Memory immune response generated in Cercopithecus aethiops against meningococcal polysaccharide serogroup C conjugate vaccine.

The chemical conjugation of bacterial polysaccharide to carrier proteins has proved to be an efficient tool to improve the immunological response against these bacterial antigens. In this study, we characterized the antibody response generated in a non-human primate model against the meningococcal capsular polysaccharide serogroup C (CCPS) conjugated to the P64k protein. Similar to licensed vaccines the CCPS conjugate is able to generate a good memory immune response with antibody titers threefold higher than the free CCPS. Three different ELISA protocols were used to measure the antibody response and the importance of the coating antigen was demonstrated. The ELISA using the derivatized CCPS showed the best results and had a high correlation with the bactericidal activity. The antibodies elicited showed a high protective capacity when assayed in the infant rat protection model.

Multicentre study of fetal cardiac time intervals using magnetocardiography.

OBJECTIVE: A database with reference values of the durations of the various waveforms in a magnetocardiogram of fetuses in uncomplicated pregnancies is assessed. This database will be of help to discriminate between pathologic and healthy fetuses. A fetal magnetocardiogram is a recording of the magnetic field in a location near the maternal abdomen and reflects the electric activity within the fetal heart. It is a non-invasive method, which can be used with nearly 100% reliability from the 20th week of gestation onward. DESIGN: Durations of the waveforms were assembled from averaged magnetocardiograms and statistically processed. SETTING: Fetal magnetocardiograms were measured with different magnetocardiographs. All measurements were carried out in magnetically shielded rooms. SAMPLE: Fetal magnetocardiograms were obtained for 582 healthy patients. METHOD: The durations of the waveforms were extracted from fetal magnetocardiograms measured at the cooperating centres. The variables collected included the duration of the P-wave, the PR interval, the PQ interval, the QRS complex, the QT interval and the T-wave and QTc value. The results were compared with values extracted from electrocardiograms of fetuses measured via electrodes attached to the maternal abdomen, from electrocardiograms measured during labour using a scalp electrode, and from electrocardiograms recorded in newborns, that were found in the literature. MAIN OUTCOME MEASURES: Values of the durations are given as a function of gestational age including the regression line as well as the bounds marking the 90%, 95% and 98% prediction interval. RESULTS: The durations of the P-wave, the PR interval, the QRS complex, the QT interval and QTc value increase linearly with gestational age. The durations of the PQ interval and the T-wave are independent of fetal age. CONCLUSION: The values found agree with those found in the literature. The scatter of the data is wide due to the variation in normal physiology, the measuring system and signal processing and the subjectivity of the researcher. However, the system can define normal ranges and may be used in diagnosis.

Immunisation with phage-displayed variable region 2 from meningococcal PorA outer membrane protein induces bactericidal antibodies against Neisseria meningitidis.

The immunogenicity and functional activity of antibodies raised in mice against the cyclic disulphide peptide corresponding to the variable region 2 of PorA outer membrane protein from Neisseria meningitidis strain B385 (serosubtype P1.15), displayed on filamentous phage, were evaluated. The epitope, flanked either by cysteine or cysteine and three glycine residues, was expressed as a fusion to PVIII protein from M13. Immunisation of Balb/C mice with either phage generated antibody specific responses. Sera raised against the phage exposing the cyclic peptide through the three-glycine linker recognised the native protein better than those raised against the peptide with no linker. Only the phage displaying the cyclic peptide with linker was capable of inducing antibodies with bactericidal activity. These results indicate the possibility of using phage display for conformational peptide expression for immunisation to elicit functional antibody responses.

Fetal sinus bradycardia and the long QT syndrome.

OBJECTIVE: Recent evidence in literature shows that the long QT syndrome accounts for a fraction of the sudden infant death syndrome. Newborn infants with prolongation of the Q-T interval often show sinus bradycardia, which led us to test whether children who were diagnosed with long QT syndrome also show sinus bradycardia in the cardiotocogram before birth. STUDY DESIGN: We identified 18 children who were born from singleton pregnancies at or near term in whom long QT syndrome (corrected QT interval, >0.440 second) was diagnosed after birth or in childhood. Cardiograms during pregnancy and delivery were available from 17 of the 18 children. RESULTS: The cardiotocogram showed persistent fetal sinus bradycardia (baseline heart rate permanently below 120 beats/min) in 12 of 17 fetuses (71%) with long QT syndrome. Two fetuses had additional intermittent tachyarrhythmias. CONCLUSION: Sinus bradycardia in the cardiotocogram during delivery or in pregnancy may indicate long QT syndrome in the fetus. Postnatal electrocardiography should be performed in these children to rule out or confirm a prolongation of the Q-T interval.

