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Influenza A (H1N1) pdm09 became the predominant circulating strain in the United States during the 2013–2014 influenza season. Little is known about the epidemiology of severe influenza during this season.
A retrospective cohort study of severely ill patients with influenza infection in intensive care units in 33 US hospitals from September 1, 2013, through April 1, 2014, was conducted to determine risk factors for mortality present on intensive care unit admission and to describe patient characteristics, spectrum of disease, management, and outcomes.
A total of 444 adults and 63 children were admitted to an intensive care unit in a study hospital; 93 adults (20.9%) and 4 children (6.3%) died. By logistic regression analysis, the following factors were significantly associated with mortality among adult patients: older age (>65 years, odds ratio, 3.1 [95% CI, 1.4–6.9], P=.006 and 50–64 years, 2.5 [1.3–4.9], P=.007; reference age 18–49 years), male sex (1.9 [1.1–3.3], P=.031), history of malignant tumor with chemotherapy administered within the prior 6 months (12.1 [3.9–37.0], P<.001), and a higher Sequential Organ Failure Assessment score (for each increase by 1 in score, 1.3 [1.2–1.4], P<.001).
Risk factors for death among US patients with severe influenza during the 2013–2014 season, when influenza A (H1N1) pdm09 was the predominant circulating strain type, shifted in the first postpandemic season in which it predominated toward those of a more typical epidemic influenza season.
Infect. Control Hosp. Epidemiol. 2015;36(11):1251–1260
Many couples whose infertility treatment requires in-vitro fertilization (IVF) also need intracytoplasmic sperm injection (ICSI) as a part of the procedure. In many respects ICSI has revolutionized infertility treatment as a whole. Both research data and clinical experience have shown that providing a sperm sample during this crucial stage of IVF/ICSI treatment could increase performance anxiety for both fertile and infertile men. The successful use of assisted reproductive technologies over the past 25 years or more has brought with it procedures that allow couples who cannot conceive using their own gametes the alternative of achieving pregnancy through the use of donated oocytes, donated sperm, and even donated embryos. The psychological evaluation is also intended to rule out gross psychopathology and depression, potential substance abuse, as well as a history of current or past family violence or abuse. Marital stability is also assessed within the context of the consultation.
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