Vaccine co-administration in adults: An effective way to improve vaccination coverage.

The ongoing COVID-19 pandemic highlights that complications and mortality associated with infectious diseases increase with age. Various vaccines are recommended for adults, but coverage rates remain suboptimal. Although co-administration would improve vaccine uptake and timely immunization, this is not routine practice in adults. We review key data on co-administration of vaccines in children and adults to reassure healthcare providers about its safety and advantages. In European countries and the United States, combined tetanus, diphtheria, and acellular pertussis boosters as well as meningococcal and human papillomavirus vaccines are recommended for healthy adolescents and adults of certain ages. Vaccination against influenza (annually), pneumococcal disease, and herpes zoster is recommended for older adults and specific risk groups. While co-administration is well established in children, it is less common in adults. Travelers can also receive multiple co-administered vaccines. Pediatric and travel vaccine co-administration has a well-established positive benefit-risk profile and is an efficient and cost-saving strategy to improve coverage. Healthcare providers could more often recommend and practice vaccine co-administration; this would not risk patient safety and health, would improve protection against vaccine-preventable diseases, and would help comply with national vaccination calendars. Recommending bodies may consider revising vaccination schedules to reduce the number of visits.

Dynamics of pure tone audiometry and DPOAE changes induced by glycerol in Meniere's disease.

The purpose of this study is to follow up the dynamics of pure tone threshold and DPOAE amplitude changes induced by glycerol with reference to its activity in the inner ear. Selection was made among 38 patients with Meniere's disease for those having positive glycerol test. Pure-tone audiometry and DP-gram were performed in four series: as an initial examination before glycerol intake, 1, 2 and 3 h after. Audiometric changes formed distinct biphasal pattern at all frequencies between 250 and 4,000 Hz. The most dynamic pure tone threshold decrease occurred during the first hour. Between the first and second hour after glycerol ingestion there was a phase of no significant hearing changes. Further pure tone threshold decrease went on within the third hour reaching its top. Observing DPOAE changes, the highest DP amplitude growth occurred after the second and the third hour at DP-gram frequencies 2, 3 and 4 kHz. The fastest DP-amplitude increase was registered as well during the first hour after glycerol ingestion. In 11 persons with both audiometry and DPOAE positive glycerol test, parallel dynamics in the course of the glycerol test was observed. Biphasal glycerol test dynamics suggests the possibility of two mechanisms of glycerol activity in the inner ear.

Experimental xenoimplantation of antlerogenic cells into mandibular bone lesions in rabbits: two-year follow-up.

Different types of cells require activation, and take part in annual, dynamic growth of deer antlers. Stem cells play the most important role in this process. This report shows the results of a two-year long observation of xenogenic implant of antlerogenic stem cells (cell line MIC-1). The cells were derived from growing antler of a deer (Cervus elaphus), seeded onto Spongostan and placed in postoperative lesions of mandibular bones of 15 experimental rabbits. The healing process observed in the implantation sites in all rabbits was normal, and no local inflammatory response was ever observed. Histological and immunohistochemical evaluations were performed after 1, 2, 6, 12 and 24 months, and confirmed the participation of xenogenic cells in the regeneration processes, as well as a lack of rejection of the implants. The deficiencies in the bones were replaced by newly formed, thick fibrous bone tissue that underwent mineralization and was later remodelled into lamellar bone. The results of the experiment with rabbits allow us to believe that antlerogenic cells could be used in reconstruction of bone tissues in other species as well.

Experimental application of xenogenous antlerogenic cells in replacement of auricular cartilage in rabbits.

BACKGROUND: Regenerative medicine in the recent years aims at explaining involvement of stem cells in regenerative processes and applying this knowledge in fulfilling human needs to find new, more efficient therapeutic methods. Growing antlers constitute a model organ for examining regeneration processes of tissues because they are the only mammalian appendages capable of regeneration. The rate of growth of deer antlers makes them one of the quickest growing structures in mammals. The cells taking part in this process have a considerable proliferating potential. The aim of the study was to analyze the possibility of using xenogenous antlerogenic cells (AC) in regeneration of cartilaginous tissues in non-immunosuppressed animals. METHODS: We undertook to use a xenogenous implant consisting of cultured antlerogenic mesenchymal cells suspended in hemostatic sponge in the reconstruction of lesions of ear cartilage in nine rabbits. A surgical site was prepared half-way up the outer, dorsal part of the right ear. About 1 cm from the free edge of the ear, a centrally peduncled flap of skin and perichondrium was prepared, measuring 1.5 cm x 1.5 cm. The exposed cartilage was excised in an area of about 1 cm x 1 cm. In the operated rabbits, in the prepared perichondrial pocket, we placed a flake of Spongostan saturated with the suspension of AC. Xenogenous cell survival and regeneration abilities were determined by histologic, immunohistochemical, and electron microscopy analysis of the grafts. RESULTS: In each case, healing occurred properly and neither local inflammation, necrosis nor implant rejection was observed. The hyaline cartilage lesion was replaced by new fibrous cartilage. This is similar to the histologic process occurring in growing deer antlers. The histologic, immunohistochemical, and electron microscopy analysis demonstrated the presence (and thus possible participation) of exogenous cells in the reconstructive process. At the same time, the immune response was very weak, which was confirmed by immunohistochemical reactions. CONCLUSION: Implanted antlerogenic cells were not rejected and possibly took part in the reconstruction of missing sections of the scaffolding of the rabbits' ear cartilages (although the mechanism is yet unknown). Low immunogenicity of AC, simplicity, efficiency, and low costs of production of implant material are the benefits of this method. Further research should unequivocally answer the question whether the MIC-1 cells are or are not the long-sought-after ideal material for the reconstruction of cartilaginous tissue lesions in various species, including human.

