Factores pronósticos del resultado del tratamiento rehabilitador en la incontinencia urinaria femenina / Prognostic factors and treatment outcomes for female urinary incontinence rehabilitation

Introducción La incontinencia urinaria es la pérdida involuntaria de orina. Presenta una alta prevalencia en el sexo femenino y un gran impacto biopsicosocial. Son numerosos los factores de riesgo asociados con esta entidad. El tratamiento rehabilitador se establece como de primera línea, aunque su uso no ha sido protocolizado. Objetivo Identificar qué factores de riesgo personales y tipo de tratamiento aplicado se encuentran relacionados estadísticamente con la mejoría de las pacientes. Material y método Estudio de cohortes retrospectivas de las pacientes de sexo femenino diagnosticadas de incontinencia urinaria y que acudieron a la consulta de Rehabilitación de Suelo Pélvico del Hospital Universitario Río Hortega de Valladolid, recibiendo tratamiento rehabilitador a lo largo del año 2021. El periodo de seguimiento mínimo fue de 12 semanas, evaluando la mejoría o no según 7 variables objetivas y subjetivas, estableciendo la mejoría como la evolución positiva en al menos 5 de las 7. Resultados Se analizaron 114 mujeres con incontinencia urinaria. Los tipos de incontinencia más frecuentes fueron: de esfuerzo (53%) y mixta (36%). Los factores de riesgo y enfermedad asociada más importantes fueron la episiotomía (68%), infecciones de orina de repetición (61%) y el estreñimiento (40,9%). Ninguno de estos factores demostró una relación estadísticamente significativa con la mejoría de las pacientes con una p>0,05. El tratamiento rehabilitador más empleado fue cinesiterapia+biofeedback (51%), que demostró una relación estadísticamente significativa con la mejoría de estas pacientes (p=0,037), junto con biofeedback+electroestimulación del nervio tibial posterior (p=0,044). Conclusión Los resultados están en consonancia con los de otros estudios publicados. El biofeedback junto con la cinesiterapia o la electroestimulación del nervio tibial posterior se establecen como los procedimientos rehabilitadores más efectivos (AU)

Background Urinary incontinence is the involuntary loss of urine. It is highly prevalent in women and has a great biopsychosocial impact. Numerous risk factors are associated with this entity. Rehabilitative treatment is established as the first line, although its use has not been protocolized. Aim To identify which personal risk factors and type of treatment applied are statistically related to patient improvement. Methods Retrospective cohort study of female patients diagnosed with urinary incontinence who attended the Pelvic Floor Rehabilitation Clinic of the Río Hortega University Hospital of Valladolid, receiving rehabilitation treatment during the year 2021. The minimum follow-up period was 12 weeks, evaluating improvement or not according to 7 objective and subjective variables, establishing improvement as positive evolution in at least 5 of the 7. Results A total of 114 women with urinary incontinence were analyzed. The most frequent types of incontinence were stress (53%) and mixed (36%). The most important risk factors and associated pathology were episiotomy (68%), repeated urinary tract infections (61%), and constipation (40.9%). None of these factors showed a statistically significant relationship with patient improvement with a p>0.05. The most used rehabilitative treatment was kinesitherapy+biofeedback (51%), which showed a statistically significant relationship with the improvement of these patients (p=0.037), together with biofeedback+posterior tibial nerve electrostimulation (p=0.044). Conclusion The results are in line with other published studies. Biofeedback together with kinesitherapy or posterior tibial nerve electrostimulation are established as the most effective rehabilitative procedures (AU)

Prognostic factors and treatment outcomes for female urinary incontinence rehabilitation.

