scholarly journals Immunogenicity and Complications of the Pentavalent Vaccine in Iranian Children

2021 ◽  
Vol 9 ◽  
Author(s):  
Mina Ekrami Noghabi ◽  
Mohammad Jafar Saffar ◽  
Shaghayegh Rezai ◽  
Hana Saffar ◽  
Hiva Saffar ◽  
...  
Keyword(s):  
Side Effects ◽  
Hepatitis B ◽  
Geometric Mean ◽  
Venous Blood ◽  
Haemophilus Influenzae Type ◽  
Chi Square ◽  
Northern Iran ◽  
Systemic Complications ◽  
Pentavalent Vaccine ◽  
Iranian Children

Objective: Vaccination is one of the most convenient and safe preventive care measures available for children. The Pentavalent vaccine which protects against five major infections including diphtheria, tetanus, pertussis, hepatitis B(HepB) and Haemophilus influenzae type b(Hib) was added to the Iranian national immunization program in November 2014. This study aimed to determine the Pentavalent vaccine adverse events and immunogenicity in an Iranian children population in Sari, northern Iran.Method: In this descriptive-analytical study, children who were vaccinated with three doses of the Pentavalent vaccine were studied. Two venous blood samples were obtained before the first dose and 4 weeks following the last booster dose. Possible local and systemic complications of the vaccine were recorded until 7 days following vaccination. Antibody titers were measured by quantitative ELISA kits and geometric mean titer(GMT) was calculated for each vaccine component before and after 3 doses of vaccine. Statistical analysis was performed by SPSS 20.0 software and Chi-square and Fisher's exact tests were used for analysis.Results: Immunogenicity of the Pentavalent vaccine for tetanus was 100%(GMT:2.52 Eu/mL, 95%CI: 2.22–2.88), Hib 98.7%(GMT:2.44 Eu/mL, 95%CI: 2.06–2.89), HepB 98.7%(GMT:153.54 Eu/mL, 95%CI: 133.73–176.29), diphtheria 93.1%(GMT:0.43 Eu/mL, 95%CI:0.37–0.51) and pertussis were 63.7% (GMT:19.44 Eu/mL, 95%CI:16.42–23.03). The most common systemic complication after vaccination was fever. Also, one infant cried for more than 3 hours after the second dose. Other serious side effects were not observed.Conclusion: The Pentavalent vaccine used in Iran can cause adequate antibody response against diphtheria, tetanus, pertussis, Hib and hepatitis B in most cases with minimal side effects. The immunogenicity of this vaccine is significantly lower for pertussis. In this study, no severe complication leading to contraindication to subsequent injections was reported. So, the present policy in replacing triple DTP vaccine with Pentavalent vaccine should be continued in Iran.

Characterization of Vaccination Policies for Attendance and Employment at Day/Summer Camps in New York State

2018 ◽  
Vol 32 (4) ◽  
pp. 382-387
Author(s):  
William A. Prescott ◽  
Kelsey C. Violanti ◽  
Nicholas M. Fusco
Keyword(s):  
New York ◽  
Hepatitis B ◽  
New York State ◽  
Survey Instrument ◽  
Summer Camps ◽  
Educational Outreach ◽  
Haemophilus Influenzae Type ◽  
Chi Square ◽  
York State ◽  
Age Appropriate

Introduction: New York state requires day/summer camps to keep immunization records for all enrolled campers and strongly recommends requiring vaccination for all campers and staff. The objective of this study was to characterize immunization requirements/recommendations for children/adolescents enrolled in and staff employed at day/summer camps in New York state. Methods: An electronic hyperlink to a 9-question survey instrument was distributed via e-mail to 178 day/summer camps located in New York state cities with a population size greater than 100 000 people. A follow-up telephone survey was offered to nonresponders. The survey instrument included questions pertaining to vaccination documentation policies for campers/staff and the specific vaccines that the camp required/recommended. Fisher’s exact and Chi-square tests were used to analyze categorical data. Results: Sixty-five day/summer camps responded to the survey (36.5% response rate): 48 (73.8%) and 23 (41.8%) camps indicated having a policy/procedure for documenting vaccinations for campers and staff, respectively. Camps that had a policy/procedure for campers were more likely to have a policy/procedure for staff ( P = .0007). Age-appropriate vaccinations that were required/recommended for campers by at least 80% of camps included: measles, mumps, and rubella (MMR), diphtheria, tetanus, and pertussis (DTaP), hepatitis B, inactivated/oral poliovirus (IPV/OPV), Haemophilus influenzae type b (Hib), and varicella. Age-appropriate vaccinations that were required/recommended for staff by at least 80% of camps included: DTaP, hepatitis B, IPV/OPV, MMR, meningococcus, varicella, Hib, and tetanus, diphtheria, and pertussis (Tdap). Conclusion: Vaccination policies at day/summer camps in New York state appear to be suboptimal. Educational outreach may encourage camps to strengthen their immunization policies, which may reduce the transmission of vaccine-preventable diseases.

