Articles: pandemics.
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Surgical infections · Apr 2011
ReviewExtracorporeal membrane oxygenation in the context of the 2009 H1N1 influenza A pandemic.
Extracorporeal membrane oxygenation (ECMO) incorporates surgical techniques as adjuncts in the management of refractory respiratory dysfunction. For many years, its primary application was for support of neonatal infants in cardiorespiratory failure. As the 2009 H1N1 influenza A pandemic developed, more reports came in of severe respiratory dysfunction and even death that seemed to be occurring preferentially in younger adults. Centers with the capability began to use ECMO to salvage these patients. ⋯ Supportive management is continued along with ECMO. Antiviral drugs and antimicrobial agents should be given as appropriate, as should nutritional support. Volume management should be used. Ventilator settings should be reduced as ECMO support allows, with a goal of reducing airway pressures, ventilator rate, and FiO(2). Complications of ECMO are common. Bleeding, the most common, can result in death, especially if it occurs intracranially.
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The purpose of the present study was to investigate the contribution of threat information as provided by the parents to the development of children's fear within the context of the 2009 Swine Flu pandemic. Normal school children aged 7-12 years (N = 223) and their parents completed questionnaires to measure fear of the Swine Flu and general fearfulness for medical affairs. Children and parents were also asked to indicate to what extent parents had provided children with threat-related information about this disease. ⋯ Further, it was found that parent's transmission of threat information was positively associated with children's fear and that this link remained significant when controlling for other sources of information (i.e., media, friends, and school) or direct experience with the disease. Most importantly, results showed that threat information as provided by the parents played a role in the association between parents' and children's fear. More precisely, support was found for a partial mediation model in which parents' fear of the Swine Flu was related with parents' threat information transmission, which in turn was associated with children's fear of the disease.
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Enferm. Infecc. Microbiol. Clin. · Apr 2011
[Low adherence to 2009 pandemic influenza A(H1N1) vaccination program among health care workers of a medical centre during the pandemic phase].
Several strategies have been designed to increase adherence to vaccination programs aimed at health professionals, though the results were not always satisfactory. ⋯ Adherence to pandemic influenza vaccination program was very low, which suggests the need to implement new strategies into vaccination programs. The main reason for vaccination was patient protection. The tolerability of the pandemic vaccine was good.
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Highly pathogenic H5N1 influenza infections are associated with enhanced inflammatory and cytokine responses, severe lung damage, and an overall dysregulation of innate immunity. C3, a member of the complement system of serum proteins, is a major component of the innate immune and inflammatory responses. However, the role of this protein in the pathogenesis of H5N1 infection is unknown. ⋯ We hypothesized that the increased complement was associated with the enhanced disease associated with the H5N1 infection. However, studies in knockout mice demonstrated that C3 was required for protection from influenza infection, proper viral clearance, and associated with changes in cellular infiltration. These studies suggest that although the levels of complement activation may differ depending on the influenza virus subtype, complement is an important host defense mechanism.