A Novel Pathogenic Mechanism of Highly Pathogenic Avian Influenza H5N1 Viruses Involves Hemagglutinin Mediated Resistance to Serum Innate Inhibitors

In this study, the effect of innate serum inhibitors on influenza virus infection was addressed. Seasonal influenza A(H1N1) and A(H3N2), 2009 pandemic A(H1N1) (H1N1pdm) and highly pathogenic avian influenza (HPAI) A(H5N1) viruses were tested with guinea pig sera negative for antibodies against all of these viruses as evaluated by hemagglutination-inhibition and microneutralization assays. In the presence of serum inhibitors, the infection by each virus was inhibited differently as measured by the amount of viral nucleoprotein produced in Madin-Darby canine kidney cells. The serum inhibitors inhibited seasonal influenza A(H3N2) virus the most, while the effect was less in seasonal influenza A(H1N1) and H1N1pdm viruses. The suppression by serum inhibitors could be reduced by heat inactivation or treatment with receptor destroying enzyme. In contrast, all H5N1 strains tested were resistant to serum inhibitors. To determine which structure (hemagglutinin (HA) and/or neuraminidase (NA)) on the virus particles that provided the resistance, reverse genetics (rg) was applied to construct chimeric recombinant viruses from A/Puerto Rico/8/1934(H1N1) (PR8) plasmid vectors. rgPR8-H5 HA and rgPR8-H5 HANA were resistant to serum inhibitors while rgPR8-H5 NA and PR8 A(H1N1) parental viruses were sensitive, suggesting that HA of HPAI H5N1 viruses bestowed viral resistance to serum inhibition. These results suggested that the ability to resist serum inhibition might enable the viremic H5N1 viruses to disseminate to distal end organs. The present study also analyzed for correlation between susceptibility to serum inhibitors and number of glycosylation sites present on the globular heads of HA and NA. H3N2 viruses, the subtype with highest susceptibility to serum inhibitors, harbored the highest number of glycosylation sites on the HA globular head. However, this positive correlation cannot be drawn for the other influenza subtypes

Use of mesuring instruments in the intesive care unit and anesthesiology and resustitation department

An integral part of nursing documentation consists in assessment tools that allow for the analysis of patients' needs and planning of follow-up care. The Bachelor thesis delves into the problem area of using measuring tools, with a focus on the Anaesthesiology and Resuscitation Departments (ARD) and Intensive Care Units (ICU). The theoretical part introduces the most commonly used scales in the framework of intensive medicine: scales for evaluating consciousness, falls, nutrition, self-sufficiency, risk of occurrence of decubiti or assessment of pain. The objectives of the present theses are 1. To map out the use of measuring tools at Intensive Care Units and Anaesthesiology and Resuscitation Departments 2. To map out nurses' awareness as regards the use of measuring tools at Intensive Care Units and Anaesthesiology and Resuscitation Departments The following hypotheses were formulated in order to accomplish the above objectives: 1: Nurses' approach to the use of measuring tools differs depending on their education. 2: The spectre of measuring tools used differs depending on work sites. 3: Nurses' awareness of the use of measuring tools differs depending on work sites. The research was carried out by a quantitative method. In the scope of the quantitative research, a non-standardized questionnaire was used and forwarded to heath care workers at Anaesthesiology and Resuscitation Departments and Intensive Care Units. Results of the quantitative research show that most of the respondents perceive measuring scales as an asset for nursing. Differences between the use of measuring tools at ARD and ICU are negligible. Respondents' approaches to measuring tools do not differ subject to education; respondents' replies are very similar. The thesis provides a comprehensive view of the problem area of the use of measuring tools at Anaesthesiology and Resuscitation Departments and Intensive Care Units. The Bachelor thesis may be serve in practice as a study material, whereas, for convenience of the reader, a brochure depicting the basic measuring tools was prepared

Do national drug control laws ensure the availability of opioids for medical and scientific purposes?

OBJECTIVE: To determine whether national drug control laws ensure that opioid drugs are available for medical and scientific purposes, as intended by the 1972 Protocol amendment to the 1961 Single Convention on Narcotic Drugs. METHODS: The authors examined whether the text of a convenience sample of drug laws from 15 countries: (i) acknowledged that opioid drugs are indispensable for the relief of pain and suffering; (ii) recognized that government was responsible for ensuring the adequate provision of such drugs for medical and scientific purposes; (iii) designated an administrative body for implementing international drug control conventions; and (iv) acknowledged a government’s intention to implement international conventions, including the Single Convention. FINDINGS: Most national laws were found not to contain measures that ensured adequate provision of opioid drugs for medical and scientific purposes. Moreover, the model legislation provided by the United Nations Office on Drugs and Crime did not establish an obligation on national governments to ensure the availability of these drugs for medical use. CONCLUSION: To achieve consistency with the Single Convention, as well as with associated resolutions and recommendations of international bodies, national drug control laws and model policies should be updated to include measures that ensure drug availability to balance the restrictions imposed by the existing drug control measures needed to prevent the diversion and nonmedical use of such drugs