Influenza

Background
Influenza virus infection, one of the most common infectious diseases, is a highly contagious airborne disease that causes an acute febrile illness and results in variable degrees of systemic symptoms, ranging from mild fatigue to respiratory failure and death. These symptoms contribute to significant loss of workdays, human suffering, mortality, and significant morbidity. The 1918-1919 H1N1 type influenza pandemic killed an estimated 20-50 million persons, with 549,000 deaths in the United States alone.

Accurately diagnosing influenza A or B infection based solely on clinical criteria is difficult because of the overlapping symptoms caused by the various viruses associated with upper respiratory tract infection (URTI). In addition, several serious viruses, including adenoviruses, enteroviruses, and paramyxoviruses, may initially cause influenzalike symptoms. The early presentation of mild or moderate cases of flavivirus infections (eg, dengue) may initially mimic influenza. For example, some cases of West Nile fever acquired in New York in 1999 were clinically misdiagnosed as influenza.

Patients with influenza frequently present with various symptoms shared by many other viral infections. In the northern and southern hemispheres, these symptoms are more common in the winter months. As a result, during the winter, clinics and emergency department waiting rooms fill with patients who have influenza or other URTIs.
Pathophysiology
Influenza results from infection with 1 of 3 basic types of influenza virus—A, B, or C—which are classified within the family Orthomyxoviridae. These single-stranded RNA viruses are structurally and biologically similar but vary antigenically.

The RNA core consists of 8 gene segments surrounded by a coat of 10 (influenza A) or 11 (influenza B) proteins. Immunologically, the most significant surface proteins include hemagglutinin and neuraminidase. The viruses are typed based on these proteins. For example, influenza A subtype H3N2 expresses hemagglutinin 3 and neuraminidase 2.

The most common prevailing influenza A subtypes that infect humans are H1N1 and H3N2. Each year, the trivalent vaccine used worldwide contains A strains from H1N1 and H3N2, along with an influenza B strain.

Influenza virus infection occurs after transfer of respiratory secretions from an infected individual to a person who is immunologically susceptible. If not neutralized by secretory antibodies, the virus invades airway and respiratory tract cells. Once within host cells, cellular dysfunction and degeneration occur, along with viral replication and release of viral progeny. Systemic symptoms result from inflammatory mediators, similar to other viruses. The incubation period of influenza ranges from 18-72 hours.

Influenza A is generally more pathogenic than influenza B. Influenza A is a zoonotic infection, and more than 100 types of influenza A infect most species of birds, pigs, horses, dogs and seals. Indeed, the 1918 pandemic that resulted in millions of human deaths worldwide is believed to have originated from a virulent strain of H1N1 from pigs or birds. Recently, scientists obtained and sequenced the 1918 H1N1 strain from a frozen corpse found in Alaska. The virus was reconstructed at the Centers for Disease Control and Prevention (CDC) laboratory in Atlanta and was found to be highly lethal when tested in mice; the virus was also found to be lethal to chicken embryos. This unique N1 neuraminidase is being studied in order to provide better insight into the N1 found in H5N1, the type responsible for avian influenza (also known as bird flu). Read more »

Bacterial Infections and Pregnancy

This article focuses on common bacterial infections in pregnancy and describes the manifestations of these infections and the therapies used to treat them.

Bacterial infections can affect pregnant women from implantation of the fertilized ovum through the time of delivery and peripartum period. They may also affect the fetus and newborn. Many women with these infections are asymptomatic, necessitating both a high degree of clinical awareness and adequate screening.

Grop B Streptococcus

Group B Streptococcus (GBS) is the most common cause of life-threatening infections in newborns; thus, GBS is the primary focus of any discussion about infections and pregnancy. Infections caused by GBS affect both mother and child. Since the emergence of this pathogen in the 1970s, the increased use of intrapartum prophylaxis has decreased the infection rate by 70%.

Etiology

Streptococcus agalactiae, or GBS, is a facultative, beta-hemolytic, fastidious, gram-positive coccus. GBS can be found as part of normal vaginal, rectal, and oral flora. The virulence of the organism depends largely on the polysaccharide capsule.

Transmission

Twenty to 25% of pregnant women are asymptomatic carriers of vaginal or rectal GBS. Intrapartum transmission occurs via ascending spread or at the time of delivery.

Clinical spectrum

Because only 0.5-1% of mothers who carry GBS develop signs and symptoms of disease, clinical diagnosis of GBS infection can be problematic.

In pregnant women, GBS is a cause of cystitis, amnionitis, endometritis, and stillbirth. Occasionally, GBS has caused endocarditis and meningitis in pregnant women, while, in postpartum women, GBS has been identified as a cause of urinary tract infections (UTIs) and pelvic abscesses. Read more »

Boston Cabs and Credit Cards

Ready to book your Boston transportation? To learn more about car service Boston option and finding a Boston car service that is right for you (or a Logan car service to Logan airport or back from it), read below.

Over two years ago, the city of Boston mandated that every taxi cab be equipped with a credit card reader for customer convenience. Today, one in every four Boston taxi cab passengers pay with credit. This installation has numerous advantages for passengers, but has created tensions between law enforcement and drivers.

Collected from registered taxi cabs, meters show that Boston cab usage has greatly increased since the credit card devices were installed. Taxis now carry more passengers, make more profitable fares, and travel longer distances. Analysts attribute the credit card readers, which were fully installed in Boston’s taxis in mid-2009, to some of the success.

Boston cab credit card processors, which are positioned in the rear seat, are attractive to passengers for various reasons. Obviously, passengers do not require cash money for their fare. This is particularly advantageous for customers after-hours, when banks or ATMs might be closed or in inclement weather, which Boston often experiences. In addition, taxi cab credit card machines are highly convenient. Many people might not carry substantial amounts of money, and cab fares in Boston can be relatively expensive. Instead, one simply needs to swipe a credit card through the taxi’s machine, and the fare and tip are accounted for without requiring cash.

However, the view from the front seat is quite different. Some taxi drivers and cab companies argue that the radio dispatch companies, which installed the machines, are profiting from the credit card readers, not the drivers.

Take Over Migraine

The light illness could be boomerang for the person itself. Sometime we do not realize that an a little pain could disturb our activity. So, we have to prevent it if we realize the symptoms. Have you ever got migraine headaches? A migraine headache is not a common headache. It has different symptoms than the common headaches.

What are the migraine symptoms? Actually, there are several symptoms that is common appear to the migraine victims. The aura is the warning sign of the migraine. What is aura? Aura is such kind a sign that the migraine will be happened. It can be blind spots, impaired vision, and a temporary loss vision. So, if you have ever experienced this way of the symptoms, now you can conclude it as a symptoms of migraine headache.

So, if you got a migraine, you can try to get the home remedy as well. Why? It is because the home remedy will affect more to your health. So, you can try to apply ice to your head. Then take a rest by sleeping within an hour. This will make you feel better. In addition, migraine treatment is also can be got by taking a tablet that you got from the doctor’s prescription.