scholarly journals Mumps Outbreak among Highly Vaccinated Teenagers and Children in the Central Region of Portugal, 2012-2013

2015 ◽  
Vol 28 (4) ◽  
pp. 435 ◽  
Author(s):  
Eugénio Cordeiro ◽  
Muriel Ferreira ◽  
Fernanda Rodrigues ◽  
Paula Palminha ◽  
Elsa Vinagre ◽  
...  
Keyword(s):  
Central Region ◽  
Clinical Laboratory ◽  
Virus Genotype ◽  
National Immunization ◽  
Duration Of Disease ◽  
Waning Immunity ◽  
Unilateral Involvement ◽  
The Mean ◽  
Epidemiological Link ◽  
Actual Vaccine

<p><strong>Introduction:</strong> Mumps vaccine was introduced in the National Immunization Program in Portugal in 1987, rapidly reaching a national coverage &gt; 92%, with important reduction in the annual incidence of the disease. We report a mumps outbreak in the Central Region of Portugal, occurred in the winter 2012-13.<br /><strong>Material and Methods:</strong> Cases of salivary-gland swelling and other symptoms compatible with mumps were investigated. Geodemographics, clinical, laboratory and vaccination data were analyzed.<br /><strong>Results:</strong> Over six months, 148 outbreak-related cases were reported: 87.8% occurred in three of the 16 affected counties and 78.4% had a known epidemiological link. Median age was 14.5 years (2-62) and 70.3% were 11-20 years old; 61.5% were male. The mean duration of disease was seven days (2-20). The disease was generally mild; 80.4% had fever and in 55.4% there was unilateral involvement of the parotid gland. Seven cases had orchitis, one oophoritis and one had nephritis. Two cases were hospitalized. School transmission predominated and class attack rates were &lt; 30%. Most of the cases occurred in vaccinated individuals (92%) of whom 86.8% had received 2 doses; 17.7% had received one dose of the vaccine containing the Rubini strain. Mumps virus genotype G was identified in 4 cases.<br /><strong>Discussion:</strong> This mumps outbreak among a highly vaccinated population, occurring mostly in teenagers at school, could be due to the partial effectiveness of the vaccine against the disease (particularly in the group vaccinated with Rubini strain), waning immunity overtime and genotype mismatch.<br /><strong>Conclusions:</strong> This outbreak report shows the importance of discussion about the need of more booster dose of the actual vaccine or new vaccine including more genotypes to improve immunogenicity.</p>

scholarly journals Mitoxantrone in secondarily progressive multiple sclerosis: a series of 18 patients

2005 ◽  
Vol 63 (2a) ◽  
pp. 225-227 ◽  
Author(s):  
María Belén Montú ◽  
Walter Oleschko Arruda ◽  
Marcelo de Souza R. de Oliveira ◽  
Ricardo Ramina
Keyword(s):  
Multiple Sclerosis ◽  
Confidence Intervals ◽  
Cumulative Dose ◽  
Clinical Laboratory ◽  
Progressive Multiple Sclerosis ◽  
Effective Drug ◽  
Long Line ◽  
Relapsing Remitting ◽  
Duration Of Disease ◽  
The Mean

Mitoxantrone hydrochloride (Novantrone®) is an anthracenedione that has been used as one of the latest in a long line of general immunosuppresive agents studied in multiple sclerosis (MS). We reviewed the clinical, laboratory, neuroimaging and echocardiography data of 18 patients from February 2001 to March 2004 out of a total number of 100 patients with definite MS. Fourteen patients were women (77.7%) and four were men. The mean age of the patients was 41.6±10 years old (confidence intervals 95%: 36.4-46.7 years old). The mean duration of disease was 10.5±6.3 years. Fourteen patients had the secondarily progressive form of MS, and four had the relapsing-remitting form. Mitoxantrone is an useful and clinically effective drug in MS and its major limitation is the potencial cardiotoxicity due to cumulative dose (140 mg).