INTRODUCTION: Urinary incontinence (UI) is the involuntary loss of urine. It is highly prevalent in women and has a great biopsychosocial impact. Rehabilitation is established as the first-line treatment, although its use has not been protocolized. OBJECTIVE: To identify which personal risk factors and type of treatment applied are statistically related to patient improvement. STUDY DESIGN: Retrospective cohort study. METHODS: Retrospective cohort study of female patients diagnosed with urinary incontinence who attended the Pelvic Floor Rehabilitation Clinic of the Río Hortega University Hospital, receiving rehabilitation treatment during the year 2021. The minimum follow-up period was 12 weeks. The presence or absence of improvement was evaluated according to seven objective and subjective variables, and improvement was established as positive evolution in at least five of the seven variables. RESULTS: A total of 114 women with urinary incontinence were analyzed. The most frequent types of incontinence were stress (53%) and mixed (36%). The most important risk factors and associated pathology were episiotomy (68%), repeated urinary tract infections (61%), and constipation (40.9%). None of these factors showed a statistically significant relationship with patient improvement. The most used rehabilitative treatment was kinesitherapy+biofeedback (51%) which showed a statistically significant relationship with the improvement of these patients (P=.037) together with biofeedback+posterior tibial nerve electrostimulation (PTNS) (P=.044). CONCLUSION: Biofeedback combined with kinesitherapy or PTNS are established as the most effective rehabilitative procedures.

Specificity of serological test for detection of tuberculosis in cattle, goats, sheep and pigs under different epidemiological situations.

BACKGROUND: Serum antibody detection has potential as a complementary diagnostic tool in animal tuberculosis (TB) control, particularly in multi-host systems. The objective of the present study was to assess the specificity (Sp) of an enzyme-linked immunosorbent assay (ELISA) based on the new multiprotein complex P22 for the detection of specific antibodies against the Mycobacterium tuberculosis complex (MTC) in the four most relevant domestic animals acting as MTC hosts: cattle, goat, sheep and pig. We used sera from an officially TB-free (OTF) country, Norway, and from a non-OTF one, Spain. The samples included sera from goats that had been vaccinated against M. avium subsp. paratuberculosis (MAP) and sheep from a herd in which Corynebacterium pseudotuberculosis had been isolated. RESULTS: In cattle, the Sp ranged from 92.5 (IC95% 90.7-94) to 99.4% (IC95% 98.3-99.8) depending on the cut-off used and the origin of the samples (Spain or Norway). Sp in cattle (cut-off point 100) was significantly higher (P < 0.05) for Norwegian samples. By contrast, Sp in goats was consistently low at the 100 cut-off [30.9 (CI95%23.4-39.5)-78% (CI95% 68.9-85)]. A higher cut-off of 150 improved Sp in Norwegian goats [97% (CI95% 91.6-99)], but still yielded a poor Sp of 56.1% (CI95% 47.3-64.6) in Spanish goats. In Norway at the 100 cut-off the Sp was 58.3 (CI95% 42.2-72.9) and 90.6% (CI95% 81-95.6) in MAP vaccinated and non-vaccinated goats, respectively, indicating interference due to MAP vaccination. Sp in sheep was between 94.4 (CI95% 91.7-96.3) and 100% (CI95% 96.3-100) depending on the cut-off and country, and no diagnostic interference due to infection with C. pseudotuberculosis was recorded. Sp in pigs was 100%, regardless the cut-off point applied, and no significant differences were observed between pigs from Norway and from Spain. CONCLUSIONS: Due to its excellent Sp in pigs and acceptable Sp in cattle and sheep, this ELISA may constitute a suitable option for TB screening at herd level, particularly in OTF-countries.

Evaluation of the Mycobacterium tuberculosis SO2 vaccine using a natural tuberculosis infection model in goats.

The development of new vaccines against animal tuberculosis (TB) is a priority for improving the control and eradication of this disease, particularly in those species not subjected to compulsory eradication programmes. In this study, the protection conferred by the Mycobacterium tuberculosis SO2 experimental vaccine was evaluated using a natural infection model in goats. Twenty-six goats were distributed in three groups: (1) 10 goats served as a control group; (2) six goats were subcutaneously vaccinated with BCG; and (3) 10 goats were subcutaneously vaccinated with SO2. Four months after vaccination, all groups were merged with goats infected with Mycobacterium bovis or Mycobacterium caprae, and tested over a 40 week period using a tuberculin intradermal test and an interferon-γ assay for mycobacterial reactivity. The severity of lesions was determined at post-mortem examination and the bacterial load in tissues were evaluated by culture. The two vaccinated groups had significantly lower lesion and bacterial culture scores than the control group (P<0.05); at the end of the study, the SO2 vaccinated goats had the lowest lesion and culture scores. These results suggest that the SO2 vaccine provides some protection against TB infection acquired from natural exposure.

