Risk factors associated with fatal influenza,Romania, October 2009 – May 2011

Background

Limited data are available from Central and Eastern Europe on risk factors for severe complications of influenza. Such data are essential to prioritize prevention and treatment resources and to adapt influenza vaccination recommendations.

Objectives

To use sentinel surveillance data to identify risk factors for fatal outcomes among hospitalized patients with severe acute respiratory infections (SARI) and among hospitalized patients with laboratory-confirmed influenza.

Methods

Retrospective analysis of case-based surveillance data collected from sentinel hospitals in Romania during the 2009/2010 and 2010/2011 winter influenza seasons was performed to evaluate risk factors for fatal outcomes using multivariate logistic regression.

Results

During 2009/2010 and 2010/2011, sentinel hospitals reported 661 SARI patients of which 230 (35%) tested positive for influenza. In the multivariate analyses, infection with influenza A(H1N1)pdm09 was the strongest risk factor for death among hospitalized SARI patients (OR: 6·6; 95% CI: 3·3–13·1). Among patients positive for influenza A(H1N1)pdm09 virus infection (n = 148), being pregnant (OR: 7·1; 95% CI: 1·6–31·2), clinically obese (OR: 2·9;95% CI: 1·6–31·2), and having an immunocompromising condition (OR: 3·7;95% CI: 1·1–13·4) were significantly associated with fatal outcomes.

Conclusion

These findings are consistent with several other investigations of risk factors associated with influenza A(H1N1)pdm09 virus infections. They also support the more recent 2012 recommendations by the WHO Strategic Advisory Group of Experts on Immunization (SAGE) that pregnant women are an important risk group for influenza vaccination. Ongoing sentinel surveillance can be useful tool to monitor risk factors for complications of influenza virus infections during each influenza season, and pandemics as well.     

The significance of human platelet-activating factor-acetylhydrolase in patients with chronic stable angina

BACKGROUND: Inflammatory reactions within coronary atherosclerotic plaques are increasingly thought to be crucial determinants of the clinical course in patients with coronary artery disease (CAD). Platelet-activating factor-acetylhydrolase (PAF-AH) is considered to reflect the ongoing inflammatory process in patients with CAD. Our objective was to determine the activity of PAF-AH in patients with stable angina and its correlations to lipoprotein levels and the inflammatory status of the patient. METHODS: Forty-five patients with documented CAD and stable angina and 20 controls were investigated for PAF-AH activity, lipoprotein levels, and peripheral neutrophil (PMN) activity. RESULTS: Patients were divided into two groups according to the values of PAF-AH activity (group 1: 250 IU/l). A correlation was observed between PAF-AH activity and LDL-C and HDL-C in controls and in all patients. The percentage of granulocytes generating intracellular O(2)(-) in unstimulated PMN was higher in group 2 patients than in group 1 patients and controls. The phagocytic activity of PMNs had an inverse correlation with PAF-AH in group 2. High intracellular O(2)(-) generation was coupled with low extracellular release of the anion and phagocytosis impairment in group 2. During the follow-up period, some of the patients in group 2 displayed a worsening of the clinical state and/or resting ECG changes. CONCLUSIONS: PAF-AH activity in patients with stable angina is correlated with hyperlipemia and a high PMN activation state, and it may be considered a potential predictor of vascular risk.     

MAPLE-based method to obtain biodegradable hybrid polymeric thin films with embedded antitumoral agents

In this work, antitumor compounds, lactoferrin [recombinant iron-free (Apo-rLf)], cisplatin (Cis) or their combination were embedded within a biodegradable polycaprolactone (PCL) polymer thin film, by a modified approach of a laser-based technique, matrix-assisted pulsed laser evaporation (MAPLE). The structural and morphological properties of the deposited hybrid films were analyzed by Fourier-transform infrared spectroscopy (FTIR) and atomic force microscopy (AFM). The in vitro effect on the cells’ morphology and proliferation of murine melanoma B16-F10 cells was investigated and correlated with the films’ surface chemistry and topography. Biological assays revealed decreased viability and proliferation, lower adherence, and morphological modifications in the case of melanoma cells cultured on both Apo-rLf and Cis thin films. The antitumor effect was enhanced by deposition of Apo-rLf with Cis within the same film. The unique capability of the new approach, based on MAPLE, to embed antitumor active factors within a biodegradable matrix for obtaining novel biodegradable hybrid platform with increased antitumor efficiency has been demonstrated.     

