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1.
Mayo Clin Proc ; 94(11): 2314-2339, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31685156

RESUMO

The pretravel management of the international traveler should be based on risk management principles. Prevention strategies and medical interventions should be based on the itinerary, preexisting health factors, and behaviors that are unique to the traveler. A structured approach to the patient interaction provides a general framework for an efficient consultation. Vaccine-preventable diseases play an important role in travel-related illnesses, and their impact is not restricted to exotic diseases in developing countries. Therefore, an immunization encounter before travel is an ideal time to update all age-appropriate immunizations as well as providing protection against diseases that pose additional risk to travelers that may be delineated by their destinations or activities. This review focuses on indications for each travel-related vaccine together with a structured synthesis and graphics that show the geographic distribution of major travel-related diseases and highlight particularly high-risk destinations and behaviors. Dosing, route of administration, need for boosters, and possible accelerated regimens for vaccines administered prior to travel are presented. Different underlying illnesses and medications produce different levels of immunocompromise, and there is much unknown in this discipline. Recommendations regarding vaccination of immunocompromised travelers have less of an evidence base than for other categories of travelers. The review presents a structured synthesis of issues pertinent to considerations for 5 special populations of traveler: child traveler, pregnant traveler, severely immunocompromised traveler, HIV-infected traveler, and traveler with other chronic underlying disease including asplenia, diabetes, and chronic liver disease.


Assuntos
Doença Relacionada a Viagens , Viagem , Vacinação/estatística & dados numéricos , Vacinas/uso terapêutico , Adulto , Criança , Feminino , Humanos , Gravidez , Medicina de Viagem/métodos
2.
Nihon Yakurigaku Zasshi ; 154(5): 270-274, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31735757

RESUMO

In the 18th century, Edward Jenner proposed the vaccine for smallpox as a first vaccine therapy based on the legend that a vaccinia prevents the infection with smallpox. Recently, the therapeutic target of vaccine will expand from infectious diseases to various diseases, such as amyloid ß or tau vaccine for Alzheimer's disease. We are now going to develop a therapeutic vaccine to lifestyle-related diseases (i.e. high blood pressure), and aim to realize a novel therapy which will be injected once or twice per year from a daily medication. For this purpose, the appropriate choice of an antigen, carrier and adjuvants should be required to activate hormonal immunity by the vaccine, leading to efficient antibody production without toxicity, because the therapeutic target of our vaccine is an endogenous protein (i.e. hormone). The clinical advantage of this therapeutic vaccine is to improve the medical adherence and drug management because the multiple drug users are increased in particular old patients, so called polypharmacy. If the vaccine will take place of a part of medicine in future, it may give us a novel therapeutic option with several social benefits.


Assuntos
Hipertensão/terapia , Estilo de Vida , Vacinas/uso terapêutico , Humanos
6.
Rev Bras Enferm ; 72(3): 671-679, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31269131

RESUMO

OBJECTIVE: to construct collectively with nursing professionals bundle for best practices of cold chain maintenance of immunobiological agents conservation at the local level. METHOD: a qualitative research of convergent care type. Bundle construction was guided by the Evidence-Based Practice criterion. Data collection was carried out from October to December 2016, through five workshops, with the participation of 21 professionals from 7 vaccination rooms of a municipality of Minas Gerais State. The framework developed by Morse and Field was adopted for data analysis. RESULTS: through bundle, care is taken regarding refrigeration equipment temperature monitoring, contingency plan performance, recyclable ice coil setting and chamber use as refrigeration equipment. FINAL CONSIDERATIONS: the chosen interventions began to guide the practice and promote a care based on safety and quality.


