IntroductionPatients with influenza A (H1N1)v infection have developed rapidly progressive lower respiratory tract disease resulting in respiratory failure. We describe the clinical and epidemiologic characteristics of the first 32 persons reported to be admitted to the intensive care unit (ICU) due to influenza A (H1N1)v infection in Spain.MethodsWe used medical chart reviews to collect data on ICU adult patients reported in a standardized form. Influenza A (H1N1)v infection was confirmed in specimens using real-time reverse transcriptase-polymerase-chain-reaction (RT PCR) assay.ResultsIllness onset of the 32 patients occurred between 23 June and 31 July, 2009. The median age was 36 years (IQR = 31 - 52). Ten (31.2%) were obese, 2 (6.3%) pregnant and 16 (50%) had pre-existing medical complications. Twenty-nine (90.6%) had primary viral pneumonitis, 2 (6.3%) exacerbation of structural respiratory disease and 1 (3.1%) secondary bacterial pneumonia. Twenty-four patients (75.0%) developed multiorgan dysfunction, 7 (21.9%) received renal replacement techniques and 24 (75.0%) required mechanical ventilation. Six patients died within 28 days, with two additional late deaths. Oseltamivir administration delay ranged from 2 to 8 days after illness onset, 31.2% received high-dose (300 mg/day), and treatment duration ranged from 5 to 10 days (mean 8.0 ± 3.3).ConclusionsOver a 5-week period, influenza A (H1N1)v infection led to ICU admission in 32 adult patients, with frequently observed severe hypoxemia and a relatively high case-fatality rate. Clinicians should be aware of pulmonary complications of influenza A (H1N1)v infection, particularly in pregnant and young obese but previously healthy persons.

The role of nonfictional and fictional media in suicide contagion has been well established, ostensibly beginning with the publication of Goethe's The Sorrows of Young Werther in 1774. In recent decades, the emergence of several new forms of media (e.g. websites, social media, blogs, smartphone applications) has revolutionized the communication and social interaction paradigms. This article reviews "the Werther effect" (or suicide contagion related to media), special populations who are more influential or susceptible, current media reporting guidelines and their effectiveness, and the latest research on new media and its effect on suicide and suicide contagion. The aim is to update recommendations on how to mitigate the potential negative effects of both traditional and new media on suicidal behavior and suicide contagion.

When otologic procedures that involve tympanic membrane repairs are performed, biomaterials or biological tissues as normal as grafts are used. At the moment, biological material from the own patient is used with varying success rates. The procedure used and the patient's tissue repair capabilities tend to determine the outcome. We present a preliminary study on tympanic membrane perforation repairs using an autograft obtained by manipulating platelet degranulation and the coagulation cascade and reinforced with a seal using platelet growth factors. We present three cases in which we used this procedure. The results will be valued based on the tympanic perforation closure index. With this study, we want to assess the effectiveness of tympanic perforation repairs with this technically simple method. If this method was objectively proved to be effective, it would lead to lower patient morbidity and sanitary costs.

Introducción: El etiquetado nutricional es una herramienta gráfica para notificar al consumidor sobre las propiedades nutricionales de un alimento lo que facilita su selección. El objetivo del presente estudio fue determinar la influencia del etiquetado nutricional y los factores socioeconómicos, culturales, demográficos, publicitarios en la selección de alimentos en un grupo de padres de niños entre 5-11 años en dos unidades educativas públicas y privadas de Quito. Métodos: Con diseño mixto, cuantitativo- transversal y cualitativa interpretativa se analizó una muestra de opiniones de 240 padres en las Unidades Educativas (UE) Nueva Aurora (Privada) y 235 padres en la UE Julio María Matovelle (Pública) de Quito. Se realizaron tres grupos focales, grabados y transcriptos de forma textual y se aplicó un cuestionario. El paquete estadístico usado fue SPSS v24.0. Resultados: Hubo mayor consumo de alimentos procesados en la UE Privada n=79/240 (32.9%). Selección por fácil preparación (39.2% UE Privada y 46.4% UE Pública). El 54.2 % y 57 % de los padres ven publicidad en la televisión. El conocimiento del etiquetado fue superior en la UE privada (94.9%; n=223). Asociación entre edad [OR: 2.3; IC 95%: 1.08-5.04] instrucción [OR: 3.95; IC 95%: 2.12-7.37], exposición a la publicidad [OR: 0.62; IC 95%: 0.36-1.05] y conocimientos (P<0.05). La actitud se asoció con el nivel de instrucción [OR: 2.57; IC 95%: 1.62-4.09] e ingresos (P<0.05). Análisis cualitativo: grado de conocimiento y publicidad elevados, con un impacto importante en la selección de los alimentos. Conclusiones: El conocimiento sobre el etiquetado nutricional fue elevado; pero no fue el principal factor para seleccionar alimentos. El tiempo de preparación y el sabor fueron más importantes que las especificaciones nutricionales.

Colonization of the medial lumen is an independent risk factor for triple-lumen catheter-related bloodstream infection, possibly due to the absence of use of this lumen.