RESUMEN
Temperature has profound effects on biological functions at all levels of organization. In ectotherms, body size is usually negatively correlated with ambient temperature during development, a phenomenon known as The Temperature-Size Rule (TSR). However, a growing number of studies have indicated that temperature fluctuations have a large influence on life history traits and the implications of such fluctuations for the TSR are unknown. Our study investigated the effect of different constant and fluctuating temperatures on the body mass and development time of red flour beetles (Tribolium castaneum Herbst, 1797); we also examined whether the sexes differed in their responses to thermal conditions. We exposed the progeny of half-sib families of a T. castaneum laboratory strain to one of four temperature regimes: constant 30°C, constant 25°C, fluctuating with a daily mean of 30°C, or fluctuating with a daily mean of 25°C. Sex-specific development time and body mass at emergence were determined. Beetles developed the fastest and had the greatest body mass upon emergence when they were exposed to a constant temperature of 30°C. This pattern was reversed when beetles experienced a constant temperature of 25°C: slowest development and lowest body mass upon emergence were observed. Fluctuations changed those effects significantly - impact of temperature on development time was smaller, while differences in body mass disappeared completely. Our results do not fit TSR predictions. Furthermore, regardless of the temperature regime, females acquired more mass, while there were no differences between sexes in development time to eclosion. This finding fails to support one of the explanations for smaller male size: that selection favors the early emergence of males. We found no evidence of genotype × environment interactions for selected set of traits.
Asunto(s)
Tamaño Corporal/fisiología , Temperatura , Tribolium/crecimiento & desarrollo , Animales , Femenino , MasculinoRESUMEN
Setting priorities in the field of infectious diseases requires evidence-based and robust baseline estimates of disease burden. Therefore, the European Centre for Disease Prevention and Control initiated the Burden of Communicable Diseases in Europe (BCoDE) project. The project uses an incidence- and pathogen-based approach to measure the impact of both acute illness and sequelae of infectious diseases expressed in disability-adjusted life years (DALYs). This study presents first estimates of disease burden for four pathogens in Germany. The number of reported incident cases adjusted for underestimation served as model input. For the study period 2005-2007, the average disease burden was estimated at 33 116 DALYs/year for influenza virus, 19 115 DALYs/year for Salmonella spp., 8708 DALYs/year for hepatitis B virus and 740 DALYs/year for measles virus. This methodology highlights the importance of sequelae, particularly for hepatitis B and salmonellosis, because if omitted, the burden would have been underestimated by 98% and 56%, respectively.
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Hepatitis B/epidemiología , Gripe Humana/epidemiología , Sarampión/epidemiología , Infecciones por Salmonella/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Hepatocelular/epidemiología , Carcinoma Hepatocelular/etiología , Niño , Preescolar , Femenino , Alemania/epidemiología , Hepatitis B/complicaciones , Hepatitis B Crónica/complicaciones , Hepatitis B Crónica/epidemiología , Humanos , Incidencia , Lactante , Gripe Humana/complicaciones , Fallo Hepático Agudo/epidemiología , Fallo Hepático Agudo/etiología , Neoplasias Hepáticas/epidemiología , Neoplasias Hepáticas/etiología , Masculino , Persona de Mediana Edad , Años de Vida Ajustados por Calidad de Vida , Síndrome de Dificultad Respiratoria/epidemiología , Síndrome de Dificultad Respiratoria/etiología , Adulto JovenRESUMEN
Surveillance and studies in a pandemic is a complex topic including four distinct components: (1) early detection and investigation; (2) comprehensive early assessment; (3) monitoring; and (4) rapid investigation of the effectiveness and impact of countermeasures, including monitoring the safety of pharmaceutical countermeasures. In the 2009 pandemic, the prime early detection and investigation took place in the Americas, but Europe needed to undertake the other three components while remaining vigilant to new phenomenon such as the emergence of antiviral resistance and important viral mutation. Laboratory-based surveillance was essential and also integral to epidemiological and clinical surveillance. Early assessment was especially vital because of the many important strategic parameters of the pandemic that could not be anticipated (the 'known unknowns'). Such assessment did not need to be undertaken in every country, and was done by the earliest affected European countries, particularly those with stronger surveillance. This was more successful than requiring countries to forward primary data for central analysis. However, it sometimes proved difficult to get even those analyses from European counties, and information from Southern hemisphere countries and North America proved equally valuable. These analyses informed which public health and clinical measures were most likely to be successful, and were summarized in a European risk assessment that was updated repeatedly. The estimate of the severity of the pandemic by the World Health Organization (WHO), and more detailed description by the European Centre for Disease Prevention and Control in the risk assessment along with revised planning assumptions were essential, as most national European plans envisaged triggering more disruptive interventions in the event of a severe pandemic. Setting up new surveillance systems in the midst of the pandemic and getting information from them was generally less successful. All European countries needed to perform monitoring (Component 3) for the proper management of their own healthcare systems and other services. The information that central authorities might like to have for monitoring was legion, and some countries found it difficult to limit this to what was essential for decisions and key communications. Monitoring should have been tested for feasibility in influenza seasons, but also needed to consider what surveillance systems will change or cease to deliver during a pandemic. International monitoring (reporting upwards to WHO and European authorities) had to be kept simple as many countries found it difficult to provide routine information to international bodies as well as undertaking internal processes. Investigation of the effectiveness of countermeasures (and the safety of pharmaceutical countermeasures) (Component 4) is another process that only needs to be undertaken in some countries. Safety monitoring proved especially important because of concerns over the safety of vaccines and antivirals. It is unlikely that it will become clear whether and which public health measures have been successful during the pandemic itself. Piloting of methods of estimating influenza vaccine effectiveness (part of Component 4) in Europe was underway in 2008. It was concluded that for future pandemics, authorities should plan how they will undertake Components 2-4, resourcing them realistically and devising new ways of sharing analyses.
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Brotes de Enfermedades/prevención & control , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/prevención & control , Vigilancia de la Población/métodos , Medición de Riesgo/métodos , Europa (Continente)/epidemiología , Salud Global , Humanos , Gripe Humana/diagnóstico , Gripe Humana/epidemiología , Cooperación Internacional , Salud Pública , InvestigaciónRESUMEN
The field site network (FSN) plays a central role in conducting joint research within all Assessing Large-scale Risks for biodiversity with tested Methods (ALARM) modules and provides a mechanism for integrating research on different topics in ALARM on the same site for measuring multiple impacts on biodiversity. The network covers most European climates and biogeographic regions, from Mediterranean through central European and boreal to subarctic. The project links databases with the European-wide field site network FSN, including geographic information system (GIS)-based information to characterise the test location for ALARM researchers for joint on-site research. Maps are provided in a standardised way and merged with other site-specific information. The application of GIS for these field sites and the information management promotes the use of the FSN for research and to disseminate the results. We conclude that ALARM FSN sites together with other research sites in Europe jointly could be used as a future backbone for research proposals.
Asunto(s)
Biodiversidad , Europa (Continente) , Medición de RiesgoRESUMEN
Variable levels of oseltamivir resistance among seasonal influenza A(H1N1) isolates have been reported in Europe during the 2007-8 northern Hemisphere influenza season. It has been questioned whether oseltamivir use could have driven the emergence and predominance of resistant viruses. This study aimed at describing the levels of use of oseltamivir in 12 European Union (EU) Member States and European Economic Area (EEA)/European Free Trade Area (EFTA) countries. The data were converted into prescription rates and compared with the national proportions of resistant influenza A(H1N1) viruses through regression analysis. Overall use of oseltamivir in European countries between 2002 and 2007 was low compared to e.g. the use in Japan. High variability between the countries and over time was observed. In eight of the 12 countries, there was a peak of prescriptions in 2005, coinciding with concerns about a perceived threat from an influenza pandemic which might have lead to personal stockpiling. Ecological comparison between national levels of use of oseltamivir in 2007 and the proportions of A(H1N1) viruses that were resistant to oseltamivir showed no statistical association. In conclusion, our results do not support the hypothesis that the emergence and persistence of these viruses in 2007-8 was related to the levels of use of oseltamivir in Europe. Further investigation is needed to elucidate the reasons for different level of use between the countries.
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Farmacorresistencia Viral , Subtipo H1N1 del Virus de la Influenza A/aislamiento & purificación , Gripe Humana/epidemiología , Gripe Humana/prevención & control , Oseltamivir/administración & dosificación , Prescripciones/estadística & datos numéricos , Medición de Riesgo/métodos , Antivirales/administración & dosificación , Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/estadística & datos numéricos , Europa (Continente) , Humanos , Incidencia , Gripe Humana/virología , Factores de Riesgo , Estadística como AsuntoRESUMEN
Pandemic vaccines from four manufacturers are now available for use within the European Union (EU). Use of these vaccines will protect individuals and reduce the impact on health services to more manageable levels. The majority of the severely ill will be from known risk groups and the best strategy will be to start vaccinating in line with the recommendation from the European Union Health Security Committee prioritizing adults and children with chronic conditions, pregnant women and healthcare workers. The composition of authorized vaccines is reviewed in this article. The vaccine strain in all authorized pandemic vaccines worldwide is based on the same initial isolate of influenza A/California/7/2009 (H1N1)v but the vaccines differ in conditions for virus propagation, antigen preparation, antigen content and whether they are adjuvanted or not. The vaccines are likely to be effective since no significant genetic or antigenic drift has occurred and there are already mechanisms for estimating clinical effectiveness. Influenza vaccines have good safety records and no safety concerns have so far been encountered with any of the vaccines developed. However, special mechanisms have been devised for the early detection and rigorous investigation of possible significant side effects in Europe through post-marketing surveillance and analysis. Delivery of the vaccines to the risk groups will pose difficulties where those with chronic illnesses are not readily identifiable to the healthcare services. There is considerable scope for European added value through Member States with excess vaccines making them available to other states.
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Subtipo H1N1 del Virus de la Influenza A/inmunología , Vacunas contra la Influenza , Gripe Humana/prevención & control , Unión Europea , Humanos , Vacunas contra la Influenza/inmunología , RiesgoRESUMEN
Illness and death from diseases caused by unsafe food are a constant threat to public health security as well as socio-economic development throughout the world. The full extent of the burden and cost of foodborne diseases associated with pathogenic bacterial, viral and parasitic microorganisms, and food contaminated by chemicals is still unknown but is thought to be substantial. The World Health Organization (WHO) Initiative to estimate the global burden of foodborne diseases aims to fill the current data gap and respond to the increasing global interest in health information. Collaborative efforts are required to achieve the ambitious task of assessing the foodborne disease burden from all causes worldwide. Recognising the need to join forces, the WHO Initiative has assembled an alliance of stakeholders which share and support the Initiative's vision, intended objectives and outcomes. One important collaborator is the European Centre for Disease Prevention and Control (ECDC) which has embarked on a burden of disease study covering at least 18 foodborne diseases in nearly 30 countries.
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Síndrome de Creutzfeldt-Jakob/epidemiología , Brotes de Enfermedades/estadística & datos numéricos , Enfermedades Transmitidas por los Alimentos/epidemiología , Cooperación Internacional , Vigilancia de la Población/métodos , Organización Mundial de la Salud/organización & administración , Incidencia , Medición de Riesgo/métodos , Factores de RiesgoRESUMEN
During the 2007-08 influenza season, high levels of oseltamivir resistance were detected among influenza A(H1N1) viruses ina number of European countries. We used surveillance data to describe influenza A(H1N1) cases for whom antiviral resistance testing was performed. We pooled data from national studies to identify possible risk factors for infection with a resistant virus and to ascertain whether such infections led to influenza illness of different severity. Information on demographic and clinical variables was obtained from patients or their physicians. Odds ratios for infection with an oseltamivir resistant virus and relative risks for developing certain clinical outcomes were computed and adjusted through multivariable analysis. Overall, 727 (24.3%) of 2,992 tested influenza A(H1N1) viruses from 22 of 30 European countries were oseltamivir-resistant. Levels of resistance ranged from 1% in Italy to 67% in Norway. Five countries provided detailed case-based data on 373 oseltamivir resistant and 796 susceptible cases. By multivariable analysis, none of the analysed factors was significantly associated with an increased risk of infection with anoseltamivir-resistant virus. Similarly, infection with an oseltamivir-resistant virus was not significantly associated with a different risk of pneumonia, hospitalisation or any clinical complication. The large-scale emergence of oseltamivir-resistant viruses in Europe calls for a review of guidelines for influenza treatment.
Asunto(s)
Antivirales/farmacología , Brotes de Enfermedades , Farmacorresistencia Viral , Subtipo H1N1 del Virus de la Influenza A/efectos de los fármacos , Gripe Humana/virología , Oseltamivir/farmacología , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Niño , Preescolar , Estudios de Cohortes , Farmacorresistencia Viral/genética , Europa (Continente)/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Subtipo H1N1 del Virus de la Influenza A/clasificación , Subtipo H1N1 del Virus de la Influenza A/genética , Gripe Humana/epidemiología , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Guías de Práctica Clínica como Asunto , Estudios Retrospectivos , Riesgo , Factores de Riesgo , Estaciones del Año , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto JovenRESUMEN
In this weeks issue of Eurosurveillance, Zambon and colleagues describe the first findings of the European Union-funded European Surveillance Network for Vigilance Against Viral Resistance (VIRGIL) of some seasonal influenza viral isolates resistant to the antiviral drug oseltamivir in Europe.
Asunto(s)
Antivirales/farmacología , Farmacorresistencia Viral , Subtipo H1N1 del Virus de la Influenza A/efectos de los fármacos , Oseltamivir/farmacología , Europa (Continente) , Humanos , Subtipo H1N1 del Virus de la Influenza A/patogenicidad , Gripe Humana/tratamiento farmacológico , Gripe Humana/mortalidad , Gripe Humana/virología , Estaciones del Año , Virulencia , Organización Mundial de la SaludRESUMEN
Differences in thermal regimes are of paramount importance in insect development. However, experiments that examine trait development under constant temperature conditions may yield less evolutionarily relevant results than those that take naturally occurring temperature fluctuations into account. We investigated the effect of different temperature regimes (constant 30 °C, constant 35 °C, fluctuating with a daily mean of 30 °C, or fluctuating with a daily mean of 35 °C) on sex-specific development time and body mass in Tribolium castaneum. Using a half-sib breeding design, we also examined whether there is any evidence for genotype-by-environment interactions (GEI) for the studied traits. In response to fluctuating temperature regimes, beetles demonstrated reaction norm patterns in which thermal fluctuations influenced traits negatively above the species' thermal optimum but had little to no effect close to the thermal optimum. Estimated heritabilities of development time were in general low and non-significant. In case of body mass of pupae and adults, despite significant genetic variance, we did not find any GEI due to crossing of reaction norms, both between temperatures and between variability treatments. We have observed a weak tendency towards higher heritabilities of adult and pupa body mass in optimal fluctuating thermal conditions. Thus, we have not found any biasing effect of stable thermal conditions as compared to fluctuating temperatures on the breeding values of heritable body-size traits. Contrary to this we have observed a strong population-wide effect of thermal fluctuations, indicated by the significant temperature-fluctuations interaction in both adult and pupa mass.
RESUMEN
BACKGROUND: Recombinant hirudin, a pure, specific antithrombin could be more effective than heparin in the treatment of deep vein thrombosis, but its short half-life requires constant intravenous infusion, whereas subcutaneous administration of recombinant hirudin can ensure stable and prolonged plasma levels. The aim of our study was to assess the pharmacokinetics, the results on the coagulation variables, and the safety of a recombinant hirudin (HBW 023) administered subcutaneously in patients suffering from deep vein thrombosis. METHODS: Recombinant hirudin (HBW 023) was administered subcutaneously to 10 patients with recent deep vein thrombosis, at a dose of 0.75 mg/kg of body weight twice daily for 5 days, after which standard heparin and acenocoumarol were introduced. Bilateral lower limb venography, and pulmonary angiography, and/or ventilation-perfusion lung scan were carried out on day 1 prior to recombinant hirudin injection and repeated on day 5. aPTT and recombinant hirudin plasma levels were serially assessed after the 1st and the 10th injections. Prothrombin fragments 1 + 2, thrombin-antithrombin III complexes, fibrin degradation products were collected on days 1 and 5. RESULTS: Clinical evolution was uneventful in all but one patient who had a probable recurrence of pulmonary embolism on day 4. No hemorrhagic complication, no untoward biological event was observed. On days 5, Marder score was unchanged or had decreased. Plasma levels of recombinant hirudin peaked in between 3 and 4 h following the injection. aPTT values paralleled, and were significantly correlated with plasma levels of recombinant hirudin on day 1 as well on day 5 (r = 0.903, r = 0.948 respectively). Fragment 1 + 2, and thrombin antithrombin complexes non-significantly decreased from day 1 to day 5. CONCLUSIONS: Subcutaneous administration of recombinant hirudin ensures prolonged stable plasma levels of recombinant hirudin which results in efficient anticoagulation. A dose-ranging study conducted with subcutaneous recombinant hirudin in comparison to conventional heparin therapy may answer the question as to efficacy.
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Hirudinas/administración & dosificación , Tromboflebitis/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Pruebas de Coagulación Sanguínea , Femenino , Hirudinas/efectos adversos , Hirudinas/farmacocinética , Humanos , Inyecciones Subcutáneas , Masculino , Persona de Mediana Edad , Proyectos Piloto , Proteínas Recombinantes/administración & dosificación , Proteínas Recombinantes/efectos adversos , Proteínas Recombinantes/farmacocinética , Tromboflebitis/metabolismoRESUMEN
BACKGROUND: During the first year that the rhesus rotavirus tetravalent vaccine (RRV-TV) was licensed, the Vaccine Adverse Event Reporting System received several reports of intussusception after vaccination. To evaluate the risk of intussusception, we conducted a retrospective cohort study in ten managed care organizations. METHODS: Cases of intussusception were identified by searching electronic databases for diagnoses of intussusception (ICD-9 Code 560.0) in infants 1 to 11 months of age and confirmed by medical chart review. Vaccination and enrollment data were obtained from administrative databases. Incidence rate ratios (RR) of intussusception were computed by dividing incidence rates in prespecified risk intervals after vaccination by the background rate of intussusception and adjusted for age by Poisson regression. Cox proportional hazard regression was used to evaluate risk by vaccine dose. RESULTS: Of 463,277 children 56,253 had been vaccinated with a total of 91 371 doses of RRV-TV. The incidence rate of intussusception was 25/100,000 person years among unexposed infants and 340/100,000 person years 3 to 7 days postvaccination. In the interval 3 to 7 days after vaccination, the age-adjusted RR was 16.0 (95% confidence interval, 5.5 to 46.7) for all doses combined and 30.4 (95% confidence interval, 8.8 to 104.9) after the first dose. RRs for the 8- to 14- and 15- to 21-day risk intervals were >1.0, but the confidence intervals substantially overlapped 1.0. The attributable risk was one case of intussusception per 11 073 children vaccinated. CONCLUSIONS: RRV-TV is associated with an increased risk of intussusception. The risk is greatest 3 to 7 days after the first vaccination dose.
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Intususcepción/etiología , Vacunas contra Rotavirus/efectos adversos , Humanos , Lactante , Intususcepción/epidemiología , Distribución de Poisson , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Riesgo , Vacunación/efectos adversosRESUMEN
CONTEXT: A link between measles virus-containing vaccines and inflammatory bowel disease (IBD) has been suggested by recent studies. OBJECTIVE: To address whether receipt or timing of measles-containing vaccine (MCV) increases risk for IBD. DESIGN: A case-control study. SETTING: Four large health maintenance organizations (HMOs) that are part of the Centers for Disease Control and Prevention's Vaccine Safety Datalink project. PATIENTS OR OTHER PARTICIPANTS: A total of 155 persons with codes from International Classification of Diseases, Ninth Revision specific for IBD, born between 1958 and 1989 and enrolled from birth to the onset of disease, were identified. Up to 5 controls were matched by sex, HMO, and birth year. INTERVENTION: None. MAIN OUTCOME MEASURES: Risk for IBD, Crohn's disease, and ulcerative colitis. RESULTS: Past vaccination was not associated with an increased risk for Crohn's disease (odds ratio [OR] for measles-mumps-rubella vaccine [MMR], 0.4; 95% confidence interval [CI], 0.08-2.0), ulcerative colitis (OR, 0.8; 95% CI, 0.18-3.56), or IBD (OR, 0.59; 95% CI, 0.21-1.68). Risk for IBD was not increased among children vaccinated who were younger than 12 months (OR for MMR, 0.61; 95% CI, 0.15-2.45) or aged 12 to 18 months (OR, 0.86; 95% CI, 0.28-2.59) relative to unvaccinated children. Children vaccinated with MMR who were older than 18 months were at significantly decreased risk for IBD (OR, 0.16; 95% CI, 0.04-0.68). Neither past vaccination nor age at vaccination with other MCV was associated with increased risk for Crohn's disease, ulcerative colitis, or IBD. Risk for Crohn's disease, ulcerative colitis, or IBD was not elevated in the time immediately following vaccination with either vaccine. CONCLUSIONS: Vaccination with MMR or other MCV, or the timing of vaccination early in life, did not increase the risk for IBD.
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Enfermedades Inflamatorias del Intestino/inducido químicamente , Vacuna contra el Sarampión-Parotiditis-Rubéola/efectos adversos , Adolescente , Adulto , Estudios de Casos y Controles , Niño , Preescolar , Colitis Ulcerosa/inducido químicamente , Enfermedad de Crohn/inducido químicamente , Femenino , Humanos , Lactante , Modelos Logísticos , Masculino , Sistemas de Registros Médicos Computarizados , Factores de RiesgoRESUMEN
No vaccine is perfectly safe or effective. As diseases such as diphtheria and polio fade, vaccine safety concerns, especially alleged links between vaccinations and several chronic illnesses, have become increasingly prominent in the media and to the public. This article reviews the current scientific evidence on several recent vaccine safety controversies. It also provides information on how various safety research is conducted, some of the concurrent challenges, and finally, some guidance on communicating with patients on vaccine risks.
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Inmunización , Seguridad , Vacunas , Trastorno Autístico/etiología , Enfermedades Autoinmunes/etiología , Recolección de Datos , Síndrome de Guillain-Barré/etiología , Humanos , Intususcepción/etiología , Medición de Riesgo , Vacunas/administración & dosificación , Vacunas/efectos adversos , Vacunas CombinadasRESUMEN
We investigated the responses of invertebrates inhabiting polluted environments to multiple stressors. Carabid beetles (Pterostichus oblongopunctatus F.) were subjected to food deprivation and insecticide treatment (dimethoate) to resolve trends associated with a gradient of heavy metal pollution. Metal concentrations along the gradient of five sites ranged from approximately 150 to 10,500 mg/kg Zn, 136 to 2600 mg/kg Pb, and 0.84 to 81.9 mg/kg Cd. There was no difference in body mass along the pollution gradient. However, the beetles originating from the most contaminated sites were significantly less tolerant to food deprivation than beetles from the reference site. Median survival time was 120 h for the two most polluted sites, compared with 168 h at the reference site. Beetles from the two most polluted sites were also significantly more susceptible to dimethoate at 0.1 microgram active ingredient/beetle. Median survival times were 12 and 123 h for beetles from the two most polluted sites and 359 h for the reference site. Carabid beetles exposed to chronic pollution, therefore, exhibit elevated susceptibility to additional stressors.
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Escarabajos/fisiología , Metales Pesados/toxicidad , Contaminantes Químicos del Agua/toxicidad , Adaptación Fisiológica , Animales , Relación Dosis-Respuesta a Droga , Privación de Alimentos , Dosificación Letal Mediana , Mortalidad , Análisis de Supervivencia , Factores de TiempoRESUMEN
Recombinant hirudin (HBW 023) has a pure and specific antithrombotic activity. It could be more effective than heparin in the treatment of deep venous thrombosis. Its half life is about three hours when administered intravenously which requires continuous infusion whereas subcutaneous administration can ensure stable plasma concentrations and antithrombotic activity over a period of approximatively 12 hours. The aim of the study was to check the safety and clinical and radiographic efficacy of recombinant hirudin administered subcutaneously to patients with recent deep venous thrombosis and to analyse the pharmacokinetics of the product and its effects on tests of coagulation. Ten patients were treated with 0.75 mg/kg of subcutaneous recombinant hirudin twice a day for 5 days. Anticoagulation was performed with standard heparin and acenocoumarol. Bilateral phlebography, pulmonary angiography or ventilation and perfusion scintigraphy were carried out before and on the 5th day of recombinant hirudin treatment. The activated cephalin time and standard anticoagulant tests and the plasma kinetics of recombinant hirudin were assayed between the 1st and 12th hour on the first and fifth days of treatment. The clinical course was simple in all but one patient who had a recurrence of pulmonary embolism on the 4th day justifying thrombolytic treatment. No haemorrhagic complications or secondary biological effects were observed. On the 5th day, control phlebography was unchanged or improved in all patients. The peak plasma concentration of recombinant hirudin was observed between the 3rd and the 4th hour following subcutaneous injection. The activated cephalin time was increased in parallel with increased concentrations of recombinant hirudin.(ABSTRACT TRUNCATED AT 250 WORDS)
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Terapia con Hirudina , Proteínas Recombinantes/uso terapéutico , Trombosis/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Pruebas de Coagulación Sanguínea , Femenino , Semivida , Heparina/uso terapéutico , Hirudinas/farmacocinética , Humanos , Inyecciones Subcutáneas , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Flebografía , Pronóstico , Cintigrafía , Proteínas Recombinantes/farmacocinética , Resultado del TratamientoRESUMEN
The list of infections, threatening patients with impaired immunological system, especially infected with HIV, prolongs systematically. Since early eighties many authors pay attention to little known type of protozoan: Microspora. More and more often new microsporidia species are described as a cause of disease, especially in patients with AIDS. We present review of literature data concerning species known up to now as pathogenic for man: Encephalitozoon cuniculi, Encephalitozoon hellem, Nosema connori and Nosema corneum, Pleistophora sp., as well as enteropathogenic for AIDS-patients-Enterocytozoon bieneusi and Septata intestinalis.
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Seropositividad para VIH/complicaciones , Seropositividad para VIH/microbiología , Microsporida/aislamiento & purificación , Microsporidiosis/inmunología , Animales , HumanosRESUMEN
In years 1979-1991 has been analysed the selected health epidemiological indices is related with liver pathology and viral hepatitis B infections in rural population of Bialystok region. In 11,086 analysed persons of an agricultural sector the frequency of antigenemia HBs (0.25-2.5%) was higher that in control groups of urban populations (0.3-0.6%). In 12 years time period observation of chronic hepatopathy syndrome, demonstrated the increased tendency with parallel pathologic increased values of serum A1AT activity and with increased tendency of HBs antigenemia.
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Encefalopatía Hepática/epidemiología , Hepatitis B/epidemiología , Hepatitis Crónica/epidemiología , Salud Rural , Adolescente , Adulto , Factores de Edad , Anciano , Femenino , Encefalopatía Hepática/etiología , Hepatitis B/complicaciones , Hepatitis B/diagnóstico , Hepatitis Crónica/complicaciones , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Polonia/epidemiología , Factores Sexuales , SíndromeRESUMEN
The increasing problem is presented of Entamoeba histolytica invasion in patients with ulcerative colitis. The diagnostic-therapeutic management in five patients with amoebiasis is discussed in detail. This parasitic invasion occurred in five out of 103 patients with ulcerative colitis which accounts for 4.85%. This data is important for the treatment of chronically ill patients with ulcerative colitis.
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Colitis Ulcerosa/complicaciones , Disentería Amebiana/etiología , Adulto , Animales , Enfermedad Crónica , Disentería Amebiana/diagnóstico , Disentería Amebiana/terapia , Entamoeba histolytica/aislamiento & purificación , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The role of the European Centre for Disease Prevention and Control (ECDC) is to strengthen the capacity of the European Union (EU) Member States to protect human health through the prevention and control of infectious diseases. The main objective of the programme on vaccine-preventable diseases and invasive bacterial infections (VPD) is to provide robust evidence and high-quality technical support to the EU Member States to help them in their efforts to prevent and control VPD. Since the establishment of ECDC, several existing VPD surveillance networks have been transferred to ECDC, namely EU-IBIS, DIPNET and EUVAC. In addition to surveillance of diseases, ECDC is collecting information and monitoring other parameters that are of crucial importance for a well-functioning immunization system, including vaccination coverage. The VPD programme also provides independent scientific opinions in the area of immunization and initiates and coordinates scientific studies in the area of vaccination to answer specific questions of public health importance, including risk perception and analysis of behaviour in different population groups. One of the overall ECDC priorities over recent years is the Centre's involvement in measles elimination. The 'Message' tool and the 'Measles Atlas' are examples of work aiming at supporting the efforts of Member States in the elimination phase.