Modificaciones en las proyecciones córtico-motoneuronales que van a la mano en pacientes que reciben rehabilitación intensiva / Modifications in the cortico-motoneuronal projections going to the hand in patients who receive intensive rehabilitation

Introducción. La enfermedad cerebrovascular es una de las principales causas de déficit motor. El presente trabajo evalúa el efecto de la rehabilitación intensiva sobre la reorganización de las proyecciones córtico-motoneuronales a la mano en pacientes con infartos cerebrales del territorio de la arteria cerebral media. Material y método. Se realizó un estudio de cohortes, seleccionando un grupo de 20 pacientes hospitalizados (grupo 1: G1) para recibir tratamiento de rehabilitación intensivo, y otro grupo de 10 pacientes ambulatorios (grupo 2: G2) no tratados en rehabilitación. Todos cumplían los siguientes criterios de inclusión: evolución post-infarto >= 6 meses; puntuación en el índice de Barthel >= 75, y >= 2 en el Medical Research Council de la mano afectada. Se excluyeron aquellos con más de un infarto cerebral, o que portaran dispositivos electromagnéticos. Se realizó la evaluación clínica y electrofisiológica, con un mapeo motor con estimulación magnética transcraneal, analizando el área de respuestas y su localización, antes y después de recibir el tratamiento de 28 días de duración. Se realizaron pruebas de hipótesis para muestras independientes (U de Mann-Whitney) y dependientes (Wilcoxon), alfa = 0,05. Resultados. No se identificaron diferencias significativas entre grupos en las variables analizadas inicialmente (Mann-Whitney U; p > 0,05). En todos los pacientes se obtuvieron respuestas contralaterales al estimular el hemisferio afectado. Los resultados de la segunda evaluación evidenciaron diferencias entre grupos (p < 0,05), con incremento en la puntuación de las escalas clínicas en el G1 con respecto a los valores iniciales (Wilcoxon; Barthel, Z = 3,4793, p = 0,000; MRC; Z = 3,8230, p = 0,00) y en el área de respuestas motoras en ambos hemisferios (Z = 3,9199, p = 0,00). Conclusiones. La rehabilitación intensiva indujo modificaciones en las proyecciones córtico-motoneuronales a la mano en pacientes con infartos cerebrales

Introduction. Cerebrovascular disease is one of the main causes of motor deficits. We evaluated the effect of an intensive rehabilitation program over the reorganization of cortico-motoneuronal projections to the affected hand in patients after stroke from the mean cerebral artery territory. Material and methods. We carried out a cohort study, selecting a group of 20 hospitalized patients (group 1:G1) who were admitted to receive intensive rehabilitation treatment and another group of 10 ambulatory patients (group 2: G2) was selected as control group, they were not receiving at this moment any physical rehabilitation treatment. All the patients fulfilled the following criteria: >= 6 months post-stroke, >= 75 points in the Barthel index, and >= 2 in Medical Research Council in the affected hand. We excluded patients with >= 2 strokes, or who were carriers of electromagnetic devices. Both groups were evaluated before and after 28 days of treatment (only G1); applying the same clinical scales and electrophysiologically with motor mapping using transcranial magnetic stimulation, defining map area and location. Test for dependent (Wilcoxon) and for independent samples (Mann-Whitney U) were performed, with alpha = 0.05. Results. Before treatment both groups were clinically and electrophysiologically similar without any significant statistical difference (Mann Whitney U; p < 0,05). Contralateral responses were obtained in all patients after stimulating the affected hemisphere. Significant differences between groups were demonstrated after treatment; higher values in clinical scales were observed in G1 in comparison to initial values (Wilcoxon: Barthel index, Z = 3.4793, p = 0.000; MRC: Z = 3.8230, p = 0.000) and in the motor map area of both hemispheres (Wilcoxon: Z = 3.9199, p = 0.00). Conclusion. Intensive rehabilitation induced changes in cortico-motoneuronal projections to the hand in patients with stroke

[Corticospinal dysfunction in patients with primary and amyotrophic lateral sclerosis]. / Disfunción corticoespinal en pacientes con esclerosis lateral primaria y amiotrófica.

