Influenza and diabetes ; immunological and epidemiological aspects

Influenza may jeopardize the health of patients with diabetes mellitus in several ways. In the first place influenza infection may inbalance a carefully established metabolic control, and in some cases trigger a process of metabolic deterioration which eventually may lead to ketoacidosis and even death (40-42). Secondly, diabetes itself might be the cause of an impaired immune response to influenza virusses. Patients are made more vulnerable to infection, especially if they are in poor metabolic control ( 46,4 7). In the third place pre-existing staphylococcal skin infections can enhance the incidence of the most dreaded complication of influenza infection: secondary staphylococcal pneumonia (32-36). · An increased carrier rate of S. aureus in combination with an impaired immune response to this microorganism can be held partly responsible for the increased morbidity and mortality in patients with diabetes mellitus. Patients who have overt skin lesions should receive anti-staphylococcal antibiotic therapy as soon as symptoms of influenza infection are observed. Though annual vaccination has been proven to reduce attack rates and alleviate illness (48) many patients with diabetes mellitus are still not vaccinated against influenza. Physicians who deny the need for annual vaccination argue that the excess mortality from influenza in patients with diabetes mellitus dates back from earlier days when patients were not very well controlled. From their point of view there is no need for mass vaccination of patients who are nowadays mostly well controlled. In our opinion there is no reason for such optimism. In both clinical studies and studies on excess mortality diabetes mellitus is a remarkably constant risk factor over a long time. Though it is difficult to calculate reliable figures on relative risks and rates of excess mortality there is sound evidence to assume that in epidemic periods mortality in patients with diabetes mellitus increases by 5-15% (9,11). If one considers the enormous effort that is made to attain satisfying metabolic control and to fight the secondary complications of diabetes a single injection once a year to protect against influenza is not overdone. Aside from annual vaccination o

Developing an Advocacy Program for Hail Cannons in Agricultural Practices

The purpose of this project was developing an advocacy program for hail cannons use in agricultural practices. The project was initiated to help farmers promote hail cannon usage within communities, so the farmer may protect their crops from hail damage. In order to capture a wide array of opinions, farmers throughout Kings, Tulare and Fresno counties completed a questionnaire to give background on current problems and statistics regarding hail cannons. An advocacy strategy was given to provide guidance for farmers to promote hail cannons. By utilizing the hail cannon advocacy strategy, farmers should notice their communities are more accepting of hail cannon use and be able to continue using hail cannons in the future

Survival of Chlamydia pneumoniae following contact with various surfaces

Objective: In this study, the survival and recovery of Chlamydia pneumoniae (Cp) strains TW‐183, AR‐39, AR‐388 and CWL‐029 were measured after inoculation on glass, stainless steel, FormicaR laminate, paper, fabric and human skin. Methods: Inoculum in throat washes from healthy volunteers was applied to each surface. Samples were taken immediately after inoculum application and at specified intervals thereafter to determine infectivity. Results: Infectious Cp was recovered from glass for up to 4 h, from paper and fabric for up to 3 h, from FormicaR laminate for up to 2 h, from stainless steel for up to 60 min and from human skin for up to 30 min. Drying of the inoculated area had no significant effect on the recovery of infectious Cp. Further experiments demonstrated that infectious Cp could be transferred to hands by touching these contaminated surfaces and could be recovered from these hands for up to 3 min. Addition of albumin, surfactant or phosphatidylcholine had no significant effect on the survival of Cp. Conclusions: These results suggest that contact with contaminated surfaces may be a potential mode of transmission of Cp. 1995 European Society of Clinical Microbiology and Infectious Disease

A conditional limit theorem for independent random variables

In this paper, we prove a conditional limit theorem for independent not necessarily identically distributed random variables. Namely, we obtain the asymptotic distribution of a large number of them given the sum

Influenza-Associated Hospitalization in a Subtropical City

BACKGROUND: The impact of influenza on morbidity and hospitalization in the tropics and subtropics is poorly quantified. Uniquely, the Hong Kong Special Administrative Region has computerized hospital discharge diagnoses on 95% of total bed days, allowing disease burden for a well-defined population to be accurately assessed. METHODS AND FINDINGS: Influenza-associated morbidity and hospitalization was assessed by Poisson regression models for weekly counts of hospitalizations in Hong Kong during 1996 to 2000, using proportions of positive influenza types A (H1N1 and H3N2) and B isolations in specimens sent for laboratory diagnosis as measures of influenza virus circulation. We adjusted for annual trend, seasonality, temperature, and relative humidity, as well as respiratory syncytial virus circulation. We found that influenza was significantly associated with hospitalization for acute respiratory disease (International Classification of Diseases version 9 codes [ICD9] 460–466 and 480–487) and its subcategory pneumonia and influenza (ICD9 480–487) for all age groups. The annual rates of excess hospitalization per 100,000 population for acute respiratory diseases for the age groups 0–14, 15–39, 40–64, 65–74, and 75+ were 163.3 (95% confidence interval [CI], 135–190), 6.0 (95% CI, 2.7–8.9), 14.9 (95% CI, 10.7–18.8), 83.8 (95% CI, 61.2–104.2), and 266 (95% CI, 198.7–330.2), respectively. Influenza was also associated with hospitalization for cerebrovascular disease (ICD9 430–438) for those aged over 75 y (55.4; 95% CI, 23.1–87.8); ischemic heart disease (ICD9 410–414) for the age group 40–64 y (5.3; 95% CI, 0.5–9.5) and over 75 y (56.4; 95% CI, 21.1–93.4); and diabetes mellitus (ICD9 250) for all age groups older than 40 y. CONCLUSIONS: Influenza has a major impact on hospitalization due to cardio-respiratory diseases as well as on cerebrovascular disease, ischemic heart disease, and diabetes mellitus in the tropics and subtropics. Better utilization of influenza vaccine during annual epidemics in the tropics will enhance global vaccine production capacity and allow for better preparedness to meet the surge in demand that is inevitable in confronting a pandemic

