Knuf M.,Klinik fur Kinder und Jugendliche |
Knuf M.,University Medicine
European Journal of Pediatrics | Year: 2014
The burden of influenza is unevenly distributed, with more severe outcomes in children aged <5 years than older children and adults. In spite of this, immunisation policies for young children are far from universal. This article provides an overview of the published evidence on the burden of influenza in children worldwide, with a particular interest in the impact of pandemic influenza in 2009-2010 (caused by the H1N1pdm09 virus). In an average season, up to 9.8 % of 0- to 14-year olds present with influenza, but incidence rates can be markedly higher in younger children. Children aged <5 years have greater rates of hospitalisation and complications than their older counterparts, particularly if the children have co-existing illnesses; historically, this age group have had higher mortality rates from the disease than other children, although during the 2009-2010 pandemic the median age of those who died of influenza was higher than in previous seasons. Admissions to hospital and emergency departments appear to have been more frequent in children with H1N1pdm09 infections than during previous seasonal epidemics, with pneumonia continuing to be a common complication in this setting. Outcomes in children hospitalised with severe disease also seem to have been worse for those infected with H1N1pdm09 viruses compared with seasonal viruses. Studies in children confirm that vaccination reduces the incidence of seasonal influenza and the associated burden, underlining the importance of targeting this group in national immunisation policies. Conclusions: Children aged <5 years are especially vulnerable to influenza, particularly that caused by seasonal viruses, and vaccination in this group can be an effective strategy for reducing disease burden. © 2013 The Author(s).
Ruhnke M.,Paracelsus Hospital Osnabruck |
Arnold R.,Oncology and Tumour Immunology |
Gastmeier P.,Oncology and Tumour Immunology |
Gastmeier P.,University Medicine
The Lancet Oncology | Year: 2014
Drug-resistant Gram-negative and Gram-positive bacteria are now increasingly identified as a cause of infections in immunocompromised hosts. Bacteria identified include the multidrug-resistant (MDR) and even pandrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa, as well as carbapenem-resistant Enterobacteriaceae spp. The threat from MDR pathogens has been well-documented in the past decade with warnings about the consequences of inappropriate use of antimicrobial drugs. Resistant bacteria can substantially complicate the treatment of infections in critically ill patients and can have a substantial effect on mortality. Inappropriate antimicrobial treatment can affect morbidity, mortality, and overall health-care costs. Evidence-based data for prevention and control of MDR pathogen infections in haematology are scarce. Although not yet established a bundle of infection control and prevention measures with an anti-infective stewardship programme is an important strategy in infection control, diagnosis, and antibiotic selection with optimum regimens to ensure a successful outcome for patients. © 2014 Elsevier Ltd.
Xu S.,St. Hedwig Hospital |
Chen G.,St. Hedwig Hospital |
Peng W.,St. Hedwig Hospital |
Renko K.,University Medicine |
Derwahl M.,St. Hedwig Hospital
Journal of Endocrinology | Year: 2013
Benign and malignant thyroid nodules are more prevalent in females than in males. Experimental data suggest that the proliferative effect of oestrogen rather than polymorphisms is responsible for this gender difference. This study analysed whether both differentiated thyroid cells and thyroid stem and progenitor cells are targets of oestrogen action. In thyroid stem/progenitor cells derived from nodular goitres, the ability of 17β-oestradiol (E2) to induce the formation of thyrospheres and the expression of oestrogen receptors (ERs) and the effect of E2 on the growth and expression of markers of stem cells and thyroid differentiation (TSH receptor, thyroperoxidase, thyroglobulin and sodium iodide symporter (NIS)) were analysed. E2 induced thyrosphere formation, albeit to a lower extent than other growth factors. Thyroid stem and progenitor cells expressed ERα (ESR1) and ERβ (ESR2) with eight times higher expression levels of ERα mRNA compared with the differentiated thyrocytes. E2 was a potent stimulator of the growth of thyroid stem/progenitor cells. In contrast, TSH-induced differentiation of progenitor cells, in particular, the expression of NIS, was significantly inhibited by E2. In conclusion, oestrogen stimulated the growth and simultaneously inhibited the differentiation of thyroid nodule-derived stem/progenitor cells. From these data and based on the concept of cellular heterogeneity, we hypothesize a supportive role of oestrogen in the propagation of thyroid stem/progenitor cells leading to the selection of a progeny of growth-prone cells with a decreased differentiation. These cells may be the origin of hypofunctioning or non-functioning thyroid nodules in females. © 2013 Society for Endocrinology.
Portillo M.E.,Microbiology Laboratory |
Salvado M.,Microbiology Laboratory |
Trampuz A.,University Medicine |
Plasencia V.,Microbiology Laboratory |
And 4 more authors.
Journal of Clinical Microbiology | Year: 2013
Biofilm removal efficacy of vortexing alone was compared with the standard vortexing-sonication procedure. Among 135 removed prostheses, 35 were diagnosed with infection and 100 with aseptic failure. At a cutoff of>50 CFU/ml, sonication was more sensitive than vortexing (60% versus 40%, P=0.151), while the specificity was 99% for both methods. Copyright © 2013, American Society for Microbiology.
Abbass A.A.,Dalhousie University |
Nowoweiski S.J.,Melbourne Center for |
Bernier D.,Dalhousie University |
Tarzwell R.,University of British Columbia |
Beutel M.E.,University Medicine
Psychotherapy and Psychosomatics | Year: 2014
The clinical efficacy of psychodynamic psychotherapy (PDT) has undergone extensive study and review. Recently, researchers have studied the effects of this treatment on brain metabolic or synaptic activity, but the collective findings have never been reviewed. The objective of this review was to describe the findings of all neuroimaging studies of any form of PDT treatment. An extensive literature search through databases along with surveying of research groups were undertaken to acquire all available published studies. Eleven series were included in the final sample, consisting of 2 randomized controlled trials, 5 controlled trials and 4 case series, altogether involving 210 people: 94 healthy controls and 116 people with mood disorders, panic disorder, somatoform disorders and borderline personality disorder. A variety of neuroimaging techniques were used to examine regional metabolic activity and synaptic neurotransmission before and after treatment. The common finding was normalization of synaptic or metabolic activity in limbic, midbrain and prefrontal regions, occurring in association with improved clinical outcomes. PDT has demonstrable effects on brain function in diverse clinical populations as evidenced by a modest group of mixed neuroimaging studies. © 2014 S. Karger AG, Basel.