scholarly journals Efficacy and Safety of a 3-Antigen (Pre-S1/Pre-S2/S) Hepatitis B Vaccine: Results of a Phase 3 Randomized Clinical Trial in the Russian Federation

2020 ◽  
Author(s):  
Elena V Esaulenko ◽  
Aleksey A Yakovlev ◽  
Genady A Volkov ◽  
Anastasia A Sukhoruk ◽  
Kirill G Surkov ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Geometric Mean ◽  
Serious Adverse Events ◽  
Double Blind ◽  
Antigen Vaccine ◽  
Single Antigen ◽  
Antibody Titers ◽  
The Russian Federation ◽  
The Difference ◽  
Mean Concentration

Abstract Background This study compares the immunogenicity and safety of a 3-antigen (S/pre-S1/pre-S2) hepatitis B (HepB) vaccine (3AV), to a single antigen vaccine (1AV) in adults to support the registration of 3AV in Russia. Methods We conducted a randomized, double-blind, comparative study of 3-dose regimens of 3AV (10 μg) and 1AV (20 µg) in adults aged 18–45 years. We evaluated immunogenicity based on hepatitis B surface (HBs) antibody titers at days 1, 28, 90, 180, and 210, adverse and serious adverse events (SAEs) to study day 210. The primary outcome was based on the difference in rates of seroconversion at day 210 (lower bound 95% confidence interval [CI]: > − 4%). Secondary outcomes were seroprotection rates (SPR), defined as anti-HBs ≥10 mIU/mL and anti-HBs geometric mean concentration (GMC). Results Rate of seroconversion in 3AV (100%) was noninferior to 1AV (97.9%) at study day 210 (difference: 2.1%, 95% CI: −2.0, 6.3%]) but significantly higher at study day 28. SPR at study day 210 was >97% in both arms. Anti-HBs titers were significantly higher at study days 90 (P = .001) and 180 (P = .0001) with 3AV. Sex, age, and body mass index (BMI) had no impact on anti-HBs titers. The rates of local reactions related to vaccination were similar between vaccine arms (3AV vs 1AV) after the first (30% vs 18.8%, P = .15), second (20.0% vs 14.6%, P = .33), and third vaccination (14.9% vs 23.4%, P = .22). No SAEs were reported. Conclusions 3AV was noninferior to 1AV. 3AV induced high SPR, and there were no safety concerns. Clinical Trials Registration. NCT04209400.

The study of Iranian children and adolescents’ physical activity: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Adel Alizadeh ◽  
Reza Negarandeh ◽  
Fahimehe Bagheri Amiri ◽  
Zahra Yazdani
Keyword(s):  
Physical Activity ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
World Health ◽  
Chi Square ◽  
The Status ◽  
Newcastle Ottawa Scale ◽  
Health Organization ◽  
Iranian Children

Abstract Objectives This systematic and meta-analysis review was conducted to determine the status of Iranian children and adolescents’ physical activity. Content All the related articles which were published in the major databases, including Pubmed, Scopus, Web of Science, Embase, Magiran, SID from the beginning of 2010 to the end of 2019, were reviewed by researchers. The Newcastle-Ottawa scale was also used to evaluate the quality of articles. Moreover, I 2 index and chi-square were used to assess the heterogeneity between the results. Summary 490 articles were found as a result of the search in the selected international and local databases, where finally, 10 articles were included into the meta-analysis after the elimination of the duplicated articles and applying inclusion and exclusion criteria. The results indicated that 29.5% of the girls were considered active according to WHO criteria (16.1–42.8: 95% CI) and also 20.5% of the boys (7.3–33.7: 95% CI). Outlook Overall, this study’s findings showed that a large percentage of Iranian children and adolescents do not achieve the level of physical activity recommended by the World Health Organization. This can lead to undesirable consequences for this group of population that is considered as the human capital of any country; consequently, it seems necessary to take basic measures at the micro and macro levels in order to reduce such problems in the society.

