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1.
Eur J Neurosci ; 56(8): 5201-5214, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35993240

RESUMO

Speech comprehension relies on the ability to understand words within a coherent context. Recent studies have attempted to obtain electrophysiological indices of this process by modelling how brain activity is affected by a word's semantic dissimilarity to preceding words. Although the resulting indices appear robust and are strongly modulated by attention, it remains possible that, rather than capturing the contextual understanding of words, they may actually reflect word-to-word changes in semantic content without the need for a narrative-level understanding on the part of the listener. To test this, we recorded electroencephalography from subjects who listened to speech presented in either its original, narrative form, or after scrambling the word order by varying amounts. This manipulation affected the ability of subjects to comprehend the speech narrative but not the ability to recognise individual words. Neural indices of semantic understanding and low-level acoustic processing were derived for each scrambling condition using the temporal response function. Signatures of semantic processing were observed when speech was unscrambled or minimally scrambled and subjects understood the speech. The same markers were absent for higher scrambling levels as speech comprehension dropped. In contrast, word recognition remained high and neural measures related to envelope tracking did not vary significantly across scrambling conditions. This supports the previous claim that electrophysiological indices based on the semantic dissimilarity of words to their context reflect a listener's understanding of those words relative to that context. It also highlights the relative insensitivity of neural measures of low-level speech processing to speech comprehension.


Assuntos
Semântica , Percepção da Fala , Percepção Auditiva/fisiologia , Compreensão/fisiologia , Eletroencefalografia , Humanos , Fala/fisiologia , Percepção da Fala/fisiologia
2.
J Neurosci ; 39(38): 7564-7575, 2019 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-31371424

RESUMO

Speech perception involves the integration of sensory input with expectations based on the context of that speech. Much debate surrounds the issue of whether or not prior knowledge feeds back to affect early auditory encoding in the lower levels of the speech processing hierarchy, or whether perception can be best explained as a purely feedforward process. Although there has been compelling evidence on both sides of this debate, experiments involving naturalistic speech stimuli to address these questions have been lacking. Here, we use a recently introduced method for quantifying the semantic context of speech and relate it to a commonly used method for indexing low-level auditory encoding of speech. The relationship between these measures is taken to be an indication of how semantic context leading up to a word influences how its low-level acoustic and phonetic features are processed. We record EEG from human participants (both male and female) listening to continuous natural speech and find that the early cortical tracking of a word's speech envelope is enhanced by its semantic similarity to its sentential context. Using a forward modeling approach, we find that prediction accuracy of the EEG signal also shows the same effect. Furthermore, this effect shows distinct temporal patterns of correlation depending on the type of speech input representation (acoustic or phonological) used for the model, implicating a top-down propagation of information through the processing hierarchy. These results suggest a mechanism that links top-down prior information with the early cortical entrainment of words in natural, continuous speech.SIGNIFICANCE STATEMENT During natural speech comprehension, we use semantic context when processing information about new incoming words. However, precisely how the neural processing of bottom-up sensory information is affected by top-down context-based predictions remains controversial. We address this discussion using a novel approach that indexes a word's similarity to context and how well a word's acoustic and phonetic features are processed by the brain at the time of its utterance. We relate these two measures and show that lower-level auditory tracking of speech improves for words that are more related to their preceding context. These results suggest a mechanism that links top-down prior information with bottom-up sensory processing in the context of natural, narrative speech listening.


Assuntos
Encéfalo/fisiologia , Compreensão/fisiologia , Modelos Neurológicos , Semântica , Percepção da Fala/fisiologia , Adulto , Eletroencefalografia , Feminino , Humanos , Masculino , Adulto Jovem
3.
Antimicrob Agents Chemother ; 58(11): 6735-41, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25182635