INTRODUCTION: Corticoespinal dysfunction is a common finding in primary and amyotrophic lateral sclerosis (PLS and ALS). AIM. To compare the behaviour of motor evoked potentials (MEP) with transcranial magnetic stimulation (TMS) in patients with ALS and PLS. PATIENTS AND METHODS: It was performed a retrospective analysis of MEP recordings of 11 patients with PLS and 10 patients with sporadic ALS. Central motor conduction time and amplitude ratio were the selected variables for the statistical analysis of MEP from abductor pollicis brevis and tibialis anterior muscle from the four limbs, using non-parametric methods. RESULTS: As a general observation there was a high incidence of abnormal recordings in both groups of patients; in 30% of recording from ALS patients response to TMS was absent, but only the 4.5% in the group of PLS had the same characteristic. In PLS patients abnormal central motor conduction time was the most frequent finding, as it was the low amplitude ratio in ALS patients; both variables showed statistically significant differences between groups (Kruskall-Wallis, H = 6.32, p = 0.011; and Kruskall-Wallis, H = 5.777, p = 0.0163, respectively). CONCLUSION: Corticoespinal dysfunction has different characteristics in ALS and PLS patients, and the analysis of MEP could add useful information for differential diagnosis of these diseases.

Disfunción corticoespinal en pacientes con esclerosis lateral primaria y amiotrófica / Corticospinal dysfunction in patients with primary and amyotrophic lateral sclerosis

Corticoespinal dysfunction is a common finding in primary and amyotrophic lateral sclerosis (PLS and ALS). AIM. To compare the behaviour of motor evoked potentials (MEP) with transcranial magnetic stimulation (TMS) in patients with ALS and PLS. It was performed a retrospective analysis of MEP recordings of 11 patients with PLS and 10 patients with sporadic ALS. Central motor conduction time and amplitude ratio were the selected variables for the statistical analysis of MEP from abductor pollicis brevis and tibialis anterior muscle from the four limbs, using non-parametric methods. As a general observation there was a high incidence of abnormal recordings in both groups of patients; in 30 percent of recording from ALS patients response to TMS was absent, but only the 4,5 percent in the group of PLS had the same characteristic. In PLS patients abnormal central motor conduction time was the most frequent finding, as it was the low amplitude ratio in ALS patients; both variables showed statistically significant differences between groups (Kruskall-Wallis, H = 6,32, p = 0,011; and Kruskall-Wallis, H = 5,777, p = 0,0163, respectively). Corticoespinal dysfunction has different characteristics in ALS and PLS patients, and the analysis of MEP could add useful information for differential diagnosis of these diseases(AU)

Tratamiento iontoforético de la hiperhidrosis palmoplantar / Iontophoretic treatment of palmoplantar hyperhidrosis

Introducción: La hiperhidrosis palmoplantar idiopática es una patología frecuente que ocasiona trastornos funcionales y emocionales importantes, llegando a alterar la actividad profesional o social de las personas que la padecen. Con este trabajo pretendemos aportar nuestra experiencia en cuanto a la eficacia y características de aplicación de una técnica novedosa para el tratamiento de la hiperhidrosis como es la iontoforesis. Pacientes y método empleado: Hemos realizado un estudio prospectivo en el que excluimos las hiperhidrosis secundarias. Tratamos 24 pacientes (14 hiperhidrosis palmares, siete palmoplantares y tres plantares), de los cuales 11 eran varones y 13 mujeres, con edades comprendidas entre 15 y 38 años. En la valoración de los resultados, empleamos un cuestionario funcional y pesamos la cantidad de sudor absorbida por un papel poroso antes y después del tratamiento. En cuanto a la técnica, se sumergen las extremidades a tratar en el agua, aplicando una corriente galvánica constante a una intensidad máxima de 0,06-0,12 mA/cm2 durante 30 minutos diarios, y alternamos la extremidad tratada en cada sesión. Resultados: Se redujo la hipersudoración entre un 8095 por ciento a las 3-7 sesiones de tratamiento; posteriormente la mayoría volvió a sudar con menor intensidad y de forma más localizada a los 3-4 meses de finalizar el tratamiento, controlándose de nuevo con tres sesiones. En dos de los pacientes se llegó a normalizar el exceso de sudoración. Conclusión: La iontoforesis con agua bidestilada desionizada es un tratamiento temporal eficaz en el control de la hiperhidrosis palmoplantar idiopática, es bien tolerado por los pacientes y sin apenas efectos adversos, mejorando la calidad de vida de las personas que sufren este trastorno (AU)

