973 research outputs found
A Trial of a 7-Valent Pneumococcal Conjugate Vaccine in HIV-Infected Adults.
No full textBACKGROUND: Streptococcus pneumoniae is a leading and serious coinfection in adults with human immunodeficiency virus (HIV) infection, particularly in Africa. Prevention of this disease by vaccination with the current 23-valent polysaccharide vaccine is suboptimal. Protein conjugate vaccines offer a further option for protection, but data on their clinical efficacy in adults are needed. METHODS: In this double-blind, randomized, placebo-controlled clinical efficacy trial, we studied the efficacy of a 7-valent conjugate pneumococcal vaccine in predominantly HIV-infected Malawian adolescents and adults who had recovered from documented invasive pneumococcal disease. Two doses of vaccine were given 4 weeks apart. The primary end point was a further episode of pneumococcal infection caused by vaccine serotypes or serotype 6A. RESULTS: From February 2003 through October 2007, we followed 496 patients (of whom 44% were male and 88% were HIV-seropositive) for 798 person-years of observation. There were 67 episodes of pneumococcal disease in 52 patients, all in the HIV-infected subgroup. In 24 patients, there were 19 episodes that were caused by vaccine serotypes and 5 episodes that were caused by the 6A serotype. Of these episodes, 5 occurred in the vaccine group and 19 in the placebo group, for a vaccine efficacy of 74% (95% confidence interval [CI], 30 to 90). There were 73 deaths from any cause in the vaccine group and 63 in the placebo group (hazard ratio in the vaccine group, 1.18; 95% CI, 0.84 to 1.66). The number of serious adverse events within 14 days after vaccination was significantly lower in the vaccine group than in the placebo group (3 vs. 17, P=0.002), and the number of minor adverse events was significantly higher in the vaccine group (41 vs. 13, P=0.003). CONCLUSIONS: The 7-valent pneumococcal conjugate vaccine protected HIV-infected adults from recurrent pneumococcal infection caused by vaccine serotypes or serotype 6A. (Current Controlled Trials number, ISRCTN54494731.) Copyright 2010 Massachusetts Medical Society
Multiple Colonization with S. pneumoniae before and after Introduction of the Seven-Valent Conjugated Pneumococcal Polysaccharide Vaccine
No full textBackground: Simultaneous carriage of more than one strain of Streptococcus pneumoniae promotes horizontal gene
transfer events and may lead to capsule switch and acquisition of antibiotic resistance. We studied the epidemiology of cocolonization with S. pneumoniae before and after introduction of the seven-valent conjugated pneumococcal vaccine(PCV7).
Methodology: Nasopharyngeal swabs (n 1120) were collected from outpatients between 2004 and 2009 within an ongoing
nationwide surveillance program. Cocolonization was detected directly from swabs by restriction fragment length
polymorphism (RFLP) analysis. Serotypes were identified by agglutination, multiplex PCR and microarray.
Principal Findings: Rate of multiple colonization remained stable up to three years after PCV7 introduction. Cocolonization was associated with serotypes of low carriage prevalence in the prevaccine era. Pneumococcal colonization density was higher in cocolonized samples and cocolonizing strains were present in a balanced ratio (median 1.38). Other characteristics of cocolonization were a higher frequency at young age, but no association with recurrent acute otitis media, recent antibiotic exposure, day care usage and PCV7 vaccination status.
