Avoidance and fear day by day in social anxiety disorder.

OBJECTIVE: Theories assert that avoidance maintains maladaptive anxiety over time, yet a clear prospective test of this effect in the day-by-day lives of people with social anxiety disorder (SAD) is lacking. METHOD: We used intensive longitudinal data to test prospective relationships between social fear and social avoidance in 32 participants with SAD who reported on a total of 4256 time points. RESULTS: Results suggested that avoidance strongly predicted future anxiety, but only in a minority of people with SAD. Relationships between anxiety and avoidance varied considerably across individuals. Pre-registered tests found that the strength of autocorrelation for social fear is a good target for future testing of prediction of exposure response. Participants with lower autocorrelations were less likely to show between-session habituation. CONCLUSIONS: Overall, results suggest avoidance maintains fear in SAD for at least some individuals, but also indicates considerable variability. Further intensive longitudinal data is needed to examine individuals with SAD across varying time courses.

Scaling of biological rates with body size as a backbone in the assembly of metacommunity biodiversity.

The dispersal-body mass association has been highlighted as a main determinant of biodiversity patterns in metacommunities. However, less attention has been devoted to other well-recognized determinants of metacommunity diversity: the scaling in density and regional richness with body size. Among active dispersers, the increase in movement with body size may enhance local richness and decrease ß-diversity. Nevertheless, the reduction of population size and regional richness with body mass may determine a negative diversity-body size association. Consequently, metacommunity assembly probably emerges from a balance between the effect of these scalings. We formalize this hypothesis by relating the exponents of size-scaling rules with simulated trends in α-, ß- and γ-diversity with body size. Our results highlight that the diversity-body size relationship in metacommunities may be driven by the combined effect of different scaling rules. Given their ubiquity in most terrestrial and aquatic biotas, these scaling rules may represent the basic determinants-backbone-of biodiversity, over which other mechanisms operate determining metacommunity assembly. Further studies are needed, aimed at explaining biodiversity patterns from functional relationships between biological rates and body size, as well as their association with environmental conditions and species interactions.

The Immunogenicity and Safety of a Combined DTaP-IPV//Hib Vaccine Compared with Individual DTaP-IPV and Hib (PRP~T) Vaccines: a Randomized Clinical Trial in South Korean Infants.

Recommended infant vaccination in Korea includes DTaP-IPV and Hib vaccines administered as separate injections. In this randomized, open, controlled study we assessed the non-inferiority of immunogenicity of DTaP-IPV//Hib pentavalent combination vaccine (Pentaxim™) compared with licensed DTaP-IPV and Hib (PRP~T) vaccines. We enrolled 418 healthy Korean infants to receive either separate DTaP-IPV and Hib vaccines (n = 206) or the pentavalent DTaP-IPV//Hib (n = 208) vaccine at 2, 4, 6 months of age. Antibodies to all components were measured before the first vaccination and one month after the third, and safety was assessed after each vaccination including recording of reactions by parents. We confirmed the non-inferiority of DTaP-IPV//Hib compared with DTaP-IPV and Hib vaccines; 100% of both groups achieved seroprotection against D, T, IPV and PRP~T, and 97.5%-99.0% demonstrated seroresponses to pertussis antigens. Antibody levels were similar in both groups, except for those to the Hib component, PRP~T. In separate and combined groups geometric mean concentrations of anti-PRP~T antibodies were 23.9 and 11.0 µg/mL, respectively, but 98.3% and 97.4% had titers ≥ 1 µg/mL, indicative of long-term protection. All vaccines were well tolerated, with no vaccine-related serious adverse event. Both groups had similar safety profiles, but the combined vaccine group had fewer injection site reactions. The immunological non-inferiority and similar safety profile of DTaP-IPV//Hib vaccine to separate DTaP-IPV and Hib vaccines, with the advantage of fewer injections and injection site reactions, supports the licensure and incorporation of DTaP-IPV//Hib into the Korean national vaccination schedule (Clinical trial registry, NCT01214889).

Influence of a passive exoskeleton on kinematics, joint moments, and self-reported ratings during a lifting task.