RESUMO

Serum penicillin G falls to low levels 2 weeks after injection as benzathine penicillin G (BPG) in young adults. Using Pmetrics and previously reported penicillin G pharmacokinetic data after 1.2 million units were given as BPG to 329 male military recruits, here we develop the first reported population pharmacokinetic model of penicillin G after BPG injection. We simulated time-concentration profiles over a broad range of pediatric and adult weights after alternative doses and dose frequencies to predict the probability of maintaining serum penicillin G concentrations of >0.02 mg/liter, a proposed protective threshold against group A Streptococcus pyogenes (GAS). The final population model included linear absorption into a central compartment, distribution to and from a peripheral compartment, and linear elimination from the central compartment, with allometrically scaled volumes and rate constants. With 1.2 million units of BPG given intramuscularly every 4 weeks in four total doses, only 23.2% of 5,000 simulated patients maintained serum penicillin G trough concentrations of >0.02 mg/liter 4 weeks after the last dose. When the doses were 1.8 million units and 2.4 million units, the percentages were 30.2% and 40.7%, respectively. With repeated dosing of 1.2 million units every 3 weeks and every 2 weeks for 4 doses, the percentages of simulated patients with a penicillin G trough concentration of >0.02 mg/liter were 37.8% and 65.2%, respectively. Our simulations support recommendations for more frequent rather than higher BPG doses to prevent recurrent rheumatic heart disease in areas of high GAS prevalence or during outbreaks.


Assuntos
Antibacterianos/farmacocinética , Penicilina G Benzatina/farmacocinética , Streptococcus pyogenes/efeitos dos fármacos , Adolescente , Adulto , Antibacterianos/sangue , Antibacterianos/metabolismo , Humanos , Masculino , Testes de Sensibilidade Microbiana , Penicilina G Benzatina/sangue , Penicilina G Benzatina/metabolismo , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/microbiologia , Cardiopatia Reumática/microbiologia , Cardiopatia Reumática/prevenção & controle , Sífilis/tratamento farmacológico , Sífilis/microbiologia , Adulto Jovem
4.
Emerg Infect Dis ; 18(9): 1430-7, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22932005

RESUMO

Meningococci have historically caused extensive illness among members of the United States military. Three successive meningococcal vaccine types were used from 1971 through 2010; overall disease incidence dropped by >90% during this period. During 2006-2010, disease incidence of 0.38 (cases per 100,000 person-years) among members of the US military was not significantly different from the incidence of 0.26 among the age-matched US general population. Of the 26 cases in the US military, 5 were fatal, 15 were vaccine failures (e.g., illness in a person who had been vaccinated), and 9 were caused by Neisseria meningitidis serogroup Y. Incidences among 17- to 19-year-old basic trainees and among US Marines were significantly higher than among comparison military populations (p<0.05). No apparent change in epidemiology of meningococcal disease was observed after replacement of quadrivalent polysaccharide vaccine with conjugate vaccine in 2007. The data demonstrate that vaccination with meningococcal vaccine is effective.


Assuntos
Infecções Meningocócicas/epidemiologia , Militares , Adolescente , Adulto , História do Século XX , História do Século XXI , Humanos , Infecções Meningocócicas/história , Infecções Meningocócicas/mortalidade , Medicina Militar/história , Medicina Militar/tendências , Neisseria meningitidis/classificação , Neisseria meningitidis/imunologia , Sorotipagem , Estados Unidos/epidemiologia , Vacinação , Adulto Jovem
5.
Sci Rep ; 11(1): 4963, 2021 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-33654202

RESUMO

Healthy ageing leads to changes in the brain that impact upon sensory and cognitive processing. It is not fully clear how these changes affect the processing of everyday spoken language. Prediction is thought to play an important role in language comprehension, where information about upcoming words is pre-activated across multiple representational levels. However, evidence from electrophysiology suggests differences in how older and younger adults use context-based predictions, particularly at the level of semantic representation. We investigate these differences during natural speech comprehension by presenting older and younger subjects with continuous, narrative speech while recording their electroencephalogram. We use time-lagged linear regression to test how distinct computational measures of (1) semantic dissimilarity and (2) lexical surprisal are processed in the brains of both groups. Our results reveal dissociable neural correlates of these two measures that suggest differences in how younger and older adults successfully comprehend speech. Specifically, our results suggest that, while younger and older subjects both employ context-based lexical predictions, older subjects are significantly less likely to pre-activate the semantic features relating to upcoming words. Furthermore, across our group of older adults, we show that the weaker the neural signature of this semantic pre-activation mechanism, the lower a subject's semantic verbal fluency score. We interpret these findings as prediction playing a generally reduced role at a semantic level in the brains of older listeners during speech comprehension and that these changes may be part of an overall strategy to successfully comprehend speech with reduced cognitive resources.