scholarly journals Clinical, Laboratory and Histological Features of Dipeptidyl Peptidase-4 Inhibitor Related Noninflammatory Bullous Pemphigoid

2021 ◽  
Vol 10 (9) ◽  
pp. 1916
Author(s):  
Ágnes Kinyó ◽  
Anita Hanyecz ◽  
Zsuzsanna Lengyel ◽  
Dalma Várszegi ◽  
Péter Oláh ◽  
...  
Keyword(s):  
Bullous Pemphigoid ◽  
Clinical Laboratory ◽  
Case Series ◽  
Dipeptidyl Peptidase ◽  
Area Index ◽  
Histological Features ◽  
Dipeptidyl Peptidase 4 ◽  
First Case ◽  
Dipeptidyl Peptidase 4 Inhibitor ◽  
The Mean

Bullous pemphigoid (BP) is an autoimmune blistering disease of elderly patients that has shown increasing incidence in the last decades. Higher prevalence of BP may be due to more frequent use of provoking agents, such as antidiabetic dipeptidyl peptidase-4 inhibitor (DPP4i) drugs. Our aim was to assess DPP4i-induced bullous pemphigoid among our BP patients and characterize the clinical, laboratory and histological features of this drug-induced disease form. In our patient cohort, out of 127 BP patients (79 females (62.2%), 48 males (37.7%)), 14 (9 females and 5 males) were treated with DPP4i at the time of BP diagnosis. The Bullous Pemphigoid Disease Area Index (BPDAI) urticaria/erythema score was significantly lower, and the BPDAI damage score was significantly higher in DPP4i-BP patients compared to the nonDPP4i group. Both the mean absolute eosinophil number and the mean periblister eosinophil number was significantly lower in DPP4i-BP patients than in nonDPP4i cases (317.7 ± 0.204 vs. 894.0 ± 1.171 cells/μL, p < 0.0001; 6.75 ± 1.72 vs. 19.09 ± 3.1, p = 0.0012, respectively). Our results provide further evidence that DPP4i-associated BP differs significantly from classical BP, and presents with less distributed skin symptoms, mild erythema, normal or slightly elevated peripheral eosinophil count, and lower titers of BP180 autoantibodies. To our knowledge, this is the first case series of DPP4i-related BP with a non-inflammatory phenotype in European patients.

scholarly journals Vaccination Coverage for Routine Vaccines and Herd Immunity Levels against Measles and Pertussis in the World in 2019

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 256
Author(s):  
Pedro Plans-Rubió
Keyword(s):  
Vaccination Coverage ◽  
Action Plan ◽  
Herd Immunity ◽  
World Health ◽  
Immunization Programs ◽  
National Immunization ◽  
The World ◽  
Measles Vaccination ◽  
The Mean ◽  
Health Organization

In 2012, the World Health Organization (WHO) established the Global Vaccine Action Plan with the objective to promote essential vaccinations in all countries and achieve at least 90% vaccination coverage for all routine vaccines by 2020. The study assessed the mean percentages of vaccination coverage in 2019 for 13 routine vaccines, vaccination coverage variation from 2015 to 2019, and herd immunity levels against measles and pertussis in 2019 in countries and regions of WHO. In 2019, the mean percentages of vaccination coverage were lower than 90% for 10 (78.9%) routine vaccines. The mean percentages of vaccination coverage also decreased from 2015 to 2019 for six (46.2%) routine vaccines. The prevalence of individuals with vaccine-induced measles immunity in the target measles vaccination population was 88.1%, and the prevalence of individuals with vaccine-induced pertussis immunity in the target pertussis vaccination population was 81.1%. Herd immunity against measles viruses with Ro = 18 was established in 63 (32.5%) countries but not established in any region. Herd immunity against pertussis agents was not established in any country and in any region of WHO. National immunization programs must be improved to achieve ≥90% vaccination coverage in all countries and regions. Likewise, it is necessary to achieve ≥95% vaccination coverage with two doses of measles vaccines and three doses of pertussis vaccines in all countries and regions.