Assuntos
Pacotes de Assistência ao Paciente/métodos , Refrigeração/métodos , Vacinas/uso terapêutico , Adulto , Competência Clínica/normas , Enfermagem Baseada em Evidências/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Pesquisa Qualitativa , Refrigeração/normas
7.
Mult Scler Relat Disord ; 31: 173-188, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31159998

RESUMO

OBJECTIVES: To establish recommendations on immunization for patients with multiple sclerosis (MS) BACKGROUND: Vaccines have been suspected in the past to trigger MS and relapses. With the extension of the immunoactive treatment arsenal, other concerns have been raised more recently about an increased risk of infection or a decreased effectiveness of immunization in immunosuppressed patients. METHODS: The French Group for Recommendations into Multiple Sclerosis (France4MS) performed a systematic search of papers in Medline and other university databases (January 1975-June 2018). The RAND/UCLA appropriateness method was chosen to review the scientific literature and to formalize the degree of agreement among experts on 5 clinical questions related to immunization and MS. Readers from the steering committee conducted a systematic analysis, wrote a critical synthesis and prepared a list of proposals that were evaluated by a rating group of 28 MS experts. The final version of the recommendations was finally reviewed by a reading group of 110 health care professionals and classified as appropriate, inappropriate or uncertain. RESULTS: Neurologists should verify the vaccination status as soon as MS is diagnosed and before disease-modifying treatments (DMTs) are introduced. The French vaccination schedule applies to MS patients and seasonal influenza vaccination is recommended. In the case of treatment-induced immunosuppression, MS patients should be informed about the risk of infection and the vaccination standards of the French High Council of Health should be applied. Live attenuated vaccines are contra-indicated in patients recently treated with immunosuppressive drugs, including corticosteroids; other vaccines can be proposed whatever the treatment, but their effectiveness may be partly reduced with some drugs. CONCLUSION: Physicians and patients should be aware of the updated recommendations for immunizations of patients with MS.


Assuntos
Imunização/normas , Esclerose Múltipla/imunologia , Esclerose Múltipla/prevenção & controle , França , Humanos , Imunização/efeitos adversos , Sociedades Médicas , Vacinas/uso terapêutico
9.
Rev Neurol (Paris) ; 175(6): 341-357, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31036391

RESUMO

OBJECTIVES: To establish recommendations on immunization for patients with multiple sclerosis (MS). BACKGROUND: Vaccines have been suspected in the past to trigger MS and relapses. With the extension of the immunoactive treatment arsenal, other concerns have been raised more recently about an increased risk of infection or a decreased effectiveness of immunization in immunosuppressed patients. METHODS: The French Group for Recommendations into Multiple Sclerosis (France4MS) performed a systematic search of papers in Medline and other university databases (January 1975-June 2018). The RAND/UCLA appropriateness method was chosen to review the scientific literature and to formalize the degree of agreement among experts on 5 clinical questions related to immunization and MS. Readers from the steering committee conducted a systematic analysis, wrote a critical synthesis and prepared a list of proposals that were evaluated by a rating group of 28 MS experts. The final version of the recommendations was finally reviewed by a reading group of 110 health care professionals and classified as appropriate, inappropriate or uncertain. RESULTS: Neurologists should verify the vaccination status as soon as MS is diagnosed and before disease-modifying treatments (DMTs) are introduced. The French vaccination schedule applies to MS patients and seasonal influenza vaccination is recommended. In the case of treatment-induced immunosuppression, MS patients should be informed about the risk of infection and the vaccination standards of the French High Council of Health should be applied. Live attenuated vaccines are contra-indicated in patients recently treated with immunosuppressive drugs, including corticosteroids; other vaccines can be proposed whatever the treatment, but their effectiveness may be partly reduced with some drugs. CONCLUSION: Physicians and patients should be aware of the updated recommendations for immunizations of patients with MS.