Assuntos
Envelhecimento/fisiologia , Encéfalo/fisiologia , Compreensão/fisiologia , Eletroencefalografia , Percepção da Fala/fisiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
Exp Brain Res ; 197(3): 223-33, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19590860

RESUMO

To address the hypothesis that Parkinson's disease (PD) patients have deficits in controlling acceleration, a drawing task was used in which target size, frequency, and weight of pen were manipulated. In accordance with previous results, it was found that, relative to controls, PD patients produced movements at the required frequency, but moved significantly slower, produced less acceleration, and drew smaller-than-required stroke sizes. This resulted in smaller-than-required movement amplitudes, suggesting that hypometria and bradykinesia in drawing and/or handwriting are related. Patients were found to perform similarly to controls when the target size was 1 cm. However, their performance became more dissimilar at greater stroke lengths. In addition to the aforementioned effects it was found that movement amplitude error was less when the pen was 20 times heavier than the normal pen and that the increased load may dampen abnormal limb-stiffness characteristics induced by PD.


Assuntos
Hipocinesia/fisiopatologia , Destreza Motora/fisiologia , Transtornos dos Movimentos/fisiopatologia , Movimento/fisiologia , Doença de Parkinson/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Braço/inervação , Braço/fisiopatologia , Fenômenos Biomecânicos/fisiologia , Feminino , Humanos , Hipocinesia/diagnóstico , Hipocinesia/etiologia , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/diagnóstico , Transtornos dos Movimentos/etiologia , Hipertonia Muscular/diagnóstico , Hipertonia Muscular/etiologia , Hipertonia Muscular/fisiopatologia , Rigidez Muscular/diagnóstico , Rigidez Muscular/etiologia , Rigidez Muscular/fisiopatologia , Músculo Esquelético/inervação , Músculo Esquelético/fisiopatologia , Doença de Parkinson/diagnóstico
8.
J Clin Microbiol ; 46(2): 644-51, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18094138

RESUMO

We have developed a PCR/electrospray ionization mass spectrometry (PCR/ESI-MS) assay for the rapid detection, identification, and serotyping of human adenoviruses. The assay employs a high-performance mass spectrometer to "weigh" the amplicons obtained from PCR using primers designed to amplify known human adenoviruses. Masses are converted to base compositions and, by comparison against a database of the genetic sequences, the serotype present in a sample is determined. The performance of the assay was demonstrated with quantified viral standards and environmental and human clinical samples collected from a military training facility. Over 500 samples per day can be analyzed with sensitivities greater than 100 genomes per reaction. This approach can be applied to many other families of infectious agents for rapid and sensitive analysis.


Assuntos
Infecções por Adenoviridae/diagnóstico , Infecções por Adenoviridae/virologia , Adenoviridae/classificação , Adenoviridae/isolamento & purificação , Microbiologia Ambiental , Reação em Cadeia da Polimerase/métodos , Espectrometria de Massas por Ionização por Electrospray/métodos , Adenoviridae/genética , Chlamydiales , Primers do DNA/genética , Processamento Eletrônico de Dados , Humanos , Sensibilidade e Especificidade , Sorotipagem/métodos
9.
Exp Brain Res ; 184(4): 457-68, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17849107

RESUMO

Daily living often requires pedestrians and drivers to adapt their behavior to the displacement of other objects in their environment in order to avoid collision. Yet little research has paid attention to the effect of age on the completion of such a challenging task. The purpose of this study was to examine the relationship between age and collision avoidance skill and whether a sporting activity affects this. Three age groups (20-30, 60-70, and 70-80 years) of tennis players and non-players launched a projectile toward a target in order to hit it before it was hit by another "object" (a stimulus represented by apparent motion of lights). If the participant judged that time-to-collision (TTC) of the moving stimulus was not long enough for him/her to launch the projectile in time to arrive before the stimulus, the participant had to inhibit the launching. Results showed that for the non-players the number of errors in the 70-80 year-old group was significantly higher than those of the 20-30 and 60-70 year-old groups, which did not differ from each other. However, this increase was not observed in the 70-80 year-old tennis players, demonstrating a beneficial effect of playing tennis on collision avoidance skill. Results also revealed that the older groups of both tennis players and non-players were subject to the typical age-related increase in response time. Additional analyses indicated that the 70-80 year-old non-players did not adjust their actions to these age-related changes in response time. The older tennis-playing participants, however, were more likely to adjust collision avoidance behavior to their diminished response times.


