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Over half of anaesthetists have nowhere to rest during or after a shift, survey finds

BMJ Recent Articles - 4 hours 52 min ago
The Royal College of Anaesthetists and the BMA are calling on the health secretary for England to ensure that all healthcare staff have access to high quality rest facilities.The call comes after a...
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Margaret Becklake: internationally renowned epidemiologist and respiratory medicine specialist

BMJ Recent Articles - 5 hours 6 min ago
bmj;363/nov19_5/k4894/FAF1faMargot BecklakeMargaret Becklake (mostly known as Margot) dedicated six decades of her life to ensuring that others could breathe easily. She undertook international...
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Social prescribing: coffee mornings, singing groups, and dance lessons on the NHS

BMJ Recent Articles - 7 hours 17 min ago
“Dance lessons for the lonely on NHS,” led the Daily Mail in October.1 “GPs should prescribe hobbies like ballroom dancing, gardening and art classes to millions of people, because it is often better...
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Guidelines should include treatment burden on ability to work

BMJ Recent Articles - 7 hours 46 min ago
Dobler and colleagues rightly point out that clinical practice guidelines should incorporate information on treatment burden to enable patients to make informed decisions about treatments.1 For...
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Study raises hopes of minimising risk of life threatening peanut allergy reactions

BMJ Recent Articles - 11 hours 41 min ago
Children and young people with peanut allergy exposed to gradually increasing doses of peanut allergen were then able to ingest far higher doses of peanut protein, a randomised trial has found.The...
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Noise pollution in hospitals

BMJ Recent Articles - 20 hours 7 min ago
Noise in hospitals is a common grievance among patients, families, and staff.1 In the US, “quietness of hospital environment” is among the lowest scoring items on patient surveys.2 In the UK, 40% of...
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Hormonal Regulation of Physiology, Innate Immunity and Antibody Response to H1N1 Influenza Virus Infection During Pregnancy.

Latest Pubmed articles about Swine flu - Thu, 11/15/2018 - 11:00
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Hormonal Regulation of Physiology, Innate Immunity and Antibody Response to H1N1 Influenza Virus Infection During Pregnancy.

Front Immunol. 2018;9:2455

Authors: Littauer EQ, Skountzou I

Abstract
In 2009, the H1N1 swine flu pandemic highlighted the vulnerability of pregnant women to influenza viral infection. Pregnant women infected with influenza A virus were at increased risk of hospitalization and severe acute respiratory distress syndrome (ARDS), which is associated with high mortality, while their newborns had an increased risk of pre-term birth or low birth weight. Pregnant women have a unique immunological profile modulated by the sex hormones required to maintain pregnancy, namely progesterone and estrogens. The role of these hormones in coordinating maternal immunotolerance in uterine tissue and cellular subsets has been well researched; however, these hormones have wide-ranging effects outside the uterus in modulating the immune response to disease. In this review, we compile research findings in the clinic and in animal models that elaborate on the unique features of H1N1 influenza A viral pathogenesis during pregnancy, the crosstalk between innate immune signaling and hormonal regulation during pregnancy, and the role of pregnancy hormones in modulating cellular responses to influenza A viral infection at mid-gestation. We highlight the ways in which lung architecture and function is stressed by pregnancy, increasing baseline inflammation prior to infection. We demonstrate that infection disrupts progesterone production and upregulates inflammatory mediators, such as cyclooxygenase-2 (COX-2) and prostaglandins, resulting in pre-term labor and spontaneous abortions. Lastly, we profile the ways in which pregnancy alters innate and adaptive cellular immune responses to H1N1 influenza viral infection, and the ways in which these protect fetal development at the expense of effective long-term immune memory. Thus, we highlight advancements in the field of reproductive immunology in response to viral infection and illustrate how that knowledge might be used to develop more effective post-infection therapies and vaccination strategies.

PMID: 30420854 [PubMed - in process]

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