Los neonatos también tienen gripe / Neonates also have flu

INTRODUCCIÓN: Los niños son la población de mayor incidencia de gripe y la principal fuente de transmisión de la enfermedad. Sin embargo, hay pocos casos reportados y poca información sobre el manejo en la edad neonatal, población especialmente vulnerable. El objetivo de este estudio es describir los casos de gripe en neonatos ingresados en un hospital terciario, comparando el manejo con otros centros descritos en la literatura. MATERIAL Y MÉTODOS: Presentamos un estudio descriptivo, longitudinal y retrospectivo de casos de gripe neonatal entre 2009 y 2019 en una unidad nivel III en neonatología. Se han estudiado variables epidemiológicas, clínicas, diagnósticas, pronósticas y terapéuticas de interés. RESULTADOS: Se estudiaron un total de 13 casos. Se encontró ambiente epidémico familiar en el 61,5% de los pacientes. La infección respiratoria superior y las desaturaciones fueron los síntomas más prevalentes (69,2%). El virus más frecuentemente aislado fue el de la Gripe A tipo H1N1 (69,2%). El 61,5% se trataron con antibioterapia y dos (15,4%) recibieron tratamiento con oseltamivir. El 46,1% de los casos precisó ingreso en Unidad de Cuidados Intensivos Neonatales y soporte ventilatorio, pero no se registró ningún éxitus. CONCLUSIONES: La población neonatal es especialmente vulnerable a la gripe y sus complicaciones, requiriendo con frecuencia ingreso en las unidades de cuidados intensivos. Evitar el ambiente epidémico es un arma importante en la prevención. Dado que es una patología infrecuente en este grupo de edad, existe escasa evidencia sobre su adecuado manejo, por lo que consideramos necesarios más estudios para optimizar su tratamiento y soporte

INTRODUCTION: Children are the population with the biggest flu incidence and the main source of transmission of this illness. However, there are few cases reported and few information regarding it management in neonates, a very vulnerable population. The aim of this study is describing flu neonatal cases admitted in a tertiary care hospital and comparing it management with other centres described in the literature. MATERIAL AND METHODS: We present a descriptive, longitudinal and retrospective study of flu neonatal cases between 2009 and 2019 in the Unit of Neonatology in a tertiary care hospital. Epidemiological, clinical, diagnostic, prognostic and therapeutic variables of interest have been studied. RESULTS: 13 cases were studied. Family epidemic environment was found in 61.5% of patients. Upper respiratory infection and desaturations were the most prevalent symptoms (69.2%). The most frequently isolated virus was Influenza A type H1N1 (69.2%). 61.5% were treated with antibiotherapy and two cases (15.4%) with oseltamivir. 46.1% of cases required admission to the Neonatal Intensive Care Unit and ventilatory support, but no exitus was recorded. CONCLUSIONS: Neonatal population is especially vulnerable to flu and its complications, often requiring admission to Intensive Care Units. Avoiding the epidemic environment is an important prevention weapon. Given that it is an infrequent pathology in this age group, there is little evidence about its proper management, so we consider that more studies are necessary for its treatment and support

Pharmacokinetics of meloxicam after intravenous, intramuscular and oral administration of a single dose to African grey parrots (Psittacus erithacus).

Meloxicam is a nonsteroidal anti-inflammatory drug commonly used in avian species. In this study, the pharmacokinetic parameters for meloxicam were determined following single intravenous (i.v.), intramuscular (i.m.) and oral (p.o.) administrations of the drug (1 mg/kg·b.w.) in adult African grey parrots (Psittacus erithacus; n = 6). Serial plasma samples were collected and meloxicam concentrations were determined using a validated high-performance liquid chromatography assay. A noncompartmental pharmacokinetic analysis was performed. No undesirable side effects were observed during the study. After i.v. administration, the volume of distribution, clearance and elimination half-life were 90.6 ± 4.1 mL/kg, 2.18 ± 0.25 mL/h/kg and 31.4 ± 4.6 h, respectively. The peak mean ± SD plasma concentration was 8.32 ± 0.95 µg/mL at 30 min after i.m. administration. Oral administration resulted in a slower absorption (tmax  = 13.2 ± 3.5 h; Cmax  = 4.69 ± 0.75 µg/mL) and a lower bioavailability (38.1 ± 3.6%) than for i.m. (78.4 ± 5.5%) route. At 24 h, concentrations were 5.90 ± 0.28 µg/mL for i.v., 4.59 ± 0.36 µg/mL for i.m. and 3.21 ± 0.34 µg/mL for p.o. administrations and were higher than those published for Hispaniolan Amazon parrots at 12 h with predicted analgesic effects.

Suicide attempt rates and intervention effects in women of Turkish origin in Berlin.

PURPOSE: Ethnic minority groups show elevated suicide attempt rates across Europe. Evidence suggests a similar trend for women of Turkish origin in Germany, yet data on suicidal behaviour in minorities in Germany is scarce. The objective was to examine rates of suicidal behaviour, underlying motives, and to explore the effectiveness of an intervention program. METHODS: From 05/2009-09/2011, data on all suicide attempts among women of Turkish origin who presented at a hospital-based emergency unit in Berlin, Germany, were collected. A multi-modal intervention was conducted in 2010 and the effects of age, generation and the intervention on suicide attempt rates were examined. RESULTS: At the start, the highest rate was found in women aged 18-24years with 225.4 (95% CI=208.8-242.0)/100,000. Adjustment disorder was the most prevalent diagnosis with 49.7% (n=79), being more common in second-generation women (P=.004). Further analyses suggested an effect of the intervention in the youngest age group (trend change of ß=-1.25; P=.017). CONCLUSION: Our findings suggest a particularly high rate of suicide attempts by 18-24-year-old, second-generation women of Turkish origin in Berlin. Furthermore, our results suggest a trend change in suicide attempts in women aged 18-24years related to a population-based intervention program.

[Suicide Rates and Suicide Prevention in Women of Turkish Origin in Berlin]. / Suizidraten und Suizidprävention bei Berliner Frauen mit türkischem Migrationshintergrund.

Suicidality in female Turkish immigrants is higher as compared to that of native-born women of the same age. The analysis of the national mortality registry in Germany reported a 2-fold suicide risk in the target group compared to German women of the same age. A population-based multi-modal intervention project was conducted. Suicidal crisis were analysed in focus groups and guided the development of the intervention module. The intervention consisted of a public awareness campaign, a telephone hotline, and the training of key persons. All parts of the intervention were subsequently evaluated. Suicide attempts of the target group that were presented at all emergency units in Berlin were registered. In a population-based interview survey the aim was to elicit central sociodemographic and psychosocial variables that may influence distress and help-seeking behaviour in women of Turkish origin.

Prevalence and types of hyponatraemia, its relationship with hyperglycaemia and mortality in ill pet rabbits.

Prevalence of hyponatraemia has not been extensively studied in pet rabbits, and the reference data for calculated plasma tonicity and osmolarity are not available. This retrospective clinical study reports the prevalence of hyponatraemia, hyposmolarity and hypotonicity in ill pet rabbits (n=356). The relationship between sodium and glucose levels was studied (n=134). Mortality rates within seven days associated with different sodium levels were calculated in ill rabbits (n=322). Venous blood samples in lithium heparin were processed using iStat EC8+ cartridges. The 95% RI for plasma sodium, calculated osmolarity and tonicity from 51 healthy pet rabbits were 136-147 mEq/l, 284-312 mOsm/l and 278-302 mOsm/l, respectively. The prevalence of hyponatraemia, hypotonicity and hyposmolarity was 39.0 per cent, 28.7 per cent and 18.0 per cent, respectively. Pseudohyponatraemia was present in 28.1 per cent and true hyponatraemia was present in 71.9 per cent of the cases of hyponatraemia. Sodium levels less than 129 mEq/l were found to be associated with 2.3-fold increase in mortality risk. Plasmatic sodium levels in rabbits decrease in conditions of hyperglycaemia in a similar manner as it occurs in human beings. As hyperglycaemia is quite a common condition in rabbits, simultaneous measurement of plasmatic sodium along with glucose in ill rabbits is advised. Hyponatraemia is a common condition in ill rabbits and, depending on its type (true hyponatraemia or pseudohyponatraemia), of varying clinical relevance. Calculation of plasmatic tonicity is necessary for differentiation of types of hyponatraemia.

Socio-economic status and emotional distress of female Turkish immigrants and native German women living in Berlin.