Estudio electromiográfico en pacientes con síndrome del canal carpiano crónico idiopático intervenidos quirúrgicamente / Electromyographic study in patients with surgically treated chronic idiopathic carpal tunnel syndrome

Objetivo: En este estudio se pretende valorar si existe una correlación entre la clínica y los parámetros electromiográficos, en pacientes que han sido intervenidos quirúrgicamente por un síndrome del canal carpiano crónico idiopático. Material y método: Se han estudiado 27 pacientes tratados quirúrgicamente, mediante la técnica convencional de liberación abierta del nervio mediano. Se comenzó valorando la clínica de las manos intervenidas, viendo que el 22,2 por ciento de las mismas aún tenían parestesias en el territorio del mediano. A continuación se realizó la exploración electromiográfica del nervio implicado, analizando tanto las fibras motoras como las sensitivas. Como parámetro EMG más sensible para detectar la persistencia de lesión nerviosa, se ha analizado la diferencia de los tiempos de conducción sensitivos entre el 4.º dedo con detección en mediano y el 4.º dedo con detección en cubital. La misma valoración EMG se hizo en un grupo control formado por 32 manos todas ellas asintomáticas. Resultados: El 75 por ciento de los pacientes seguían teniendo, después de la intervención quirúrgica, una diferencia de tiempos de conducción entre el 4.º dedo mediano y el 4.º dedo cubital alterada, a pesar de que estaban asintomáticos (AU)

Tratamiento de la tendinitis calcificante del hombro mediante iontoforesis con ácido acético y ultrasonidos / Treatment of calcifying tendinitis of the shoulder by acetic acid iontophoresis and ultrasound

Objetivo: Valorar la eficacia del tratamiento combinado de iontoforesis con ácido acético y ultrasonidos en la tendinitis calcificante del hombro.Pacientes y métodos: En el estudio prospectivo han participado 34 pacientes; edad media: 48 años y nueve meses. Incidencia por sexos: 23 mujeres y 11 hombres. Hombro más afectado: derecho (21 pacientes), cuatro afectación bilateral. Se valoró antes de iniciar el tratamiento, grado de dolor (escala analógica visual) y tamaño de la calcificación (radiología simple). Tras 20 y 40 sesiones se hizo una nueva valoración de la intensidad del dolor y del tamaño de la calcificación. El tratamiento consistió en iontoforesis con ácido acético al 5 por ciento (cinco días/semana), seguido de ultrasonidos pulsantes durante cinco minutos (área de radiación efectiva de 5 cm).Resultados: Tras 20 sesiones, en el 35,9 por ciento de los hombros tratados no hubo dolor y desapareció la calcificación. En el 64,1 por ciento el dolor disminuyó un 57 por ciento de su intensidad inicial por término medio y la calcificación persistía igual o de menor tamaño. Tras 40 sesiones, los resultados globales fueron: en el 46 por ciento de los hombros tratados desapareció la calcificación y en el 18 por ciento disminuyó; supone un 64 por ciento de hombros en los que se modificó la calcificación. El dolor disminuyó, por término medio, un 85 por ciento de su intensidad inicial al finalizar el tratamiento.Conclusión: el tratamiento es eficaz en la tendinitis calcificante del hombro, tanto en la modificación del tamaño de la calcificación, como en la solución del cuadro doloroso (AU)

Tratamiento combinado de la fascitis plantar crónica en el adulto de edad superior a los 50 años / Combined treatment of the chronic plantar fasciitis in the adult patient over 50 years of age