Assuntos
Atividades Cotidianas , Envelhecimento/fisiologia , Condução de Veículo , Desempenho Psicomotor/fisiologia , Tênis/fisiologia , Acidentes de Trânsito/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Estilo de Vida , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Atividade Motora/fisiologia , Tempo de Reação/fisiologia
10.
Curr Biol ; 28(24): R1396-R1398, 2018 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-30562533

RESUMO

How heard speech is transformed into words in the brain remains poorly understood. New research reveals signals in auditory cortex that reflect predictions the brain makes in transforming phonetic information into words.


Assuntos
Córtex Auditivo , Percepção da Fala , Motivação , Fonética , Fala
11.
Curr Biol ; 28(5): 803-809.e3, 2018 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-29478856

RESUMO

People routinely hear and understand speech at rates of 120-200 words per minute [1, 2]. Thus, speech comprehension must involve rapid, online neural mechanisms that process words' meanings in an approximately time-locked fashion. However, electrophysiological evidence for such time-locked processing has been lacking for continuous speech. Although valuable insights into semantic processing have been provided by the "N400 component" of the event-related potential [3-6], this literature has been dominated by paradigms using incongruous words within specially constructed sentences, with less emphasis on natural, narrative speech comprehension. Building on the discovery that cortical activity "tracks" the dynamics of running speech [7-9] and psycholinguistic work demonstrating [10-12] and modeling [13-15] how context impacts on word processing, we describe a new approach for deriving an electrophysiological correlate of natural speech comprehension. We used a computational model [16] to quantify the meaning carried by words based on how semantically dissimilar they were to their preceding context and then regressed this measure against electroencephalographic (EEG) data recorded from subjects as they listened to narrative speech. This produced a prominent negativity at a time lag of 200-600 ms on centro-parietal EEG channels, characteristics common to the N400. Applying this approach to EEG datasets involving time-reversed speech, cocktail party attention, and audiovisual speech-in-noise demonstrated that this response was very sensitive to whether or not subjects understood the speech they heard. These findings demonstrate that, when successfully comprehending natural speech, the human brain responds to the contextual semantic content of each word in a relatively time-locked fashion.


Assuntos
Compreensão/fisiologia , Semântica , Fala/fisiologia , Adulto , Eletroencefalografia , Feminino , Humanos , Masculino , Adulto Jovem
12.
Clin Vaccine Immunol ; 23(8): 672-80, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27280619

RESUMO

Immunological responses to vaccination can differ depending on whether the vaccine is given alone or with other vaccines. This study was a retrospective evaluation of the immunogenicity of a tetravalent meningococcal conjugate vaccine for serogroups A, C, W, and Y (MenACWY) administered alone (n = 41) or concomitantly with other vaccines (n = 279) to U.S. military personnel (mean age, 21.6 years) entering the military between 2006 and 2008. Concomitant vaccines included tetanus/diphtheria (Td), inactivated polio vaccine (IPV), hepatitis vaccines, and various influenza vaccines, among others; two vaccine groups excluded Tdap and IPV. Immune responses were evaluated in baseline and postvaccination sera for Neisseria meningitidis serogroups C and Y 1 to 12 months (mean, 4.96 months) following vaccination. Functional antibodies were measured by using a serum bactericidal antibody assay with rabbit complement (rSBA) and by measurement of serogroup-specific immunoglobulin G (IgG) antibodies. The percentage of vaccinees reaching threshold levels (IgG concentration in serum, ≥2 µg/ml; rSBA titer, ≥8) corresponding to an immunologic response was higher postvaccination than at baseline (P < 0.001). Administration of MenACWY along with other vaccines was associated with higher geometric means of IgG concentrations and rSBA titers than those measured 4.60 months after a single dose of MenACWY. In addition, higher percentages of vaccinees reached the immunological threshold (range of odds ratios [ORs], 1.5 to 21.7) and more of them seroconverted (OR range, 1.8 to 4.8) when MenACWY was administered with any other vaccine than when administered alone. Additional prospective randomized clinical trials are needed to confirm the observed differences among groups in the immune response to MenACWY when given concomitantly with other vaccines to U.S. military personnel.