scholarly journals Efficacy and Tolerability of Methotrexate and Methylprednisolone in a Comparative Assessment of the Primary and Long-Term Outcomes in Patients with Pulmonary Sarcoidosis

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1289
Author(s):  
Volodymyr Gavrysyuk ◽  
Ievgenia Merenkova ◽  
Yaroslav Dziublyk ◽  
Nataliia Morska ◽  
Nataliia Pendalchuk ◽  
...  
Keyword(s):  
Side Effects ◽  
Relapse Rate ◽  
Total Duration ◽  
Treatment Resistance ◽  
Pulmonary Sarcoidosis ◽  
Long Term Outcomes ◽  
High Resolution Computed Tomography ◽  
Chi Square ◽  
Ct Data

Background: There is insufficient information in the literature on the comparative efficacy and tolerability of methotrexate (MTX) and methylprednisolone (MP) in patients with pulmonary sarcoidosis in assessing primary outcomes and the relapse rate. Purpose: The aim of our study was to evaluate primary and long-term outcomes of using MTX and MP in patients with pulmonary sarcoidosis. Methods: A total of 143 patients with newly diagnosed pulmonary sarcoidosis, verified by high-resolution computed tomography (CT) data, were examined. Corticosteroid (CS) therapy was used in 97 patients using MP at a dose of 0.4 mg/kg body weight for 4 weeks, followed by a dose reduction to 0.1 mg/kg by the end of the sixth month. The total duration of CS therapy was 12 months on average. Forty-six patients were treated with MTX at a dose of 10 mg/week (28) and 15 mg/week (18) per os for 6 to 12 months. The study of the relapse rate was conducted within 12 months after the CT data normalization in 60 patients after CS therapy and in 24 after MTX treatment. Results: MP treatment was successfully completed in 68 (70.1%), and MTX in 29 (60.4%) patients. In five MP patients (5.2%) and in five (10.9%) MTX, treatment was discontinued due to serious side effects. In seven (7.2%) MP patients and ten (21.7%) MTX patients, treatment required additional therapy due to the lack of efficacy. Progression with MP treatment (17–17.5%) was more common than with MTX (2–4.3%; Chi square = 4.703, p = 0.031). Relapses after MP therapy were observed in 26 (43.3%) patients, and after MTX therapy in 2 (8.3%; Chi square = 9.450, p = 0.003). Conclusion: In patients with pulmonary sarcoidosis, MTX monotherapy does not differ significantly from MP monotherapy in terms of the level of efficacy and the rate of serious side effects. Increasing the MTX dose from 10 to 15 mg/week accelerates the rate of regression of sarcoidosis, improves treatment efficacy, and does not affect the rate of serious side effects. When using MTX, there is a significant decrease in the incidence of treatment resistance and the relapse rate.

scholarly journals Phase 1 and Phase 2 Studies of Salmonella enterica Serovar Paratyphi A O-Specific Polysaccharide-Tetanus Toxoid Conjugates in Adults, Teenagers, and 2- to 4-Year-Old Children in Vietnam

2000 ◽  
Vol 68 (3) ◽  
pp. 1529-1534 ◽  
Author(s):  
Edward Y. Konadu ◽  
Feng-Ying C. Lin ◽  
Vô Anh Hó ◽  
Nguyen Thi Thanh Thuy ◽  
Phan Van Bay ◽  
...  
Keyword(s):  
Side Effects ◽  
Bactericidal Activity ◽  
Tetanus Toxoid ◽  
Salmonella Enterica ◽  
Phase 1 ◽  
Geometric Mean ◽  
Age Groups ◽  
Significant Rise ◽  
Phase 2 ◽  
Specific Polysaccharide

ABSTRACT Salmonella enterica serovar Paratyphi A O-specific polysaccharide (O-SP) was activated with 1-cyano-4-dimethylaminopyridinium tetrafluoroborate (CDAP) and bound to tetanus toxoid (TT) with adipic acid dihydrazide as a linker (SPA-TT1) or directly (SPA-TT2). In mice, these two conjugates elicited high levels of immunoglobulin G (IgG) anti-lipopolysaccharide (LPS) in serum with bactericidal activity (E. Konadu, J. Shiloach, D. A. Bryla, J. B. Robbins, and S. C. Szu, Infect. Immun. 64:2709–2715, 1996). The safety and immunogenicity of the two conjugates were then evaluated sequentially in Vietnamese adults, teenagers, and 2- to 4-year-old children. None of the vaccinees experienced significant side effects, and all had preexisting LPS antibodies. At 4 weeks after injection, there were significant increases of the geometric mean IgG and IgM anti-LPS levels in the adults and teenagers: both conjugates elicited a greater than fourfold rise in the IgG anti-LPS level in serum in ≥80% of the volunteers. SPA-TT2 elicited slightly higher, though not statistically significantly, levels of IgG anti-LPS than did SPA-TT1 in these age groups. Accordingly, only SPA-TT2 was evaluated in the 2- to 4-year-old children. On a random basis, one or two injections were administered 6 weeks apart to the children. No significant side effects were observed, and the levels of preexisting anti-LPS in serum were similar in children of all ages. A significant rise in the IgG anti-LPS titer was elicited by the first injection (P = 0.0001); a second injection did not elicit a booster response. Representative sera from all groups had bactericidal activity that could be adsorbed by S. enterica serovar Paratyphi A LPS.