Conclusions: Pneumococcal cocolonization is dominated by serotypes of low carriage prevalence in the prevaccine era,
which coexist in the nasopharynx. Emergence of such previously rare serotypes under vaccine selection pressure may promote cocolonization in the future
Continued control of pneumococcal disease in the UK - the impact of vaccination
No full textStreptococcus pneumoniae, also known as the pneumococcus, is an important cause of morbidity and mortality in the developed and developing world. Pneumococcal conjugate vaccines were first introduced for routine use in the USA in 2000, although the seven-valent pneumococcal conjugate vaccine (PCV7) was not introduced into the UK's routine childhood immunization programme until September 2006. After its introduction, a marked decrease in the incidence of pneumococcal disease was observed, both in the vaccinated and unvaccinated UK populations. However, pneumococci are highly diverse and serotype prevalence is dynamic. Conversely, PCV7 targets only a limited number of capsular types, which appears to confer a limited lifespan to the observed beneficial effects. Shifts in serotype distribution have been detected for both non-invasive and invasive disease reported since PCV7 introduction, both in the UK and elsewhere. The pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, Synflorix; GlaxoSmithKline) and 13-valent pneumococcal conjugate vaccine (PCV13, Prevenar 13; Pfizer) have been newly licensed. The potential coverage of the 10- and 13-valent conjugate vaccines has also altered alongside serotype shifts. Nonetheless, the mechanism of how PCV7 has influenced serotype shift is not clear-cut as the epidemiology of serotype prevalence is complex. Other factors also influence prevalence and incidence of pneumococcal carriage and disease, such as pneumococcal diversity, levels of antibiotic use and the presence of risk groups. Continued surveillance and identification of factors influencing serotype distribution are essential to allow rational vaccine design, implementation and continued effective control of pneumococcal disease
Ancora e sempre. Italo Valent e la formula del pensiero
No full textAncora e sempre suona come il motto araldico di un’impresa pervicace, paziente ed ostinata. Il saggio descrive lo scavo dialettico che Italo Valent compie nell’opera di Wittgenstein. La formula, meditatamente aforistica, è la chiave con cui il filosofo esplora i temi wittgensteiniani a livello sia del metodo che dello stile; è anche, nella sua natura avverbiale ed endiadica – dove il sempre depotenzia la piega dell’ancora, ma l’ancora inquieta la continuità del sempre – la modulazione di una pratica di pensiero che esprime il lavoro svolto dall’autore sui testi di Wittgenstein e, insieme, la forma singolare della sua scrittura filosofica, dove l’aforisma mostra proprio quell’esuberanza del pensare sul dire da cui muove l’impresa della filosofia. Ecco che l’itinerario attraverso quello che Valent chiama lo stile speculativo di Wittgenstein permette di riconoscere l’attività in cui consiste la filosofia: dal combattimento con il linguaggio che compendia contenuto, metodo e stile della filosofia wittgensteiniana emerge l’autonomia del pensiero rispetto alla volontà di comunicazione, alle prestazioni sociali del discorso e alle regole della logica. Si rivela così l’originaria atopìa del filosofo, la sua collocazione tattica fuori luogo rispetto ai ruoli della società, alle etichette della cultura e agli effetti delle pratiche dei discorsi e dei saperi."Ancora e sempre"(Immer wieder) sounds like the heraldic motto of a tenacious, patient and obstinate enterprise. The essay describes the dialectical excavation that Italo Valent carries out in Wittgenstein's work. The formula, thoughtfully aphoristic, is the key with which the philosopher explores Wittgensteinian themes at the level of both method and style; it is also, in its adverbial and hendiadic nature - where the "sempre"(always) weakens the fold of the "ancora"(again), but the "ancora"(again) disturbs the continuity of the "sempre"(always) - the modulation of a practice of thought that expresses the work carried out by the author on Wittgenstein's texts and, at the same time, the singular form of his philosophical writing, where the aphorism shows precisely that exuberance of thinking about saying from which the enterprise of philosophy moves. Here the itinerary through what Valent calls Wittgenstein’s speculative style allows us to recognize the activity in which philosophy consists: from the fight with the language that summarizes the content, method and style of Wittgensteinian philosophy emerges the autonomy of thought with respect to the will to communicate, to the social performances of discourse and to the rules of logic. Thus the original atopy of the philosopher is revealed, his tactical positioning out of place with respect to the roles of society, to the labels of culture and to the effects of the practices of discourses and knowledge
Alfaites romeo gen. et sp. nov., a new Hyolitha from the Cambrian of Skryje-Týřovice Basin (Czech Republic)
No full textValent, Martin, Fatka, Oldřich, Marek, Ladislav (2019): Alfaites romeo gen. et sp. nov., a new Hyolitha from the Cambrian of Skryje-Týřovice Basin (Czech Republic). European Journal of Taxonomy 491: 1-10, DOI: 10.5281/zenodo.255282
Pneumococcal antibody concentrations and carriage of pneumococci more than 3 years after infant immunization with a pneumococcal conjugate vaccine.
No full textBACKGROUND: A 9-valent pneumococcal conjugate vaccine (PCV-9), given in a 3-dose schedule, protected Gambian children against pneumococcal disease and reduced nasopharyngeal carriage of pneumococci of vaccine serotypes. We have studied the effect of a booster or delayed primary dose of 7-valent conjugate vaccine (PCV-7) on antibody and nasopharyngeal carriage of pneumococci 3-4 years after primary vaccination. METHODOLOGY/PRINCIPAL FINDINGS: We recruited a subsample of children who had received 3 doses of either PCV-9 or placebo (controls) into this follow-up study. Pre- and post- PCV-7 pneumococcal antibody concentrations to the 9 serotypes in PCV-9 and nasopharyngeal carriage of pneumococci were determined before and at intervals up to 18 months post-PCV-7. We enrolled 282 children at a median age of 45 months (range, 38-52 months); 138 had received 3 doses of PCV-9 in infancy and 144 were controls. Before receiving PCV-7, a high proportion of children had antibody concentrations >0.35 µg/mL to most of the serotypes in PCV-9 (average of 75% in the PCV-9 and 66% in the control group respectively). The geometric mean antibody concentrations in the vaccinated group were significantly higher compared to controls for serotypes 6B, 14, and 23F. Antibody concentrations were significantly increased to serotypes in the PCV-7 vaccine both 6-8 weeks and 16-18 months after PCV-7. Antibodies to serotypes 6B, 9V and 23F were higher in the PCV-9 group than in the control group 6-8 weeks after PCV-7, but only the 6B difference was sustained at 16-18 months. There was no significant difference in nasopharyngeal carriage between the two groups. CONCLUSIONS/SIGNIFICANCE: Pneumococcal antibody concentrations in Gambian children were high 34-48 months after a 3-dose primary infant vaccination series of PCV-9 for serotypes other than serotypes 1 and 18C, and were significantly higher than in control children for 3 of the 9 serotypes. Antibody concentrations increased after PCV-7 and remained raised for at least 18 months
Hyoliths of the Barrandian area
No full textof Mgr. Martin Valent doctoral thesis Hyoliths of the Barrandian Area The submitted Ph.D. thesis summarizes recent information on comparatively poorly known group of invertebrates - the hyoliths. The first part of the thesis is composed by six main chapters focussed in detail on various aspects of hyoliths; major characteristics and ecology of hyoliths, progress in systematic of hyoliths, principles of hyolith classification, stratigraphical and palaeogeographical distribution of hyoliths, hyoliths within the Bohemian Massif and morphology of hyoliths. Up-to-date information has been included in all chapters. New data were published in five author's papers on hyolith colour patterns, systematics of hyoliths, pattern of palaeogeographic distribution and palaeoecologic interactions between hyoliths and various elements of the Cambrian invertebrate fauna. Short appendage consists of the Czech-English-Chinese terminological dictionary, simplifying study of Chinese literature
An open-label randomized clinical trial of prophylactic paracetamol coadministered with 7-valent pneumococcal conjugate vaccine and hexavalent diphtheria toxoid, tetanus toxoid, 3-component acellular pertussis, hepatitis B, inactivated poliovirus, and Haemophilus influenzae type b vaccine
No full textBACKGROUND: In two clinical trials, low-grade fever was observed more frequently after coadministration than after separate administration of two recommended routine pediatric vaccines. Since fever is an important issue with vaccine tolerability, we performed this open-label study on the efficacy and safety of prophylactic use of paracetamol (acetaminophen, Benuron(R)) in children administered routine 7-valent pneumococcal conjugate vaccine (PCV-7) coadministered with hexavalent vaccine (diphtheria-tetanus-acellular pertussis-hepatitis B, polio, Haemophilus influenzae type b vaccine [DTPa-HBV-IPV/Hib]) in Germany.