Assuntos
Anticorpos Antibacterianos/sangue , Esquemas de Imunização , Vacinas Meningocócicas/imunologia , Neisseria meningitidis/imunologia , Adolescente , Adulto , Animais , Atividade Bactericida do Sangue , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Infecções Meningocócicas/prevenção & controle , Vacinas Meningocócicas/administração & dosagem , Militares , Coelhos , Estudos Retrospectivos , Estados Unidos , Vacinas Conjugadas/administração & dosagem , Vacinas Conjugadas/imunologia , Adulto Jovem
13.
Vaccine ; 33(24): 2842-8, 2015 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-25131729

RESUMO

BACKGROUND: Administration of multiple simultaneous vaccines to infants, children, and military recruits is not uncommon. However, little research exists to examine associated serological and health effects, especially in adults. METHOD: We retrospectively examined 416 paired serum specimens from U.S. military subjects who had received the inactivated polio vaccine (IPV) alone or in combination with either 1 other vaccine (<3 group) or 4 other vaccines (>4 group). Each of the 2 groups was subdivided into 2 subgroups in which Tdap was present or absent. RESULTS: The >4 group was associated with a higher proportion of polio seroconversions than the <3 group (95% vs. 58%, respectively, p<0.01). Analysis of the <3 subgroup that excluded Tdap vs. the >4 subgroup that excluded Tdap showed no difference between them (p>0.1). However, the >4 subgroup that included Tdap had significantly more seroconversions than either the <3 subgroup that excluded Tdap or the >4 subgroup that excluded Tdap (p<0.01). Overall, at least 98% of subjects were at or above the putative level of seroprotection both pre- and post-vaccination, yet at least 81% of subjects seroconverted. In an analysis of 400 of the subjects in which clinic in- and outpatient encounters were counted over the course of 1 year following vaccinations, there was no significant difference between the 2 groups (p>0.1). CONCLUSION: A combination of >4 vaccines including IPV appeared to have an immunopotentiation effect on polio seroconversion, and Tdap in particular was a strong candidate for an important role. The dose of IPV we studied in our subjects, who already had a high level of seroprotection, acted as a booster. In addition, there appear to be no negative health consequences from receiving few versus more multiple simultaneous vaccinations.


Assuntos
Anticorpos Antivirais/sangue , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Poliomielite/imunologia , Vacina Antipólio de Vírus Inativado/administração & dosagem , Poliovirus/imunologia , Vacinas Combinadas/administração & dosagem , Adolescente , Adulto , Vacina contra Difteria, Tétano e Coqueluche/imunologia , Feminino , Seguimentos , Humanos , Imunização Secundária , Masculino , Vacina Antipólio de Vírus Inativado/imunologia , Estudos Retrospectivos , Soroconversão , Vacinação/efeitos adversos , Vacinação/métodos , Vacinas Combinadas/efeitos adversos , Vacinas Combinadas/imunologia , Adulto Jovem
14.
J Exp Psychol Hum Percept Perform ; 29(6): 1083-101, 2003 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-14640832

RESUMO

The goal of this study was to test whether 1st-order information, which does not account for acceleration, is used (a) to estimate the time to contact (TTC) of an accelerated stimulus after the occlusion of a final part of its trajectory and (b) to indirectly intercept an accelerated stimulus with a thrown projectile. Both tasks require the production of an action on the basis of predictive information acquired before the arrival of the stimulus at the target and allow the experimenter to make quantitative predictions about the participants' use (or nonuse) of 1st-order information. The results show that participants do not use information about acceleration and that they commit errors that rely quantitatively on 1st-order information even when acceleration is psychophysically detectable. In the indirect interceptive task, action is planned about 200 ms before the initiation of the movement, at which time the 1st-order TTC attains a critical value.