Humoral immune response and delayed type hypersensitivity to influenza vaccine in patients with diabetes mellitus

The antibody response and delayed type hypersensitivity reaction to commercially available trivalent influenza vaccine in 159 patients with diabetes mellitus was compared with response and reaction in 28 healthy volunteers. A correction for prevaccination titres was made. No differences were found between diabetic patients and control subjects with respect to antibody response to the three vaccine strains as measured by the difference between geometric mean titres of post- and prevaccination sera. In Type 1 (insulin-dependent) diabetic patients the incidence of non-responders to two vaccine components was significantly increased (p less than 0.05). The delayed type hypersensitivity reaction to influenza antigen was significantly decreased in patients with high concentrations of glycosylated haemoglobin (p less than 0.01). These findings suggest a role for impaired immune response in the increased influenza morbidity and mortality in patients with diabetes mellitus. Implications for therapy and vaccination strategy are discussed

Phylogeographic Distribution of Human and Hare Francisella Tularensis Subsp. Holarctica Strains in the Netherlands and Its Pathology in European Brown Hares (Lepus Europaeus)

Sequence-based typing of Francisella tularensis has led to insights in the evolutionary developments of tularemia. In Europe, two major basal clades of F. tularensis subsp. holarctica exist, with a distinct geographical distribution. Basal clade B.6 is primarily found in Western Europe, while basal clade B.12 occurs predominantly in the central and eastern parts of Europe. There are indications that tularemia is geographically expanding and that strains from the two clades might differ in pathogenicity, with basal clade B.6 strains being potentially more virulent than basal clade B.12. This study provides information on genotypes detected in the Netherlands during 2011–2017. Data are presented for seven autochthonous human cases and for 29 European brown hares (Lepus europaeus) with laboratory confirmed tularemia. Associated disease patterns are described for 25 European brown hares which underwent post-mortem examination. The basal clades B.6 and B.12 are present both in humans and in European brown hares in the Netherlands, with a patchy geographical distribution. For both genotypes the main pathological findings in hares associated with tularemia were severe (sub)acute necrotizing hepatitis and splenitis as well as necrotizing lesions and hemorrhages in several other organs. Pneumonia was significantly more common in the B.6 than in the B.12 cases. In conclusion, the two major basal clades present in different parts in Europe are both present in the Netherlands. In hares found dead, both genotypes were associated with severe acute disease affecting multiple organs. Hepatitis and splenitis were common pathological findings in hares infected with either genotype, but pneumonia occurred significantly more frequently in hares infected with the B.6 genotype compared to hares infected with the B.12 genotype

The preparatory Set: A Novel Approach to Understanding Stress, Trauma, and the Bodymind Therapies

Basic to all motile life is a differential approach/avoid response to perceived features of environment. The stages of response are initial reflexive noticing and orienting to the stimulus, preparation, and execution of response. Preparation involves a coordination of many aspects of the organism: muscle tone, posture, breathing, autonomic functions, motivational/emotional state, attentional orientation, and expectations. The organism organizes itself in relation to the challenge. We propose to call this the preparatory set (PS). We suggest that the concept of the PS can offer a more nuanced and flexible perspective on the stress response than do current theories. We also hypothesize that the mechanisms of body-mind therapeutic and educational systems (BTES) can be understood through the PS framework. We suggest that the BTES, including meditative movement, meditation, somatic education, and the body-oriented psychotherapies, are approaches that use interventions on the PS to remedy stress and trauma. We discuss how the PS can be adaptive or maladaptive, how BTES interventions may restore adaptive PS, and how these concepts offer a broader and more flexible view of the phenomena of stress and trauma. We offer supportive evidence for our hypotheses, and suggest directions for future research. We believe that the PS framework will point to ways of improving the management of stress and trauma, and that it will suggest directions of research into the mechanisms of action of BTES

Pasteurization and Freezing Effect on Colostrum Characteristics, Morbidity, IgG Absorption, and Growth Rates of Holstein Heifer Calves

The objective of this study was to determine if fresh frozen, pasteurized frozen, or fresh refrigerated colostrum impacted morbidity, growth rates, and the overall serum immunoglobulins (IgGs) in newborn calves. The second objective was to compare the effects that pasteurization and freezing had on colostrum IgG concentration and total bacteria counts compared to raw refrigerated colostrum. A controlled trial was completed on a 6,000-cow dairy in California where colostrum was harvested twice daily, pooled, and then divided into three different treatment groups and processed accordingly. One treatment was pasteurized at 60oC for 60 min and then frozen, the other two were both fresh, one going into the freezer and the other into the refrigerator. Samples of all treatment groups were taken to determine total plate count, total E. Coli count, and total IgG immediately before the colostrum was fed. Newborn calves were randomly assigned to be fed 4 quarts of either pasteurized frozen (Past, n=60), fresh-frozen (FF, n=60), or fresh-refrigerated (FR, n=60) colostrum within 2 hours of birth. Calves were weighed daily and picked up after receiving 2 or 3 feedings of treatment colostrum (dependent on time of birth) and taken to a custom heifer raising facility where they were weighed and monitored for morbidity (number of treatments) until weaning (60d). Pasteurization improved the serum IgG count in the calves compared to fresh and fresh frozen treatments. Pasteurization decreased bacteria counts and appeared to decrease IgG concentration in the colostrum but had no effects on morbidity or weaning weight