Effects of an opioid stewardship program on opioid consumption and related outcomes after multilevel lumbar spine fusion: a pre- and postimplementation analysis of 268 patients

2021 ◽  
pp. 1-9
Author(s):  
Marie-Jacqueline Reisener ◽  
Alexander P. Hughes ◽  
Ichiro Okano ◽  
Jiaqi Zhu ◽  
Artine Arzani ◽  
...  
Keyword(s):  
Side Effects ◽  
Spine Surgery ◽  
Effect Size ◽  
Lumbar Fusion ◽  
Opioid Consumption ◽  
Opioid Use ◽  
Chi Square ◽  
Opioid Prescribing ◽  
Pain Scores ◽  
Stewardship Program

OBJECTIVE Opioid stewardship programs combine clinical, regulatory, and educational interventions to minimize inappropriate opioid use and prescribing for orthopedic and spine surgery. Most evaluations of stewardship programs quantify effects on prescriber behavior, whereas patient-relevant outcomes have been relatively neglected. The authors evaluated the impact of an opioid stewardship program on perioperative opioid consumption, prescribing, and related clinical outcomes after multilevel lumbar fusion. METHODS The study was based on a retrospective, quasi-experimental, pretest-posttest design in 268 adult patients who underwent multilevel lumbar fusion in 2016 (preimplementation, n = 141) or 2019 (postimplementation, n = 127). The primary outcome was in-hospital opioid consumption (morphine equivalent dose [MED], mg). Secondary outcomes included numeric rating scale pain scores (0–10), length of stay (LOS), incidence of opioid-induced side effects (gastrointestinal, nausea/vomiting, respiratory, sedation, cognitive), and preoperative and discharge prescribing. Outcomes were measured continuously during the hospital admission. Differences in outcomes between the epochs were assessed in bivariable (Wilcoxon signed-rank or Fisher’s exact tests) and multivariable (Wald’s chi-square test) analyses. RESULTS In bivariable analyses, there were significant decreases in preoperative opioid use (46% vs 28% of patients, p = 0.002), preoperative opioid prescribing (MED 30 mg [IQR 20–60 mg] vs 20 mg [IQR 11–39 mg], p = 0.003), in-hospital opioid consumption (MED 329 mg [IQR 188–575 mg] vs 199 mg [100–372 mg], p < 0.001), the incidence of any opioid-related side effect (62% vs 50%, p = 0.03), and discharge opioid prescribing (MED 90 mg [IQR 60–135 mg] vs 60 mg [IQR 45–80 mg], p < 0.0001) between 2016 and 2019. There were no significant differences in postanesthesia care unit pain scores (4 [IQR 3–6] vs 5 [IQR 3–6], p = 0.33), nursing floor pain scores (4 [IQR 3–5] vs 4 [IQR 3–5], p = 0.93), or total LOS (118 hours [IQR 81–173 hours] vs 103 hours [IQR 81–132 hours], p = 0.21). On multivariable analysis, the opioid stewardship program was significantly associated with decreased discharge prescribing (Wald’s chi square = 9.45, effect size −52.4, 95% confidence interval [CI] −86 to −19.0, p = 0.002). The number of lumbar levels fused had the strongest effect on total opioid consumption during the hospital stay (Wald’s chi square = 16.53, effect size = 539, 95% CI 279.1 to 799, p < 0.001), followed by preoperative opioid use (Wald’s chi square = 44.04, effect size = 5, 95% CI 4 to 7, p < 0.001). CONCLUSIONS A significant decrease in perioperative opioid prescribing, consumption, and opioid-related side effects was found after implementation of an opioid stewardship program. These gains were achieved without adverse effects on pain scores or LOS. These results suggest the major impact of opioid stewardship programs for spine surgery may be on changing prescriber behavior.

