Antibody persistence and response to 2010-2011 trivalent influenza vaccine one year after a single dose of 2009 AS03-adjuvanted pandemic H1N1 vaccine in children

Background

In 2009, several countries used the ASO3-adjuvanted pandemic A/H1N1 vaccine. We assessed the persistence of antibody and the priming induced by a single paediatric dose of this vaccine in children.

Methods

Children aged 15-120 months vaccinated one year before with the ASO3-adjuvanted monovalent pandemic vaccine were tested for the presence of antibody against 2010-2011 TIV components (A/California/7/2009(H1N1), A/Wisconsin/15/2009 (H3N2 A/Perth/16/2009-like) and B/Brisbane/60/2008) before and 21-28 days after each dose of 2010-2011 TIV. Hemagglutination-inhibition (HAI) assay was used. Children received one or two doses of 2010-2011 TIV at 21-28 days interval in relation with their previous immunization status.

Results

The results of 128 children were included in the ATP analysis. Before the 2010-2011 TIV administration, 46% of children showed sero-protection to the A/California/7/2009(H1N1) strain (HAI titre ≥40) with lower rates of sero-protection to the H3N2A/Perth/16/2009 (37%) and B/Brisbane/60/2008 (19%). After the first dose of 2010-2011 TIV, 98%, 75%, and 57% of vaccinees attained a sero-protective titre to A/California/7/2009(H1N1), A/Perth/16/2009(H3N2), and B/Brisbane/60/2008 strain, respectively. The youngest age group showed significantly lower antibody response to the influenza B component compared to the older age groups after the first dose of vaccine. Among vaccinees who received the second dose of TIV, 96% and 87% had a sero-protective titre to H3N2A/Perth/16/2009 and B/Brisbane/60/2008, respectively. The 2010-2011 TIV was well tolerated.

Conclusions

We found substantial persistence of antibody to the A/California/7/2009 strain one year after a single paediatric dose of AS03-adjuvanted pandemic vaccine and a seroprotective level of antibody to this strain in virtually all children who received one year later a single dose of the 2010-2011 TIV. In contrast, two doses of the 2010-2011 TIV were necessary to induce an adequate immune response to the A/Perth/16/2009(H3N2) and B/Brisbane/60/2008 strains in children previously naïve to seasonal vaccine.     

The state of psychiatry in Sweden

Abstract The number of practising psychiatrists in Sweden has increased by nearly 30% between the years 1995-2009; however, the profession has suffered serious recruitment difficulties. The Swedish National Board of Health and Welfare estimated that about 5-10% of the population is in need of psychiatric treatment, but only 3-4% seek psychiatric care. Among patients who receive psychiatric care, approximately 47% are treated with psychopharmacology, 13% are treated with psychotherapy and 40% receive both treatments. There are still challenges facing Swedish psychiatry: reduction in waiting times for psychiatric care, broader accessibility of evidence-based treatment methods for all groups of psychiatric patients both in rural and urban areas, and targeting the needs of immigrants and refugees. The allocation of resources to psychiatric research, and development of novel treatment methods are crucially needed. The Swedish government is strongly committed to decreasing the number of suicides, as there are approximately 1,400 individuals lost to suicide every year in a country with a population of around 10 million. Given that nearly 20% of all suicides are amongst psychiatric inpatients, a regulation has been passed regarding the analysis of all completed suicides in the healthcare system. Results from these analyses can be used for increasing quality of treatment.     

Congenital brain tumors in a series of 56 patients

Introduction

Central nervous system tumors diagnosed before the end of the first year of life differ from those found in older children and in adults. The differences include mode of clinical presentation, anatomical distribution, histopathological diagnoses, response to therapy, and outcome.

Materials and methods

The material consists of 56 children (23 girls and 33 boys), aged at recognition 32Hbd–12?months. We reviewed charts and MR exams according to age of the onset of symptoms, location of tumors, treatment, histopathology, and outcomes. Data of the outcome were analyzed using Kaplan–Meier plots and chi-square test.

Results

Eleven cases were recognized before 6?weeks of life, 24 before the age of 6?months, and 21 were diagnosed up to the end of 1?year of age. Thirty-eight tumors were located in the supratentorial compartment; 18 were infratentorial. Median age of tumors’ recognition was 5.2?months; 4.3?months for supratentorial and 7.2?months for infratentorial tumors. We found 18 glial cell tumors (high and low grade), 15 embryonal tumors, and 12 choroid plexus tumors.

Conclusions

The outcome of congenital CNS tumors depends on the size, location, time of diagnosis, histological type of the tumor, and therapeutic option. Neurosurgical procedures are necessary in most cases. Despite the notable advances in therapy, the outcome remains poor.     

Long-term results of vagus nerve stimulation in children and adolescents with drug-resistant epilepsy

Purpose  

The purpose of this study was to evaluate long-term seizure reduction and on-demand magnet use in children and adolescents with drug-resistant epilepsy who were treated with vagus nerve stimulation therapy.     

