Search

Objective: To compare the patient characteristics, clinical features and outcomes of adult patients hospitalised with pandemic (H1N1) 2009 influenza and seasonal influenza.Design and Setting: Retrospective medical record review of all patients admitted to Liverpool Hospital, Sydney, with laboratory-confirmed influenza from the initiation of the "PROTECT" phase of the pandemic response on 17 June until the end of our study period on 31 July 2009.Main Outcome Measures: Severity of illness; requirement for admission to the intensive care unit (ICU) and/or invasive ventilation; mortality.Results: Sixty-four adults were admitted to Liverpool Hospital with influenza, 48 with pandemic (H1N1) 2009 influenza and 16 with seasonal influenza. Thirteen patients were admitted to the ICU. Seven required invasive ventilation, with 2 patients requiring ongoing extracorporeal membrane oxygenation (ECMO). Five patients died (mortality rate, 8%) with two deaths occurring after the study period. Patients with pandemic (H1N1) 2009 influenza were younger and less likely to be immunocompromised than patients with seasonal influenza. However, the clinical features of pandemic (H1N1) 2009 influenza and seasonal influenza were similar.Conclusions: Our findings show that the clinical course and outcomes of pandemic (H1N1) 2009 influenza virus are comparable to those of the current circulating seasonal influenza in Sydney. The high number of hospital admissions reflects a high incidence of disease in the community rather than an enhanced virulence of the novel pandemic influenza virus. [ABSTRACT FROM AUTHOR]

The percutaneous absorption of tritiated water ((3)H(2)O) through sulfur mustard (SM) exposed abdominal pig skin was measured using in vitro Franz-type static diffusion cells. The barrier function to water permeation following exposure to liquid SM for 8 min and excision 3h later did not change significantly. A small, but statistically significant difference (P<0.05) in steady state penetration (Jss), permeability coefficient (Kp) and lag time (t(L)) of (3)H(2)O was observed between fresh skin and skin stored frozen (-20 °C) for up to two weeks. Steady-state penetration and Kp values were significantly higher (P < 0.05) in skin stored frozen compared with fresh skin. Fresh naïve skin had an average Kp of 1.65 × 10(-3) cm h(-1), whereas frozen naïve skin was 2.04 × 10(-3) cm h(-1). Fresh SM exposed skin had a mean Kp of 1.72 × 10(-3) cm h(-1), whereas frozen SM exposed skin was 2.31 × 10(-3) cm h(-1). Lag times were also shorter (P<0.05) in skin that had been stored frozen. Frozen, SM-exposed porcine abdominal skin may be used for in vitro penetration studies, but effects of treatment and storage on the barrier layer should be taken into account., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Eight DNA extraction products or methods (Applied Biosystems PrepFiler Forensic DNA Extraction Kit; Bio-Rad Instagene Only, Bio-Rad Instagene & Spin Column Purification; EpiCentre MasterPure DNA & RNA Kit; FujiFilm QuickGene Mini80; Idaho Technologies 1-2-3 Q-Flow Kit; MoBio UltraClean Microbial DNA Isolation Kit; Sigma Extract-N-Amp Plant and Seed Kit) were adapted to facilitate extraction of DNA under BSL3 containment conditions. DNA was extracted from 12 common interferents or sample types, spiked with spores of Bacillus atropheaus. Resulting extracts were tested by real-time PCR. No one method was the best, in terms of DNA extraction, across all sample types. Statistical analysis indicated that the PrepFiler method was the best method from six dry powders (baking, biological washing, milk, plain flour, filler and talcum) and one solid (Underarm deodorant), the UltraClean method was the best from four liquids (aftershave, cola, nutrient broth, vinegar), and the MasterPure method was the best from the swab sample type. The best overall method, in terms of DNA extraction, across all sample types evaluated was the UltraClean method.

1. The effects of stimulating the substantia nigra (SN) or the ventral tegmental area (VTA) on the excitability of cells in the rat hippocampal formation have been investigated in vivo. 2. A train of conditioning stimuli to either of the midbrain nuclei produced inhibition of evoked population spikes recorded in the CA1 pyramidal cell layer of the hippocampus. 3. These trains of pulses had no effect on the evoked synaptic field potential recorded in the stratum radiatum although they were effective in suppressing glutamate-induced firing of cells in the hippocampus. These observations suggest that the inhibition is mediated through a postsynaptic mechanism. 4. The inhibition of the test population spike was observed at a latency of 50 ms after the conditioning train to either the SN or the VTA but did not reach a maximum until 300-500 ms and 500-750 ms post-conditioning, respectively. The total duration of the inhibition in each case was about 5 s. 5. Following stimulation of the VTA, comparable levels of inhibition were recorded in the ventral and dorsal hippocampus. However, after stimulation of the SN, significantly less inhibition was observed in the ventral hippocampus. 6. Unlike the effects on the commissural-evoked population spike in CA1, stimulation of SN or VTA had no effect on perforant path-induced granule cell excitability in the dentate gyrus. 7. These results suggest that activity in the substantia nigra or ventral tegmental areas could have a powerful regulatory or feedback role in suppressing hippocampal excitability.

Fungal and mycobacterial infections are among the most common opportunistic infections in patients infected with human immunodeficiency virus (HIV). Candida infections are the bell-wether of progression to symptomatic HIV infection and candida oesophagitis often marks the onset of the acquired immunodeficiency syndrome (AIDS). More than 80% of AIDS patients have candida disease. Candida infections remain local and respond to treatment but tend to recur. Cryptococcal infections initially affect few HIV positive patients but involve 10-30% with AIDS. Meningitis is the usual presentation and dissemination is common. Amphotericin usually produces improvement but cure is infrequent, and maintenance therapy is advisable. Mycobacteria cause intracellular infections increasing in parallel with immunodeficiency. Mycobacterium avium-intracellulare is predominant, occurring with other opportunistic pathogens causing systemic and local symptoms with high bacterial density in infected cells. Multidrug treatment is best, but the results are disappointing. Tuberculosis is prevalent in certain groups of patients. It often presents with atypical clinical and pathological features. Anti-tuberculous treatment is effective and prophylaxis should be considered. Endemic fungi with mycobacteria cause sporadic infections. Opportunistic infections are the lethal arm of HIV infection. Diligent diagnosis and persistent treatment offer benefit to HIV-infected patients.