It was found that the Auxivo LiftSuit reduced the load on the back and hip muscles when lifting heavy loads, but its effect on lower body kinematics, joint moments, and self-reported ratings was unclear. The purpose of this study was to assess the effect of this passive lift-exoskeleton design, on lower body kinematics, joint moments, and self-reported ratings during lifting of heavy loads. Twenty healthy subjects performed lifting of heavy loads with and without the exoskeleton under surveillance of a motion capture system. Medium and maximum level adjustments of the exoskeleton, as well as no exoskeleton use were analyzed. Our results indicate significant reduction (p <.01) in pelvis segment tilt and hip flexion ROM with the exoskeleton at maximum level adjustment in males during lifting. Lumbosacral flexion moment ranges were significantly decreased (p <.013) with the exoskeleton at maximum and medium level adjustment in males during lifting. The general user impressions were mostly positive, with participants reporting that it was easier to perform the task with the exoskeleton than without it (p <.0.001), and preferring and recommending the exoskeleton for the task. Although our findings may suggest negative effects of the Auxivo LiftSuit in males and females due to a ROM restriction and loose fit, respectively, it does not mean that the Auxivo LiftSuit is not useful for lifting tasks. Further design improvements are required to allow full range of motion of hips and pelvis, as well to provide better adjustment and level of support in female users.

Automated ASPECTS Segmentation and Scoring Tool: a Method Tailored for a Colombian Telestroke Network.

To evaluate our two non-machine learning (non-ML)-based algorithmic approaches for detecting early ischemic infarcts on brain CT images of patients with acute ischemic stroke symptoms, tailored to our local population, to be incorporated in our telestroke software. One-hundred and thirteen acute stroke patients, excluding hemorrhagic, subacute, and chronic patients, with accessible brain CT images were divided into calibration and test sets. The gold standard was determined through consensus among three neuroradiologist. Four neuroradiologist independently reported Alberta Stroke Program Early CT Scores (ASPECTSs). ASPECTSs were also obtained using a commercial ML solution (CMLS), and our two methods, namely the Mean Hounsfield Unit (HU) relative difference (RELDIF) and the density distribution equivalence test (DDET), which used statistical analyze the of the HUs of each region and its contralateral side. Automated segmentation was perfect for cortical regions, while minimal adjustment was required for basal ganglia regions. For dichotomized-ASPECTSs (ASPECTS < 6) in the test set, the area under the receiver operating characteristic curve (AUC) was 0.85 for the DDET method, 0.84 for the RELDIF approach, 0.64 for the CMLS, and ranged from 0.71-0.89 for the neuroradiologist. The accuracy was 0.85 for the DDET method, 0.88 for the RELDIF approach, and was ranged from 0.83 - 0.96 for the neuroradiologist. Equivalence at a margin of 5% was documented among the DDET, RELDIF, and gold standard on mean ASPECTSs. Noninferiority tests of the AUC and accuracy of infarct detection revealed similarities between both DDET and RELDIF, and the CMLS, and with at least one neuroradiologist. The alignment of our methods with the evaluations of neuroradiologist and the CMLS indicates the potential of our methods to serve as supportive tools in clinical settings, facilitating prompt and accurate stroke diagnosis, especially in health care settings, such as Colombia, where neuroradiologist are limited.

Reexamining gender differences and the transdiagnostic boundaries of various conceptualizations of perseverative cognition.

Research examining gender differences in perseverative cognition (repetitive, negative, and difficult-to-control thoughts) has focused on depressive rumination and internalizing syndromes. This study examines the transdiagnostic role of depressive rumination, anger rumination, and repetitive negative thinking across gender on internalizing and externalizing symptoms. Utilizing an ethnoracially diverse sample (33% Black, 35% Latinx, 32% White non-Hispanic) of n = 1,187 young adults (49.5% women), we found equivalent instrument functioning across gender for depressive rumination (specifically brooding), anger rumination, and internalizing problems. Differential item functioning was found for repetitive negative thinking and externalizing problems; partial metric and scalar invariance were established for repetitive negative thinking, and partial metric invariance was established for externalizing problems. After accounting for bias in measurement, women engaged in more perseverative cognition, though effects were small for brooding and anger rumination and large for repetitive negative thinking. Different types of perseverations were positively associated with internalizing and externalizing symptoms across gender. Perseverative cognition may be a transdiagnostic mechanism beyond internalizing problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prey selection along a predators' body size gradient evidences the role of different trait-based mechanisms in food web organization.