Assuntos
Imunização/normas , Esclerose Múltipla/imunologia , Esclerose Múltipla/terapia , Prática Clínica Baseada em Evidências , França , Humanos , Imunização/efeitos adversos , Imunização/métodos , Esquemas de Imunização , Guias de Prática Clínica como Assunto , Recidiva , Fatores de Risco , Sociedades Médicas/organização & administração , Sociedades Médicas/normas , Vacinação/efeitos adversos , Vacinação/métodos , Vacinas/efeitos adversos , Vacinas/uso terapêutico
10.
Pediatrics ; 143(6)2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31113831

RESUMO

BACKGROUND AND OBJECTIVES: California implemented Senate Bill 277 (SB277) in 2016, becoming the first state in nearly 30 years to eliminate nonmedical exemptions from immunization requirements for schoolchildren. Our objectives were to determine (1) the impacts of SB277 on the percentage of kindergarteners entering school not up-to-date on vaccinations and (2) if geographic patterns of vaccine refusal persisted after the implementation of the new law. METHODS: At the state level, we analyzed the magnitude and composition of the population of kindergarteners not up-to-date on vaccinations before and after the implementation of SB277. We assessed correlations between previous geographic patterns of nonmedical exemptions and patterns of the remaining entry mechanisms for kindergarteners not up-to-date after the law's implementation. RESULTS: In the first year after SB277 was implemented, the percentage of kindergartners entering school not up-to-date on vaccinations decreased from 7.15% to 4.42%. The conditional entrance rate fell from 4.43% to 1.91%, accounting for much of this decrease. Other entry mechanisms for students not up-to-date, including medical exemptions and exemptions for independent study or homeschooled students, largely replaced the decrease in the personal belief exemption rate from 2.37% to 0.56%. In the second year, the percentage of kindergartners not up-to-date increased by 0.45%, despite additional reductions in conditional entrants and personal belief exemptions. The correlational analysis revealed that previous geographic patterns of vaccine refusal persisted after the law's implementation. CONCLUSIONS: Although the percentage of incoming kindergarteners up-to-date on vaccinations in California increased after the implementation of SB277, we found evidence for a replacement effect.


Assuntos
Política de Saúde/legislação & jurisprudência , Imunização/legislação & jurisprudência , Serviços de Saúde Escolar/legislação & jurisprudência , Recusa de Vacinação/legislação & jurisprudência , Vacinação/legislação & jurisprudência , California/epidemiologia , Criança , Pré-Escolar , Feminino , Política de Saúde/tendências , Humanos , Imunização/tendências , Masculino , Serviços de Saúde Escolar/tendências , Instituições Acadêmicas/legislação & jurisprudência , Instituições Acadêmicas/tendências , Vacinação/tendências , Recusa de Vacinação/tendências , Vacinas/uso terapêutico
12.
Vet Res ; 50(1): 29, 2019 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-31029163

RESUMO

Vaccines and genetic resistance offer potential future alternatives to the exclusive use of anthelmintics to control gastrointestinal nematodes (GIN). Here, a Teladorsagia circumcincta prototype vaccine was administered to two sheep breeds which differ in their relative levels of resistance to infection with GIN. Vaccination of the more susceptible Canaria Sheep (CS) breed induced significant reductions in worm length and numbers of worm eggs in utero (EIU) when compared to control CS sheep. In the more resistant Canaria Hair Breed (CHB), although vaccination induced a reduction in all parasitological parameters analysed, differences between vaccinated and control sheep were not statistically significant. Such interactions between sheep breed and vaccination may allow better integrated control of GIN in future.


Assuntos
Doenças dos Ovinos/parasitologia , Trichostrongyloidea , Tricostrongiloidíase/veterinária , Vacinação/veterinária , Animais , Feminino , Ovinos , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/prevenção & controle , Espanha/epidemiologia , Especificidade da Espécie , Tricostrongiloidíase/epidemiologia , Tricostrongiloidíase/parasitologia , Tricostrongiloidíase/prevenção & controle , Vacinas/uso terapêutico
13.
Proc Biol Sci ; 286(1894): 20182406, 2019 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-30963866