Surveillance for Transmission of Hepatitis B in Child Day Care

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 1002-1004
Author(s):  
Hjordis M. Foy ◽  
Paul D. Swenson ◽  
M. Jayne Freitag-Koontz ◽  
Janice Boase ◽  
Tianji-Yu ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Day Care ◽  
Case Reports ◽  
Hepatitis B Surface Antigen ◽  
Horizontal Transmission ◽  
Acute Infection ◽  
Venous Blood ◽  
Core Antigen ◽  
Day Care Centers ◽  
Blood Specimens

Relatively little is known about the risk of transmission of hepatitis B virus (HBV) in day-care centers; the virus is primarily spread by blood and other body secretions. Gradual horizontal transmission of hepatitis B has been observed in homes for the mentally retarded.1-3 Horizontal spread in children appears to be of equal importance with vertical transmission in countries where hepatitis B is endemic.4 These infections, which usually are asymptomatic, may result in chronic carriage and may go undetected unless children are tested for hepatitis B markers. Studies in day-care centers in Okinawa, where HBV carriage is relatively common, suggest that transmission may occur in day-care centers.5 Case reports of HBV transmission in school or day-care settings in the US6 and Italy7 have been published. Our study was undertaken to determine whether there is evidence of horizontal transmission of HBV infections in US day-care facilities. To evaluate this, we screened for the antibody to hepatitis B core antigen (anti-HBc), a marker which is seen both in those who have recovered from hepatitis B and those who are carriers.8 Capillary blood specimens, obtained by finger prick, were used. Children who tested positive had venous blood specimens drawn and their families were approached for consent to draw venous specimens also from the household members to evaluate if the infection may have originated in the family. The venous specimens were tested also for additional markers, especially for hepatitis B surface antigen (HBsAg), which is found during acute infection and in carriers, and antibody to HBsAg (anti-HBs) which develops after infection and immunization.

A DOUBLE BLIND COMPARATIVE STUDY BETWEEN INTRATHECAL BUPIVACAINE AND INTRATHECAL FENTANYLAS THE INITIAL DOSE OF COMBINED SPINAL EPIDURAL TECHNIQUE FOR LABOUR ANALGESIA

2021 ◽  
pp. 48-50
Author(s):  
Niraj Kumar Mishra ◽  
Sushil Kumar
Keyword(s):  
Side Effects ◽  
Fetal Distress ◽  
Labour Pain ◽  
Sampling Procedure ◽  
Chi Square ◽  
Double Blind ◽  
Motor Weakness ◽  
Group I ◽  
Group Ii ◽  
Fetal Oxygenation

Introduction: Labour pain is among the most severe pain a woman can experience in her lifetime. Painful labour has decrimental effects on both mother and fetus leads to severe physical and psychological stress. Maternal hyperventilation in response to pain reduces fetal oxygenation and hypoventilation between contractions combined with decreased blood ow worsens fetal hypoxemia. It has been suggested that conning women to bed during labour may cause the labour to be longer and more painful with increase in abnormal presentation, instrumental deliveries and fetal distress. Aims And Objectives:The onset, quality and duration of their analgesic action. Incidence of unwanted effects like muscle weakness, hypotension, pruritus, nausea/vomiting, fetal bradycardia by the individual drugs. Materials And Methods: The study was conducted in the department of anesthesia, Darbhanga Medical College & Hospital, Laheriasarai, Bihar. Methods of collection of data (including sampling procedure if any) : After institutional committee approval and written informed consent from parturients and their relatives for the procedure the study was conducted and data were collected. Results: Duration of analgesia was found varying widely. It was 55±12.34 minutes in Group I whereas 75 ±14.36 minutes in Group II. The incidence of pruritus almost mild or negligible in both groups. The incidence of motor weakness in group II was 24 (80%) whereas in group I it was 10(33%). There was signicant statistics difference in motor weakness between two groups (p< 0.001) by Chi square test 9 with yate's correction. Other side effects differences between two groups were not statistically signicant. Summary And Conclusion:Both the drugs provided excellent quality of analgesia to the parturient in pain. The difference in duration of analgesia was signicant between the two groups statistically. Mean duration of analgesia lasted for 55 minutes in group I whereas in group II, it lasted for 75 minutes. Main side effects encountered in this study were motor weakness of longer duration in group II than in group I. Other side effects like nausea-vomiting were comparable to each other and were minimal in nature.

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