An increase in prey richness, prey size and predator trophic position with predator body size has been consistently reported as prime features of food web organization. These trends have been explained by non-exclusive mechanisms. First, the increase in energy demand with body size determines that larger predators must reduce prey selectivity for achieving the required number of resources, being consumption relationships independent of prey traits. Second, when consumption is restricted by gape limitation, small predators are constrained to select among small prey. However, this selection weakens over large predators, which progressively consume more and larger prey. Finally, the optimal foraging mechanism predicts that larger predators optimize their diet by selecting only large prey with high energy reward. Each one of these mechanisms can individually explain the increase in prey richness, prey size and predator trophic position with predator body size but their relative importance or the direct evidence for their combined role was seldom considered. Here we use the community assembly by trait selection (CATS) theory for evaluating the support for each one of these mechanisms based on the prey selection patterns that they predict. We analyzed how prey body size and trophic guild determine prey selection by predators of increasing body size in a killifish guild from a temporary pond system. Results support the combination of the three mechanisms to explain the structural trends in our food web, although their strength is contingent on prey trophic group. Overall, high energy prey are preferred by larger predators, and small predators select small prey of all trophic status. However, large predators prefer large primary producers and avoid large carnivorous prey, probably because of the inherent risk of consuming other carnivorous. Our study provides a mechanistic understanding of how predator traits determine the selection of prey traits affecting food web assembly.

Post-Marketing Safety Surveillance of a Childhood Pentavalent Diphtheria-Tetanus-Acellular Pertussis-Polio and Haemophilus influenzae Type B (DTaP-IPV//Hib) Vaccine in South Korea.

INTRODUCTION: PENTAXIM™ (Sanofi), DTaP-IPV//Hib, a pentavalent combination vaccine for protection against diphtheria, tetanus, pertussis, poliomyelitis, and invasive infections caused by Haemophilus influenzae type b, has been licensed in South Korea by the Ministry of Food and Drug Safety (MFDS) on May 9, 2016, and is currently used in routine vaccination. The aim of this phase IV study, conducted as a post-licensure commitment in South Korea, was to evaluate the safety of the DTaP-IPV//Hib vaccine when administered in infants at 2, 4, and 6 months of age in the real-world clinical practice. METHODS: This multicenter, observational, post-marketing surveillance (PMS) study was conducted in real-world practice in South Korea. Infants aged 2 months or older were enrolled across seven centers from July 31, 2018 to February 11, 2020. The study outcomes included occurrence, time to onset, duration, intensity, and causality assessment (for unsolicited adverse events [AEs] only) for several pre-listed solicited injection-site and systemic reactions, unsolicited AEs, and serious adverse events (SAEs). RESULTS: Data from 619 participants were included in the safety analysis. Overall, 618 AEs were reported by 273 (44.1%) participants consisting of 121 solicited injection-site reactions (15.4%), 344 solicited systemic reactions (24.6%), and 153 unsolicited AEs (15.7%) of which, 124 were unexpected AEs (12.9%) (regardless of intensity). None of the unsolicited AEs were reported to have a causal relationship with the study vaccine. One SAE of pyrexia (solicited reaction) was reported. Most AEs were of mild intensity, and all participants recovered. CONCLUSION: This PMS study of the DTaP-IPV//Hib vaccine confirmed its safety profile in a real-life setting in South Korea and justified that the vaccine is well tolerated when used in infants aged 2 months or older for the primary series.

Endodontic Tissue Regeneration: A Review for Tissue Engineers and Dentists.

The paradigm shift in the endodontic field from replacement toward regenerative therapies has witnessed the ever-growing research in tissue engineering and regenerative medicine targeting pulp-dentin complex in the past few years. Abundant literature on the subject that has been produced, however, is scattered over diverse areas of knowledge. Moreover, the terminology and concepts are not always consensual, reflecting the range of research fields addressing this subject, from endodontics to biology, genetics, and engineering, among others. This fact triggered some misinterpretations, mainly when the denominations of different approaches were used as synonyms. The evaluation of results is not precise, leading to biased conjectures. Therefore, this literature review aims to conceptualize the commonly used terminology, summarize the main research areas on pulp regeneration, identify future trends, and ultimately clarify whether we are really on the edge of a paradigm shift in contemporary endodontics toward pulp regeneration.

Long-term immunogenicity assessment of a DTaP-IPV//PRP-T vaccine given at 2, 4, 6 and 18-19 months of age, and immunogenicity and safety of a DTaP-IPV vaccine given as a booster dose at 4 to 6 years of age in Thai children.

