study of OHCA due to drowning reported according to the guidelines of the Utstein Style. Being witnessed, having a short duration of submersion, having early resuscitation by EMS, and rapid transportation are important for survival after drowning.


. What is the purpose of the "Utstein Style for Drowning" established in this paper?

a) Teach how to swim in order to avoid drawning
b) To improve resuscitation techniques
c) Supply epidemiological stratification and the right treatments
d) Implementation of techniques

The important matter of this study besides evaluating the guidelines is…

a) Location of arrest
b) Time of incident
c) Gender
d) Survival


In order to preserve life, according to Utstein variables; what influences survival?

a) Duration of submersion and time of EMS
b) Style of resuscitation
c) Know potential problems
d) Conflicts of interest

Which other important factors were associated with survival?

a) Age of patient
b) How many witnesses were at the scene of incident
c) Water temperature
d) Transportation time had duration of ACLS




RESP
1.C
2.D
3.A
4.D




DENADAAAAAAA Mad
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el Mar Ago 23, 2011 7:51 pm
Gene therapy for immunodeficiency due to adenosine deaminase deficiency.
Aiuti A, Cattaneo F, Galimberti S, Benninghoff U, Cassani B, Callegaro L, Scaramuzza S, Andolfi G, Mirolo M, Brigida I, Tabucchi A, Carlucci F, Eibl M, Aker M, Slavin S, Al-Mousa H, Al Ghonaium A, Ferster A, Duppenthaler A, Notarangelo L, Wintergerst U, Buckley RH, Bregni M, Marktel S, Valsecchi MG, Rossi P, Ciceri F, Miniero R, Bordignon C, Roncarolo MG.
Source

San Raffaele Telethon Institute for Gene Therapy, Milan, Italy.
Abstract
BACKGROUND:

We investigated the long-term outcome of gene therapy for severe combined immunodeficiency (SCID) due to the lack of adenosine deaminase (ADA), a fatal disorder of purine metabolism and immunodeficiency.
METHODS:

We infused autologous CD34+ bone marrow cells transduced with a retroviral vector containing the ADA gene into 10 children with SCID due to ADA deficiency who lacked an HLA-identical sibling donor, after nonmyeloablative conditioning with busulfan. Enzyme-replacement therapy was not given after infusion of the cells.
RESULTS:

All patients are alive after a median follow-up of 4.0 years (range, 1.8 to 8.0). Transduced hematopoietic stem cells have stably engrafted and differentiated into myeloid cells containing ADA (mean range at 1 year in bone marrow lineages, 3.5 to 8.9%) and lymphoid cells (mean range in peripheral blood, 52.4 to 88.0%). Eight patients do not require enzyme-replacement therapy, their blood cells continue to express ADA, and they have no signs of defective detoxification of purine metabolites. Nine patients had immune reconstitution with increases in T-cell counts (median count at 3 years, 1.07x10(9) per liter) and normalization of T-cell function. In the five patients in whom intravenous immune globulin replacement was discontinued, antigen-specific antibody responses were elicited after exposure to vaccines or viral antigens. Effective protection against infections and improvement in physical development made a normal lifestyle possible. Serious adverse events included prolonged neutropenia (in two patients), hypertension (in one), central-venous-catheter-related infections (in two), Epstein-Barr virus reactivation (in one), and autoimmune hepatitis (in one).
CONCLUSIONS:

Gene therapy, combined with reduced-intensity conditioning, is a safe and effective treatment for SCID in patients with ADA deficiency. (ClinicalTrials.gov numbers, NCT00598481 and NCT00599781.)