RESUMO

Addressing vaccine compliance problems is of particular relevance and significance to public health. Despite resurgence of vaccine-preventable diseases and public awareness of vaccine importance, why is it so challenging to boost population vaccination coverage to desired levels especially in the wake of declining vaccine uptake? To understand this puzzling phenomenon, here we study how social imitation dynamics of vaccination can be impacted by the presence of imperfect vaccine, which only confers partial protection against the disease. Besides weighing the perceived cost of vaccination with the risk of infection, the effectiveness of vaccination is also an important factor driving vaccination decisions. We discover that there can exist multiple stable vaccination equilibria if vaccine efficacy is below a certain threshold. Furthermore, our bifurcation analysis reveals the occurrence of hysteresis loops of vaccination rate with respect to changes in the perceived vaccination cost as well as in the vaccination effectiveness. Moreover, we find that hysteresis is more likely to arise in spatial populations than in well-mixed populations, even for parameter choices that do not allow for bifurcation in the latter. Our work shows that hysteresis can appear as an unprecedented roadblock for the recovery of vaccination uptake, thereby helping explain the persistence of vaccine compliance problem.


Assuntos
Tomada de Decisões , Comportamento Imitativo , Vacinação em Massa/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Vacinas/uso terapêutico , Humanos , Vacinação em Massa/estatística & dados numéricos , Vacinas/classificação
14.
Arch Oral Biol ; 101: 122-129, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30927661

RESUMO

OBJECTIVE: To investigate whether the recombinant FimH-S.T protein could modulate immune response to anti-caries vaccine in vitro and in vivo. DESIGN: Recombinant FimH protein derived from Salmonella was constructed and purified. The expression of dendritic cell maturation markers and cytokines release were performed by flow cytometry, Real-time PCR and ELISA. In addition, BALB/c mice were administered with anti-caries PAc vaccine plus FimH-S.T, antibody responses were evaluated by ELISA. Splenocytes of immunized mice were detected for their proliferative ability in response to in vitro retreatment with PAc antigen by flow cytometry. Caries protection against dental caries formation was also investigated. RESULTS: The purified FimH-S.T induced phenotypic maturation of DC2.4 by up-regulating the expression of costimulatory molecules and MHC II, provoked the production and secretion of cytokines via TLR4-dependent signaling pathway in vitro. Furthermore, the mice immunized with the mixture of FimH-S.T and PAc significantly enhanced the PAc-specific antibodies in the serum along with saliva and promoted splenocyte proliferation. Our results also confirmed that PAc+FimH-S.T decreased the caries lesions formation which provided high protective efficacy against dental caries. CONCLUSION: Our study demonstrates that recombinant FimH-S.T could enhance specific IgA responses and protection of anti-caries vaccine, possessing mucosal adjuvant ability by activating DC2.4 via TLR4 signaling pathway.


Assuntos
Adjuvantes Imunológicos/farmacologia , Cárie Dentária/prevenção & controle , Proteínas de Fímbrias/farmacologia , Imunidade nas Mucosas , Vacinas/uso terapêutico , Animais , Anticorpos Antibacterianos/imunologia , Formação de Anticorpos , Imunoglobulina A/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Proteínas Recombinantes/farmacologia , Receptor 4 Toll-Like/metabolismo
15.
Psychopharmacology (Berl) ; 236(10): 2899-2907, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30726515