Booster vaccination of infants aims to further reduce the burden of childhood infectious diseases. This study assessed the antibody persistence induced by a primary series vaccination at 2, 4, 6 months of age and a first booster at 18-19 months of age with a pentavalent diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Haemophilus influenzae type b combined vaccine (DTaP-IPV//PRP-T) in 4-6 year-old Thai children (N=123). The safety and immunogenicity of a tetravalent acellular pertussis combined vaccine (containing the same DTaP-IPV antigens as the previous vaccine) given as a second booster at 4 to 6 years of age was also evaluated. Seroprotective antibody levels against diphtheria (> or = 0.01 IU/ml), tetanus (> or = 0.10 IU/ml), and polioviruses (> or = 8 1/dil) were maintained 4-6 years after primary-vaccination and first booster by > or = 92.7% of children, and anti-pertussis antibodies > or = 5 EU/ml were observed in the majority of children. The second booster with DTaP-IPV elicited a strong response for all antigens. GMT or GMC ratios for all antigens at the pre- and post-booster samples were from 4.7 to 52.5. Primary vaccination at 2, 4, 6 and a booster at 18-19 months of age with the DTaP-IPV//PRP-T vaccine induced satisfactory antibody persistence at 4-6 years of age. A second booster with DTaP-IPV induced a strong immune response and was well tolerated.

Antibody persistence after primary and booster doses of a pentavalent vaccine against diphtheria, tetanus, acellular pertussis, inactivated poliovirus, haemophilus influenzae type B vaccine among Thai children at 18-19 months of age.

The World Health Organization recommends a booster dose of a pertussis-containing vaccine for children aged 1-6 years, preferably during the second year of life. This study assessed the immunogenicity and safety of a pentavalent combination vaccine containing diphtheria, tetanus, acellular pertussis, inactivated poliovirus, and conjugated-Hib polysaccharide antigens, [(DTaP-IPV//PRP-T (Pentaxim)], as a booster at 18-19 months of age. Participants had received primary doses of the same vaccine at 2, 4 and 6 months of age. Antibody concentrations were measured immediately before and one month after the booster dose. Adverse events were evaluated from parental reports. Geometric mean concentrations (GMCs) or titers (GMTs) decreased from post-primary to pre-booster vaccination; however, at least 94.4% of children had protective levels of anti-tetanus (> or = 0.01 IU/ml), antipoliovirus (> or = 81/dil) and anti-PRP (Hib, > or = 0.15 microg/ml) antibodies prior to the booster. Anti-diphtheria antibody titers > or = 0.01 IU/ml were also observed in the majority of children pre-booster. One month after the booster, seroprotection rates were 99.4% for PRP (> or = 1.0 microg/ml), 95.0% for diphtheria (> or = 0.10 IU/ml) and 100% for tetanus (> or = 0.1 IU/ml) and poliovirus types 1, 2, 3 (> or = 81/dil). At least 93.1% of subjects had 4 fold post-booster increases in anti-pertussis antibody titers. GMCs increased from 14.0 to 307.3 EU/ml and from 13.9 to 271.9 EU/ml for anti-PT and anti-FHA, respectively. Anti-PRP GMC increased from 1.2 to 62.2 microg/ml. The booster was well tolerated. A booster dose during the second year of life was safe and induced a strong immune response, indicative of long-term protection.

Evaluation of Injectable Hyaluronic Acid-Based Hydrogels for Endodontic Tissue Regeneration.

Dental pulp tissue engineering (TE) endeavors to regenerate dentin/pulp complex by combining a suitable supporting matrix, stem cells, and biochemical stimuli. Such procedures foresee a matrix that can be easily introduced into the root canal system (RCS) and tightly adhere to dentin walls to assure the dentin surface's proper colonization with progenitor cells capable of restoring the dentin/pulp complex. Herein was investigated an injectable self-setting hyaluronic acid-based (HA) hydrogel system, formed by aldehyde-modified (a-HA) with hydrazide-modified (ADH), enriched with platelet lysate (PL), for endodontic regeneration. The hydrogels' working (wT) and setting (sT) times, the adhesion to the dentine walls, the hydrogel's microstructure, and the delivery of human dental pulp cells (DPCs) were studied in vitro. Hydrogels incorporating PL showed a suitable wT and sT and a porous microstructure. The tensile tests showed that the breaking point occurs after 4.3106 ± 1.8677 mm deformation, while in the indentation test after 1.4056 ± 0.3065 mm deformation. Both breaking points occur in the hydrogel extension. The HA/PL hydrogels exhibited supportive properties and promoted cell migration toward dentin surfaces in vitro. Overall, these results support using PL-laden HA injectable hydrogels (HA/PL) as a biomaterial for DPCs encapsulation, thereby displaying great clinical potential towards endodontic regenerative therapies.

