Measles Virus Neutralizing Antibodies in Intravenous Immunoglobulins: Is an Increase by Revaccination of Plasma Donors Possible?

We report a screen of plasma donors confirming that widespread use of childhood measles vaccination since 1963 resulted in a decrease in average measles virus antibody titers among plasma donors, which is reflected in intravenous immunoglobulins (IVIGs). The measles virus antibody titer, however, is a potency requirement for IVIGs, as defined in a Food and Drug Administration regulation. To mitigate the decline in measles virus antibody titers in IVIGs and to ensure consistent product release, revaccination of plasma donors was investigated as a means to boost titers. However, revaccination-induced titer increases were only about 2-fold and short-lived.

Anti-A and anti-B titers in donor plasma, plasma pools, and immunoglobulin final products.

BACKGROUND: High-dose intravenous immunoglobulin (IVIG) treatments are implicated in hemolytic events in some patients receiving treatment. The passive transfer of IgG anti-A and anti-B agglutinin is thought to play a role in the development of these events. The purpose of this study was to determine the prevalence of high-titer IgG anti-A and anti-B in plasma donors and investigate if there is any advantage of excluding these donors from the donor pool to limit anti-A and anti-B content in IVIG product. STUDY DESIGN AND METHODS: IgG anti-A and anti-B levels were assessed from group O donor plasma, manufacturing IgG plasma pools, and finished IVIG product (Gammagard Liquid). Antibody level in group O donors was also assessed by sex and age for their relative contribution of antibody to the plasma pool. RESULTS: The majority of group O donors (80%) had antibody titers of less than 1000. Of those with titers of at least 1000, theoretical estimates provide further evidence that the effects of high-titer donors are minimal. Antibody levels in plasma pools both during the manufacturing process and from the final IVIG product also support that anti-A and anti-B levels are low. In general, there were more females than males with higher antibody titer levels, with significantly more females than males with anti-A. CONCLUSION: Excluding donors with high anti-A and anti-B titers has minimal impact on the finished IVIG product titers due to ABO antibody neutralization and the dilution factor in the manufacturing pool.

Prefrontal cortical thickness and clinical characteristics of long-term treatment response to valproate in bipolar disorder.

Valproate compositions are frequently used to treat bipolar disorder (BD); however, 87% of patients do not report full response in the long-term. There is scarce information about the clinical features and brain structural characteristics of long-term treatment response (LTTR) to this medication. In this study, we aim to evaluate the clinical characteristics and prefrontal cortical thickness (CT) of LTTR to valproate in BD. We evaluated 30 BD outpatients on valproate treatment, and 20 controls with a 3T T1-weighted 3D brain scan and Alda's scale for LTTR. An analysis of covariance was used to evaluate CT measures and a logistic regression was conducted to predict the full response (FR) using clinical features and CT measures. Patients with an insufficient response (IR) reported thinner right frontal eye fields, anterior and dorsolateral prefrontal cortexes compared with controls. FR patients presented thicker right dorsolateral prefrontal cortex than IR and no differences with controls. Patients with mixed features presented increased odds of achieving FR, while CT measures reported non-significant results. This is the first study to report mixed features as a clinical predictor of valproate LTTR. Our findings also suggest better preservation of the right prefrontal cortex of subjects with FR to valproate.

Intoxicación por plomo de origen ocupacional en la rehabilitación de viviendas antiguas / Occupational lead poisoning in rehabilitation of old houses

Presentamos dos casos de intoxicación por plomo o saturnismo de origen ocupacional en trabajadores de la construcción, en los que la fuente de exposición probablemente fue la inhalación de polvo procedente de pintura tratada con plomo, durante la restauración de una vivienda antigua. Ambos presentaron cuadros clínicos similares con dolor abdominal; en uno de ellos se observaron además anemia normocítica e hipertensión. Ambos fueron tratados con EDTA cálcico disódico, con buena evolución clínica. Nuestros casos nos recuerdan que es preciso mantener un alto índice de sospecha para la intoxicación por plomo en el contexto clínico adecuado y subrayan la importancia de unas adecuadas medidas de prevención en entornos de trabajo potencialmente contaminados. (AU)

We present two cases of lead poisoning or saturnism in construction workers, which the source of exposure was probably the inhalation of dust coming from lead-treated paint during the refurbishing of an old house. Both patients had similar clinical symptoms such as abdominal pain; in one of them normocytic anaemia and hypertension were also observed. Both were treated with calcium disodium EDTA, with good clinical evolution. Our cases remark the importance of maintaining a high index of suspicion for lead poisoning in the appropriate clinical context and underline the importance of adequate preventive measures in potentially contaminated work environments. (AU)

[Puppet shows, Mexican television and health education in the mid-twentieth century]. / El teatro guiñol, la televisión mexicana y la educación para la salud a mediados del siglo XX.