RESUMO

RATIONALE: Since substance use disorders have few or no effective pharmacotherapies, researchers have developed vaccines as immune-therapies against nicotine, cocaine, methamphetamine, and opioids including fentanyl. OBJECTIVES: We focus on enhancing antibody (AB) production through stimulation of toll-like receptor-5 (TLR5) during active vaccination. The stimulating adjuvant is Entolimod, a novel protein derivative of flagellin. We review the molecular and cellular mechanisms underlying Entolimod's actions on TLR5. RESULTS: Entolimod shows excellent efficacy for increasing AB levels to levels well beyond those produced by anti-addiction vaccines alone in animal models and humans. These ABs also significantly block the behavioral effects of the targeted drug of abuse. The TLR5 stimulation involves a wide range of immune cell types such as dendritic, antigen presenting, T and B cells. Entolimod binding to TLR5 initiates an intracellular signaling cascade that stimulates cytokine production of tumor necrosis factor and two interleukins (IL-6 and IL-12). While cytokine release can be catastrophic in cytokine storm, Entolimod produces a modulated release with few side effects even at doses 30 times greater than doses needed in these vaccine studies. Entolimod has markedly increased AB responses to all of our anti-addiction vaccines in rodent models, and in normal humans. CONCLUSIONS: Entolimod and TLR5 stimulation has broad application to vaccines and potentially to other psychiatric disorders like depression, which has critical inflammatory contributions that Entolimod could reduce.


Assuntos
Imunoterapia/métodos , Transtornos Mentais/tratamento farmacológico , Neuroimunomodulação/efeitos dos fármacos , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Receptor 5 Toll-Like/agonistas , Vacinas/uso terapêutico , Animais , Humanos , Transtornos Mentais/imunologia , Neuroimunomodulação/imunologia , Peptídeos/farmacologia , Peptídeos/uso terapêutico , Ligação Proteica/efeitos dos fármacos , Ligação Proteica/fisiologia , Psicofarmacologia , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/fisiologia , Transtornos Relacionados ao Uso de Substâncias/imunologia , Vacinas/farmacologia
17.
Curr Top Microbiol Immunol ; 423: 95-118, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30790078

RESUMO

Antibody/antigen binding results in immune complexes (IC) that have a variety of regulatory functions. One important feature is the enhanced host immune activation against antigen contained in the complex. ICs play important roles at several critical steps that lead to B and T cell activation, including antigen targeting/retention, facilitated antigen uptake, antigen presenting cell activation and proper balancing of positive and negative stimulatory signals. In both poultry industry and clinical health care, ICs have been used as preventive and therapeutic vaccines. With our deepening understanding of antibody biology, particularly in light of new revelations of regulatory functions of Fc receptors, mechanistically more precise engineering has spearheaded tailored use of this tool for infection control and cancer therapy. IC-based treatment and prophylaxis have been tested to different extents in HBV, HIV and influenza viral infection control and are actively examined as an alternative treatment for several forms of tumor. As a part of this book series, this chapter aims to discuss the mechanistic aspects of IC signaling and their impact on immune cells. We give samples how this old technology has been used by practitioners over the last several decades and suggest potential paths for future development of IC-based immune therapy.


Assuntos
Complexo Antígeno-Anticorpo/imunologia , Vacinação , Vacinas/imunologia , Vacinas/uso terapêutico , Células Apresentadoras de Antígenos/imunologia , Antígenos/imunologia , Humanos , Ativação Linfocitária
18.
Recent Pat Biotechnol ; 13(3): 170-186, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30648529

RESUMO

BACKGROUND: The different fields of biotechnology can be classified by colors, as a "rainbow" methodology. In this sense, the red biotechnology, focused on the preservation of health, has been outstanding in helping to solve this challenge through the provision of technologies, including diagnostic kits, molecular diagnostics, vaccines, innovations in cancer research, therapeutic antibodies and stem cells. OBJECTIVE: The main goal of this work is to highlight the different areas within the red Biotechnology. In this sense, we revised some patents regarding red biotechnology as examples to cover this subject. METHODS: A literature search of patents was performed from the followings Patents Database: INPI, USPTO, Esp@cenet, WIPO and Google Patents. RESULTS: Our analysis showed the following numbers from patents found: cancer research (8), diagnosis kit (9), vaccines (8), stem cells (9) and therapeutic antibodies (5), where the United States is the leader for most filled patents in Red Biotechnology. CONCLUSION: This mini-review has provided an update of some patents on Recent Patents in Red Biotechnology. As far as we know, this is the first mini-review report on Red Biotechnology based on patents.