METHODS: Healthy infants (N = 301) who received a 3-dose infant series of PCV-7 and DTPa-HBV-IPV/Hib plus a toddler dose were randomly assigned 1:1 to prophylactic paracetamol (125 mg or 250 mg suppositories, based on body weight) at vaccination, and at 6--8 hour intervals thereafter, or a control group that received no paracetamol. Rectal temperature and local and other systemic reactions were measured for 4 days post vaccination; adverse events were collected throughout the study.
RESULTS: In the intent-to-treat population, paracetamol reduced the incidence of fever >=38[degree sign]C, but this reduction was only significant for the infant series, with computed efficacy of 43.0% (95% confidence interval [CI]: 17.4, 61.2), and not significant after the toddler dose (efficacy 15.9%; 95% CI: -19.9, 41.3); results were similar in the per protocol (PP) population. Fever >39[degree sign]C was rare during the infant series, such that there were too few cases for assessment. After the toddler dose, paracetamol effectively reduced fever >39[degree sign]C, reaching statistical significance in the PP population only (efficacy 79%; 95% CI: 3.9, 97.7). Paracetamol also reduced reactogenicity, but there were few significant differences between groups after any dose. No vaccine-related serious adverse events were reported.
CONCLUSIONS: Paracetamol effectively prevented fever and other reactions, mainly during the infant series. However, as events were generally mild and of no concern in either group our data support current recommendations to administer paracetamol to treat symptoms only and not for routine prophylaxis.Trial registration: NCT00294294
Sender, those who have not returned : Carlo Salsa and his ‘Trenches’
No full textCarlo Salsa’s book ‘Trenches: A foot-soldier’s tales’ (Trincee. Confidenze di un fante, 1924) was one of many published in Italy after the end of the First World War. It describes the facts of the war as they were lived by officers and soldiers on the Italian front line. The article tries to compare the book with the contemporary war literature in Italy and in Europe, without forgetting the use of the international historiography on the matter. Thus, it is analysed the way an Italian author described to his readers the brutal carnage of the war in years when Fascism was the rising star in Italian policy and the censorship was becoming the more and more a thornily factor for every writer of those days. From this analysis it is possible to note the quality of the volume both from the literary point of view, and its historical value as a reliable testimony of the facts, stepping up our knowledge of what the war literature was for the Italian public opinion after the 1918. As it is possible to note, the book puts under test our notions of the role played by this kind of literature in shaping the Italian political life at the end of the 1910s and at the start of 1920s, when Italy was becoming a country lead by the Fascist regime
A longitudinal household study of Streptococcus pneumoniae nasopharyngeal carriage in a UK setting.
No full textA 10-month longitudinal household study of pre-school children and their families was undertaken with monthly visits collecting epidemiological data and nasopharyngeal swabs in Hertfordshire, England from 2001 to 2002. Pneumococcal culture was with standard methods. In total, 121 families (489 individuals) took part. Mean prevalence of carriage ranged from 52% for age groups 0-2 years, 45% for 3-4 years, 21% for 5-17 years and 8% for >or=18 years. Carriage occurred more than once in 86% of children aged 0-2 years compared to 36% of those aged >or=18 years. The most prevalent serotypes in the 0-2 years age group were 6B followed by 19F, 23F, 6A and 14. Young children were responsible for the majority of introductions of new serotypes into a household. Erythromycin resistance (alone or in combination) occurred in 10% of samples and penicillin non-susceptibility in 3.7%. Overall the recently licensed 7-valent conjugate vaccine (PCV) would protect against 64% of serotypes with no intra-serogroup cross protection and 82% with such protection. Nasopharyngeal carriage of S. pneumoniae is common in a UK setting in the pre-conjugate vaccine era. PCV would protect against a large proportion of carriage isolates. However, the impact of vaccination on non-vaccine serotypes will need to be monitored
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