Corticosteroid-induced laryngeal disorders in asthma.

BACKGROUND: Inhaled corticosteroids have proven to be the most effective agent available in treating bronchial asthma, and such treatment is believed to be very safe. Concerns regarding side effects of inhaled corticosteroids usually focus on potential systemic effects, where local side effects are often overlooked. The purpose of this study was to analyze and assess the influence of inhaled corticosteroids on the vocal cords of patients treated for bronchial asthma. MATERIAL/METHODS: Fifty patients (mean age: 50 years, range: 22 to 83 years) suffering from asthma and receiving corticosteroidal inhaled agents entered in this study. All of the patients underwent detailed videoscopic examination of the larynx. None complained of any laryngeal disorders or dysfunction before the diagnosis of asthma. All of the patients were non-smokers. RESULTS: Significant changes in the laryngeal status were observed. Changes included atrophy of laryngeal mucosa, vocal fold atrophy, and vocal fold bowing. CONCLUSIONS: Damage to the larynx is an important factor in patients with asthma treated with inhaled corticosteroids, which elicit apoptosis of the epithelium.

[Changes of laryngeal mucosa in the course of pemphigus vulgaris]. / Zmiany na blonach sluzowych krtani w przebiegu pecherzycy.

Blister diseases are chronic autoimmune reactions connected with formation of intraepithelial blisters. Pemphigus vulgaris (PV) change is appear most often, almost 80% of all cases. Erosions on mucosa appear as first symptoms at 50-70% patients. Blisters occurring on the skin are typical for this illness and usually come into with weeks or months with delay in relation to the changes on mucous membranes. In this work we have described character and location of changes on mucous membranes at 5 patients with PV, diagnosed based on clinical symptoms and confirmed in immunofluorescent investigations.

Treatment of Reincke's edema among different professional groups: presentation of results.

OBJECTIVES: Reincke's edema is one of the most common voice disorders in adults. The main purpose of our study, was to analyze factors that may influence the development of this disease. We also estimated the results of surgical treatment. MATERIALS AND METHODS: The research was performed on a group of 261 patients with Reincke's edema treated in the ENT Department of the Medical University of Wroclaw in the years 1994--2000. In the study population, women were in a majority and teachers formed the largest occupational group (30%) followed by salespersons (15%). Most of the patients (86%) were tobacco smokers. All of the patients underwent detailed videostroboscopic examination of the larynx and perceptual analysis of the voice quality before and after treatment. RESULTS: The symmetry of vocal cords before and after treatment was found in 75 patients. Lack of symmetry before treatment, and proper symmetry after surgery was observed in 71 subjects. Fifty patients showed less symmetry after treatment, and 65 patients were asymmetric before and after surgery. The difference between the symmetry of vocal folds before and after treatment was at the border of statistical significance (p = 0.069). The number of patients with full vocal cords closure increased after treatment. This difference was statistically significant (p = 0.032). The periodicity of vocal cord movements was significantly higher after treatment (p < 0.001). CONCLUSIONS: The perceptual assessment of voice, before and after treatment, revealed statistically significant post-treatment improvement in voice quality.

[Laryngeal symptoms in patients with gastroesophageal reflux diseases]. / Objawy laryngologiczne u chorych z choroba refluksowa przelyku.

Gastroesophageal reflux disease (GERD) is considered an important etiological factor of numerous larynx dysfunctions. The goal of our study was to describe larynx status of patients with GERD before and after treatment. Forty-five patients with GERD symptoms entered our study. GERD was confirmed in 24-hours pH-metric examination. Patients were treated with proton pump inhibitors in doses chosen accordingly to GERD severity. All patients underwent endoscopic evaluation of the larynx and acoustic voice analysis before and after the treatment. GERD was diagnosed in 35 out of 45 patients. Acoustic voice analysis revealed that voice disorders appeared more often in patients with severe than moderate or mild refluxes (p = 0.023). Laryngeal changes found in endoscopic evaluation also depended on reflux severity (p = 0.05). The voice quality improved (p = 0.031) and the changes in larynx diminished after anti-reflux treatment (p = 0.016).