Assuntos
Pesquisa Biomédica/métodos , Biotecnologia/métodos , Terapia Baseada em Transplante de Células e Tecidos/métodos , Invenções/estatística & dados numéricos , Patentes como Assunto , Patologia Molecular/métodos , Antineoplásicos Imunológicos/uso terapêutico , Pesquisa Biomédica/história , Biotecnologia/história , Bases de Dados Factuais , História do Século XXI , Humanos , Kit de Reagentes para Diagnóstico , Vacinas/biossíntese , Vacinas/síntese química , Vacinas/uso terapêutico
19.
Crit Rev Biotechnol ; 39(3): 306-320, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30654663

RESUMO

Foot and mouth disease (FMD) is a highly contagious disease of cloven-hoofed animals, which causes severe economic losses in the livestock industry. Currently available vaccines are based on inactivated FMD virus (FMDV). Although inactivated virus vaccines have proved to be effective in FMD control, they have a number of disadvantages, including the need for high bio-containment production facilities and the lack of induction of immunological memory. Novel FMD vaccines based on the use of recombinant empty capsids have shown promising results. These recombinant empty capsids are attractive candidates because they avoid the use of virus in the production facilities but conserve its complete repertoire of conformational epitopes. However, many of these recombinant empty capsids require time-consuming procedures that are difficult to scale up. Achieving production of a novel and efficient FMD vaccine requires not only immunogenic antigens, but also industrially relevant processes. This review intends to summarize and compare the different strategies already published for the production of FMDV recombinant empty capsids, focusing on large-scale production.


Assuntos
Proteínas do Capsídeo/genética , Febre Aftosa/tratamento farmacológico , Proteínas Recombinantes/genética , Vacinas/genética , Animais , Capsídeo/química , Capsídeo/imunologia , Proteínas do Capsídeo/imunologia , Proteínas do Capsídeo/uso terapêutico , Febre Aftosa/imunologia , Febre Aftosa/virologia , Vírus da Febre Aftosa/efeitos dos fármacos , Vírus da Febre Aftosa/imunologia , Vírus da Febre Aftosa/patogenicidade , Humanos , Proteínas Recombinantes/imunologia , Proteínas Recombinantes/uso terapêutico , Vacinas/uso terapêutico , Vacinas de Produtos Inativados/genética , Vacinas de Produtos Inativados/imunologia
20.
Blood Rev ; 34: 84-94, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30683446

RESUMO

The introduction of new therapeutic agents in multiple myeloma (MM), including proteasome inhibitors, immunoregulatory drugs and monoclonal antibodies, has improved the outcomes of patients, but in parallel has changed the frequency and epidemiology of infections. Hence, the great strides in the indications and use of new active treatments for MM need parallel progresses on the best approach to prophylaxis and supportive therapy for infections. Moving from the recognition that the above issue represents an unmet clinical need in MM, an expert panel assessed the scientific literature and composed a framework of recommendations for optimal infection control in patients candidate to active treatment for MM. The present publication represents a consensus document from questionnaires and consensus meetings held during 2017. The issues tackled in the project dealt with: infectious risk assessment, risk management and prophylaxis, intravenous immunoglobulin replacement therapy, antiviral and antibacterial vaccination. Considering the lack of conclusive and/or enough large studies for certain topics several recommendations derived from the personal experience of the experts.


Assuntos
Controle de Infecções , /terapia , Mieloma Múltiplo/complicações , Anti-Infecciosos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Consenso , Gerenciamento Clínico , Prova Pericial , Humanos , Imunoglobulinas Intravenosas , Incidência , Controle de Infecções/métodos , /epidemiologia , Mieloma Múltiplo/epidemiologia , Mieloma Múltiplo/terapia , Guias de Prática Clínica como Assunto , Pré-Medicação , Vacinas/uso terapêutico
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