Computation of the Electrical Resistance of a Low Current Multi-Spot Contact

In high complexity electrical systems such as those used in the automotive industries, electric connectors play an important role. The automotive industry is gradually shifting its attention to electric cars, which means more electrical connectors for sensors and data collection. A fault in connectors for sensors used in a vehicle can cause drastic damage to capital equipment and, in the worst case, the loss of life. The studies of faults or degradation of electrical contacts are essential for safety in vehicles and various industries. Although such faults can be due to numerous factors (such as dust, humidity, mechanical vibration, etc.) and some yet to be discovered, high contact resistance is the main factor causing erratic behavior of electrical contacts. This paper presents a study on the computation of electrical contact resistance of two metal conductors (in the form of a disk) with analytical relations and a numerical computation model based on the finite element method (FEM) in COMSOL Multiphysics. The contact spots were considered to have a higher electrical resistivity value (ρ_cs) than those of the two metal conductors (ρ_Cu). Studies such as the one in view that is carried out on a microscopic level are often difficult to investigate experimentally. Therefore, with the help of a simplified numerical model, the consequences of the degradation of electrical contacts are investigated. To validate the FEM model, the numerical results were compared to those obtained from analytical models.     

Epidemiology of acute drug poisoning in a tertiary center from Iasi County, Romania

The aim of this retrospective epidemiological study was to investigate the demographical, etiological and clinical characteristics of acute drug poisonings in Iasi County, Romania. All patients were referred and admitted in the Toxicology Clinic of "Sf. Ioan" Emergency Clinic Hospital Iasi, Romania. Between 2003 and 2009, 811 cases of acute drug poisonings were recorded, counting for 28.43% from the total number of poisonings. The majority of these poisonings resulted in mild (51.94%) and medium (28.35%) clinical forms, while 19.71% were coma situations. In all, 63.51% of patients originated from urban areas, 39.94% were unemployed and the patients were predominantly women (66.46%). A high percentage (97.27%) were suicide attempts, using only one type of drug (65.88%) and the 21-30 years group (29.8%) records the highest incidence, for both women and men. The most frequently involved drugs were benzodiazepines 13.69%, anticonvulsive drugs 8.63%, barbiturates 8.51% and cardiovascular drugs 5.92%. Drugs combinations were recorded in 32.92% of cases and 1.2% were combinations between drugs and other substances. Mortality was the outcome in 0.3% of the total registered number of acute drug poisonings. This study underlines that in order to provide a proper management of these situations, a Regional Poison Information Center is absolutely necessary.     

Artificial device for extracorporeal blood oxygenation in rats

Abstract:  Blood oxygenation devices are an essential component of any cardiopulomonary bypass circuit in various species of laboratory animals. When using larger animals like dogs or pigs, the human and pediatric blood oxygenators could be easily used, but the disadvantage of these species is the scarcity of biochemical and genetic assays for experimental follow-up. However, small rodents like rats have plenty of biochemical assays, but their size requires special oxygenators adapted for their small blood volume and often primed with blood of another animal or other physiological solution. We showed the new design of a blood oxygenator with direct blood–gas contact in an open circuit, specially designed for rats in which the blood oxygenation takes place in a slowly rotating plastic tube with blood spread onto its inner walls in a thin layer. The oxygenator is simple and efficient, does not require priming with the blood of another rat, has a small dead volume, is reusable, and easy to clean and sterilize.