Assuntos
Percepção de Movimento/fisiologia , Percepção do Tempo , Percepção Visual/fisiologia , Adulto , Humanos , Masculino , Distribuição Aleatória
15.
J Exp Psychol Hum Percept Perform ; 29(2): 379-87, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12760622

RESUMO

In this article, the authors examined the hypothesis that the direction of the change (increase or decrease) in the dynamical degrees of freedom (dimension) regulated as a function of motor learning is task-dependent. Adult participants learned 1 of 2 isometric force-production tasks (Experiment 1: constant force output; Experiment 2: sinusoidal force output) over 5 days of practice and a 6th day with augmented information withdrawal. The results showed that over practice, the task goal induced either an increase (Experiment 1) or a decrease (Experiment 2) in the dimension of force output as performance error was reduced. These findings support the proposition that the observed increase or decrease in dimension with learning is dependent on both the intrinsic dynamics of the system and the short-term change required to realize the task goal.


Assuntos
Aprendizagem/fisiologia , Destreza Motora/fisiologia , Prática Psicológica , Resolução de Problemas/fisiologia , Desempenho Psicomotor/fisiologia , Adaptação Fisiológica , Adaptação Psicológica , Adulto , Objetivos , Humanos , Contração Isométrica/fisiologia , Cinestesia/fisiologia , Pessoa de Meia-Idade , Psicofísica , Psicofisiologia
16.
Vaccine ; 32(30): 3805-9, 2014 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-24837781

RESUMO

Serogroup C meningococcal (MenC) disease accounts for one-third of all meningococcal cases and causes meningococcal outbreaks in the U.S. Quadrivalent meningococcal vaccine conjugated to diphtheria toxoid (MenACYWD) was recommended in 2005 for adolescents and high risk groups such as military recruits. We evaluated anti-MenC antibody persistence in U.S. military personnel vaccinated with either MenACYWD or meningococcal polysaccharide vaccine (MPSV4). Twelve hundred subjects vaccinated with MenACYWD from 2006 to 2008 or MPSV4 from 2002 to 2004 were randomly selected from the Defense Medical Surveillance System. Baseline serologic responses to MenC were assessed in all subjects; 100 subjects per vaccine group were tested during one of the following six post-vaccination time-points: 5-7, 11-13, 17-19, 23-25, 29-31, or 35-37 months. Anti-MenC geometric mean titers (GMT) were measured by rabbit complement serum bactericidal assay (rSBA) and geometric mean concentrations (GMC) by enzyme-linked immunosorbent assay (ELISA). Continuous variables were compared using the Wilcoxon rank sum test and the proportion of subjects with an rSBA titer ≥ 8 by chi-square. Pre-vaccination rSBA GMT was <8 for the MenACWYD group. rSBA GMT increased to 703 at 5-7 months post-vaccination and decreased by 94% to 43 at 3 years post-vaccination. GMT was significantly lower in the MenACWYD group at 5-7 months post-vaccination compared to the MPSV4 group. The percentage of MenACWYD recipients achieving an rSBA titer of ≥ 8 decreased from 87% at 5-7 months to 54% at 3 years. There were no significant differences between vaccine groups in the proportion of subjects with a titer of ≥ 8 at any time-point. GMC for the MenACWYD group was 0.14 µg/mL at baseline, 1.07 µg/mL at 5-7 months, and 0.66 µg/mL at 3 years, and significantly lower than the MPSV4 group at all time-points. Anti-MenC responses wane following vaccination with MenACYWD; a booster dose is needed to maintain protective levels of circulating antibody.


Assuntos
Anticorpos Antibacterianos/sangue , Formação de Anticorpos , Infecções Meningocócicas/imunologia , Vacinas Meningocócicas/uso terapêutico , Adolescente , Adulto , Humanos , Infecções Meningocócicas/prevenção & controle , Militares , Neisseria meningitidis Sorogrupo C , Estudos Retrospectivos , Ensaios de Anticorpos Bactericidas Séricos , Fatores de Tempo , Estados Unidos , Vacinas Conjugadas/uso terapêutico , Adulto Jovem
17.
Pediatr Infect Dis J ; 31(7): 722-5, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22481428

RESUMO

BACKGROUND: An interval of 3-4 weeks between intramuscular injections of 1.2 million units of benzathine penicillin G as prophylaxis against group A streptococcal infection is recommended by health organizations for patients with pediatric rheumatic fever and heart disease. METHODS: We reviewed the literature for evidence of the persistence of serum penicillin G during the first 4 weeks after the recommended dose of benzathine penicillin G. RESULTS: The weighted-mean concentration was <0.02 µg/mL by 3 weeks after the initial dose. Weighted means were lower in studies done after 1990 than before (P<0.01), in studies dealing with secondary versus primary prophylaxis (P<0.01) and in studies in children versus those in adults (P<0.02). CONCLUSIONS: Recommendations for benzathine penicillin G prophylaxis may need reevaluation.


