Our aim was to evaluate the evolution of 20 patients with H1N1 pneumonia, focusing our attention on patients with severe clinical and radiological findings who developed post-acute respiratory distress syndrome (post-ARDS) pulmonary fibrosis. ⋯ In patients with H1N1 pneumonia, post-ARDS pulmonary fibrosis is not a rare complication. Therefore, a CT scan should be performed in all patients with severe clinical findings. Our study demonstrated that in these patients, fibrosis could present a different spatial distribution and a different temporal trend, with delayed late onset; moreover, in one case, the signs of interstitial lung disease partially regressed over time. Therefore, CT should be considered not only in the diagnostic stage, but also during the follow-up.
Neuroimaging studies show that nociceptive stimuli elicit responses in an extensive cortical network. Functional near-infrared spectroscopy (fNIRS) allows for functional assessment of changes in oxyhemoglobin (HbO), an indirect index for cortical activity. Unlike functional magnetic resonance imaging (fMRI), fNIRS is portable, relatively inexpensive, and allows subjects greater function. No systematic review or meta-analysis has drawn together the data from existing literature of fNIRS studies on the effects of experimental pain on oxyhemoglobin changes in the superficial areas of the brain. ⋯ Pain affects the prefrontal and sensory-motor cortices of the brain and can be measured using fNIRS. Implications of this study may lead to a simple and readily accessible objective measure of pain.
Accidental drowning can cause out-of-hospital cardiac arrest (OHCA). We investigated the effect of drowning location on outcomes of individuals who experienced drowning-OHCA. ⋯ Individuals who experience drowning-OHCA in public locations with safety regulations had a better rate of survival. There should be improved public awareness of the significantly greater risk of drowning-OHCA in locations that have no safety regulations.
In the paper there is presented the hygienic assessment of the effectiveness of the implementation of a program aimed at improving conditions of the water supply in the oil producing regions of the Republic of Tatarstan. As a result of realization of measures it was able to improve the quality of drinking water in terms of chemical safety and to reduce the risk to public health. For the present time the following factors: water quality of the water source, the mismatch of sanitary protective zone to requirements of sanitary laws and failure to comply with security measures on its territory, deterioration of water quality during transport and imperfection of laboratory control monitoring were shown to make the highest contribution to the disadvantage of centralized drinking water systems.
Randomized Controlled Trial Multicenter Study
To determine the efficacy, safety, and tolerability of 3 different dosages of CP-690,550, a potent, orally active JAK inhibitor, in patients with active rheumatoid arthritis (RA) in whom methotrexate, etanercept, infliximab, or adalimumab caused an inadequate or toxic response. ⋯ Our findings indicate that CP-690,550 is efficacious in the treatment of RA, resulting in rapid, statistically significant, and clinically meaningful reductions in the signs and symptoms of RA. Further studies of CP-690,550 in RA are warranted.