Efficacy of Danazol with Autoimmune Thrombocytopenia

1997 ◽  
Vol 3 (4) ◽  
pp. 251-255 ◽  
Author(s):  
Steven W. Kim ◽  
Lawrence Rice ◽  
John J. McCarthy
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Evans Syndrome ◽  
Systemic Lupus ◽  
Autoimmune Thrombocytopenia ◽  
Treatment Regimens ◽  
Duration Of Disease ◽  
Males And Females ◽  
The Mean ◽  
Favorable Side Effect Profile

Seventy-nine cases of autoimmune thrombocytopenia seen by the Baylor Hematology section of The Methodist Hospital between 1991 and 1996 were retrospectively reviewed to assess the effectiveness of danazol in the treatment of autoimmune thrombocytopenia. Among the 42 patients who received danazol, the mean initial platelet count prior to treatment was 24.3 ± 17.4 (SD) × 109/L with a mean duration of disease of 53 months. Most cases were idiopathic, but some patients had underlying secondary disorders (rheumatoid arthritis, systemic lupus erythematosus, HIV, and/or Evans' syndrome). Overall 57% of the patients treated with danazol had an excellent or a good response with three patients who had unmaintained remission for >11 months. Minimal side effects were noted. Fifty percent of the patients with associated secondary disorders achieved an excellent or good response. The hemolytic component of all three Evans' syndrome cases was well controlled with danazol. In two cases, danazol was effective where a variety of other treatment regimens were not. An excellent or a good response was found in 58%, 62%, and 53% in patients >65 years old, between 45 and 65 years old, and <45 years old, respectively. Response rates were similar in males and females, Seventy percent of the nonsplenectomized patients had an excellent or a good response compared to 33% in postsplenectomy patients. Overall in view of its favorable side-effect profile, it is rational early on to attempt to abrogate the need for splenectomy, it may salvage splenectomy failures, and there is a reasonable response rate in those refractory to multiple prior therapies. Key Words: Autoimmune thrombocytopenia—Idiopathic thrombocytopenic purpura—Danazol— Systemic lupus erythematosus—HIV—Evans' syndrome.

Mechanical load-dependent regulation of satellite cell and fiber size in rat soleus muscle

2006 ◽  
Vol 290 (4) ◽  
pp. C981-C989 ◽  
Author(s):  
X. D. Wang ◽  
F. Kawano ◽  
Y. Matsuoka ◽  
K. Fukunaga ◽  
M. Terada ◽  
...  
Keyword(s):  
Satellite Cell ◽  
Muscle Fiber ◽  
Satellite Cells ◽  
Central Region ◽  
Sarcomere Length ◽  
Sectional Area ◽  
Cross Sectional ◽  
Fiber Properties ◽  
Rat Soleus Muscle ◽  
The Mean

The effects of mechanical unloading and reloading on the properties of rat soleus muscle fibers were investigated in male Wistar Hannover rats. Satellite cells in the fibers of control rats were distributed evenly throughout the fiber length. After 16 days of hindlimb unloading, the number of satellite cells in the central, but not the proximal or distal, region of the fiber was decreased. The number of satellite cells in the central region gradually increased during the 16-day period of reloading. The mean sarcomere length in the central region of the fibers was passively shortened during unloading due to the plantarflexed position at the ankle joint: sarcomere length was maintained at <2.1 μm, which is a critical length for tension development. Myonuclear number and domain size, fiber cross-sectional area, and the total number of mitotically active and quiescent satellite cells of whole muscle fibers were lower than control fibers after 16 days of unloading. These values then returned to control values after 16 days of reloading. These results suggest that satellite cells play an important role in the regulation of muscle fiber properties. The data also indicate that the satellite cell-related regulation of muscle fiber properties is dependent on the level of mechanical loading, which, in turn, is influenced by the mean sarcomere length. However, it is still unclear why the region-specific responses, which were obvious in satellite cells, were not induced in myonuclear number and fiber cross-sectional area.