Evaluation of an acellular pertussis, diphtheria, tetanus, inactivated poliovirus, Hib-conjugate combined vaccine (Pentaxim) at 2, 4, and 6 months of age plus hepatitis B vaccine at birth, 2, and 6 months of age in infants in Thailand.

The objective of this study was to evaluate the immunogenicity and safety of a pentavalent vaccine (Pentaxim) containing diphtheria, tetanus, acellular pertussis, inactivated poliovirus, and Hib polysaccharide-conjugate (DTaP-IPV//PRP-T) antigens, in Thai children. One hundred eighty-six infants who had received a hepatitis B vaccine at birth were given a pentavalent vaccine at 2, 4 and 6 months of age and a hepatitis B vaccine concomitantly at 2 and 6 months of age. Immunogenicity was high for each vaccine antigen. The study vaccine was well tolerated and side effects were few. After the third dose, 100% of subjects had an anti-PRP > or = 0.15 microg/ml and 96.5% > or = 1.0 microg/ml; the anti-PRP GMT was 9.53 microg/ml. Seroprotective rates for diphtheria and tetanus (> or = 0.01 IU/ml) were 99.4% and 100%, respectively, and 100% for all three poliovirus types (> or = 8 1/dil U). The vaccine response rates to pertussis antigens (a 4-fold increase in antibody titer were 94.1% for PT and 93.0% for FHA. The DTaP-IPV//PRP-T vaccine given at 2, 4 and 6 months of age concomitantly with a monovalent hepatitis B vaccine, was well tolerated and highly immunogenic for primary immunization of infants in Thailand.

Immunogenicity and safety of a DTaP-IPV//PRP-T vaccine (Pentaxim) booster during the second year of life in Thai children primed with an acellular pertussis combined vaccine.

This study assessed the booster immune response to a pentavalent combination vaccine containing diphtheria, tetanus, acellular pertussis, inactivated poliovirus, and conjugated-Hib polysaccharide antigens, (DTaP-IPV//PRP-T, Pentaxim, an AcXim family vaccine) at 18-24 months of age. Study subjects received a three-dose primary vaccination at 2, 4 and 6 months with a hexavalent vaccine containing the same antigens plus recombinant hepatitis B surface antigen. Antibody concentrations were measured immediately before and one month after vaccination. Reactogenicity and safety were evaluated from parent reports. Before the booster dose, 92.9% of the 156 children included in this study still had anti-PRP antibody titers > or = 0.15 microg/ml. Seroprotective concentrations of anti-diphtheria, tetanus and poliovirus antibodies were maintained in 97 to 100% of subjects in the interval between primary and booster vaccination. One month after the booster dose, all subjects had seroprotective anti-PRP (> or = 1 microg/ml), diphtheria and tetanus (> or = 0.1 IU/ml) and poliovirus types 1, 2, 3 (> or = 8 1/dil) antibody levels. At least 92.3% of subjects had 4-fold increases in concentrations of anti-pertussis antigens from pre- to post-booster dose. Geometric mean titers (GMTs) increased from 3.8 to 181.2 EU/ml and from 18.0 to 289.7 EU/ml for anti-PT and anti-FHA, respectively. The anti-PRP GMT increased from 1.6 to 58.0 microg/ml. The pentavalent DTaP-IPV//PRP-T vaccine booster was well tolerated and highly immunogenic, following primary vaccination with a hexavalent vaccine.

Immunogenicity and safety of a DTaP-IPV//PRP approximately T combination vaccine given with hepatitis B vaccine: a randomized open-label trial.

