Navigation Links
Researchers find new patterns in H1N1 deaths
Date:12/23/2009

Brazilian researchers have performed the first-ever autopsy study to examine the precise causes of death in victims of the H1N1 swine flu.

"The lack of information on the pathophysiology of this novel disease is a limitation that prevents better clinical management and hinders the development of a therapeutic strategy," said lead author, Thais Mauad, M.D., Ph.D., associate professor of the Department of Pathology at So Paulo University, in Brazil.

The results of their study will be published in the January 1 issue of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

The researchers examined 21 patients who had died in So Paulo with confirmed H1N1 infection in July and August, 2009. Most were between the ages of 30 and 59. They found that three-quarters (76 percent) of the patients had underlying medical conditions such as heart disease or cancer, but there was no clear complicating medical condition in the remaining quarter. All presented a progressive and rapidly fatal form of the disease.

While previous data has shown that most patients with a non-fatal infection have fever, cough and achiness (myalgia), Dr. Mauad noted that "most patients with a fatal form of the disease presented with difficulty breathing (dyspnea), with fever and myalgia being less frequently present."

All patients died of severe acute lung injury, but there were three distinct patterns of the damage to their lungs, indicating that the infection killed in distinct ways. "All patients have a picture of acute lung injury," said Dr. Mauad. "In some patients this is the predominant pattern; in others, acute lung injury is associated with necrotizing bronchiolitis (NB); and in others there is a hemorrhagic pattern."

"Patients with NB are more likely to have a bacterial co-infection. Patients with heart disease and cancer are more likely to have a hemorrhagic condition in their lungs. It is important to bear in mind that patients with underlying medical conditions must be adequately monitored, since they are at greater risk of developing a severe H1N1 infection," said Dr. Mauad. In these patients, H1N1 infection may present as a potential fatal disease, requiring early and prompt intensive care management, including protective ventilation strategies and adequate hemodynamic management. "We found that 38 percent of these patients had a bacterial infection (bronchopneumonia). This has important consequences because these patients need to receive antibiotic therapy, in addition to antiviral therapy."

The researchers also found evidence of an influenza-associated "cytokine storm," an aberrant immune response in the lungs of certain individuals, which was almost certainly involved in the pathogenesis in these fatal cases of the H1N1 infection. "[This] suggests that an overly vigorous host inflammatory response triggered by the viral infection may spill over to and damage lung tissue, thereby causing acute lung injury and fatal respiratory failure," noted John Heffner, M.D., past president of the ATS.

Further research is needed to understand precisely how and why certain patients succumb to a fatal progression when infected with H1N1. While most patients experience a mild illness with no lasting effects, this research lays important groundwork for future efforts by defining the histological patterns associated with a fatal infection.

"We would like to deepen our efforts into the understanding of the immune responses in cases of severe infection," said Dr. Mauad. "This could ultimately lead to new therapeutic approaches."


'/>"/>

Contact: Keely Savoie
ksavoie@thoracic.org
212-311-58620
American Thoracic Society
Source:Eurekalert

Related medicine news :

1. Stanford researchers find culprit in aging muscles that heal poorly
2. UCLA researchers identify markers that may predict diabetes in still-healthy people
3. Mayo Clinic researchers discover new diagnostic test for detecting infection in prosthetic joints
4. Bipolar disorder relapses halved by Melbourne researchers
5. Cell that triggers symptoms in allergy attacks can also limit damage, Stanford researchers find
6. High and mighty: first common height gene identified by researchers behind obesity gene finding
7. Researchers estimate about 9 percent of US children age 8 to 15 meet criteria for having ADHD
8. Majority of 2.4 Million U.S. Children With ADHD Not Diagnosed or Consistently Treated, According to New Gold Standard Study by Cincinnati Childrens Researchers
9. Researchers develop long-lasting growth hormone
10. Jefferson immunology researchers halt lethal rabies infection in brain
11. Purdue researchers develop technology to detect cancer by scanning surface veins
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/31/2016)... ... ... The Global Wellness Summit (GWS), an annual conference for international ... travel, spa and beauty in Europe. The organization asked its partner experts in Europe ... researchers - to forecast where wellness is headed in Europe. Predictions range from European ...
(Date:5/31/2016)... IL (PRWEB) , ... May 31, 2016 , ... The ... and executive committee members: , David G. Lewallen, MD, began his term as ... past president. Michael L. Parks, MD, is OREF’s new president-elect. Richard F. Kyle, MD, ...
(Date:5/31/2016)... ... May 31, 2016 , ... In a recent interview on ... broadcast on New Rochelle, NY-based WVOX (1460 AM), leading medical insurance advocate ... calls the country’s “modern medical money maelstrom.” , During the interview with Mr. ...
(Date:5/31/2016)... , ... May 31, 2016 , ... ... apply information technology solutions to the healthcare industry, The University of Scranton is ... offers an accelerated path to a career in rapidly growing field of healthcare ...
(Date:5/30/2016)... ... May 30, 2016 , ... "This plugin comes with ... Austin - CEO of Pixel Film Studios. , TransPack Volume 7 features ... Choose from abstract transitions to more simple wipes with blur & drop shadow ...
Breaking Medicine News(10 mins):
(Date:5/31/2016)... , May 31, 2016 ... and Annotate Content From Elsevier,s ScienceDirect Database ... scientific, technical and medical information products and services, ... Berlin -based scientific collaboration platform PaperHive to enable ... over 12 million articles on ScienceDirect , ...
(Date:5/31/2016)... ZIONA, Israel , May ... regenerative medicine company utilizing its proprietary plant-based rhCollagen technology ... received authorization from the Chief Scientist of ... 50% of its NIS 12 million development project for ... measurably higher than last year,s authorized grant, which totaled ...
(Date:5/31/2016)... -- 194 Mitgliedsstaaten verpflichten sich ... viraler Hepatitis    Am 28. Mai ... Hepatitis bis 2030 zu eliminieren. Bei der ... sich die Staaten einstimmig dafür entschieden, die erste ... Strategy) zu verabschieden, was das bisher weltweit größte ...
Breaking Medicine Technology: