Preventative Care in the Patient with Inflammatory Bowel Disease: What Is New?

Patients with inflammatory bowel disease (IBD) do not receive routine preventative care at the same rate as general medical patients. This patient population is at increased risk of vaccine preventable illness such as influenza and pneumococcal pneumonia. This review will discuss health maintenance needs and preventative care issues in patients with IBD.

Physiological parameters of Macaca fascicularis immunized with anti-rubella vaccine with germanium-based adjuvants.

Clinical status, hematological and biochemical parameters, and allergenic activity of organogermanium compounds used as adjuvants in complex with preparation from Orlov rubella virus vaccine strain and reference commercial anti-rubella vaccine based on Wistar RA 27/3 strain were studied on Macaca fascilcularis of both genders. Physiological parameters of monkeys immunized with the Russian and foreign rubella virus vaccine strains with and without adjuvants did not differ. The adjuvants were inessential for the safety of vaccines (absence of toxicity, reactogenic activity, or allergenic activity) in preclinical studies on lower primates.

[Clinical and experimental study on effects of huanglan granule in inhibiting rubella virus].

OBJECTIVE: To explore the therapeutic effect and acting mechanism of Huanglan Granule (HLG) on rubella virus (RuV). METHODS: Sixty patients with positive RuV-IgM were randomly assigned to two groups equally, the treatment group was medicated by HLG (one dosage per day, containing milkvetch root, isatis root and basket fern, each 30 g), while the control group by ribavirin (0.2 g, three times per day) for 20 days. The negative conversion rate of RuV-IgM and the serum levels of interleukin-2 (IL-2) and tumor necrosis factor alpha (TNF-alpha) were observed before and after treatment. Moreover, the in vitro inhibitory activity of HLG against RuV Gos line on cultured Vero cells was determined by cytopathic inhibition method. RESULTS: The difference of negative conversion rate between the two groups after one course treatment was significant (86.7% vs 63.3%, P <0.05). However, it turned to insignificant after two courses of treatment (100% vs 86.7%, P >0.05). The serum level of IL-2 was lower and TNF-alpha was higher significantly in patients with positive RuV-IgM as compared with the normal range, and the two indexes returned to the normal range rapidly after HLG treatment. In vitro study showed that the inhibitory effect of HLG on RuV caused cellular change was evident. CONCLUSION: HLG has obvious inhibitory effect on RuV, both in vitro and in vivo, it can also raise the immunity of organism and thus it serves as a safe and effective Chinese medicine for treatment of active RuV infection.

Evaluation of the national immunisation programme in the Netherlands: immunity to diphtheria, tetanus, poliomyelitis, measles, mumps, rubella and Haemophilus influenzae type b.

The immunity to vaccine-preventable diseases included in the Dutch immunisation programme in the general population and among orthodox reformed individuals who refuse vaccination was assessed. The programme induces good protection. However, a large proportion of adults lacks diphtheria and tetanus immunity. Measles, mumps and rubella seroprevalence was somewhat lower among vaccinated compared to unvaccinated cohorts. The prevalence of HibPS antibodies declined during 2.5 years after the fourth vaccination. However, protection occurs also by memory immunity. Herd immunity is sufficient among the general population, but not among orthodox reformed individuals. Immunosurveillance is an efficient way to evaluate the effects of immunisation programmes and identify risk groups for infection.

Prevalence of rubella antibodies among schoolgirls in Sana'a, Republic of Yemen.

To determine the prevalence of rubella antibodies and age of exposure to rubella among Yemeni schoolgirls, we studied the sera samples of 323 female students (age range 11-21 years; mean age 16.26 +/- 1.89 years) drawn from three schools in Sana'a. All samples were screened for rubella IgG antibodies using enzyme linked immunosorbent assay and, if negative, for IgM in order to exclude the possibility of recent exposure. Of 323 sera, 296 (91.64%) were positive for rubella IgG. All IgG negative sera were also IgM negative. Comparable antibody prevalence was observed in all age groups. The prevalence of rubella IgG among Yemeni schoolgirls is high, with most becoming immune between the ages of 11 and 21 years. Although the age of exposure seems to be < or = 13 years, further investigation is needed to confirm this.

Psychological variables as predictors of rubella antibody titers and fatigue--a prospective, double blind study.

When exposed to infectious pathogens, human beings manifest variability in the incidence and severity of infection. This variability may partly depend on psychological variables, which have long been thought to contribute to the predisposition, onset, and course of various physical illnesses, including infectious diseases. The objective of the study was to investigate the predictive value of several personality and other psychological variables on antibody titers and fatigue following a specific viral infection. Subjects were divided into a seronegative group (not immune prior to vaccination) (N = 60) and a seropositive group (immune prior to vaccination) (N = 180), based on antibody titers to rubella before and 10.5 weeks after vaccination with live-attenuated rubella virus. Questionnaires assessing externalizing, internalizing, self-esteem, neuroticism, and fatigue-related symptoms were administered to the subjects before vaccination. Fatigue-related symptoms were re-evaluated 10 weeks post vaccination. In the seronegative group, low titers of rubella antibodies, 10.5 post-vaccination, were predicted by high internalizing or neuroticism scores, and by low self-esteem, measured at baseline. Higher externalizing scores indirectly predicted lower titers of antibodies, via fatigue-related symptoms, measured 10 weeks post vaccination. In contrast, in the seropositive group no association was found between any of the psychological variables and antibody titers. Personality and other psychological variables can predict antibody titers to rubella vaccination, in infected individuals. The associations between the psychological variables and antibody titers are complex, and involve both direct and indirect associations. Specific psychological variables can also be used to predict levels of post-vaccination fatigue.

Influence of socioeconomic status on behavioral, emotional and cognitive effects of rubella vaccination: a prospective, double blind study.

A double-blind prospective design was used to investigate the immediate and prolonged psychological effects of a specific viral infection, and the role of immune activation in mediating these effects. Subjects were 240 female teenager girls who were vaccinated with rubella vaccine. Based on analysis of levels of antibodies to rubella, subjects were divided into two groups. An experimental group (n = 60), which included subjects who were initially seronegative and were infected following vaccination, and a control group (n = 180), which included subjects who were already immune to rubella before vaccination. Compared with the control group and to their own baseline, low socioeconomic status (SES) subjects within the experimental group showed a significant increase in the severity of depressed mood, social and attention problems, and delinquent behavior. Ten weeks post-vaccination there were no differences between the experimental and control groups in serum levels of interleukin-1 beta, interferon-gamma, soluble interleukin-2 receptors (sIL-2r), and cortisol. However, a significant negative correlation was found between fatigue-related symptoms and sIL-2r levels in the experimental (r = -0.325), but not the control group (r = -0.046). These findings suggest that viral infection can produce prolonged behavioral, emotional and cognitive problems mainly in subjects belonging to the low SES.

A suscetibilidade à rubéola das gestantes - Bauru, 1987 / The susceptibility to pregnant woman rubella - Bauru, 1987

A vacinação contra a rubéola tem como objetivo único, a proteção de futuras gerações de crianças em desenvolver a rubéola congênita. As experiências de mais de duas décadas no uso da vacina nos programas de controle da Síndrome da Rubéola Congênita (SRC) mostraram que a epidemiologia da rubéola, assim como a operacionalização das metas propostas para a cobertura vacinal são bastante complexas. O óbito de crianças malformadas detectadas em alguns meses do ano de 1986 chamou a atenção dos epidemiologistas do Município de Bauru para uma possível associação com a epidemia de rubéola ocorrida na cidade em 1985. Conhecer a proporção de suscetibilidade à rubéola entre gestantes é uma das maneiras para se estimar o risco de ocorrências de SRC. Em 1987, 689 gestantes no Município de Bauru foram entrevistadas e submetidas a teste de inibição de hemaglutinação para determinação de suscetibilidade à rubéola. Destas gestantes, 66 (9,7 por cento) foram consideradas suscetíveis à rubéola. Este resíduo de suscetibilidade dificilmente seria eliminado naturalmente, como mostram as diferentes experiências nos países que iniciaram um programa de controle da SRC. Seria necessária uma alta cobertura vacinal (cerca de 95 por cento) de todas as coortes de crianças e adolescentes para se conseguir a quebra na cadeia do processo infeccioso e a proteção de todas as mulheres em idade fértil. Uma intervenção desta natureza não poderia ser implementada sem o respaldo de um sistema de vigilância epidemiológica fortalecido e atuante. Considerando as características de polimorfismo da SRC e as dificuldades em se medir a magnitude da infecção congênita, a avaliação de um programa que envolve pelo menos duas gerações de indivíduos é um grande desafio para os administradores de saúde (AU)