BACKGROUND: Many immigrants face more economic strains and hardship than non-immigrants. Income inequality and an increasing social gap between immigrants and non-immigrants in Europe warrant further studies on the impact of socioeconomic factors on health in immigrant groups. The purpose of this study was to examine the association of socioeconomic status (SES) and emotional distress in women of Turkish descent and in women of German descent. METHODS AND SUBJECTS: A total of 405 women of German or Turkish descent residing in Berlin were interviewed. Emotional distress was assessed by the General Health Questionnaire-28 (GHQ-28), and SES was examined by level of education, employment status, and income. The associations of emotional distress and SES were estimated in multivariate linear regression analyses. RESULTS: Unemployment was associated with increased levels of emotional distress in all women, with the highest level of distress in the group of unemployed Turkish women. The overall SES level was related to a greater level of emotional distress in Turkish women, but not in German women (-3.2, 95%CI -5.9 - -.5; p=.020 vs. -.8, 95%CI -2.7 - 1.2; p=.431). Further stratified analyses by relationship status revealed that the association of SES and emotional distress only remained significant among single women. CONCLUSION: The impact of socioeconomic hardship appears to be complicated by social roles and expectations related to these. Further in-depth study of the complex nature of the interaction of social roles and socioeconomic position in female Turkish immigrants in Germany is needed to better understand differing risk patterns for emotional distress.

The influence of stigma on depression, overall psychological distress, and somatization among female Turkish migrants.

BACKGROUND: Even though some studies suggest that in Mediterranean and non-western cultures more somatic and less psychological symptoms are reported, this so-called 'somatization' hypothesis has been challenged. Reviews show that somatic symptoms are a core component of depressive episodes regardless of cultural background. The expression of symptoms might be related to the psychosocial, social and cultural context surrounding the patient rather than 'ethnicity' or related constructs. Also, stigma associated with mental disorders can affect patients'symptom presentation. METHODS: The interrelationships of perceived stigmatization (Explanatory Model Interview Catalogue - Stigma Scale), depression (Beck Depression Index II), overall psychological distress (Symptom Checklist-90-R), and somatic symptoms (The screening for SOMATOFORM SYMPTOMS II) was assessed in a sample of female patients with Turkish descent with a diagnosis of depression (N=63). RESULTS: Depression, overall psychological distress, and somatic symptoms were positively and significantly related. Stigma was positively related to depression and overall psychological distress. There was no significant relationship between stigma and somatic symptoms, neither among the severely depressed group (N=39), nor among the less depressed group (N=24). CONCLUSION: The positive relationships between stigma, depression, and overall psychological distress indicate that patients who are more depressed and who have higher levels of overall psychological distress experience their condition as more stigmatizing. Since somatic symptoms and stigma were not related (neither positively, nor negatively), it appears that depressive symptoms and other symptoms of psychological distress affect concerns about stigmatizing attitudes in a way that somatic symptoms do not. This result challenges common assumption of the 'somatization'hypothesis, i.e. that depression is 'somatized'because of concern about stigmatizing attitudes.

Mental health of Turkish women in Germany: resilience and risk factors.

BACKGROUND: The purpose of the present study was to examine the protective and risk factors of mental distress among Turkish women living in Germany. METHOD: 105 Turkish immigrant women living in Berlin were investigated with measures of extraversion/neuroticism (NEO-FFI), general self-efficacy (GSE), social support (BSSS), social strain (F-SOZU) and mental distress (GHQ-28). Interrelations between psychosocial variables were assessed using simple Pearson correlations. RESULTS: In all subjects, social strain (Pearson's r=.26(**), p=.008) and neuroticism (r=.34(**), p<.001) were positively associated with mental distress. In contrast, perceived self-efficacy (r=-.38(**), p<.001) and extraversion (r=-.36(**), p<.001) were negatively associated with mental distress. CONCLUSION: Protective factors such as extraversion and self-efficacy seem to have a buffering effect on the process of migration. However, in addition to neuroticism, social strain seems to be positively associated with mental distress.

Congestive heart failure in 6 African grey parrots (Psittacus e erithacus).