2009 Massachusetts Medical Society


. What are the aims of this research?

a) Study bone marrow cells response to treatment
b) Scrutinize a therapy for SCID
c) The lack of adenosine
d) Understand purine metabolism

What kind of responses were extracted following vaccination?

a) Hematopoietic responses
b) Nonmyeloablative response
c) Enzymatic response
d) Antigen-specific antibody


Where does manifestation of adenosine deaminase occurs?

a) In T-cells
b) In antibody responses
c) In metabolism disorders
d) Blood cells


What is a harmless treatment for SCID?

a) Enzyme replacement therapy
b) Immnue reconstitution
c) Normalization of T-cell counts
d) Treatment with genes


Which cells characterize and atachted into myeloid cells?

a) Blood cells
b) T-cells
c) Transduced hematopoietic stem cells
d) Marrow cells




RESP
1.B
2.D
3.D
4.D
5.C

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el Mar Ago 23, 2011 11:30 pm
Gracias! cheers
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el Miér Ago 24, 2011 12:50 am
albino
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el Miér Ago 24, 2011 1:28 am
Interleukin-1 receptor antagonist gene (IL1RN) polymorphism possibly associated to severity of rheumatic carditis in a Brazilian cohort.
Azevedo PM, Bauer R, Caparbo Vde F, Silva CA, Bonfá E, Pereira RM.
Source

Rheumatology Division, Faculdade de Medicina da Universidade de Sao Paulo, CEP: 01246903 Sao Paulo, SP, Brazil.
Abstract
AIMS:

To evaluate the IL1RN polymorphism as a possible marker for Rheumatic Fever (RF) susceptibility or disease severity.
METHODS:

The genotypes of 84 RF patients (Jones criteria) and 84 normal race-matched controls were determined through the analysis of the number of 86-bp tandem repeats in the second intron of IL1RN. The DNA was extracted from peripheral-blood leukocytes and amplified with specific primers. Clinical manifestations of RF were obtained through a standardized questionnaire and an extensive chart review. Carditis was defined as new onset cardiac murmur that was perceived by a trained physician with corresponding valvae regurgitation or stenosis on echocardiogram. Carditis was classified as severe in the presence of congestive heart failure or upon the indication for cardiac surgery. The statistical association among the genotypes, RF and its clinical variations was determined.
RESULTS:

The presence of allele 1 and the genotype A1/A1 were found less frequently among patients with severe carditis when compared to patients without this manifestation (OR=0.11, p=0.031; OR=0.092, p=0.017). Neither allele 1 nor allele 2 were associated with the presence of RF (p=0.188 and p=0.106), overall carditis (p=0.578 and p=0.767), polyarthritis (p=0.343 and p=0.313) and chorea (p=0.654 and p=0.633).
CONCLUSION:

In the Brazilian population, the polymorphism of the IL-1ra gene is a relevant factor for rheumatic heart disease severity.


Which member of a pair and how frequently was found in patients with very serious inflammation of the heart?

a) Allele A1
b) Allele 2
c) Allele 1
d) IL-1ra

How was carditis categorized?

a) By the thickness of the heart muscle
b) New heart sounds
c) Very serious
d) b and c are correct

How many base pairs were in the second intron of IL1RN

a) 84
b) None
c) 86
d) 188

In the Brazilian population, assessment was carried out in order to…

a) If it lacks association with other interleukins
b) Relate RHD with malaria
c) Determine if IL1RN could be used as an indicator for RF
d) Other types of carditis






RESP

1.C
2.C
3.C
4.C
















dr fer
dr fer
Foroenarmita Avanzado
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Lema : "competencia drs"... confio q algún día desaparezca de sus mentes. Pues la competencia sólo está en la irrealidad colectiva!!!...La competencia es con uno mismo!!

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el Jue Ago 25, 2011 9:12 am
@Klausen escribió:Gracias! cheers


oye klausen,,,, q onda con tu avatar????? jajajajjajajjajajajjajaj Laughing Laughing Laughing Laughing Laughing
Klausen
Klausen
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el Jue Ago 25, 2011 11:15 am
@dr fer escribió:
@Klausen escribió:Gracias! cheers


oye klausen,,,, q onda con tu avatar????? jajajajjajajjajajajjajaj Laughing Laughing Laughing Laughing Laughing


Campaña publicitaria para evitar confusiones Doc. Hay mucha gente distraída... Gracias por las preguntas!
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el Jue Ago 25, 2011 1:32 pm
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