Objetivo: Valorar la eficacia de la asociación de iontoforesis-corticoide, ultrasonidos, transferencia eléctrica capacitativa y plantillas de silicona en el tratamiento de la fascitis plantar. Pacientes: 74 pacientes de los que fueron excluidos 17 por no cumplir los requisitos previos (edad inferior a 50 años, dolor de más de tres meses de evolución, síndrome del canal tarsiano, etc.). Otros ocho pacientes también fueron excluidos, seis por no realizar el tratamiento de forma continuada y dos por abandono del mismo. La distribución por edad y sexo fue de 33 mujeres y 16 hombres con una edad media de 54 años y cuatro meses. En cuanto a la localización de la fascitis plantar, 20 pacientes tuvieron afectación del pie derecho, 15 del izquierdo y 14 fueron bilaterales. Método: El tratamiento aplicado ha sido iontoforesis con fosfato sódico de dexametasona al 0,4 por ciento; ultrasonidos continuos con un área de radiación efectiva de cinco cm2; diatermia con 0,8 MHz de frecuencia (Transferencia Eléctrica Capacitativa) y plantillas de silicona. Resultados: Antes del tratamiento de los 63 pies, 25 presentaban afectación intensa y 38 afectación moderada. Tras 15 sesiones de tratamiento: 12 pies quedaron asintomáticos (no continuaron el tratamiento), cuatro afectación intensa, 22 moderada, 19 leve y seis no siguieron por no realizar de forma adecuada el tratamiento. De los 45 pies restantes, dos no finalizaron las sesiones y fueron excluidos por no cumplir el protocolo. Tras 30 sesiones el resultado fue de un pie con afectación intensa, dos moderada, 11 leve y 29 asintomáticos (AU)

Prediction of valproate serum concentrations in adult psychiatric patients using Bayesian model estimations with NPEM2 population pharmacokinetic parameters.

Valproate serum concentrations between 45 and 125 microg/mL are associated with the drug's efficacy in acute mania. Adaptive control dosing of valproate has not been fully studied in psychiatry. The objective of this study was to derive population pharmacokinetic (PK) parameters for valproate in healthy volunteers and to test the ability of these PK parameters to estimate concentrations in adult psychiatric patients using a Bayesian program. Population PK parameters for oral valproate were estimated from 18 PK studies in six healthy volunteers (1) using NPEM2. A Bayesian PK program using these population parameters was used to predict valproate concentration-time points in a second cohort of 21 adult psychiatry patients using 0, 1, or 2 prior concentrations. Estimated population parameters (mean +/- SD) were: Ka, 1.15+/-1.75/h; V, 0.14+/-0.042 L/Kg; and CL, 0.902+/-0.133 L/h. Bayesian valproate estimations using these parameters were negatively biased (underestimations) using zero prior concentration and unbiased using 1 or 2 prior concentrations. Mean error values (95% CI) in microg/mL for predictions using 0, 1, or 2 prior concentration-time points were -12.0 (-22.5, -1.5), -9.5 (-19.1, 0.1), and -2.5 (-11.1, 6.1), respectively, and mean absolute error values in microg/mL (95% CI) were 19.8 (12.6, 27.1), 16.3 (9.4, 23.3), and 10.1 (4.9, 15.2), respectively. Population parameters derived from healthy adult volunteers provided biased predictions of valproate concentrations in adult psychiatric patients. However, estimates using 1 or 2 valproate concentration time points predicted future concentrations that were precise and unbiased, given the wide therapeutic target range.

Parálisis diafragmática iatrogénica y persistencia de ducto arterioso en un hijo de madre diabética / Diaphragmatic paralysis iatrogenic and patent ductus arterioso in child of moter diabetica

Introducción. La parálisis diafragmática neonatal se ha asociado a las siguientes causas: traumatismos obstétricos, venodisección yugular interna, aplicación de la sonda torácica y a cirugía intratorácica. Caso clínico. Se presenta el caso de un neonato de 34 semanas de gestación, masculino, de 3,00 g, que al tercer día de vida extrauterina presentó neumotórax derecho, manejándose con sonda en el tórax, la que fue colocada inadecuadamente. Simultáneamente presentó persistencia del conducto arterioso (PAC) practicándose ligadura quirúrgica y posteriormente plicatura diafragmática derecha, al décimo día y décimo séptimo día de vida, respectivamente. Su evolución fue favorable y egresó al mes de edad. Conclusión. La parálisis diafragmática iatrogénica y la PCA son dos patologías que con frecuencia requieren manejo quirúrgico. En este caso coexistieron ambas entidades

Interference between Neisseria meningitidis and PC-KLH induced anti-phosphorylcholine PFC responses in NZB/W autoimmune mice.

