Treatment effects of mandibular anterior position training versus a fixed Class II corrector in growing patients with skeletal Class II malocclusion

Purpose

To compare treatment effects of Class II elastics and anterior mandibular position training against fixed Class II corrector (PowerScope?) during the correction of skeletal Class II malocclusion with fixed appliance in growing patients.

Elimination of human rabies in a canine endemic province in Thailand: five-year programme

A five-year project to prevent human deaths from rabies in Phetchabun Province, Thailand involved increasing accessibility of post-exposure treatment with the Thai Red Cross intradermal (2-2-2-0-1-1) regimen for humans exposed to potentially and confirmed rabid animals; intensifying documentation of post-exposure treatment; increasing educational awareness through advocacy in provincial schools, television programmes, and newspapers; reducing canine rabies by monitoring the dog population and implementing vaccination and sterilization programmes; increasing the cooperation between the Ministries of Public Health, Agriculture, and Education on a provincial level; and assessing the impact of the programme through intensified follow-up of patients exposed to suspected and laboratory-confirmed rabid animals. Between 1996 and 2001, 10350 patients received post-exposure treatment; 7227 of these received the Thai Red Cross intradermal regimen. Fewer than 3% of exposed patients received rabies immunoglobulin. Seventy-three percent of all patients presented with WHO category III exposures. In a retrospective study, 188 patients exposed to laboratory-confirmed rabid animals were followed to determine their health status. Of these patients, 20 received the intramuscular Essen regimen and 168 the Thai Red Cross intradermal regimen (148 received 0.1 ml purified chick embryo cell rabies vaccine, 10 received 0.1 ml purified vero cell rabies vaccine, and 10 received 0.2 ml purified duck embryo cell rabies vaccine). All patients were alive one year after exposure. Two human deaths occurred in the first two years of the programme - neither patient had received vaccine or rabies immunoglobulin after exposure. No deaths occurred during the last three years of the programme, which indicated that the programme was successful.     

Rabies intradermal post-exposure vaccination of humans using reconstituted and stored vaccine

Thailand's northern Petchabun province is endemic for canine rabies. There were 27 reported human rabies deaths between 1989 and 1998. A rabies control plan was formulated in 1997 between medical and veterinary public health officials. It started an intense education program and an ongoing dog vaccination campaign. Economic constraints and the high cost of biological were the main reasons for inadequate human post-exposure management (PET). It was therefore decided to use the economical Thai Red Cross Intradermal Vaccine Regimen (TRC-ID) throughout the province. The original TRC-ID method is only suitable for clinics that see more than one PET patient daily. TRC-ID was therefore modified by storing the reconstituted vaccine in a refrigerator for the same patient's next two visits. Data on a total of 8157 PET patients were collected. An additional modification of TRC-ID also eliminated the 90 day booster. There were no treatment failures and no human rabies deaths in 1999, 2000 and 2001. The modified TRC-ID method induces adequate levels of neutralizing antibodies, protects humans bitten by rabid dogs and results in significant savings in vaccine and travel costs.