Recombinant Opc protein from Neisseria meningitidis reconstituted into liposomes elicits opsonic antibodies following immunization.

The reconstitution of recombinant bacterial outer membrane proteins (OMPs) into their native conformations after purification has been the major problem in their use as effective vaccines. Liposomes have been shown to be an attractive approach, providing a native-like environment for these antigens. The meningococcal recombinant Opc (rOpc) protein, produced as inclusion bodies in Escherichia coli, was incorporated into phospholipid vesicles consisting of dipalmitoyl phosphatidylcholine and cholesterol. The incorporation of rOpc into the lipid bilayer was demonstrated, and the reconstitution of some native epitopes was tested using a set of monoclonal antibodies. Subcutaneous immunization of Balb/c mice with rOpc-containing vesicles resulted in the generation of a high level of specific antibodies. The elicited antibodies reacted with the native meningococcal protein and showed opsonic activity.

Prenatal diagnosis of QT prolongation by magnetocardiography.

Magnetocardiography constitutes a new tool for monitoring fetal cardiac activity. The fetal magnetocardiogram (FMCG) recorded noninvasively over the maternal abdomen is detectable with high temporal resolution and permits analysis of all parts of the PQRST waveform. In this way measurements of cardiac time intervals, including the QT interval, become possible. The following article constitutes the first report of antenatal detection of QT prolongation in two fetuses by FMCG.

Characterisation of the lpdA gene from Neisseria meningitidis by polymerase chain reaction, restriction fragment length polymorphism and sequencing.

P64k protein from Neisseria meningitidis is well recognised in sera from individuals convalescent from meningococcal disease or vaccinated with the Cuban antimeningococcal vaccine VA-MENGOC-BC. The presence of the protein in more than 80 meningococcal strains has also been verified. It is immunogenic in animal models and the antibodies elicited show bactericidal activity against meningococci. To further investigate at the molecular level whether lpdA, the gene coding for P64k protein, is conserved among different N. meningitidis strains, a total of 20 strains isolated from different geographic areas were differentiated on the basis of restriction fragment length polymorphism (RFLP) patterns after polymerase chain reaction (PCR) amplification of the lpdA gene and restriction endonuclease digestion with HpaII. Although a total of five different PCR-RFLP patterns were present, nucleotide sequence determination showed that identity levels were as high as 93-99% among the N. meningitidis strains analysed.

Antigenic and genetic characterization of a putative hybrid transferrin-binding protein B from Neisseria meningitidis.

The transferrin-binding protein Bs (TbpBs) from the bacterium Neisseria meningitidis have been divided into two families according to genetic and antigenic features. TbpB from meningococcal strain B385 showed a molecular mass similar to that exhibited by TbpBs belonging to the high molecular mass family of TbpBs. TbpB was recognized by immunoassay using a specific serum directed against the TbpB of the reference strain for this family (strain M982). It was also recognized by a serum elicited against the TbpB of the reference strain for the low molecular mass family (strain B16B6). The tbpB gene from strain B385 was cloned and sequenced. The highest degree of sequence homology was found to be with the TbpBs belonging to the high molecular mass family, although a region of 14 amino acids that is only present in the TbpB from strain B16B6 was also found. This report illustrates a TbpB that shows hybrid antigenic and genetic behaviour.

[Prenatal recording of fetal heart action with magnetocardiography]. / Pränatale Registrierung fetaler Herzaktionen mit Magnetokardiographie.

Fetal magnetocardiography (fMCG) registers the magnetic field generated by the fetal heart. In contrast to the fetal electrocardiogram, fECG permits non-invasive registration of fetal heart activity and documentation of all parts of the PQRST-wave-forms from the second trimenon onwards. This facilitates the determination of cardiac time intervals and establishment of reference values for different stages of pregnancy. We examined 53 women in 104 recordings from the 10th week of gestation onwards (1 to 10 recordings per individual). The fMCG (37 magnetic channels, sampling rate 1024 Hz, bandwidth 1-200 Hz) was recorded non-invasively over the mother's abdomen in a magnetically shielded room. Registration of fetal heart beats was generally successful from the 20/21th week of gestation onwards. In a few cases, fetal heart beats could be registered as early as in the 16th week. Cardiac time intervals and amplitudes of fMCG increased concordantly with fetal growth. Mean P wave duration increased from 31 to 49 ms (p < 0.05), PQ interval from 95 to 107 ms (n.s.) and QRS duration from 36 to 52 ms (p < 0.01). The mean amplitudes of the P and R waves also increased. FMCG, furthermore permits a prenatal diagnosis of fetal cardiac arrhythmias. We recorded fetal arrhythmias in 20 cases (26-38th week), including episodes of ventricular and supraventricular arrhythmias or atrioventricular blockings. Due to its high resolution, fMCG offers new information on the development of fetal cardiac activity which cannot be achieved by conventional methods like cardiotocography or dopplerultrasound. Therefore, fMCG could become a new diagnostic instrument for monitoring fetal wellbeing during pregnancy.