Assuntos
Antibacterianos/administração & dosagem , Antibacterianos/farmacocinética , Antibioticoprofilaxia/métodos , Penicilina G Benzatina/administração & dosagem , Penicilina G Benzatina/farmacocinética , Adulto , Antibacterianos/sangue , Criança , Pré-Escolar , Humanos , Injeções Intramusculares , Penicilina G Benzatina/sangue , Soro/química , Infecções Estreptocócicas/prevenção & controle
18.
PLoS One ; 6(10): e25308, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21991307

RESUMO

When introduced in the 1950s, benzathine penicillin G (BPG) was shown to be effective in eradicating group A beta-hemolytic streptococcus (GAS) for at least 3 weeks after administration. Several studies since the 1990s suggest that at 3-4 weeks serum penicillin G levels are less than adequate (below MIC(90) of 0.016 µg/ml). We studied these levels for 4 weeks after the recommended dose of BPG in military recruits, for whom it is used as prophylaxis against GAS. The 329 subjects (mean age 20 years) each received 1.2 million units BPG IM and gave sera 1 day post injection and twice more at staggered time points over 4 weeks. Serum penicillin G levels were measured by liquid chromatography/tandem mass spectometry. The half-life of serum penicillin G was 4.1 days. By day 11, mean levels were <0.02 µg/ml, and by day 15<0.01 µg/ml. Levels in more than 50% of the subjects were below 0.02 µg/ml on day 9, and <.01 µg/ml on day 16. There was no demonstrable effect of subject body-surface area nor of the four different lots of BPG used. These data indicate that in healthy young adults serum penicillin G levels become less than protective <2½ weeks after injection of 1.2 million units of BPG. The findings require serious consideration in future medical and public health recommendations for treatment and prophylaxis of GAS upper respiratory tract infections.


Assuntos
Penicilina G/administração & dosagem , Penicilina G/sangue , Adolescente , Adulto , Intervalos de Confiança , Demografia , Relação Dose-Resposta a Droga , Humanos , Injeções Intramusculares , Masculino , Adulto Jovem
20.
J Infect Dis ; 198(10): 1420-6, 2008 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-18823270

RESUMO

BACKGROUND: In both military and civilian settings, transmission of respiratory pathogens may be due to person-to-person and environmental contributions. This possibility was explored in a military training setting, where rates of febrile respiratory illness (FRI) often reach epidemic levels. METHODS: Population size and FRI rates were monitored over 10 months in the units of 50-90 individuals. Some units were open to the influx of potentially infectious convalescents (hereafter referred to as "open units," and some were closed to such an influx (hereafter referred to as "closed units"). Virologic testing and polymerase chain reaction analysis were used to detect adenovirus on surface structures. RESULTS: The odds ratio (OR) associated with FRI in closed units, compared with open units, was 1.13 (95% confidence interval [CI], 0.99-1.28). The OR in units with a population greater than the median size, compared with units with a population lower than the median size was 1.38 (95% CI, 1.23-1.55). Between 5% and 9% of surface samples obtained from selected units harbored viable adenovirus. CONCLUSIONS: FRI rates were not reduced in units that were closed to potentially contagious individuals. These findings imply that the primary source of the pathogen is likely environmental rather than human, and they underscore what is known about other virus types. Diligence in identifying the relative roles of different transmission routes is suggested for civilian settings similar to those described in the current study.


Assuntos
Infecções por Adenovirus Humanos/transmissão , Meio Ambiente , Doença Ambiental/epidemiologia , Militares , Infecções Respiratórias/transmissão , Infecções Respiratórias/virologia , Infecções por Adenovirus Humanos/epidemiologia , Adulto , Doença Ambiental/diagnóstico , Microbiologia Ambiental , Humanos , Controle de Infecções , Modelos Logísticos , Masculino , Densidade Demográfica , Infecções Respiratórias/epidemiologia , Adulto Jovem
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