This article resurrects the puppet show Las calenturas de Don Ferruco (Don Ferruco's Fevers), which was televised in the late 1950s in order to help eradicate malaria in Mexico, as a useful instrument for health education. It analyzes how the spread of educational puppet shows on Mexican television showed the need to keep updating preventive healthcare pedagogy and it underlines the importance of television as an educational health-promotion production in the mid-twentieth century. The article discusses the early use of puppet shows as an especially important tool for what would later become mass-media transmission of discourses from the Secretaría de Salubridad y Asistencia (Department of Health and Healthcare).

[Epidemiological characteristics of new HIV infections compared with AIDS cases. The HIV/AIDS epidemic in the Basque Country]. / Características epidemiológicas de las nuevas infecciones causadas por el VIH comparadas con los casos de sida. La epidemia de VIH/sida en el País Vasco.

OBJECTIVE: To describe the epidemiological characteristics of new cases of HIV infection diagnosed from 1997-2001 and compare them with AIDS cases (1991-2001). METHODS: Data were retrospectively collected on new cases of HIV infection detected in the Basque Country (1997-2001) and were compared with AIDS cases (1991-2001). RESULTS: A total of 912 new cases of HIV infection were diagnosed. In 299 of the new cases (32.8%), HIV and AIDS were diagnosed simultaneously. The most common mechanism of transmission was heterosexual transmission, followed by intravenous and homo/bisexual transmission. Significant epidemiological differences (p < 0.001) were found with regard to AIDS cases. CONCLUSIONS: Sexual transmission has replaced intravenous drug use as the most common mechanism of HIV transmission. A large percentage of patients were simultaneously diagnosed with HIV and AIDS, indicating the need for new prevention strategies.

El teatro guiñol, la televisión mexicana y la educación para la salud a mediados del siglo XX / Puppet shows, Mexican television and health education in the mid-twentieth century

Resumen Este artículo rescata la obra de teatro guiñol Las calenturas de Don Ferruco, televisada a finales de la década de 1950 para promover la erradicación del paludismo en México como un útil instrumento de educación para la salud. Se analiza cómo la difusión del teatro guiñol educativo en la televisión mexicana evidenció la necesidad de mantener vigente la enseñanza dirigida a prevenir enfermedades y se subraya la importancia de la televisión como una producción educativa para promover la salud hacia mediados del siglo XX. El artículo muestra los inicios de su uso como una herramienta de especial importancia para lo que posteriormente sería la masificación de los discursos emitidos por la Secretaría de Salubridad y Asistencia.

This article resurrects the puppet show Las calenturas de Don Ferruco (Don Ferruco’s Fevers), which was televised in the late 1950s in order to help eradicate malaria in Mexico, as a useful instrument for health education. It analyzes how the spread of educational puppet shows on Mexican television showed the need to keep updating preventive healthcare pedagogy and it underlines the importance of television as an educational health-promotion production in the mid-twentieth century. The article discusses the early use of puppet shows as an especially important tool for what would later become mass-media transmission of discourses from the Secretaría de Salubridad y Asistencia (Department of Health and Healthcare).

El teatro guiñol, la televisión mexicana y la educación para la salud a mediados del siglo XX / Puppet shows, Mexican television and health education in the mid-twentieth century

Este artículo rescata la obra de teatro guiñol Las calenturas de Don Ferruco, televisada a finales de la década de 1950 para promover la erradicación del paludismo en México como un útil instrumento de educación para la salud. Se analiza cómo la difusión del teatro guiñol educativo en la televisión mexicana evidenció la necesidad de mantener vigente la enseñanza dirigida a prevenir enfermedades y se subraya la importancia de la televisión como una producción educativa para promover la salud hacia mediados del siglo XX. El artículo muestra los inicios de su uso como una herramienta de especial importancia para lo que posteriormente sería la masificación de los discursos emitidos por la Secretaría de Salubridad y Asistencia.(AU)

Hemispheric asymmetries of functional connectivity and grey matter volume in the default mode network.

Resting state networks such as the default mode network have been widely reported. Although a plethora of information on its functional relevance has been generated, little is known about lateralization or hemisphere asymmetry within the DMN. We used high-resolution resting state fMRI and T1 3D data to investigate such asymmetries in two groups of healthy subjects, one right-handed and one left-handed. Independent component analysis and the dual regression approach were carried out to identify functional asymmetries, while voxel-based morphometry was used to identify structural asymmetries in grey matter volume within the DMN. Greater leftward functional connectivity was observed in the posterior cingulate gyrus (PCG) for both groups. Leftward functional asymmetry was observed in the thalamus and rightward functional asymmetries were observed in the middle frontal and middle/superior temporal gyrus in the right-handed group. Rightward asymmetries in grey matter volume were observed in the posterior portion of the PCG for both groups. The right-handed group exhibited leftward structural asymmetries in the anterior portion of the PCG and in the middle frontal and posterior portion of the middle temporal gyrus, while rightward asymmetries were observed in the posterior portion of the PCG and anterior portions of temporal regions. These results suggest that functional connectivity and grey matter volume are not equally distributed between hemispheres within the DMN, and that functional asymmetries are not always reflected or determined by structural asymmetries.