High mortality from respiratory failure secondary to swine-origin influenza A (H1N1) in South Africa

Background: The novel influenza A (H1N1) pandemic affected South Africa late during the 2009 Southern hemisphere winter and placed an extra burden on a health care system already dealing with a high prevalence of chronic lung diseases and human immunodeficiency virus (HIV) infection. Aim: The aim of this study was to describe the epidemiological characteristics, clinical features, management and outcomes of patients with confirmed influenza A (H1N1) infection complicated by respiratory failure. Methods: We included all adult patients with confirmed influenza A (H1N1) infection that were referred to the medical intensive care unit of a large academic hospital in Cape Town for ventilatory support in this prospective observational study. Results: A total of 19 patients (39.5 ± 14.8 years) needed ventilatory support over a 6-week period. Of these, 15 were female and 16 had identifiable risk factors for severe disease, including pregnancy (n = 6), type 2 diabetes mellitus (n = 6), obesity (n = 4), HIV infection (n = 3), immunosuppressive therapy (n = 3) and active pulmonary tuberculosis (n = 2). The most frequent complications were acute renal failure (n = 13), acute respiratory distress syndrome (n = 12) and ventilator associated pneumonia (n = 10). Thirteen patients died (mortality: 68.4%). Fatal cases were significantly associated with an APACHE II score >=20 (P = 0.034), but not with a PaO2/FIO2 <200 (P = 0.085) and a chest radiograph score >=12 (P = 0.134). Conclusions: The majority of patients with respiratory failure secondary to influenza A (H1N1) infection were young females and had an underlying risk factor for severe disease. The condition had a high mortality, particularly amongst patients with an APACHE II score >=20.

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Stem cell research at Children's Hospital Boston

A YEAR SINCE OBAMA'S LIFTING OF BAN ON STEM CELL FUNDING, BOSTON TEAM READY TO DISTRIBUTE LINES WORLDWIDE BUT OBSTACLES REMAIN. NEW WEBSITE TO END PUBLIC CONFUSION AND PUSH SCIENCE FORWARD Researchers at Children's Hospital Boston Aim to Demystify Science and Share Potential for Treatments and Cures on Range of Diseases from Diabetes to Parkinson's StemCell.ChildrensHospital.org MARCH 9, 2010 [Boston] - Exactly one year to the day after President Obama's historic decision to reverse an eight-year restriction on federally funded embryonic stem cell research, the Children's Hospital Boston Stem Cell Program today announced the development of a unique, comprehensive web site and released a candid video message from its top researchers on the current state of stem cell research to introduce the new site:stemcell.childrenshospital.org. Designed as an engaging and accessible resource, the new site seeks to demystify the science, clear up misperceptions and illuminate the public about the power and value of different types of stem cells to create cost effective treatments and potential cures for a range of diseases--including Type I diabetes, Parkinson's, leukemia and other blood cancers, Huntington's, sickle cell anemia, neurological disorders, and more. Beginning today, visitors to stemcell.childrenshospital.org can access an introductory video, featuring Drs. Leonard Zon and George Daley, along with Stem Cell Task Force leader President of the Kraft group and the New England Patriots, Jonathan Kraft, --who together cite the promise and ongoing challenges in this field and call for new support. Visitors can also sign up to receive updates leading up to the official launch of the website--which will be fully operational on April 26, 2010. The timing of the April 26th date is also significant in the field of stem cell research, because it marks the 5th anniversary of the release of guidelines from the US National Academy of Sciences (NAS) for the responsible conduct of embryonic stem cell research. Children's was among the first to adopt those guidelines, and in the five years since the guidelines were released, the Stem Cell Program at Children's Hospital has emerged as an internationally recognized leader in stem cell research. Despite operating under significant constraints over the past eight years, Children's made remarkable progress on multiple fronts: Children's created an aggressive business plan, their roadmap for bringing research from the bench to the bedside. Children's produced 11 of the first 13 hESC lines approved by the US National Institutes of Health (NIH) for federal funding in December, 2009. Children's is receiving requests for these lines from scientists across the U.S. who are studying diseases from diabetes to Parkinson's. Drs. Daley and Zon have been awarded major grants from the NIH for the creation of human models of disease and to study whether stem cells reprogrammed from adult stem cells (iPS) cells are equivalent to those derived from human embryos, one of the field's most pressing questions. Dr. Zon's research has already been rapidly translated from the laboratory to the clinic: studies on blood formation in the zebrafish--a model organism pioneered by the Zon lab--led to the discovery of a drug that expands blood stem cells, which is now being tested in patients undergoing umbilical cord blood transplants. Children's Researchers were the first to isolate lung stem cells, with implications for treating lung cancer, cystic fibrosis and pulmonary diseases. Science Magazine cited Dr. Daley's creation of disease-specific stem cells from patients in its 2008 "Breakthrough of the Year" issue. "Stem cell research is an incredibly exciting field and this is an extraordinary time to be part of it," said Leonard Zon, MD, Director of Children's Hospital's Stem Cell Program. "In just the five short years since the release of the NAS guidelines, we have seen major break-throughs in the science and in the techniques we can use to investigate potential therapies for a wide range of diseases. It's absolutely essential that we continue that forward momentum." The Human Face of Stem Cell Research Now, the stem cell program at Children's Hospital Boston, the principal pediatric teaching hospital for Harvard Medical School, invites the public to become part of the dialogue and the progress. The new web site will clarify misconceptions about stem cell research and provide a broad range of easily accessible information about the history and science of stem cells, current research and issues, a primer on the ethical debates surrounding stem cell research, and much more. Special areas on the site will be devoted to some of the specific diseases mentioned above--and will show individuals how they can help. The newsroom portion will feature the latest breakthroughs in the field, and will also enable visitors to opt in to receive the latest updates via Twitter and Facebook. The site will also give people a chance to experience the human face of stem cell therapy through inspiring videos and interviews with families and patients who have been treated by stem cell transplants or have donated their own cell lines to research in the hope of one day helping to bring about breakthroughs and cures: A teenaged sickle cell patient and gifted student who spent his summer helping out by working in Dr. George Daley's stem cell lab. An avid cyclist paralyzed in an accident five years ago, whose own tissues have been made into stem cells by Children's researchers, who has organized major support for new studies that could one day benefit patients with spinal cord injuries. A family whose decision to conceive a baby daughter using IVF enabled life-saving stem cells from her umbilical cord to save the life of her infant brother, who was born with a fatal genetic defect. "Over the past year, improvements in governmental policy and breakthroughs in the lab have advanced the field of stem cell research at a more rapid pace the than ever before, but the public dialogue suggests that people want to learn more," said George Daley, MD, PhD, Director of Stem Cell Transplantation at Children's Hospital Boston. "It's critical for people to have a clear understanding of the science, and to appreciate the promise and the limitations of this research. I think this website will help us achieve that." CONTACT: Eileen Campion Dera, Roslan + Campion Public Relations 212-966-4600 / Eileen@drcpublicrelations.com

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