Six African grey parrots (Psittacus e erithacus) were diagnosed with cardiomyopathy and congestive heart failure based on gross and microscopic findings. Ages ranged from 15 days to 8 years, and 5 of 6 parrots were either neonates or juveniles at the time of diagnosis. Two neonates and 2 juveniles came from the same breeding aviary; the 2 juveniles were born to the same breeding pair. The 2 other parrots were kept as pets. Clinical signs included distention of the coelomic cavity (4 of 6), rales (3 of 6), weakness (4 of 6), bradyarrhythmia (1 of 6), growth retardation (1 of 6), crop stasis (1 of 6), and regurgitation (1 of 6). Three parrots were euthanized and 3 died. Gross findings included cardiomegaly due to biventricular, right-, or left-sided cardiomyopathy (6 of 6); coelomic effusion (6 of 6); whitish or yellow foci in the liver (6 of 6); atrophy of the liver (particularly, the left lobe; 5 of 6); reddened or grey lungs (5 of 6); subcutaneous edema (2 of 6); hydropericardium (1 of 6); and bilateral thyroid gland enlargement (1 of 6). Relevant microscopic findings included passive hepatic congestion (6 of 6) and pulmonary congestion (2 of 6), lymphocytic thyroiditis (2 of 6), and diffuse thyroid follicular hyperplasia (2 of 6). Microscopically, the heart was unremarkable (2 of 6) or had mild lymphocytic myocarditis (2 of 6), mild multifocal cytoplasmic vacuolation of cardiomyocytes (2 of 6), mild lymphocytic myocardial (Purkinje cell) ganglioneuritis (1 of 6), and mild multifocal interstitial fibrosis and nuclear hypertrophy of cardiomyocytes (1 of 6). One parrot had concurrent proventricular dilatation disease (systemic ganglioneuritis). The cause of cardiomyopathy in these parrots was not determined.

[New procedures for recognition and differentiation of depression in immigrants. Case report of a patient with Turkish immigrant background]. / Neue Ansätze zur Erkennung und Differenzierung von Depression bei Migranten. Fallbeispiel einer Patientin mit türkischem Migrationshintergrund.

Depression is a cross-cultural disorder, which displays cultural differences in symptom presentation and prevalence. The guidelines for the assessment of cultural influencing factors for the medical history and therapy and the consideration of stressors associated with the immigration process can help to better understand the socio-cultural background of patients with an immigration background and facilitate the differential diagnosis. Using these strategies, psychiatry and psychotherapy are better prepared to deal with this large heterogeneous population given the fact that one fifth of Germany's population has an immigration background. The transcultural aspects of depression are illustrated with a case report.

Clinicopathologic features of a systemic coronavirus-associated disease resembling feline infectious peritonitis in the domestic ferret (Mustela putorius).

From 2002 to 2007, 23 ferrets from Europe and the United States were diagnosed with systemic pyogranulomatous inflammation resembling feline infectious peritonitis (FIP). The average age at the time of diagnosis was 11 months. The disease was progressive in all cases, and average duration of clinical illness was 67 days. Common clinical findings were anorexia, weight loss, diarrhea, and large, palpable intra-abdominal masses; less frequent findings included hind limb paresis, central nervous system signs, vomiting, and dyspnea. Frequent hematologic findings were mild anemia, thrombocytopenia, and hypergammaglobulinemia. Grossly, whitish nodules were found in numerous tissues, most frequently the mesenteric adipose tissue and lymph nodes, visceral peritoneum, liver, kidneys, spleen, and lungs. One ferret had a serous abdominal effusion. Microscopically, pyogranulomatous inflammation involved especially the visceral peritoneum, mesenteric adipose tissue, liver, lungs, kidneys, lymph nodes, spleen, pancreas, adrenal glands, and/or blood vessels. Immunohistochemically, all cases were positive for coronavirus antigen using monoclonal antibody FIPV3-70. Electron microscopic examination of inflammatory lesions identified particles with coronavirus morphology in the cytoplasm of macrophages. Partial sequencing of the coronavirus spike gene obtained from frozen tissue indicates that the virus is related to ferret enteric coronavirus.

Hematological, protein electrophoresis and cholinesterase values of free-living nestling peregrine falcons in Spain.

Protein electrophoresis, hematological and cholinesterase values were determined in 32 nestling free-living peregrine falcons (Falco peregrinus) (15- to 27-days-old) in order to establish normal reference values for this population. The following values (mean +/- SD) were observed: prealbumin 0.31 +/- 0.04 g/dl, albumin 1.25 +/- 0.06 g/dl, alpha1 and alpha2-globulin 0.23 +/- 0.02 and 0.16 +/- 0.02 g/dl respectively, beta-globulin 1.02 +/- 0.05 g/dl, gamma-globulin 0.060 +/- 0.08 g/dl, total protein 3.79 +/- 0.18 g/dl, 21.26 +/- 1.30 white blood cells/microl (1 x 10(3)), 2.17 +/- 0.07 red blood cells/microl (1 x 10(6)), packed cell volume 37.58 +/- 0.82%, hemoglobin 20.96 +/- 0.29 g/dl, heterophils 61.14 +/- 2.50% and cholinesterase 1,184 +/- 75 IU/L. There were no difference in any of these parameters among males and females. The hematological values obtained could be considered as representative values in free-living nestling peregrine falcons.

A new efficient method for 3D registration using human brain atlases.

In this article a new efficient method in deformable brain atlases is proposed. To achieve this goal we use the composition of two applications, an affine transformation and other one. In this second application we have used three different approaches. One approach that has been used and two new approaches. We use a set of points to be identified both in brain atlas and in patient's brain for registration. The three approach present an advantage: the mathematical solution obtained makes it to be very fast, almost immediate. Several results have been obtained and they have been classified as very satisfactory by the neurosurgeons that have tested our system.

[Ask-Upmark kidney: description of a case and review of the literature]. / Riñón de Ask--Upmark: descripción de un caso y revisión en la literatura.

We present a 15-year-old male patient diagnosed histopathologically as suffering from Ask-Upmark kidney, in the absence of vesicoureteral reflux and with hypertension. The first clinical manifestation was completely atypical: right loin pain, with so many agudisation treated at our emergency serve that justified a thorough study. The pathogenesis of the Ask-Upmark kidney is still unknown; some authors defend the congenital malformation hypothesis, as it was first described in 1929, but there are groups who support the Ask-Upmark kidney as a form of reflux nephropathy. After our description we present a review of the literature.

Premenstrual symptoms in Mexican women with different educational levels.

Most women present some premenstrual symptoms, which may be influenced by diverse sociocultural factors. The authors studied the premenstrual symptoms of 89 healthy Mexican women living in rural areas and whose education ranged from no schooling to middle school attendance, and 182 women living in urban areas whose education ranged from elementary school to professional studies. The Menstrual Distress Questionnaire (R. H. Moos, 1968) was completed by all the women during the premenstrual and postmenstrual phases of one menstrual cycle. The percentage of women who reported mild symptoms was 87% on somatic scales and 86% on psychological scales. Premenstrual symptoms were more severe among women engaged in professional studies. Urban women reported more severe psychological symptoms than rural women. When women who were engaged in professional studies were excluded from the data analyses, no differences between the groups were found. Thus, it appears that the women's level of education affected premenstrual symptoms more than their rural or urban backgrounds did.

Hematological and plasma biochemical reference intervals in young white storks.

Hematological and plasma chemistry parameters were measured in 129 juvenile white storks (Ciconia ciconia), either wild or captive bred, April to June 1994. Wild storks were members of a colony in the Lozoya River Valley, Madrid, Spain. Red blood cells count, packed cell volume and hemoglobin increased significantly with age. White blood cells count, lymphocytes count and platelets decreased with age. Total solids, total proteins, fibrinogen, albumin, alpha, beta, gamma-globulins and urea increased with age. Differences between captive and wild birds were not notable.

[Hypertensive patients treated in Spain, 1990-1993]. / Estudio sobre los enfermos hipertensos en tratamiento en España durante el período 1990-1993.

BACKGROUND: The main goal of our work was to gain knowledge from the pharmaco-epidemiological perspective on the use of anti-hypertensive drugs in our country, in order to obtain a rough estimation of the number of hypertensive patients under treatment in various Autonomous Communities. METHODS: The data regarding the consumption of hypertensive drugs (mono-medicines) from 1990 to 1993 have been obtained from the Vice-Directorate General for Treatment and Pharmaceutical Planning. The methodology used to calculate the "Estimated Prevalence Patient-day" under treatment with these drugs is based on the WHO recommendations for the Studies on the use of Medicines. Estimated Prevalence of Patient-day (EPPD) has been calculated by using the Defined Daily Dosage of each anti-hypertensive drug. RESULTS: The number of hypertensive patients under treatment with these drugs was 1.763.937, 1.966.396, 2.226.225 and 2.435.294, from 1990 to 1993, respectively. At the end of our study, in 1993, the number of hypertensive patients under treatment in Spain is nearly 50% of the total number of hypertensive patients. There are some differences amongst regions; thus, the Autonomous Communities of Aragón, Castilla-La Mancha, Cataluña, País Valenciano and Murcia are noticeable as regions where the number of hypertensive patients treated exceeds the national average. CONCLUSIONS: The number of hypertensive patients under treatment has considerably increased between 1990 to 1993 (+ 40%). An increase is observed in the number of hypertensive patients treated with calcium antagonists and ECA inhibitors and a decrease is observed in the proportion of hypertensive patients under treatment with Beta-blockers and diuretics.