The Effectiveness of Preventative Mass Vaccination Regimes Against the Incidence of Highly Pathogenic Avian Influenza on Java Island,Indonesia

We conducted an operational research study involving backyard and semicommercial farms on Java Island, Indonesia, between April 2008 and September 2009 to evaluate the effectiveness of two preventive mass vaccination strategies against highly pathogenic avian influenza (HPAI). One regimen used Legok 2003 H5N1 vaccine, while the other used both Legok 2003 H5N1 and HB1 Newcastle disease (ND) vaccine. A total of 16 districts were involved in the study. The sample size was estimated using a formal power calculation technique that assumed a detectable effect of treatment as a 50% reduction in the baseline number of HPAI‐compatible outbreaks. Within each district, candidate treatment blocks with village poultry populations ranging from 80 000 to 120 000 were created along subdistrict boundary lines. Subsequently, four of these blocks were randomly selected and assigned one treatment from a list that comprised control, vaccination against HPAI, vaccination against HPAI + ND. Four rounds of vaccination were administered at quarterly intervals beginning in July 2008. A vaccination campaign involved vaccinating 100 000 birds in a treatment block, followed by another 100 000 vaccinations 3 weeks later as a booster dose. Data on disease incidence and vaccination coverage were also collected at quarterly intervals using participatory epidemiological techniques. Compared with the unvaccinated (control) group, the incidence of HPAI‐compatible events declined by 32% (P = 0.24) in the HPAI‐vaccinated group and by 73% (P = 0.00) in the HPAI‐ and ND‐vaccinated group. The effect of treatment did not vary with time or district. Similarly, an analysis of secondary data from the participatory disease and response (PDSR) database revealed that the incidence of HPAI declined by 12% in the HPAI‐vaccinated group and by 24% in the HPAI + ND‐vaccinated group. The results suggest that the HPAI + ND vaccination significantly reduced the incidence of HPAI‐compatible events in mixed populations of semicommercial and backyard poultry.     

IMI Pathologic Myopia

Pathologic myopia is a major cause of visual impairment worldwide. Pathologic myopia is distinctly different from high myopia. High myopia is a high degree of myopic refractive error, whereas pathologic myopia is defined by a presence of typical complications in the fundus (posterior staphyloma or myopic maculopathy equal to or more serious than diffuse choroidal atrophy). Pathologic myopia often occurs in eyes with high myopia, however its complications especially posterior staphyloma can also occur in eyes without high myopia.Owing to a recent advance in ocular imaging, an objective and accurate diagnosis of pathologic myopia has become possible. Especially, optical coherence tomography has revealed novel lesions like dome-shaped macula and myopic traction maculopathy. Wide-field optical coherence tomography has succeeded in visualizing the entire extent of large staphylomas. The effectiveness of new therapies for complications have been shown, such as anti-VEGF therapies for myopic macular neovascularization and vitreoretinal surgery for myopic traction maculopathy.Myopia, especially childhood myopia, has been increasing rapidly in the world. In parallel with an increase in myopia, the prevalence of high myopia has also been increasing. However, it remains unclear whether or not pathologic myopia will increase in parallel with an increase of myopia itself. In addition, it has remained unclear whether genes responsible for pathologic myopia are the same as those for myopia in general, or whether pathologic myopia is genetically different from other myopia.     

Assessing the validity of corneal power estimation using conventional keratometry for intraocular lens power calculation in eyes with Fuch’s dystrophy undergoing Descemet membrane endothelial keratoplasty

Graefe's Archive for Clinical and Experimental Ophthalmology - The present retrospective study was designed to test the hypothesis that the postoperative posterior to preoperative anterior...     

Local cooling reduces regional bone blood flow

Local cooling is very common after bone and joint surgery. Therefore the knowledge of bone blood flow during local cooling is of substantial interest. Previous studies revealed that hypothermia leads to vasoconstriction followed by decreased blood flow levels. The aim of this study was to characterize if local cooling is capable of inducing reduced blood flow in bone tissue using a stepwise‐reduced temperature protocol in experimental rabbits. To examine bone blood flow we utilized the fluorescent microsphere (FM) method. In New Zealand white rabbits one randomly chosen hind limb was cooled stepwise from 32 to 2°C, whereas the contra lateral hind limb served as control. Injection of microspheres was performed after stabilization of bone and muscle temperature at each temperature level. Bones were removed, dissected and fluorescence intensity was determined to calculate blood flow values. We found that blood flow of all cooled regions decreased relative to the applied external temperature. At maximum cooling blood flow was almost completely disrupted, indicating local cooling as powerful regulatory mechanism for regional bone blood flow (RBBF). Postoperative cooling therefore may lead to strongly decreased bone blood flow values. As a result external cooling has capacity to both diminish bone healing and reduce bleeding complications. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31:1820–1827, 2013     

Evidence of an autoregulatory mechanism of regional bone blood flow at hypotension

Background

Blood flow in various organs is determined by an autoregulatory mechanism that guarantees constant organ perfusion over a wide range of arterial blood pressure changes. This physiological principle has been proven for the kidney, brain and intestinal tract, but so far not for bone. This study was carried out to determine whether there is an autoregulatory mechanism of bone or not.

Methods

The fluorescent microsphere reference sample method was used to determine blood flow within the bone and kidneys. Eight anesthetized female New Zealand rabbits received left ventricular injections of fluorescent microspheres over a wide range of arterial pressure levels prior to removal of kidney, femur and tibia. Blood flow values were calculated by measurement of fluorescence intensity in kidney and bone and correlated to fluorescence intensity in the peripheral blood (reference sample).

Results

Despite a reduction of mean arterial pressure from 100 to 80 mmHg bone blood flow remained constant. Further reduction of mean arterial pressure results in a linear decrease in bone blood flow.

Conclusion

The correlation between arterial pressure and organ perfusion in the bone is similar to blood flow within the kidney, indicating the presence of an autoregulated blood flow mechanism within the bone tissue.     

Post-partum acquired haemophilia after IVF without recurrence during a second pregnancy obtained by IVF

Sir, We were highly interested in the case report published by Nakauchi-Tanakaet al. (2003), reporting a factor VIII inhibitor in ovarianhyperstimulation syndrome (OHSS). Briefly, acquired haemophilia is a rare disease most often dueto the development of autoantibodies directed against factorVIII that interfere with its coagulant function. The incidenceis about 1 per million persons per year. Acquired haemophiliamay occur in association with autoimmune diseases such as systemiclupus erythematosus or rheumatoid arthritis, neoplastic diseases,drug hypersensitivity and pregnancy. However, 50% of the casesremain idiopathic. Post-partum factor VIII inhibitors most oftendisappear     

Psychodrama in der Palliative Care

Zeitschrift für Psychodrama und Soziometrie - Der vorliegende Beitrag der Zeitschrift für Psychodrama und Soziometrie befasst sich mit der Palliative Care als Einsatzfeld für...     

Application of subretinal fluid to close refractory full thickness macular holes: treatment strategies and primary outcome: APOSTEL study

Graefe's Archive for Clinical and Experimental Ophthalmology - Persisting macular holes (PMH) after surgical release of any epiretinal traction of the vitreous and adjacent membrane may rely on...