[Review of 408 cases of prostatism syndrome. Have the new classifications improved its practical management?]. / Revisión de 408 casos de síndrome de prostatismo. Han mejorado las nuevas clasificaciones su manejo práctico?

To the variety of symptoms known as prostatism, ultrasound, flowmetry, PSA and other complementary testing has been added over the last few years in an attempt to define it better. Also, several score tables such IPSS have been used to grade more objectively each symptom. It remains to be seen, however, whether all this is really useful to define a specific treatment in the clinical practice. To this end, we intend to analyze our own series taking advantage of a table of symptoms routinely used for years, together with the patient's own perception of his quality of life, checking which factors have more influence on the latter. We believe that the use of different overall scores in the usual practice is not effective, although they could be added to the patient's evaluation since they seem a good tool to establish comparisons between different communities.

Infarto cardíaco. Factores que influyen en su pronóstico a largo plazo / Cardiac infarction. Factors influencing on its long term prognosis

Se realiza un seguimiento por 3 años o hasta su fallecimiento a 227 pacientes supervivientes de un ataque agudo de infarto del miocardio (IM) que fueron atendidos en el ICCCV durante los años 1972 y 1973. La mortalidad del grupo total fue de 21,2 porciento, siendo mucho mayor en el primer año que siguió al cuadro agudo. El riesgo de morir fue mayor en el primer año y fue disminuyendo en los subsiguientes. No se encontró que influyeran significativamente en el pronóstico: el sexo índice de Pool al ingreso localización del infarto y la presión arterial elevada al ingreso. Como factores influyentes se señalan: la edad, tamaño cardíaco, cifra de TGO, complicaciones y antecedentes patológicos personales. Por último, se señala el grado de recuperación física de estos pacientes al final del período estudiado(AU)

Factores de riesgo coronario. Estudio de una población industrial / Coronary risk factors. A study in an industrial population

Se presenta un estudio transversal de prevalencia de factores de riesgo coronario, en 1 757 obreros de cuatro centros industriales de la Ciudad de Holguín. Se analiza en su conjunto el sexo, la edad, el hábito de fumar, la presencia de hipertensión arterial, la diabetes mellitus, la obesidad, el tipo de trabajo que realizan y su implicación en la aparición de las cardiopatías isquémicas, así como la forma de influir sobre las mismas y modificarlas, con el objetivo final de disminuir la incidencia futura de esta entidad. Los hallazgos obtenidos son presentados en cuadros preparados al efecto(AU)

Datos preliminares de un estudio sobre prevalencia de hipertensión arterial en una población obrera de la ciudad de Holguín / Preliminary results of a study on arterial hypertension prevalence among workers of the Holguin city

Se presentan los datos preliminares de un estudio transversal sobre prevalencia de hipertensión arterial en 1 757 obreros de cuatro centros laborales de la ciudad de Holguín, región norte de Oriente, con edades que fluctúan entre los 17 y los 69 años. Se diagnostica hipertensión arterial a 120 trabajadores, según los actuales criterios establecidos por la OMS, acorde con la edad. Se estudia, además, la influencia que sobre esta enfermedad puedan tener el hábito de fumar, el grado de obesidad, el sexo, los antecedentes familiares y el tipo de actividad laboral que realizan. Se finaliza con algunas consideraciones generales sobre la prevalencia de hipertensión arterial encotradas en la población estudiada(AU)

Remoción de un catéter-electrodo adherido al endocardio ventricular derecho por el método de tracción contínua / Removal of a catheter-electrode attached to the right ventricular endocardium by the continuous traction method

Se presenta un caso en el que se extrajo catéter-electrodo adherido al V.D. en una paciente con alto riesgo quirúrgico. La indicación se debió a una complicación séptica originada por la ulceración de la piel con exteriorización del catéter en la fosa supraclavicular derecha, muy cerca de la penetración del mismo en la vena. El método utilizado fue el de la tracción continua según han descrito Bilgutay y colaboradores (AU)