Effects of D-cycloserine and midazolam on the expression of the GABA-A alpha-2 receptor subunits in brain structures of fear conditioned rats

The role of the GABA-A alpha-2 receptor subunit in the basolateral amygdala (BLA), dentate gyrus of the hippocampus (DG) and prefrontal cortex (M2 area) during a fear session (performed one week after the conditioned fear test), was studied. We employed a model of high (HR) and low anxiety (LR) rats divided according to their conditioned freezing response. Pretreatment of rats with d-cycloserine immediately before the fear session attenuated fear response in HR and LR rats and increased the density of alpha-2 subunits in the BLA, M2 area and DG of HR animals. The less potent behavioural influence of midazolam (in HR group only) was linked to the increased expression of alpha-2 subunit in M2 area and DG. These results support a role of the GABA-A receptor alpha-2 subunit in processing of emotional cortico-hippocampal input to the BLA.     

Kynurenic acid: a new effector of valproate action?

We investigated the changes in hippocampal kynurenic acid (KYNA) concentrations and the amino acids involved in neuronal activity regulation following valproate (VPA) administration (400 mg/kg ip) in pentylenetetrazole-kindled rats (in vivo). We found a remarkably long-lasting increase in KYNA levels following VPA administration, and this effect correlated with a rise in GABA levels. No changes in the concentration of other analyzed amino acids were present. It is likely that the antiepileptic and neuroprotective properties of VPA may also be a consequence of an increase in the hippocampal KYNA concentration.     

Heart rate variability (HRV) and muscular system activity (EMG) in cases of crash threat during simulated driving of a passenger car

Objectives

The aim of the study was to verify whether simultaneous responses from the muscular and circulatory system occur in the driver’s body under simulated conditions of a crash threat.

Materials and Methods

The study was carried out in a passenger car driving simulator. The crash was included in the driving test scenario developed in an urban setting. In the group of 22 young male subjects, two physiological signals — ECG and EMG were continuously recorded. The length of the RR interval in the ECG signal was assessed. A HRV analysis was performed in the time and frequency domains for 1-minute record segments at rest (seated position), during undisturbed driving as well as during and several minutes after the crash. For the left and right side muscles: m. trapezius (TR) and m. flexor digitorum superficialis (FDS), the EMG signal amplitude was determined. The percentage of maximal voluntary contraction (MVC) was compared during driving and during the crash.

Results

As for the ECG signal, it was found that in most of the drivers changes occurred in the parameter values reflecting HRV in the time domain. Significant changes were noted in the mean length of RR intervals (mRR). As for the EMG signal, the changes in the amplitude concerned the signal recorded from the FDS muscle. The changes in ECG and EMG were simultaneous in half of the cases.

Conclusion

Such parameters as mRR (ECG signal) and FDS-L amplitude (EMG signal) were the responses to accident risk. Under simulated conditions, responses from the circulatory and musculoskeletal systems are not always simultaneous. The results indicate that a more complete driver’s response to a crash in road traffic is obtained based on parallel recording of two physiological signals (ECG and EMG).     

Joint Position Statement of the Polish Cardiologic Society,the Polish Gynaecological Society and the Polish Menopause and Andropause Society on the effect of postmenopausal hormone replacement therapy on the cardiovascular system

The group of experts representing the Polish Cardiologic Society, the Polish Gynecological Society and the Polish Menopause and Andropause Society has issued this Joint Position Statement based on the review of available literature on the effect of postmenopausal hormone replacement therapy on the cardiovascular system. The results of older clinical and epidemiological studies are confronted with the most recently published data. The importance of type, doses and delivery route of hormones is discussed with respect to the cardiovascular safety of HRT.     

Sodium and Potassium and the Pathogenesis of Hypertension

The evidence relating blood pressure to salt intake in humans originates from population studies and randomized clinical trials of interventions on dietary salt intake. Estimates from meta-analyses of trials in normotensive subjects generally are similar to estimates derived from prospective population studies (+1.7-mm Hg increase in systolic blood pressure per 100 mmol increment in 24-hour urinary sodium). This estimate, however, does not translate into an increased risk of incident hypertension in subjects consuming a high-salt diet. The meta-analyses of intervention trials have consistently shown that potassium supplementation is associated with lowering of blood pressure. However, prospective studies relating health outcomes to 24-hour urinary sodium and/or potassium excretion produced inconsistent results. Taken together, available evidence does not support the current recommendations of a generalized and indiscriminate reduction of salt intake at the population level, although the blood-pressure lowering effect of dietary sodium restriction might be of value in hypertensive patients. Potassium supplementation in hypertensive patients or healthy persons is not recommended by the current guidelines, but importance of adhering to healthy diet rich in vegetables and fruits is emphasized.