Clinical and molecular epidemic characterization of rotavirus infection among children under five years old in Shandong province, China.

2021 ◽  
Author(s):  
Shixiao Dong ◽  
Deyu Huang ◽  
Zheng Wang ◽  
Guanyou Zhang ◽  
Fengjuan Zhang ◽  
...  
Keyword(s):  
Lower Incidence ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Shandong Province ◽  
Rotavirus Infection ◽  
National Immunization ◽  
Significant Difference ◽  
The Mean ◽  
And Control

Abstract Rotavirus was the an important causative agent of acute gastroenteritis in children. In China, rotavirus was positive in approximately 30% of the diarrhea children and become a serious public problem. This study was carried out to investigate the clinical and molecular epidemic characterization of rotavirus infection among children under 5 years old with acute diarrhea in Shandong province, China. From July 2017 to June 2018, a total of 1211 fecal specimens were detected and the prevalence of rotavirus infection was 32.12%. The mean age of positive children was 12.2 ± 10.9 months and the highest infection rate was observed in children aged 7–12 months with a rate of 41.64%. G9P[8] (76.61%) was the most prevalent combinations followed by G2P[4] (7.20%), G3P[8] (3.60%) and G9P[4] (2.06%). In addition to diarrhea, vomiting, fever and dehydration were the most common accompanied symptoms. In general, there was no significant difference in clinical manifestations among different age groups. However, the clinical manifestations between vaccinated and unvaccinated children were significantly different. Vaccinated children showed lower incidence and frequency of vomiting, lower incidence and degree of dehydration, lower incidence of severe cases than unvaccinated children. The findings suggested necessary to continue rotavirus strains surveillance in order to monitor the change of prevalent genotype. Moreover, introducing vaccine into national immunization program to prevent and control rotavirus infections is needed in China.

scholarly journals Comparison of the Echinocandin Caspofungin with Amphotericin B for Treatment of Histoplasmosis following Pulmonary Challenge in a Murine Model

2000 ◽  
Vol 44 (7) ◽  
pp. 1850-1854 ◽  
Author(s):  
Steve Kohler ◽  
L. Joseph Wheat ◽  
Patricia Connolly ◽  
Carol Schnizlein-Bick ◽  
Michelle Durkin ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Histoplasma Capsulatum ◽  
Clinical Laboratory ◽  
Antigen Detection ◽  
National Committee ◽  
Slight Effect ◽  
Fungal Burden ◽  
Detection Techniques ◽  
The Mean

ABSTRACT Twenty clinical isolates of Histoplasma capsulatum were tested for their in vitro susceptibilities to caspofungin in comparison to those to amphotericin B by following National Committee for Clinical Laboratory Standards guidelines for yeasts. The mean MICs were 16.6 μg/ml (range, 8 to 32 μg/ml) for caspofungin and 0.56 μg/ml (range, 0.5 to 1.0 μg/ml) for amphotericin B. Survival experiments used a 105 dose in a pulmonary challenge model with B6C3F1 mice. All mice that received amphotericin B at 2 mg/kg of body weight every other day (q.o.d.), 30% of mice that received caspofungin at 8 mg/kg/day, and 20% of mice that received caspofungin at 4 mg/kg/day survived to day 15, while mice that received caspofungin at 2 mg/kg/day and all control mice that received the vehicle died by day 14. Amphotericin B at 2 mg/kg q.o.d. markedly reduced the fungal burden in the lungs and spleens, as measured byHistoplasma antigen detection techniques and quantitative cultures, for each comparison. Caspofungin at 10 mg/kg twice a day (b.i.d.) did not reduce the fungal burden, as measured by antigen detection techniques, but slightly reduced the levels of fungi in both the lungs and spleens, as determined by quantitative cultures. Caspofungin at 5 mg/kg b.i.d. did not affect fungal burden. Overall, caspofungin had only a slight effect on survival or fungal burden.