OBJECTIVE: To determine seroprotection and vaccine response rates produced by a diphtheria-tetanus-acellular pertussis-inactivated poliovirus-Haemophilus influenzae type-b conjugate (DTaP-IPV//PRP approximately T) vaccine containing a polyribosyl-ribitol-phosphate (PRP)-tetanus toxoid conjugate (Pentaxim) and given with a hepatitis B vaccine. METHODS: In this multicentre open-label trial, 424 infants who received DTaP-IPV//PRP approximately T at 6, 10 and 14 weeks of age were also randomized to receive hepatitis B vaccine at either 6, 10 and 14 weeks or 0, 6 and 14 weeks of age. Antibody levels were determined at 6 and 18 weeks of age, and reactogenicity was monitored using parental reports. FINDINGS: Immunogenicity was high for all vaccine antigens and was similar to that in a historical control study. After primary vaccination, 98.7% of all infants had an anti-PRP antibody titre > 0.15 microg/ml. Seroprotection against poliovirus type-1, -2 and -3 and tetanus was obtained in all infants, and against diphtheria, in 97.1%. Pertussis seroconversion, defined as a > fourfold increase in antibody titre, occurred in 95.3% for anti-pertussis toxoid antibody and in 89.0% for anti-filamentous haemagglutinin antibody. The hepatitis B seroprotection rate was 99.5% with administration at 0, 6 and 14 weeks, and 97.8%, at 6, 10 and 14 weeks. However, the antibody titre was higher with the 0, 6 and 14-week schedule (601 mIU/ml versus 207 mIU/ml). The reactogenicity of both vaccines was low. CONCLUSION: The DTaP-IPV//PRP approximately T vaccine was highly immunogenic. The anti-hepatitis B antibody response was seroprotective with both schedules, though the antibody titre was higher with the 0, 6 and 14-week schedule.

One-year post-primary antibody persistence and booster immune response to a fully liquid five-component acellular pertussis, diphtheria, tetanus, inactivated poliomyelitis, Haemophilus influenzae type b conjugate vaccine.

OBJECTIVE: To evaluate antibody persistence one year after three-dose primary vaccination and booster immune response during the second year of life for a fully liquid diphtheria-tetanus-acellular pertussis-inactivated poliomyelitis-Haemophilus influenzae type b (DTaP-IPV-PRP approximately T) vaccine. METHODS: Infants at 18-19 months of age were given a booster dose of either DTaP-IPV-PRP approximately T (group A) or DTaP-IPV plus PRP approximately T at separate injection sites (group B), after primary vaccination at two, four and six months of age, with the same vaccines. Antibody concentrations were measured pre- and post-booster. Reactogenicity and safety were evaluated from parent reports. RESULTS: Before the booster dose, 93.1% of group A and 95.1% of group B children still had anti-PRP antibody titers > or =0.15 microg/ml. All children had antibody levels believed to protect against tetanus, polio 1 (except one subject in group B), polio 2, polio 3, and diphtheria (except one subject in group A). At least 94% of children still had antibody concentrations > or =5 ELISA units (EU) to pertussis antigens (pertussis toxoid (PT), filamentous hemagglutinin (FHA), pertactin (PRN), fimbriae 2 and 3 (FIM2+3)). One month after the booster dose, all subjects achieved antibody concentrations or titers believed to be protective for PRP (polyribose ribitol phosphate)(> or =1 microg/ml), diphtheria and tetanus (> or =0.1 IU/ml) and poliovirus types 1, 2, and 3 (> or =81/dil.), and at least 90.5% of subjects had four-fold increases in antibody concentrations to pertussis antigens following the booster. Anti-PRP geometric mean titers (GMTs) increased from 1.07 to 59.6 microg/ml and from 1.8 to 62.2 microg/ml in groups A and B, respectively. Both vaccine groups showed low reactogenicity rates. CONCLUSIONS: The fully liquid pentavalent DTaP-IPV-PRP approximately T vaccine is highly immunogenic, with good antibody persistence for each antigen approximately one year after primary vaccination and strong booster responses at 18-19 months of age. Because this combined vaccine is fully liquid, requiring no reconstitution of lyophilized PRP approximately T, the ease of use and proper administration are improved.

A fully liquid diphtheria-tetanus-five component acellular pertussis-inactivated poliomyelitis--Haemophilus influenzae type b conjugate vaccine: immunogenicity and safety of primary vaccination in Taiwanese infants.

