A Nosocomial Outbreak of Influenza A

InfluenzaInfluenza occurs every winter in the United States, its geographic distribution and incidence depending on several factors, including major antigenic shifts in the virus and the susceptibility of the population affected. The winter of 1974 was characterized by widespread outbreaks of influenza В in midwinter during the months of January and February, followed by the appearance in March and April of localized outbreaks of influenza A in various parts of the country, especially the east and west coasts and Puerto Rico.

There have been isolated reports of nosocomial outbreaks of influenza in the United States and elsewhere, with severe and unusual symptoms occurring in debilitated patients suffering from underlying chronic diseases, such as rheumatic heart disease, and in children with congenital malformations. This report describes an outbreak of acute respiratory tract illness in eight female patients in a 27-bed ward during the first week of March 1974, and a single community-acquired case of lethal infection with influenza A in a healthy man.

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Canadian Health&Care Mall: Immunodeficiency Diseases

immunodeficiency diseasePatients with immunodeficiency diseases have undue susceptibility to infection. This can mean (1) too many infections, (2) unusually severe infections, (3) infections without a symptom-free period, (4) infections with unusual organisms (Giardia, Pneumocystis), (5) undue complications from infections, and (6) poor response to treatment. Many patients with immunodeficiency must take continuous antibiotics to remain free of infection.

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Immunodeficiency: Cells of the Immune System

immune systemWe have all seen the familiar diagram of the immune system with its T cell limb and В cell limb. It seems that as soon as one becomes familiar with it, new information is made available that makes it outdated, particularly because of the known interactions of the В and T cell systems. The circulating cells of the immune system include the granulocytes, composing about 50 percent of the peripheral white blood cells; the monocytes, composing about 10 percent; and the lymphocytes, composing about 40 percent. The lymphocytes can be further divided into three classes: the T lymphocytes, the В lymphocytes and the null lymphocytes, composing about 70 percent, 10 percent, and 20 percent of the circulating lymphocytes, respectively. Morphologically these lymphocytes are indistinguishable.

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Bacterial Infections of the Lung: Bacterial Pathogens and Therapy

feverCommon symptoms and signs of bacterial pneumonia are fever, chills or rigors, cough, purulent sputum production, pleurisy, dyspnea, and anorexia. In the case of anaerobic lung abscess or necrotizing pneumonia, symptoms are often present for several weeks before the patient seeks medical care.

Patients with pneumonia may occasionally fail to respond to that which is considered to be effective therapy; possible causes of such failure are shown in Table 2. Complications of bacterial pneumonia include necrosis of pulmonary parenchyma (necrotizing pneumonia or lung abscess), empyema, bacteremia, metastatic suppuration, pericarditis, and acute and chronic respiratory insufficiency.

Streptococcus pneumoniae: S pneumoniae is by far the most frequent bacterial cause of pneumonia; onset is classically an abrupt shaking chill or rigor, fever, dyspnea, pleuritic pain, and cough productive of rusty sputum. Lobar infiltration is common in adults. Bacteremia occurs in approximately 30 percent of patients with pneumococcal pneumonia and is associated with both metastatic infection and an appreciable increase in mortality.

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Sleep-deprived teens find it harder to cope with stress

Nearly 70% of American adolescents lack sleep. Shortage of sleep and other difficulties with sleeping can lead to cognitive problems and poor physical health over time.

Now it seems that sleep problems or sleeping for too long can make adolescents more reactive to stress, potentially affecting academic performance, behavior and health.

The key could lie in the hypothalamic-pituitary-adrenal axis, or HPA axis, a part of the neuroendocrine system that controls reactions to stress and regulates many body processes.

The association between sleep and the HPA axis has been studied in both children and adults.

However, what happens during puberty, a key period of development when both sleep and the HPA axis are undergoing significant changes, is unclear.

Sylvie Mrug and colleagues, from the University of Alabama in Birmingham (UAB) and Arizona State University, wanted to investigate the relationship between sleep and reactivity to stress in adolescents, focusing on the HPA-axis activity.

Read more information on http://www.medicalnewstoday.com/articles/305180.php.

Canadian Health&Care Mall: Diagnostic Approach of Bacterial Infections of the Lung

pulmonary infiltrateThe sine qua non of bacterial pneumonia is the presence of a new pulmonary infiltrate on chest roentgenogram. Although certain findings on chest roentgenogram may suggest specific pathogens (eg, bulging of a fissure in К pneumoniae pneumonia), these features are neither sensitive nor specific enough to be relied on as a means for making an etiologic diagnosis.

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Bacterial Infections of the Lung: Factors that Predispose to Development of Pneumonia

bacterial pneumoniaIt has been estimated that greater than 1,200,000 cases of bacterial pneumonia (with 55,000 deaths) occur annually in the United States. The purpose of this article is to review bacterial pneumonia in adults.

Pulmonary defense mechanisms are normally effective in preventing pneumonia. These defenses include humidification of inspired air, mucus secretion and ciliary action of airway epithelium, cough, lymphoid tissue, immunoglobulins and complement, pulmonary macrophages and leukocytes, and leukocyte chemotactic factors.

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Rehabilitation Conclusions of Ventilator-Dependent Subjects with Lung Diseases

chest wall diseasesOur experience indicates that not only can ventilator-dependent persons be discharged from the hospital and cared for in their homes, but also that these individuals can be mobile, functional, and retain a good deal of independence. Although it is well known that patients with neuromuscular and chest wall diseases can successfully receive ventilatory support in the home, there has been mixed success in the home care of ventilator-dependent persons with COPD.

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