scholarly journals The epidemiology and influence of osteoarthritis on clinical, laboratory and ultrasound parameters of patients with early rheumatoid arthritis

2019 ◽  
Vol 2 (1) ◽  
pp. 41-47
Author(s):  
Teodora Serban ◽  
Iulia Satulu ◽  
Ioana Cretu ◽  
Oana Vutcanu ◽  
Mihaela Milicescu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Laboratory Tests ◽  
Clinical Laboratory ◽  
Early Arthritis ◽  
Symptom Duration ◽  
Knee Oa ◽  
The Mean ◽  
Clear Predominance ◽  
Ultrasound Parameters

AbstractBackground: Osteoarthritis (OA) and rheumatoid arthritis (RA) can overlap and the presence of OA can interfere with the evaluation of patients with RA.Objectives: The aim of this study was to evaluate the possible impact of OA on the clinical, laboratory and ultrasound parameters currently evaluated in patients with early RA (ERA).Methods: We have evaluated the data obtained from patients with ERA referred to our Early Arthritis Research Center (EARC). Only data from patients who fulfilled EULAR/ ACR 2010 criteria for RA and had symptom duration of less than 12 months were analyzed. All patients underwent clinical examination, laboratory tests and ultrasound (US) examination.Results: There was a clear predominance of women (62.8%). The mean age was 55.47±13.71 years. At baseline, 21 patients (48.8%) were diagnosed with OA. Hand OA did not influence the values of any of the parameters assessed (p>0.05). For patients with knee OA, significantly higher values were observed only for DAS28 at baseline (p=0.018) as well as after 12 months of observation (p=0.031).Conclusions: Significantly higher values of DAS28 were observed in patients with ERA who associated knee OA, while the values of SDAI were not influenced, suggesting that SDAI may be superior to DAS28 in evaluating patients with ERA and knee OA. The values of patient’s VAS were not influenced by the presence of hand or knee OA suggesting that these types of OA do not influence the patients’ perception of the disease activity. Moreover, the values of ultrasound scores were not influenced by the presence of OA.

scholarly journals Varicella complications in children one-site Polish population – a 19- year long survey

2019 ◽  
pp. 459-467
Author(s):  
Beata Smok ◽  
Justyna Franczak ◽  
Krzysztof Domagalski ◽  
Małgorzata Pawłowska
Keyword(s):  
Gastrointestinal Tract ◽  
Survey Methods ◽  
Varicella Vaccine ◽  
Herd Immunity ◽  
Neurological Complications ◽  
National Immunization ◽  
The Mean ◽  
Tract Infections ◽  
Bacterial Skin Infections ◽  
Length Of Hospitalization

OBJECTIVES. The aim of this study was to describe the epidemiology of chickenpox complications in children, based on a 19-year long survey. METHODS. This publication constitutes a review of medical records of 761 patients under the age of 18 who were hospitalized at the T. Browicz Provincial Hospital for Infectious Diseases in Bydgoszcz, Poland from the 1st of January 1999 to the 31st of December 2017. RESULTS. Over the study period, 761 children diagnosed with varicella complications were hospitalized. The mean number of hospitalizations in each year amounted to 40. The median age of admitted patients was 4 years. The median length of hospitalization was 5 days (ranged from 1 to 30 days). The most frequent varicella complications included respiratory tract infections – 229/761 (30.1%), bacterial skin infections – 189/761 (24.8%) and gastrointestinal tract disorders – 142/761 (18.6%). Pneumonia, bronchitis and gastrointestinal tract disturbances, were reported most often in children under 2 years of age, while neurological complications occurred most frequently in children at 3-6 years of age. No significant differences in the number of varicella complications between immunocompromised and immunocompetent children were reported. CONCLUSIONS. Varicella complications mainly affect the youngest immunocompetent children. Population-wide vaccination and herd immunity appears to be the best way to reduce the incidence of chickenpox and the rate of varicella complications. This study gives support for inclusion of universal varicella vaccine in the National Immunization Program in Poland.

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