OBJECTIVE: To assess the immunogenicity of a fully liquid diphtheria-tetanus-five component acellular pertussis-inactivated poliomyelitis-Haemophilus influenzae type b (DTaP-IPV-Hib) conjugate vaccine compared to DTaP-IPV and lyophilized Hib conjugate vaccines given simultaneously at separate sites as a three-dose primary vaccination in Taiwanese infants. METHODS: Two hundred infants were randomized to receive either DTaP-IPV-Hib or DTaP-IPV plus Hib vaccine at 2, 4, and 6 months of age. Both combined vaccines contained the same five pertussis antigens: pertussis toxoid (PT), filamentous hemagglutinin (FHA), pertactin (PRN), fimbriae 2 and 3 (FIM 2&3). Antibody concentrations were measured before the first and after the third dose. Reactogenicity was evaluated from parental reports. All subjects received hepatitis B vaccine at 0, 1, and 6 months of age following the national vaccination schedule of Taiwan. RESULTS: The immunogenicity after the third dose was high for each vaccine antigen in both groups, and the vaccines had low reactogenicity. Statistical analysis showed no differences in the immune responses to the fully liquid DTaP-IPV-Hib vaccine compared with those to the DTaP-IPV plus Hib control vaccines, notably the anti-PRP (polyribose ribitol phosphate capsular polysaccharide) response, with 97-99% of infants having concentrations >or=1.0 microg/mL. Approximately 95% of all infants developed seroprotective levels of anti-hepatitis B surface antigen (HBs) antibodies (>or=10 mIU/mL). CONCLUSIONS: Both combination vaccines had similar high immunogenicity for each antigen, and both were well tolerated. Thus, inclusion of a Haemophilus influenzae type b conjugate vaccine in the combination did not result in clinically significant decrease in the PRP response or increase reactogenicity. The fully liquid pentavalent vaccine has the advantages of not requiring reconstitution and of administration as a single injection.

Spinal anesthesia in a patient with Charcot-Marie-Tooth disease undergoing orthopedic surgery: case report / Anestesia raquídea en un paciente con enfermedad de Charcot-Marie-Tooth sometido a cirugía ortopédica: reporte de caso

Abstract Introduction: It is uncommon to come across patients with neuromuscular diseases in the daily practice of anesthesia, given the low prevalence of those conditions. Charcot-Marie-Tooth (CMT) disease is the most frequently, caused by an inherited abnormal myelin structure pattern. In view of the low prevalence of this condition (1:25,000), there is little information, derived mostly from case reports, about the use of neuroaxial anesthesia in these patients. Case presentation: Description of a patient with underlying CMT disease compromising lower limb mobility, who comes to the emergency service due to lower limb pain. After being diagnosed with an acetabular fracture, the patient underwent orthopedic surgery under spinal anesthesia, selected based on patient comorbidities, and the immediate postoperative follow-up. Results: The anesthetic and surgical procedures proceeded uneventfully and no neuropathic worsening was observed during the next 24 hours. Conclusion: Uneventful neuroaxial anesthesia is reported in a patient with neuromuscular disease. The case contributes to show the benefits and safety of this form of anesthesia when compared with other options.

Resumen Introducción: En la práctica anestésica diaria es raro enfrentarse a pacientes con patologías neuromusculares, dada la poca pre-valencia de dichas patologías. La más frecuente de ellas es la enfermedad de Charcot-Marie-Tooth, en la cual se hereda un patrón alterado en la estructura de la mielina. Debido a la baja prevalencia de esta patología (1:25000), el uso de anestesia neuroaxial en dichos pacientes no cuenta con mucha información, y mucha de ella proviene de reportes de casos. Presentación del caso: Se describe el caso de un paciente con enfermedad de Charcot-Marie-Tooth, de base, con compromiso de la movilidad en miembros inferiores, y quien asiste a urgencias por dolor en miembro inferior. Tras ser diagnosticado con fractura de acetábulo, fue sometido a cirugía ortopédica bajo anestesia raquídea, indicada a la luz de sus comorbilidades, y el posterior seguimiento inmediato. Resultados: Se realiza el procedimiento anestésico y quirúrgico sin complicaciones, y no se presenta empeoramiento de la neuropatía en las 24 horas posteriores. Conclusiones: Se reporta un caso de anestesia neuroaxial en paciente con enfermedad neuromuscular sin incidencias, que ayuda así a ir mostrando los beneficios de la mencionada anestesia y su seguridad frente a otras opciones.