In this work, we demonstrate that the simultaneous injection of PC-KLH and Neisseria meningitidis-derived antigens [NMB or PC-(NMB)HI] induced in old NZB/W mice defective responses as does PC-KLH challenge. On the other hand, the simultaneous injection of both immunogenic preparations of N. meningitidis evoked responses similar to those shown by old mice challenged with NMB alone. Alteration in PC-specific PFC responses also affected hapten-free inhibition profiles and their heterogeneities. The increase in PC50s of anti-phosphorylcholine PFC responses and their heterogeneities induced by certain antigens with aging is correlated with a decrease in T15 idiotype expression, suggesting that after the T15 dominant clone disappears no other clone takes control of the anti-PC response. These results suggest that the mechanism(s) involved in the regulation of T15 marker expression play an important role in the inability of old NZB/W mice to mount good anti-PC responses and suggest that regulatory mechanisms induced by PC-KLH dominate those elicited by NMB.

Efficacy of various non-oily adjuvants in immunization against the Aujeszky's disease (pseudorabies) virus.

Standard oil and various non-oily adjuvants were compared for use in immunization against the Aujeszky's disease (pseudorabies) virus, both in mice and swine, and using either inactivated virions or purified glycoproteins as antigen. Mineral oil, sodium alginate, aluminium hydroxide, and saponin were assayed in mice as adjuvants for inactivated virions, saponin being the most efficient. The addition of Mab anti-CD3 did not improve either immune response or protection achieved in mice using viral particles with oil or sodium alginate. When purified glycoproteins were used as antigens, the use of ISCOM greatly enhanced specific T-cell responses and protection of mice. The incorporation of Mab anti-CD3 into ISCOM conferred 100% protection of mice. Surprisingly, when an ISCOM containing glycoproteins was assayed in swine in a single-dose trial, no improvement on the protection conferred by the oily adjuvant was observed.

Comparison of the protective efficacy of Aujeszky's disease (pseudorabies) virus glycoproteins obtained from different sources.

The immunogenic properties of a series of glycoprotein preparations are compared using inactivated conventional vaccines as reference. Serological response and protective efficacy of vaccination of mice and pigs are evaluated for glycoprotein immunogens obtained from various sources. BHK-21 cell cultures were infected with Aujeszky's disease virus and used as antigenic source. Glycoproteins were obtained from (i) the whole culture (ii) the cell sediment and (iii) the clarified supernatant. Both in pigs and in mice, protection was greater with glycoproteins purified from infected-cell membranes than with viral mature particle glycoproteins. The specific profiles of humoral responses were basically identical regardless of the source of glycoprotein. Bartha strain, one of the gI- strains most commonly used as an attenuated vaccine, was also used as a glycoprotein source. Immunogens obtained from this strain were protective in challenge trials with the virulent E-974 strain of the Aujeszky's disease virus. Glycoproteins did not induce detectable delayed type hypersensitivity in mice but conferred greater protection than particulate antigens (which, conversely, did induce a detectable delayed type hypersensitivity reaction). Until the recent proposal of the potency criterion delta 7, no objective method was available to evaluate the degree of protection conferred by Aujeszky's disease vaccines. In this study, we thus used the protection index, a quantitative parameter designed to evaluate potency of vaccines against Aujeszky's disease virus.

Antigens involved in vaccination of swine against Aujeszky's disease (pseudorabies) virus.

The polypeptide and glycopolypeptide composition of a local virulent Aujeszky's disease virus (suid herpesvirus 1, SHV-1) strain (E-974) was determined in order to characterize the individual SHV-1 antigens inducing the serological responses in immunized and non-immunized animals. A commercially available inactivated vaccine of known efficacy and three experimental immunogen preparations (whole inactivated SHV-1 particles, lectin-purified glycoproteins from SHV-1 culture, and a combination of both) were used for immunization. Sera of two-month old immunized and non-immunized animals were analyzed by ELISA, seroneutralization and Western immunoblotting prior to and following challenge with E-974. Sera of 7- to 30-day-old piglets littered by immunized and non-immunized sows were likewise analyzed by immunoblotting. The following variables were determined: the total level of anti-SHV-1 antibodies, the level of neutralizing antibodies, the IgG responses to individual SHV-1 antigens, and the clinical parameters and degree of protection of the animals. The whole-particle experimental immunogen conferred greatest protection, but correlation between antibody levels and the degree of protection was imperfect. Serological responses seemed to be directed against certain structural polypeptides and viral envelope glycoproteins. The glycoprotein immunogen caused a selective response to bands which closely resemble the glycopolypeptides gII and gIII. A 71 kDa component of uncertain location within the viral structure appeared to be one of the main antigens involved in porcine serological response to SHV-1 and colostral protection of piglets.